Generated Narrative: StructureDefinition profile-ChargeItem Name Flags Card. Type Description & Constraints ChargeItem 0..* ChargeItem Item containing charge code(s) associated with the provision of healthcare provider products #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:definitionCanonical 0..* uri R5: Resource defining the code of this ChargeItem (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.definitionCanonical #xD; extension:costCenter 0..1 Reference(Cross-version Profile for R5.Organization for use in FHIR STU3(0.1.0) | Organization) R5: Organization that has ownership of the (potential, future) revenue (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.costCenter #xD; extension:unitPriceComponent 0..1 (Complex) R5: Unit price overriding the associated rules (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.unitPriceComponent #xD; extension:totalPriceComponent 0..1 (Complex) R5: Total price overriding the associated rules (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.totalPriceComponent #xD; extension:product 0..* (Complex) R5: Product charged (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.product #xD; partOf #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:partOf 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: partOf additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; subject #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:subject 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: subject additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; context #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:encounter 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Encounter associated with this ChargeItem additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; participant #xD; actor #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:actor 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: actor URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; performingOrganization #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:performingOrganization 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Organization providing the charged service additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; requestingOrganization #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:requestingOrganization 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: requestingOrganization additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; overrideReason #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:overrideReason 0..1 CodeableConcept R5: overrideReason additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.overrideReason #xD; enterer #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:enterer 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: enterer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; service #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:service 0..* (Complex) R5: service additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ChargeItem.service #xD; account #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:account 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: account additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; supportingInformation #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:supportingInformation 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Further information supporting this charge additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; Documentation for this format
Cross-version Profile for R5.ChargeItem for use in FHIR STU3
This cross-version profile allows R5 ChargeItem content to be represented via FHIR STU3 ChargeItem resources.
Item containing charge code(s) associated with the provision of healthcare provider products
The resource ChargeItem describes the provision of healthcare provider products for a certain patient, therefore referring not only to the product, but containing in addition details of the provision, like date, time, amounts and participating organizations and persons. Main Usage of the ChargeItem is to enable the billing process and internal cost allocation.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL NOT contain any narrative
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource, and may 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.
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 in formation is added later.
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.
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.
R5: Resource defining the code of this ChargeItem (new)
R5: `ChargeItem.definitionCanonical` (new:canonical(ChargeItemDefinition))
Element `ChargeItem.definitionCanonical` has a context of ChargeItem based on following the parent source element upwards and mapping to `ChargeItem`. Element `ChargeItem.definitionCanonical` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
R5: Organization that has ownership of the (potential, future) revenue (new)
R5: `ChargeItem.costCenter` (new:Reference(Organization))
Element `ChargeItem.costCenter` has a context of ChargeItem based on following the parent source element upwards and mapping to `ChargeItem`. Element `ChargeItem.costCenter` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The costCenter could either be given as a reference to an Organization(Role) resource or as the identifier of the cost center determined by Reference.identifier.value and Reference.identifier.system, depending on use case requirements.
R5: Unit price overriding the associated rules (new)
R5: `ChargeItem.unitPriceComponent` (new:MonetaryComponent)
Element `ChargeItem.unitPriceComponent` has a context of ChargeItem based on following the parent source element upwards and mapping to `ChargeItem`. Element `ChargeItem.unitPriceComponent` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This could be communicated in ChargeItemDefinition. But if ChargeItemDefinition is not supported or not available, the unit price can be communicated in this property.
R5: Total price overriding the associated rules (new)
R5: `ChargeItem.totalPriceComponent` (new:MonetaryComponent)
Element `ChargeItem.totalPriceComponent` has a context of ChargeItem based on following the parent source element upwards and mapping to `ChargeItem`. Element `ChargeItem.totalPriceComponent` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Often, the total price may be be calculated and recorded on the Invoice, but if a calculated total price must be exchanged prior to Invoice creation, it can be communicated in this property.
R5: `ChargeItem.product` (new:CodeableReference(Device,Medication,Substance))
Element `ChargeItem.product` has a context of ChargeItem based on following the parent source element upwards and mapping to `ChargeItem`. Element `ChargeItem.product` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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. Usually modifier elements provide negation or qualification. In order 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.
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.
Identifiers assigned to this event performer or other systems.
Allows identification of the charge Item as it is known by various participating systems and in a way that remains consistent across servers.
Defining information about the code of this charge item
References the source of pricing information, rules of application for the code this ChargeItem uses.
Target Resource is yet to be defined as a container that holds information about list prices and rules applicable to the charge item code. Once defined, change type back to Reference(Definition Type).
planned | billable | not-billable | aborted | billed | entered-in-error | unknown
Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. This element is labeled as a modifier because the status contains the code entered-in-error that marks the charge item as not currently valid.
Codes identifying the stage lifecycle stage of a ChargeItem
ChargeItems can be grouped to larger ChargeItems covering the whole set.
E.g. Drug administration as part of a procedure, procedure as part of observation, etc.
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
R5: `ChargeItem.partOf` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.partOf` is mapped to FHIR STU3 element `ChargeItem.partOf` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.partOf` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.partOf` with unmapped reference targets: ChargeItem.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Logical reference, when literal reference is not known
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
A code that identifies the charge, like a billing code
A code that identifies the charge, like a billing code.
Example set of codes that can be used for billing purposes
The individual or set of individuals the action is being or was performed on.
R5: `ChargeItem.subject` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.subject` is mapped to FHIR STU3 element `ChargeItem.subject` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.subject` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.subject` with unmapped reference targets: Group, Patient.
Encounter / Episode associated with event
The encounter or episode of care that establishes the context for this event.
