Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B Ballot #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

StructureDefinition: Shareable ValueSet - XML

Vocabulary Work Group Maturity Level: 0Trial UseUse Context: Any

Shareable ValueSet

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="shareablevalueset"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="5"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="vocab"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/shareablevalueset"/> 
  <version value="4.1.0"/> 
  <name value="Shareable ValueSet"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2021-01-17T07:06:13+11:00"/> 
  <publisher value="HL7"/> 
  <description value="Enforces the minimum information set for the value set metadata required by HL7 and other
   organizations that share and publish value sets"/> 
  <fhirVersion value="4.1.0"/> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="objimpl"/> 
    <uri value="http://hl7.org/fhir/object-implementation"/> 
    <name value="Object Implementation Information"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="ValueSet"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="ValueSet">
      <path value="ValueSet"/> 
      <short value="A set of codes drawn from one or more code systems"/> 
      <definition value="A ValueSet resource instance specifies a set of codes drawn from one or more code systems,
       intended for use in a particular context. Value sets link between [CodeSystem](codesystem.html)
       definitions and their use in [coded elements](terminologies.html)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="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 value="contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
        nts().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(uri) = '#').exists()).not()).trace('unmatched',
         id).empty()"/> 
        <xpath value="not(exists(for $resource in . return (for $contained in $resource/f:contained return $contained[not(
        descendant::f:*/@value='#' or (exists(f:id) and $resource//f:*/@*=concat('#', $contained/*/f:id/@valu
        e)))])))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="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."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <xpath value="exists(f:text/h:div)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-0"/> 
        <severity value="warning"/> 
        <human value="Name should be usable as an identifier for the module by machine processing applications
         such as code generation"/> 
        <expression value="name.matches('[A-Z]([A-Za-z0-9_]){0,254}')"/> 
        <xpath value="not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="conformance.terminology"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.id">
      <path value="ValueSet.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="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 value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ValueSet.meta">
      <path value="ValueSet.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="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 value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ValueSet.implicitRules">
      <path value="ValueSet.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="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 value="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 value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="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 value="true"/> 
    </element> 
    <element id="ValueSet.language">
      <path value="ValueSet.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="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 value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="A human language."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="ValueSet.text">
      <path value="ValueSet.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="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 &quot;clinically
       safe&quot; 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 value="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 &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded information is added
       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.contained">
      <path value="ValueSet.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="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 value="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 value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.extension">
      <path value="ValueSet.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.modifierExtension">
      <path value="ValueSet.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.url">
      <path value="ValueSet.url"/> 
      <short value="Canonical identifier for this value set, represented as a URI (globally unique)"/> 
      <definition value="An absolute URI that is used to identify this value set when it is referenced in a specification,
       model, design or an instance; also called its canonical identifier. This SHOULD be globally
       unique and SHOULD be a literal address at which at which an authoritative instance of
       this value set is (or will be) published. This URL can be the target of a canonical reference.
       It SHALL remain the same when the value set is stored on different servers."/> 
      <comment value="Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances
       may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version)
       vs. defining a new artifact is up to the author.  Considerations for making this decision
       are found in [Technical and Business Versions](resource.html#versions). 

In some cases, the resource can no longer be found at the stated url, but the url itself
       cannot change. Implementations can use the [meta.source](resource.html#meta) element to
       indicate where the current master source of the resource can be found."/> 
      <requirements value="Allows the value set to be referenced by a single globally unique identifier."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.url"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.url"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.identifier">
      <path value="ValueSet.identifier"/> 
      <short value="Additional identifier for the value set (business identifier)"/> 
      <definition value="A formal identifier that is used to identify this value set when it is represented in
       other formats, or referenced in a specification, model, design or an instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)
       data type, and can then identify this value set outside of FHIR, where it is not possible
       to use the logical URI."/> 
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated
       with the module."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.version">
      <path value="ValueSet.version"/> 
      <short value="Business version of the value set"/> 
      <definition value="The identifier that is used to identify this version of the value set when it is referenced
       in a specification, model, design or instance. 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. There is also no expectation
       that versions can be placed in a lexicographical sequence."/> 
      <comment value="There may be different value set instances that have the same identifier but different
       versions.  The version can be appended to the url in a reference to allow a reference
       to a particular business version of the value set with the format [url]|[version]."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.version"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.name">
      <path value="ValueSet.name"/> 
      <short value="Name for this value set (computer friendly)"/> 
      <definition value="A natural language name identifying the value set. This name should be usable as an identifier
       for the module by machine processing applications such as code generation."/> 
      <comment value="The name is not expected to be globally unique. The name should be a simple alphanumeric
       type name to ensure that it is machine-processing friendly.A name should be provided unless
       the value set is a contained resource (e.g. an anonymous value set in a profile). Most
       registries will require a name."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ValueSet.title">
      <path value="ValueSet.title"/> 
      <short value="Name for this value set (human friendly)"/> 
      <definition value="A short, descriptive, user-friendly title for the value set."/> 
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation,
       white-space, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.title"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.status">
      <path value="ValueSet.status"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The status of this value set. Enables tracking the life-cycle of the content. The status
       of the value set applies to the value set definition (ValueSet.compose) and the associated
       ValueSet metadata. Expansions do not have a state."/> 
      <comment value="Allows filtering of value sets that are appropriate for use versus not.See also the [valueset-workfl
      owStatus](extension-valueset-workflowstatus.html) extension for additional status information
       related to the editorial process."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not use a retired
       {{title}} without due consideration"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="The lifecycle status of an artifact."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The lifecycle status of an artifact."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.experimental">
      <path value="ValueSet.experimental"/> 
      <short value="For testing purposes, not real usage"/> 
      <definition value="A Boolean value to indicate that this value set is authored for testing purposes (or education/evalu
      ation/marketing) and is not intended to be used for genuine usage."/> 
      <comment value="Allows filtering of value sets that are appropriate for use versus not."/> 
      <requirements value="Enables experimental content to be developed following the same lifecycle that would be
       used for a production-level value set."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.experimental"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.experimental"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.date">
      <path value="ValueSet.date"/> 
      <short value="Date last changed"/> 
      <definition value="The date (and optionally time) when the value set was created or revised (e.g. the 'content
       logical definition')."/> 
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource
       may be a secondary representation of the value set. Additional specific dates may be added
       as extensions or be found by consulting Provenances associated with past versions of the
       resource."/> 
      <alias value="Revision Date"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.date"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.publisher">
      <path value="ValueSet.publisher"/> 
      <short value="Name of the publisher (organization or individual)"/> 
      <definition value="The name of the organization or individual that published the value set."/> 
      <comment value="Usually an organization but may be an individual. The publisher (or steward) of the value
       set is the organization or individual primarily responsible for the maintenance and upkeep
       of the value set. This is not necessarily the same individual or organization that developed
       and initially authored the content. The publisher is the primary point of contact for
       questions or issues with the value set. This item SHOULD be populated unless the information
       is available from context."/> 
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the value set.  May also allow
       for contact."/> 
      <alias value="steward"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.publisher"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.publisher"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.contact">
      <path value="ValueSet.contact"/> 
      <short value="Contact details for the publisher"/> 
      <definition value="Contact details to assist a user in finding and communicating with the publisher."/> 
      <comment value="May be a web site, an email address, a telephone number, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.contact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.contact"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.description">
      <path value="ValueSet.description"/> 
      <short value="Natural language description of the value set"/> 
      <definition value="A free text natural language description of the value set from a consumer's perspective.