Links the request to the Encounter context.
.inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
R5: Encounter associated with this ChargeItem additional types
R5: `ChargeItem.encounter` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.encounter` is mapped to FHIR STU3 element `ChargeItem.context` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.encounter` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.encounter` with unmapped reference targets: Encounter. This ChargeItem may be recorded during planning, execution or after the actual encounter takes place.
Date/time(s) or duration when the charged service was applied.
The list of types may be constrained as appropriate for the type of charge item.
Indicates who or what performed or participated in the charged service.
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order 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.
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Describes the type of performance or participation(e.g. primary surgeon, anaesthesiologiest, etc.).
Codes describing the types of functional roles performers can take on when performing events
The device, practitioner, etc. who performed or participated in the service.
Element `ChargeItem.performer.actor` is mapped to FHIR STU3 element `ChargeItem.participant.actor` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.performer.actor` with unmapped reference targets: CareTeam, Device, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.
Organization providing the charged sevice
The organization requesting the service.
Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered.
R5: Organization providing the charged service additional types
R5: `ChargeItem.performingOrganization` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.performingOrganization` is mapped to FHIR STU3 element `ChargeItem.performingOrganization` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.performingOrganization` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.performingOrganization` with unmapped reference targets: Organization. Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered.
Organization requesting the charged service
The organization performing the service.
The rendered Service may not be associated with a Request. It has to be made clear, ob which Organization's Request, the services have been rendered. (In many cases, this may just be the Department associated with the Encounter.location).
R5: requestingOrganization additional types
R5: `ChargeItem.requestingOrganization` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.requestingOrganization` is mapped to FHIR STU3 element `ChargeItem.requestingOrganization` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.requestingOrganization` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.requestingOrganization` with unmapped reference targets: Organization. The rendered Service might not be associated with a Request. This property indicates which Organization requested the services to be rendered. (In many cases, this may just be the Department associated with the Encounter.location).
Quantity of which the charge item has been serviced
Quantity of which the charge item has been serviced.
In many cases this may just be a value, if the underlying units are implicit in the definition of the charge item code.
The anatomical location where the related service has been applied.
Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](http://hl7.org/fhir/STU3/extension-body-site-instance.html). May be a summary code, or a reference to a very precise definition of the location, or both.
Codes describing anatomical locations. May include laterality.
Factor overriding the factor determined by the rules associated with the code.
There is no reason to carry the factor in the instance of a ChargeItem unless special circumstances require a manual override. The factors are usually defined by a set of rules in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
Total price of the charge overriding the list price associated with the code.
There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
Reason for overriding the list price/factor
If the list price or the rule based factor associated with the code is overridden, this attribute can capture a text to indicate the reason for this action.
Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled.
unique id for the element within a resource (for internal references)
R5: `ChargeItem.overrideReason` additional types (CodeableConcept) additional types from child elements (coding)
Element `ChargeItem.overrideReason` is mapped to FHIR STU3 element `ChargeItem.overrideReason` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.overrideReason` do not cover the following types: CodeableConcept. The mappings for `ChargeItem.overrideReason` do not cover the following types based on type expansion: coding.
The device, practitioner, etc. who entered the charge item.
The enterer is also te person considered responsible for factor/priceOverrides if applicable.
Element `ChargeItem.enterer` is mapped to FHIR STU3 element `ChargeItem.enterer` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.enterer` with unmapped reference targets: Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson. The enterer is also the person considered responsible for factor/price overrides if applicable.
The actual date when the service associated with the charge has been rendered is captured in occurrence[x].
Describes why the event occurred in coded or textual form.
If the application of the charge item requires a reason to be given, it can be captured here. Textual reasons can be captured using reasonCode.text.
Which rendered service is being charged?
Indicated the rendered service that caused this charge.
R5: `ChargeItem.service` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport), CodeableReference(http://hl7.org/fhir/StructureDefinition/ImagingStudy), CodeableReference(http://hl7.org/fhir/StructureDefinition/Immunization), CodeableReference(http://hl7.org/fhir/StructureDefinition/MedicationAdministration), CodeableReference(http://hl7.org/fhir/StructureDefinition/MedicationDispense), CodeableReference(http://hl7.org/fhir/StructureDefinition/MedicationRequest), CodeableReference(http://hl7.org/fhir/StructureDefinition/Observation), CodeableReference(http://hl7.org/fhir/StructureDefinition/Procedure), CodeableReference(http://hl7.org/fhir/StructureDefinition/ServiceRequest), CodeableReference(http://hl7.org/fhir/StructureDefinition/SupplyDelivery))
Element `ChargeItem.service` is mapped to FHIR STU3 element `ChargeItem.service` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.service` do not cover the following types: CodeableReference.
Account into which this ChargeItems belongs.
Systems posting the ChargeItems may not always be able to determine, which accounts the Items need to be places into. It is up to the potprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate.
R5: `ChargeItem.account` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.account` is mapped to FHIR STU3 element `ChargeItem.account` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.account` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.account` with unmapped reference targets: Account. Systems posting the ChargeItems might not always be able to determine, which accounts the Items need to be places into. It is up to the postprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate.
Comments made about the event by the performer, subject or other participants.
.inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
Further information supporting the this charge
Further information supporting the this charge.
R5: Further information supporting this charge additional types
R5: `ChargeItem.supportingInformation` additional types from child elements (display, identifier, reference, type)
Element `ChargeItem.supportingInformation` is mapped to FHIR STU3 element `ChargeItem.supportingInformation` as `SourceIsBroaderThanTarget`. The mappings for `ChargeItem.supportingInformation` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ChargeItem.supportingInformation` with unmapped reference targets: Resource.