       The textual description specifies the span of meanings for concepts to be included within
       the Value Set Expansion, and also may specify the intended use and limitations of the
       Value Set."/> 
      <comment value="This description can be used to capture details such as why the value set was built, comments
       about misuse, instructions for clinical use and interpretation, literature references,
       examples from the paper world, etc. It is not a rendering of the value set as conveyed
       in the 'text' field of the resource itself. This item SHOULD be populated unless the information
       is available from context (e.g. the language of the value set is presumed to be the predominant
       language in the place the value set was created).The description is not intended to describe
       the semantics of the Value Set - there are no intrinsic semantics separate from the codes
       contained in its expansion. The description should capture its intended use, which is
       needed for ensuring integrity for its use in models across future changes. A description
       should be provided unless the value set is a contained resource (e.g. an anonymous value
       set in a profile). Most registries will require a description."/> 
      <alias value="Scope"/> 
      <alias value="Purpose"/> 
      <alias value="scope"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.description"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.useContext">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use"/> 
      </extension> 
      <path value="ValueSet.useContext"/> 
      <short value="The context that the content is intended to support"/> 
      <definition value="The content was developed with a focus and intent of supporting the contexts that are
       listed. These contexts may be general categories (gender, age, ...) or may be references
       to specific programs (insurance plans, studies, ...) and may be used to assist with indexing
       and searching for appropriate value set instances."/> 
      <comment value="When multiple useContexts are specified, there is no expectation that all or any of the
       contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.useContext"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.jurisdiction">
      <path value="ValueSet.jurisdiction"/> 
      <short value="Intended jurisdiction for value set (if applicable)"/> 
      <definition value="A legal or geographic region in which the value set is intended to be used."/> 
      <comment value="It may be possible for the value set to be used in jurisdictions other than those for
       which it was originally designed or intended."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.jurisdiction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="Countries and regions within which this artifact is targeted for use."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Countries and regions within which this artifact is targeted for use."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.jurisdiction"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.immutable">
      <path value="ValueSet.immutable"/> 
      <short value="Indicates whether or not any change to the content logical definition may occur"/> 
      <definition value="If this is set to 'true', then no new versions of the content logical definition can be
       created.  Note: Other metadata might still change."/> 
      <comment value="Normally immutability is set to 'false', which is the default assumption if it is not
       populated.  Note that the implication is that if this is set to 'true', there may be only
       one ValueSet version for this definition. Immutability tends to be set to 'true' in one
       of two cases: - Where the value set, by the nature of its usage, cannot change.  For example
       &quot;All specializations of ACT in ActClassCode&quot; - Where there's no safe way to
       express the &quot;Purpose&quot; such that someone else could safely make changes to the
       value set definition. Source workflow control must guarantee that the same URI always
       yields the same definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.immutable"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ValueSet.purpose">
      <path value="ValueSet.purpose"/> 
      <short value="Why this value set is defined"/> 
      <definition value="Explanation of why this value set is needed and why it has been designed as it has."/> 
      <comment value="This element does not describe the usage of the value set. Instead, it provides traceability
       of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may
       be used to point to source materials or specifications that drove the structure of this
       value set."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.purpose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.purpose"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.copyright">
      <path value="ValueSet.copyright"/> 
      <short value="Use and/or publishing restrictions"/> 
      <definition value="A copyright statement relating to the value set and/or its contents. Copyright statements
       are generally legal restrictions on the use and publishing of the value set."/> 
      <comment value="nullFrequently, the copyright differs between the value set and the codes that are included.
       The copyright statement should clearly differentiate between these when required."/> 
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the value set
       and/or its content."/> 
      <alias value="License"/> 
      <alias value="Restrictions"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.copyright"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.copyright"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose">
      <path value="ValueSet.compose"/> 
      <short value="Content logical definition of the value set (CLD)"/> 
      <definition value="A set of criteria that define the contents of the value set by including or excluding
       codes selected from the specified code system(s) that the value set draws from. This is
       also known as the Content Logical Definition (CLD)."/> 
      <alias value="Content Logical Definition"/> 
      <alias value="CLD"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.compose.id">
      <path value="ValueSet.compose.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.extension">
      <path value="ValueSet.compose.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.modifierExtension">
      <path value="ValueSet.compose.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.lockedDate">
      <path value="ValueSet.compose.lockedDate"/> 
      <short value="Fixed date for references with no specified version (transitive)"/> 
      <definition value="The Locked Date is  the effective date that is used to determine the version of all referenced
       Code Systems and Value Set Definitions included in the compose that are not already tied
       to a specific version."/> 
      <comment value="With a defined lockedDate the value set is considered &quot;Locked&quot;. Otherwise, the
       value set may have different expansions as underlying code systems and/or value sets evolve.
        The interpretation of lockedDate is often dependent on the context - e.g. a SNOMED CT
       derived value set with a lockedDate will have a different expansion in USA than in UK.
        If a value set specifies a version for include and exclude statements, and also specifies
       a locked date, the specified versions need to be available that date, or the value set
       will not be usable."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.lockedDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.init"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.inactive">
      <path value="ValueSet.compose.inactive"/> 
      <short value="Whether inactive codes are in the value set"/> 
      <definition value="Whether inactive codes - codes that are not approved for current use - are in the value
       set. If inactive = true, inactive codes are to be included in the expansion, if inactive
       = false, the inactive codes will not be included in the expansion. If absent, the behavior
       is determined by the implementation, or by the applicable $expand parameters (but generally,
       inactive codes would be expected to be included)."/> 
      <comment value="Note that in the FHIR terminology framework, &quot;deprecated&quot; does not mean inactive,
       but in some code systems, e.g. LOINC, &quot;deprecated&quot; does mean inactive. Code
       systems should define what codes are considered to be inactive. If this is not clearly
       defined (including in the FHIR code system resource), then all codes are assumed to be
       active.

The Value Set Definition specification defines an ActiveOnly element, which is the reverse
       of this element e.g. (ValueSet.compose.inactive=FALSE) is the same as (VSD.ActiveOnly=TRUE)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.inactive"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="ValueSet.compose.include">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ConceptSet"/> 
      </extension> 
      <path value="ValueSet.compose.include"/> 
      <short value="Include one or more codes from a code system or other value set(s)"/> 
      <definition value="Include one or more codes from a code system or other value set(s)."/> 
      <comment value="All the conditions in an include must be true. If a system is listed, all the codes from
       the system are listed. If one or more filters are listed, all of the filters must apply.
       If one or more value sets are listed, the codes must be in all the value sets. E.g. each
       include is 'include all the codes that meet all these conditions'."/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.include"/> 
        <min value="1"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-1"/> 
        <severity value="error"/> 
        <human value="A value set include/exclude SHALL have a value set or a system"/> 
        <expression value="valueSet.exists() or system.exists()"/> 
        <xpath value="exists(f:valueSet) or exists(f:system)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-2"/> 
        <severity value="error"/> 
        <human value="A value set with concepts or filters SHALL include a system"/> 
        <expression value="(concept.exists() or filter.exists()) implies system.exists()"/> 
        <xpath value="not(exists(f:concept) or exists(f:filter)) or exists(f:system)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-3"/> 
        <severity value="error"/> 
        <human value="Cannot have both concept and filter"/> 
        <expression value="concept.empty() or filter.empty()"/> 
        <xpath value="not(exists(f:concept)) or not(exists(f:filter))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.id">
      <path value="ValueSet.compose.include.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.extension">
      <path value="ValueSet.compose.include.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.modifierExtension">
      <path value="ValueSet.compose.include.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.system">
      <path value="ValueSet.compose.include.system"/> 
      <short value="The system the codes come from"/> 
      <definition value="An absolute URI which is the code system from which the selected codes come from."/> 
      <comment value="If there are no codes or filters, the entire code system is included. Note that the set
       of codes that are included may contain abstract codes. See ''Coding.system'' for further
       documentation about the correct value for the system element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.system"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <condition value="vsd-1"/> 
      <condition value="vsd-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.version">
      <path value="ValueSet.compose.include.version"/> 
      <short value="Specific version of the code system referred to"/> 
      <definition value="The version of the code system that the codes are selected from, or the special version
       '*' for all versions."/> 
      <comment value="This is used when selecting the descendants of a concept - they may change between versions.
       If no version is specified, then the exact contents of the value set might not be known
       until a context of use binds it to a particular version. The special value '*' means all
       versions; It is at server discretion regarding expansions and which versions must be supported."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ConceptReference"/> 
      </extension> 
      <path value="ValueSet.compose.include.concept"/> 
      <short value="A concept defined in the system"/> 
      <definition value="Specifies a concept to be included or excluded."/> 
      <comment value="The list of concepts is considered ordered, though the order might not have any particular
       significance. Typically, the order of an expansion follows that defined in the compose
       element."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.include.concept"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="vsd-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.id">
      <path value="ValueSet.compose.include.concept.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.extension">
      <path value="ValueSet.compose.include.concept.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.modifierExtension">
      <path value="ValueSet.compose.include.concept.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.code">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="ValueSet.compose.include.concept.code"/> 
      <short value="Code or expression from system"/> 
      <definition value="Specifies a code for the concept to be included or excluded."/> 
      <comment value="Expressions are allowed if defined by the underlying code system."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.display">
      <path value="ValueSet.compose.include.concept.display"/> 
      <short value="Text to display for this code for this value set in this valueset"/> 
      <definition value="The text to display to the user for this concept in the context of this valueset. If no
       display is provided, then applications using the value set use the display specified for
       the code by the system."/> 
      <comment value="The value set resource allows for an alternative display to be specified for when this
       concept is used in this particular value set. See notes in the value set narrative about
       the correct use of this element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.display"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation">
      <path value="ValueSet.compose.include.concept.designation"/> 
      <short value="Additional representations for this concept"/> 
      <definition value="Additional representations for this concept when used in this value set - other languages,
       aliases, specialized purposes, used for particular purposes, etc."/> 
      <comment value="Concepts have both a ```display``` and an array of ```designation```. The display is equivalent
       to a special designation with an implied ```designation.use``` of &quot;primary code&quot;
       and a language equal to the [Resource Language](resource.html#language)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.designation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.id">
      <path value="ValueSet.compose.include.concept.designation.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.extension">
      <path value="ValueSet.compose.include.concept.designation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.modifierExtension">
      <path value="ValueSet.compose.include.concept.designation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.language">
      <path value="ValueSet.compose.include.concept.designation.language"/> 
      <short value="Human language of the designation"/> 
      <definition value="The language this designation is defined for."/> 
      <comment value="In the absence of a language, the resource language applies."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.designation.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="A human language."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.use">
      <path value="ValueSet.compose.include.concept.designation.use"/> 
      <short value="Types of uses of designations"/> 
      <definition value="A code that represents types of uses of designations."/> 
      <comment value="If no use is provided, the designation can be assumed to be suitable for general display
       to a human user."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.designation.use"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="Details of how a designation would be used."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConceptDesignationUse"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Details of how a designation would be used."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/designation-use"/> 
      </binding> 
    </element> 
    <element id="ValueSet.compose.include.concept.designation.value">
      <path value="ValueSet.compose.include.concept.designation.value"/> 
      <short value="The text value for this designation"/> 
      <definition value="The text value for this designation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.concept.designation.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.compose.include.filter">
      <path value="ValueSet.compose.include.filter"/> 
      <short value="Select codes/concepts by their properties (including relationships)"/> 
      <definition value="Select concepts by specify a matching criterion based on the properties (including relationships)
       defined by the system, or on filters defined by the system. If multiple filters are specified,
       they SHALL all be true."/> 
      <comment value="Selecting codes by specifying filters based on properties is only possible where the underlying
       code system defines appropriate properties. Note that in some cases, the underlying code
       system defines the logical concepts but not the literal codes for the concepts. In such
       cases, the literal definitions may be provided by a third party."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.include.filter"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="vsd-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.id">
      <path value="ValueSet.compose.include.filter.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.extension">
      <path value="ValueSet.compose.include.filter.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.modifierExtension">
      <path value="ValueSet.compose.include.filter.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.property">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="ValueSet.compose.include.filter.property"/> 
      <short value="A property/filter defined by the code system"/> 
      <definition value="A code that identifies a property or a filter defined in the code system."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.filter.property"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.op">
      <path value="ValueSet.compose.include.filter.op"/> 
      <short value="= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists"/> 
      <definition value="The kind of operation to perform as a part of the filter criteria."/> 
      <comment value="In case filter.property represents a property of the system, the operation applies to
       the selected property. In case filter.property represents a filter of the system, the
       operation SHALL match one of the CodeSystem.filter.operator values."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.filter.op"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/build/StructureDefinition/definition">
          <valueString value="The kind of operation to perform as a part of a property based filter."/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FilterOperator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The kind of operation to perform as a part of a property based filter."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/filter-operator|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.filter.value">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="ValueSet.compose.include.filter.value"/> 
      <short value="Code from the system, or regex criteria, or boolean value for exists"/> 
      <definition value="The match value may be either a code defined by the system, or a string value, which is
       a regex match on the literal string of the property value  (if the filter represents a
       property defined in CodeSystem) or of the system filter value (if the filter represents
       a filter defined in CodeSystem) when the operation is 'regex', or one of the values (true
       and false), when the operation is 'exists'."/> 
      <comment value="Use regex matching with care - full regex matching on every SNOMED CT term is prohibitive,
       for example."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.compose.include.filter.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.include.valueSet">
      <path value="ValueSet.compose.include.valueSet"/> 
      <short value="Select the contents included in this value set"/> 
      <definition value="Selects the concepts found in this value set (based on its value set definition). This
       is an absolute URI that is a reference to ValueSet.url.  If multiple value sets are specified
       this includes the union of the contents of all of the referenced value sets."/> 
      <comment value="The value set URI is either a logical reference to a defined value set such as a [SNOMED
       CT reference set](snomedct.html#implicit), or a direct reference to a value set definition
       using ValueSet.url. The reference might not refer to an actual FHIR ValueSet resource;
       in this case, whatever is referred to is an implicit definition of a value set that needs
       to be clear about how versions are resolved."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.include.valueSet"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </type> 
      <condition value="vsd-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.compose.exclude">
      <path value="ValueSet.compose.exclude"/> 
      <short value="Explicitly exclude codes from a code system or other value sets"/> 
      <definition value="Exclude one or more codes from the value set based on code system filters and/or other
       value sets."/> 
      <comment value="Usually this is used to selectively exclude codes that were included by subsumption in
       the inclusions. Any display names specified for the codes are ignored."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.compose.exclude"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.compose.include"/> 
      <condition value="vsd-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion">
      <path value="ValueSet.expansion"/> 
      <short value="Used when the value set is &quot;expanded&quot;"/> 
      <definition value="A value set can also be &quot;expanded&quot;, where the value set is turned into a simple
       collection of enumerated codes. This element holds the expansion, if it has been performed."/> 
      <comment value="Expansion is performed to produce a collection of codes that are ready to use for data
       entry or validation. Value set expansions are always considered to be stateless - they
       are a record of the set of codes in the value set at a point in time under a given set
       of conditions, and are not subject to ongoing maintenance.

Expansion.parameter is  a simplified list of parameters - a subset of the features of
       the [Parameters](parameters.html) resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.id">
      <path value="ValueSet.expansion.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.extension">
      <path value="ValueSet.expansion.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.modifierExtension">
      <path value="ValueSet.expansion.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.identifier">
      <path value="ValueSet.expansion.identifier"/> 
      <short value="Identifies the value set expansion (business identifier)"/> 
      <definition value="An identifier that uniquely identifies this expansion of the valueset, based on a unique
       combination of the provided parameters, the system default parameters, and the underlying
       system code system versions etc. Systems may re-use the same identifier as long as those
       factors remain the same, and the expansion is the same, but are not required to do so.
       This is a business identifier."/> 
      <comment value="Typically, this uri is a UUID (e.g. urn:uuid:8230ff20-c97a-4167-a59d-dc2cb9df16dd)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.identifier"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.timestamp">
      <path value="ValueSet.expansion.timestamp"/> 
      <short value="Time ValueSet expansion happened"/> 
      <definition value="The time at which the expansion was produced by the expanding system."/> 
      <comment value="This SHOULD be a fully populated instant, but in some circumstances, value sets are expanded
       by hand, and the expansion is published without that precision."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.timestamp"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.total">
      <path value="ValueSet.expansion.total"/> 
      <short value="Total number of codes in the expansion"/> 
      <definition value="The total number of concepts in the expansion. If the number of concept nodes in this
       resource is less than the stated number, then the server can return more using the offset
       parameter."/> 
      <comment value="Paging only applies to flat expansions."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.total"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.offset">
      <path value="ValueSet.expansion.offset"/> 
      <short value="Offset at which this resource starts"/> 
      <definition value="If paging is being used, the offset at which this resource starts.  I.e. this resource
       is a partial view into the expansion. If paging is not being used, this element SHALL
       NOT be present."/> 
      <comment value="Paging only applies to flat expansions. If a filter is applied, the count is the number
       of concepts that matched the filter, not the number of concepts in an unfiltered view
       of the expansion."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.offset"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <meaningWhenMissing value="Paging is not being used"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.parameter">
      <path value="ValueSet.expansion.parameter"/> 
      <short value="Parameter that controlled the expansion process"/> 
      <definition value="A parameter that controlled the expansion process. These parameters may be used by users
       of expanded value sets to check whether the expansion is suitable for a particular purpose,
       or to pick the correct expansion."/> 
      <comment value="The server decides which parameters to include here, but at a minimum, the list SHOULD
       include all of the parameters that affect the $expand operation. If the expansion will
       be persisted all of these parameters SHALL be included. If the codeSystem on the server
       has a specified version then this version SHALL be provided as a parameter in the expansion
       (note that not all code systems have a version)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.expansion.parameter"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.parameter.id">
      <path value="ValueSet.expansion.parameter.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.parameter.extension">
      <path value="ValueSet.expansion.parameter.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.parameter.modifierExtension">
      <path value="ValueSet.expansion.parameter.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.parameter.name">
      <path value="ValueSet.expansion.parameter.name"/> 
      <short value="Name as assigned by the client or server"/> 
      <definition value="Name of the input parameter to the $expand operation; may be a server-assigned name for
       additional default or other server-supplied parameters used to control the expansion process."/> 
      <comment value="The names are assigned at the discretion of the server."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.parameter.name"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.parameter.value[x]">
      <path value="ValueSet.expansion.parameter.value[x]"/> 
      <short value="Value of the named parameter"/> 
      <definition value="The value of the parameter."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.parameter.value[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <type> 
        <code value="uri"/> 
      </type> 
      <type> 
        <code value="code"/> 
      </type> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains">
      <path value="ValueSet.expansion.contains"/> 
      <short value="Codes in the value set"/> 
      <definition value="The codes that are contained in the value set expansion."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.expansion.contains"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-6"/> 
        <severity value="error"/> 
        <human value="SHALL have a code or a display"/> 
        <expression value="code.exists() or display.exists()"/> 
        <xpath value="exists(f:code) or exists(f:display)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-9"/> 
        <severity value="error"/> 
        <human value="Must have a code if not abstract"/> 
        <expression value="code.exists() or abstract = true"/> 
        <xpath value="exists(f:code) or (f:abstract/@value = true())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <constraint> 
        <key value="vsd-10"/> 
        <severity value="error"/> 
        <human value="Must have a system if a code is present"/> 
        <expression value="code.empty() or system.exists()"/> 
        <xpath value="exists(f:system) or not(exists(f:code))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.id">
      <path value="ValueSet.expansion.contains.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUri value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.contains.extension">
      <path value="ValueSet.expansion.contains.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="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 value="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 value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.contains.modifierExtension">
      <path value="ValueSet.expansion.contains.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="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 value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.expansion.contains.system">
      <path value="ValueSet.expansion.contains.system"/> 
      <short value="System value for the code"/> 
      <definition value="An absolute URI which is the code system in which the code for this item in the expansion
       is defined."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.system"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.abstract">
      <path value="ValueSet.expansion.contains.abstract"/> 
      <short value="If user cannot select this entry"/> 
      <definition value="If true, this entry is included in the expansion for navigational purposes, and the user
       cannot select the code directly as a proper value."/> 
      <comment value="This should not be understood to exclude its use for searching (e.g. by subsumption testing).
       The client should know whether it is appropriate for the user to select an abstract code
       or not."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.abstract"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="If this is not populated, systems can assume that the concept it not abstract. This SHALL
       always be populated for abstract concepts"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.inactive">
      <path value="ValueSet.expansion.contains.inactive"/> 
      <short value="If concept is inactive in the code system"/> 
      <definition value="If the concept is inactive in the code system that defines it. Inactive codes are those
       that are no longer to be used, but are maintained by the code system for understanding
       legacy data. It might not be known or specified whether an concept is inactive (and it
       may depend on the context of use)."/> 
      <comment value="This should only have a value if the concept is inactive."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.inactive"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.version">
      <path value="ValueSet.expansion.contains.version"/> 
      <short value="Version in which this code/display is defined"/> 
      <definition value="The version of the code system from this code was taken. Note that a well-maintained code
       system does not need the version reported, because the meaning of codes is consistent
       across versions. However this cannot consistently be assured, and when the meaning is
       not guaranteed to be consistent, the version SHOULD be exchanged."/> 
      <comment value="The exact value of the version string is specified by the system from which the code is
       derived."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.code">
      <extension url="http://hl7.org/fhir/build/StructureDefinition/no-binding">
        <valueBoolean value="true"/> 
      </extension> 
      <path value="ValueSet.expansion.contains.code"/> 
      <short value="Code - if blank, this is not a selectable code"/> 
      <definition value="The code for this item in the expansion hierarchy. If this code is missing the entry in
       the hierarchy is a place holder (abstract) and does not represent a valid code in the
       value set."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.code"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="vsd-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.display">
      <path value="ValueSet.expansion.contains.display"/> 
      <short value="User display for the concept"/> 
      <definition value="The recommended display for this item in the expansion."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="ValueSet.expansion.contains.display"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <condition value="vsd-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.designation">
      <path value="ValueSet.expansion.contains.designation"/> 
      <short value="Additional representations for this item"/> 
      <definition value="Additional representations for this item - other languages, aliases, specialized purposes,
       used for particular purposes, etc. These are relevant when the conditions of the expansion
       do not fix to a single correct representation."/> 
      <comment value="The designations provided must be based on the value set and code system definitions."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.expansion.contains.designation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.compose.include.concept.designation"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="ValueSet.expansion.contains.contains">
      <path value="ValueSet.expansion.contains.contains"/> 
      <short value="Codes contained under this entry"/> 
      <definition value="Other codes and entries contained under this entry in the hierarchy."/> 
      <comment value="If the expansion uses this element, there is  no implication about the logical relationship
       between them, and the  structure cannot be used for logical inferencing. The structure
        exists to provide navigational assistance for helping human users to  locate codes in
       the expansion."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="ValueSet.expansion.contains.contains"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.expansion.contains"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="ValueSet">
      <path value="ValueSet"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="ValueSet.url">
      <path value="ValueSet.url"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
    </element> 
    <element id="ValueSet.version">
      <path value="ValueSet.version"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
    </element> 
    <element id="ValueSet.name">
      <path value="ValueSet.name"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
    </element> 
    <element id="ValueSet.status">
      <path value="ValueSet.status"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="ValueSet.experimental">
      <path value="ValueSet.experimental"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
    </element> 
    <element id="ValueSet.publisher">
      <path value="ValueSet.publisher"/> 
      <alias value="steward"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
    </element> 
    <element id="ValueSet.description">
      <path value="ValueSet.description"/> 
      <alias value="scope"/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition>