2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). 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: R4 R3 R2

V3-ActCode.xml

Raw XML (canonical form)

A code specifying the particular kind of Act that the Act-instance represents within its class. Constraints: The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc. Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure. Act.classCode and Act.code are not modifiers of each other but the Act.code concept should really imply the Act.classCode concept. For a negative example, it is not appropriate to use an Act.code "potassium" together with and Act.classCode for "laboratory observation" to somehow mean "potassium laboratory observation" and then use the same Act.code for "potassium" together with Act.classCode for "medication" to mean "substitution of potassium". This mutually modifying use of Act.code and Act.classCode is not permitted.

Raw XML

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="v3-ActCode"/>
  <meta>
    <lastUpdated value="2014-12-11T00:00:00.000+11:00"/>
    <profile value="http://hl7.org/fhir/Profile/valueset-shareable-definition"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/v3/vs/ActCode"/>
  <version value="2014-12-11"/>
  <name value="v3 Code System ActCode"/>
  <publisher value="HL7, Inc"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
  </contact>
  <description value=" A code specifying the particular kind of Act that the Act-instance represents within
     its class.  Constraints: The kind of Act (e.g. physical examination, serum potassium,
     inpatient encounter, charge financial transaction, etc.) is specified with a code from
     one of several, typically external, coding systems.  The coding system will depend on
     the class of Act, such as LOINC for observations, etc. Conceptually, the Act.code must
     be a specialization of the Act.classCode. This is why the structure of ActClass domain
     should be reflected in the superstructure of the ActCode domain and then individual codes
     or externally referenced vocabularies subordinated under these domains that reflect the
     ActClass structure. Act.classCode and Act.code are not modifiers of each other but the
     Act.code concept should really imply the Act.classCode concept. For a negative example,
     it is not appropriate to use an Act.code &quot;potassium&quot; together with and Act.classCode
     for &quot;laboratory observation&quot; to somehow mean &quot;potassium laboratory observation&quot;
     and then use the same Act.code for &quot;potassium&quot; together with Act.classCode for
     &quot;medication&quot; to mean &quot;substitution of potassium&quot;. This mutually modifying
     use of Act.code and Act.classCode is not permitted."/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2014-12-11"/>
  <define>
    <extension url="http://hl7.org/fhir/ExtensionDefinition/valueset-oid">
      <valueUri value="urn:oid:2.16.840.1.113883.5.4"/>
    </extension>
    <system value="http://hl7.org/fhir/v3/ActCode"/>
    <caseSensitive value="true"/>
    <concept>
      <code value="_ActAccountCode"/>
      <abstract value="true"/>
      <display value="ActAccountCode"/>
      <definition value="An account represents a grouping of financial transactions that are tracked and reported
         together with a single balance.    Examples of account codes (types) are Patient billing
         accounts (collection of charges), Cost centers; Cash."/>
      <concept>
        <code value="ACCTRECEIVABLE"/>
        <abstract value="false"/>
        <display value="account receivable"/>
        <definition value="An account for collecting charges, reversals, adjustments and payments, including deductibles,
           copayments, coinsurance (financial transactions) credited or debited to the account receivable
           account for a patient's encounter."/>
      </concept>
      <concept>
        <code value="CASH"/>
        <abstract value="false"/>
        <display value="Cash"/>
      </concept>
      <concept>
        <code value="CC"/>
        <abstract value="false"/>
        <display value="credit card"/>
        <definition value="Description: Types of advance payment to be made on a plastic card usually issued by a
           financial institution used of purchasing services and/or products."/>
        <concept>
          <code value="AE"/>
          <abstract value="false"/>
          <display value="American Express"/>
        </concept>
        <concept>
          <code value="DN"/>
          <abstract value="false"/>
          <display value="Diner's Club"/>
        </concept>
        <concept>
          <code value="DV"/>
          <abstract value="false"/>
          <display value="Discover Card"/>
        </concept>
        <concept>
          <code value="MC"/>
          <abstract value="false"/>
          <display value="Master Card"/>
        </concept>
        <concept>
          <code value="V"/>
          <abstract value="false"/>
          <display value="Visa"/>
        </concept>
      </concept>
      <concept>
        <code value="PBILLACCT"/>
        <abstract value="false"/>
        <display value="patient billing account"/>
        <definition value="An account representing charges and credits (financial transactions) for a patient's encounter."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActAdjudicationCode"/>
      <abstract value="true"/>
      <display value="ActAdjudicationCode"/>
      <definition value="Includes coded responses that will occur as a result of the adjudication of an electronic
         invoice at a summary level and provides guidance on interpretation of the referenced adjudication
         results."/>
      <concept>
        <code value="_ActAdjudicationGroupCode"/>
        <abstract value="true"/>
        <display value="ActAdjudicationGroupCode"/>
        <definition value="Catagorization of grouping criteria for the associated transactions and/or summary (totals,
           subtotals)."/>
        <concept>
          <code value="CONT"/>
          <abstract value="false"/>
          <display value="contract"/>
          <definition value="Transaction counts and value totals by Contract Identifier."/>
        </concept>
        <concept>
          <code value="DAY"/>
          <abstract value="false"/>
          <display value="day"/>
          <definition value="Transaction counts and value totals for each calendar day within the date range specified."/>
        </concept>
        <concept>
          <code value="LOC"/>
          <abstract value="false"/>
          <display value="location"/>
          <definition value="Transaction counts and value totals by service location (e.g clinic)."/>
        </concept>
        <concept>
          <code value="MONTH"/>
          <abstract value="false"/>
          <display value="month"/>
          <definition value="Transaction counts and value totals for each calendar month within the date range specified."/>
        </concept>
        <concept>
          <code value="PERIOD"/>
          <abstract value="false"/>
          <display value="period"/>
          <definition value="Transaction counts and value totals for the date range specified."/>
        </concept>
        <concept>
          <code value="PROV"/>
          <abstract value="false"/>
          <display value="provider"/>
          <definition value="Transaction counts and value totals by Provider Identifier."/>
        </concept>
        <concept>
          <code value="WEEK"/>
          <abstract value="false"/>
          <display value="week"/>
          <definition value="Transaction counts and value totals for each calendar week within the date range specified."/>
        </concept>
        <concept>
          <code value="YEAR"/>
          <abstract value="false"/>
          <display value="year"/>
          <definition value="Transaction counts and value totals for each calendar year within the date range specified."/>
        </concept>
      </concept>
      <concept>
        <code value="AA"/>
        <abstract value="false"/>
        <display value="adjudicated with adjustments"/>
        <definition value="The invoice element has been accepted for payment but one or more adjustment(s) have been
           made to one or more invoice element line items (component charges).                  
                    Also includes the concept 'Adjudicate as zero' and items not covered under a
           particular Policy.                            Invoice element can be reversed (nullified).
                                      Recommend that the invoice element is saved for DUR (Drug Utilization
           Reporting)."/>
        <concept>
          <code value="ANF"/>
          <abstract value="false"/>
          <display value="adjudicated with adjustments and no financial impact"/>
          <definition value="The invoice element has been accepted for payment but one or more adjustment(s) have been
             made to one or more invoice element line items (component charges) without changing the
             amount.                            Invoice element can be reversed (nullified).      
                                  Recommend that the invoice element is saved for DUR (Drug Utilization
             Reporting)."/>
        </concept>
      </concept>
      <concept>
        <code value="AR"/>
        <abstract value="false"/>
        <display value="adjudicated as refused"/>
        <definition value="The invoice element has passed through the adjudication process but payment is refused
           due to one or more reasons.                          Includes items such as patient not
           covered, or invoice element is not constructed according to payer rules (e.g. 'invoice
           submitted too late').                          If one invoice element line item in the
           invoice element structure is rejected, the remaining line items may not be adjudicated
           and the complete group is treated as rejected.                          A refused invoice
           element can be forwarded to the next payer (for Coordination of Benefits) or modified
           and resubmitted to refusing payer.                          Invoice element cannot be
           reversed (nullified) as there is nothing to reverse.                            Recommend
           that the invoice element is not saved for DUR (Drug Utilization Reporting)."/>
      </concept>
      <concept>
        <code value="AS"/>
        <abstract value="false"/>
        <display value="adjudicated as submitted"/>
        <definition value="The invoice element was/will be paid exactly as submitted, without financial adjustment(s).
                                    If the dollar amount stays the same, but the billing codes have
           been amended or financial adjustments have been applied through the adjudication process,
           the invoice element is treated as &quot;Adjudicated with Adjustment&quot;.           
                         If information items are included in the adjudication results that do not
           affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached
           Plan Maximum on this Claim').                            Invoice element can be reversed
           (nullified).                            Recommend that the invoice element is saved for
           DUR (Drug Utilization Reporting)."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActAdjudicationResultActionCode"/>
      <abstract value="true"/>
      <display value="ActAdjudicationResultActionCode"/>
      <definition value="Actions to be carried out by the recipient of the Adjudication Result information."/>
      <concept>
        <code value="DISPLAY"/>
        <abstract value="false"/>
        <display value="Display"/>
        <definition value="The adjudication result associated is to be displayed to the receiver of the adjudication
           result."/>
      </concept>
      <concept>
        <code value="FORM"/>
        <abstract value="false"/>
        <display value="Print on Form"/>
        <definition value="The adjudication result associated is to be printed on the specified form, which is then
           provided to the covered party."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActBillableModifierCode"/>
      <abstract value="true"/>
      <display value="ActBillableModifierCode"/>
      <definition value="Definition:An identifying modifier code for healthcare interventions or procedures."/>
      <concept>
        <code value="CPTM"/>
        <abstract value="false"/>
        <display value="CPT modifier codes"/>
        <definition value="Description:CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition."/>
      </concept>
      <concept>
        <code value="HCPCSA"/>
        <abstract value="false"/>
        <display value="HCPCS Level II and Carrier-assigned"/>
        <definition value="Description:HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers
           are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActBillingArrangementCode"/>
      <abstract value="true"/>
      <display value="ActBillingArrangementCode"/>
      <definition value="The type of provision(s)  made for reimbursing for the deliver of healthcare services
         and/or goods provided by a Provider, over a specified period."/>
      <concept>
        <code value="BLK"/>
        <abstract value="false"/>
        <display value="block funding"/>
        <definition value="A billing arrangement where a Provider charges a lump sum to provide a prescribed group
           (volume) of services to a single patient which occur over a period of time.  Services
           included in the block may vary.                            This billing arrangement is
           also known as Program of Care for some specific Payors and Program Fees for other Payors."/>
      </concept>
      <concept>
        <code value="CAP"/>
        <abstract value="false"/>
        <display value="capitation funding"/>
        <definition value="A billing arrangement where the payment made to a Provider is determined by analyzing
           one or more demographic attributes about the persons/patients who are enrolled with the
           Provider (in their practice)."/>
      </concept>
      <concept>
        <code value="CONTF"/>
        <abstract value="false"/>
        <display value="contract funding"/>
        <definition value="A billing arrangement where a Provider charges a lump sum to provide a particular volume
           of one or more interventions/procedures or groups of interventions/procedures."/>
      </concept>
      <concept>
        <code value="FINBILL"/>
        <abstract value="false"/>
        <display value="financial"/>
        <definition value="A billing arrangement where a Provider charges for non-clinical items.  This includes
           interest in arrears, mileage, etc.  Clinical content is not  included in Invoices submitted
           with this type of billing arrangement."/>
      </concept>
      <concept>
        <code value="ROST"/>
        <abstract value="false"/>
        <display value="roster funding"/>
        <definition value="A billing arrangement where funding is based on a list of individuals registered as patients
           of the Provider."/>
      </concept>
      <concept>
        <code value="SESS"/>
        <abstract value="false"/>
        <display value="sessional funding"/>
        <definition value="A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/pr
          ocedures to one or more patients within a defined period of time, typically on the same
           date.  Interventions/procedures included in the session may vary."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActBoundedROICode"/>
      <abstract value="true"/>
      <display value="ActBoundedROICode"/>
      <definition value="Type of bounded ROI."/>
      <concept>
        <code value="ROIFS"/>
        <abstract value="false"/>
        <display value="fully specified ROI"/>
        <definition value="A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those
           dimensions participate that are specified by boundary criteria, whereas all other dimensions
           are excluded.  For example a ROI to mark an episode of &quot;ST elevation&quot; in a subset
           of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3,
           and V4."/>
      </concept>
      <concept>
        <code value="ROIPS"/>
        <abstract value="false"/>
        <display value="partially specified ROI"/>
        <definition value="A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least
           all values in the dimensions specified by the boundary criteria participate. For example,
           if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make
           sense to exclude any EKG leads from the observation and the partially specified ROI would
           contain only one boundary for time indicating the time interval where VFib was observed."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActCareProvisionCode"/>
      <abstract value="true"/>
      <display value="act care provision"/>
      <definition value="Description:The type and scope of responsibility taken-on by the performer of the Act
         for a specific subject of care."/>
      <concept>
        <code value="_ActCredentialedCareCode"/>
        <abstract value="true"/>
        <display value="act credentialed care"/>
        <definition value="Description:The type and scope of legal and/or professional responsibility taken-on by
           the performer of the Act for a specific subject of care as described by a credentialing
           agency, i.e. government or non-government agency. Failure in executing this Act may result
           in loss of credential to the person or organization who participates as performer of the
           Act. Excludes employment agreements.                                                 
               Example:Hospital license; physician license; clinic accreditation."/>
        <concept>
          <code value="_ActCredentialedCareProvisionPersonCode"/>
          <abstract value="true"/>
          <display value="act credentialed care provision peron"/>
          <definition value="Description:The type and scope of legal and/or professional responsibility taken-on by
             the performer of the Act for a specific subject of care as described by an agency for
             credentialing individuals."/>
          <concept>
            <code value="CACC"/>
            <abstract value="false"/>
            <display value="certified anatomic pathology and clinical pathology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CAIC"/>
            <abstract value="false"/>
            <display value="certified allergy and immunology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CAMC"/>
            <abstract value="false"/>
            <display value="certified aerospace medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CANC"/>
            <abstract value="false"/>
            <display value="certified anesthesiology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CAPC"/>
            <abstract value="false"/>
            <display value="certified anatomic pathology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CBGC"/>
            <abstract value="false"/>
            <display value="certified clinical biochemical genetics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CCCC"/>
            <abstract value="false"/>
            <display value="certified clinical cytogenetics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CCGC"/>
            <abstract value="false"/>
            <display value="certified clinical genetics (M.D.) care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CCPC"/>
            <abstract value="false"/>
            <display value="certified clinical pathology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CCSC"/>
            <abstract value="false"/>
            <display value="certified colon and rectal surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CDEC"/>
            <abstract value="false"/>
            <display value="certified dermatology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CDRC"/>
            <abstract value="false"/>
            <display value="certified diagnostic radiology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CEMC"/>
            <abstract value="false"/>
            <display value="certified emergency medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CFPC"/>
            <abstract value="false"/>
            <display value="certified family practice care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CIMC"/>
            <abstract value="false"/>
            <display value="certified internal medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CMGC"/>
            <abstract value="false"/>
            <display value="certified clinical molecular genetics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CNEC"/>
            <abstract value="false"/>
            <display value="certified neurology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board"/>
          </concept>
          <concept>
            <code value="CNMC"/>
            <abstract value="false"/>
            <display value="certified nuclear medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CNQC"/>
            <abstract value="false"/>
            <display value="certified neurology with special qualifications in child neurology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CNSC"/>
            <abstract value="false"/>
            <display value="certified neurological surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="COGC"/>
            <abstract value="false"/>
            <display value="certified obstetrics and gynecology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="COMC"/>
            <abstract value="false"/>
            <display value="certified occupational medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="COPC"/>
            <abstract value="false"/>
            <display value="certified ophthalmology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="COSC"/>
            <abstract value="false"/>
            <display value="certified orthopaedic surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="COTC"/>
            <abstract value="false"/>
            <display value="certified otolaryngology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPEC"/>
            <abstract value="false"/>
            <display value="certified pediatrics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPGC"/>
            <abstract value="false"/>
            <display value="certified Ph.D. medical genetics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPHC"/>
            <abstract value="false"/>
            <display value="certified public health and general preventive medicine care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPRC"/>
            <abstract value="false"/>
            <display value="certified physical medicine and rehabilitation care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPSC"/>
            <abstract value="false"/>
            <display value="certified plastic surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CPYC"/>
            <abstract value="false"/>
            <display value="certified psychiatry care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CROC"/>
            <abstract value="false"/>
            <display value="certified radiation oncology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CRPC"/>
            <abstract value="false"/>
            <display value="certified radiological physics care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CSUC"/>
            <abstract value="false"/>
            <display value="certified surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CTSC"/>
            <abstract value="false"/>
            <display value="certified thoracic surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CURC"/>
            <abstract value="false"/>
            <display value="certified urology care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="CVSC"/>
            <abstract value="false"/>
            <display value="certified vascular surgery care"/>
            <definition value="Description:Scope of responsibility taken on for specialty care as defined by the respective
               Specialty Board."/>
          </concept>
          <concept>
            <code value="LGPC"/>
            <abstract value="false"/>
            <display value="licensed general physician care"/>
            <definition value="Description:Scope of responsibility taken-on for physician care of a patient as defined
               by a governmental licensing agency."/>
          </concept>
        </concept>
        <concept>
          <code value="_ActCredentialedCareProvisionProgramCode"/>
          <abstract value="true"/>
          <display value="act credentialed care provision program"/>
          <definition value="Description:The type and scope of legal and/or professional responsibility taken-on by
             the performer of the Act for a specific subject of care as described by an agency for
             credentialing programs within organizations."/>
          <concept>
            <code value="AALC"/>
            <abstract value="false"/>
            <display value="accredited assisted living care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="AAMC"/>
            <abstract value="false"/>
            <display value="accredited ambulatory care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="ABHC"/>
            <abstract value="false"/>
            <display value="accredited behavioral health care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="ACAC"/>
            <abstract value="false"/>
            <display value="accredited critical access hospital care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="ACHC"/>
            <abstract value="false"/>
            <display value="accredited hospital care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="AHOC"/>
            <abstract value="false"/>
            <display value="accredited home care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="ALTC"/>
            <abstract value="false"/>
            <display value="accredited long term care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="AOSC"/>
            <abstract value="false"/>
            <display value="accredited office-based surgery care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the respective accreditation agency."/>
          </concept>
          <concept>
            <code value="CACS"/>
            <abstract value="false"/>
            <display value="certified acute coronary syndrome care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CAMI"/>
            <abstract value="false"/>
            <display value="certified acute myocardial infarction care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CAST"/>
            <abstract value="false"/>
            <display value="certified asthma care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CBAR"/>
            <abstract value="false"/>
            <display value="certified bariatric surgery care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CCAD"/>
            <abstract value="false"/>
            <display value="certified coronary artery disease care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CCAR"/>
            <abstract value="false"/>
            <display value="certified cardiac care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CDEP"/>
            <abstract value="false"/>
            <display value="certified depression care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CDGD"/>
            <abstract value="false"/>
            <display value="certified digestive/gastrointestinal disorders care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CDIA"/>
            <abstract value="false"/>
            <display value="certified diabetes care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CEPI"/>
            <abstract value="false"/>
            <display value="certified epilepsy care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CFEL"/>
            <abstract value="false"/>
            <display value="certified frail elderly care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CHFC"/>
            <abstract value="false"/>
            <display value="certified heart failure care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CHRO"/>
            <abstract value="false"/>
            <display value="certified high risk obstetrics care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CHYP"/>
            <abstract value="false"/>
            <display value="certified hyperlipidemia care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CMIH"/>
            <abstract value="false"/>
            <display value="certified migraine headache care"/>
            <definition value="Description:."/>
          </concept>
          <concept>
            <code value="CMSC"/>
            <abstract value="false"/>
            <display value="certified multiple sclerosis care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="COJR"/>
            <abstract value="false"/>
            <display value="certified orthopedic joint replacement care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CONC"/>
            <abstract value="false"/>
            <display value="certified oncology care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="COPD"/>
            <abstract value="false"/>
            <display value="certified chronic obstructive pulmonary disease care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CORT"/>
            <abstract value="false"/>
            <display value="certified organ transplant care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CPAD"/>
            <abstract value="false"/>
            <display value="certified parkinsons disease care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CPND"/>
            <abstract value="false"/>
            <display value="certified pneumonia disease care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CPST"/>
            <abstract value="false"/>
            <display value="certified primary stroke center care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CSDM"/>
            <abstract value="false"/>
            <display value="certified stroke disease management care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CSIC"/>
            <abstract value="false"/>
            <display value="certified sickle cell care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CSLD"/>
            <abstract value="false"/>
            <display value="certified sleep disorders care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CSPT"/>
            <abstract value="false"/>
            <display value="certified spine treatment care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CTBU"/>
            <abstract value="false"/>
            <display value="certified trauma/burn center care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CVDC"/>
            <abstract value="false"/>
            <display value="certified vascular diseases care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CWMA"/>
            <abstract value="false"/>
            <display value="certified wound management care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
          <concept>
            <code value="CWOH"/>
            <abstract value="false"/>
            <display value="certified women's health care"/>
            <definition value="Description:Scope of responsibility taken on by an organization for care of a patient
               as defined by the disease management certification agency."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_ActEncounterCode"/>
        <abstract value="true"/>
        <display value="ActEncounterCode"/>
        <definition value="Domain provides codes that qualify the ActEncounterClass (ENC)"/>
        <concept>
          <code value="AMB"/>
          <abstract value="false"/>
          <display value="ambulatory"/>
          <definition value="A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs
             office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually
             implies that the patient has come to the location and is not assigned to a bed. Sometimes
             referred to as an outpatient encounter."/>
        </concept>
        <concept>
          <code value="EMER"/>
          <abstract value="false"/>
          <display value="emergency"/>
          <definition value="A patient encounter that takes place at a dedicated healthcare service delivery location
             where the patient receives immediate evaluation and treatment, provided until the patient
             can be discharged or responsibility for the patient's care is transferred elsewhere (for
             example, the patient could be admitted as an inpatient or transferred to another facility.)"/>
        </concept>
        <concept>
          <code value="FLD"/>
          <abstract value="false"/>
          <display value="field"/>
          <definition value="A patient encounter that takes place both outside a dedicated service delivery location
             and outside a patient's residence. Example locations might include an accident site and
             at a supermarket."/>
        </concept>
        <concept>
          <code value="HH"/>
          <abstract value="false"/>
          <display value="home health"/>
          <definition value="Healthcare encounter that takes place in the residence of the patient or a designee"/>
        </concept>
        <concept>
          <code value="IMP"/>
          <abstract value="false"/>
          <display value="inpatient encounter"/>
          <definition value="A patient encounter where a patient is admitted by a hospital or equivalent facility,
             assigned to a location where patients generally stay at least overnight and provided with
             room, board, and continuous nursing service."/>
          <concept>
            <code value="ACUTE"/>
            <abstract value="false"/>
            <display value="inpatient acute"/>
            <definition value="An acute inpatient encounter."/>
          </concept>
          <concept>
            <code value="NONAC"/>
            <abstract value="false"/>
            <display value="inpatient non-acute"/>
            <definition value="Any category of inpatient encounter except 'acute'"/>
          </concept>
        </concept>
        <concept>
          <code value="PRENC"/>
          <abstract value="false"/>
          <display value="pre-admission"/>
          <definition value="A patient encounter where patient is scheduled or planned to receive service delivery
             in the future, and the patient is given a pre-admission account number. When the patient
             comes back for subsequent service, the pre-admission encounter is selected and is encapsulated
             into the service registration, and a new account number is generated.                
                                                  Usage Note: This is intended to be used in advance
             of encounter types such as ambulatory, inpatient encounter, virtual, etc."/>
        </concept>
        <concept>
          <code value="SS"/>
          <abstract value="false"/>
          <display value="short stay"/>
          <definition value="An encounter where the patient is admitted to a health care facility for a predetermined
             length of time, usually less than 24 hours."/>
        </concept>
        <concept>
          <code value="VR"/>
          <abstract value="false"/>
          <display value="virtual"/>
          <definition value="A patient encounter where the patient and the practitioner(s) are not in the same physical
             location. Examples include telephone conference, email exchange, robotic surgery, and
             televideo conference."/>
        </concept>
      </concept>
      <concept>
        <code value="_ActMedicalServiceCode"/>
        <abstract value="true"/>
        <display value="ActMedicalServiceCode"/>
        <definition value="General category of medical service provided to the patient during their encounter."/>
        <concept>
          <code value="ALC"/>
          <abstract value="false"/>
          <display value="Alternative Level of Care"/>
          <definition value="Provision of Alternate Level of Care to a patient in an acute bed.  Patient is waiting
             for placement in a long-term care facility and is unable to return home."/>
        </concept>
        <concept>
          <code value="CARD"/>
          <abstract value="false"/>
          <display value="Cardiology"/>
          <definition value="Provision of diagnosis and treatment of diseases and disorders affecting the heart"/>
        </concept>
        <concept>
          <code value="CHR"/>
          <abstract value="false"/>
          <display value="Chronic"/>
          <definition value="Provision of recurring care for chronic illness."/>
        </concept>
        <concept>
          <code value="DNTL"/>
          <abstract value="false"/>
          <display value="Dental"/>
          <definition value="Provision of treatment for oral health and/or dental surgery."/>
        </concept>
        <concept>
          <code value="DRGRHB"/>
          <abstract value="false"/>
          <display value="Drug Rehab"/>
          <definition value="Provision of treatment for drug abuse."/>
        </concept>
        <concept>
          <code value="GENRL"/>
          <abstract value="false"/>
          <display value="General"/>
          <definition value="General care performed by a general practitioner or family doctor as a responsible provider
             for a patient."/>
        </concept>
        <concept>
          <code value="MED"/>
          <abstract value="false"/>
          <display value="Medical"/>
          <definition value="Provision of diagnostic and/or therapeutic treatment."/>
        </concept>
        <concept>
          <code value="OBS"/>
          <abstract value="false"/>
          <display value="Obstetrics"/>
          <definition value="Provision of care of women during pregnancy, childbirth and immediate postpartum period.
              Also known as Maternity."/>
        </concept>
        <concept>
          <code value="ONC"/>
          <abstract value="false"/>
          <display value="Oncology"/>
          <definition value="Provision of treatment and/or diagnosis related to tumors and/or cancer."/>
        </concept>
        <concept>
          <code value="PALL"/>
          <abstract value="false"/>
          <display value="Palliative"/>
          <definition value="Provision of care for patients who are living or dying from an advanced illness."/>
        </concept>
        <concept>
          <code value="PED"/>
          <abstract value="false"/>
          <display value="Pediatrics"/>
          <definition value="Provision of diagnosis and treatment of diseases and disorders affecting children."/>
        </concept>
        <concept>
          <code value="PHAR"/>
          <abstract value="false"/>
          <display value="Pharmaceutical"/>
          <definition value="Pharmaceutical care performed by a pharmacist."/>
        </concept>
        <concept>
          <code value="PHYRHB"/>
          <abstract value="false"/>
          <display value="Physical Rehab"/>
          <definition value="Provision of treatment for physical injury."/>
        </concept>
        <concept>
          <code value="PSYCH"/>
          <abstract value="false"/>
          <display value="Psychiatric"/>
          <definition value="Provision of treatment of psychiatric disorder relating to mental illness."/>
        </concept>
        <concept>
          <code value="SURG"/>
          <abstract value="false"/>
          <display value="Surgical"/>
          <definition value="Provision of surgical treatment."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActClaimAttachmentCategoryCode"/>
      <abstract value="true"/>
      <display value="ActClaimAttachmentCategoryCode"/>
      <definition value="Description: Coded types of attachments included to support a healthcare claim."/>
      <concept>
        <code value="AUTOATTCH"/>
        <abstract value="false"/>
        <display value="auto attachment"/>
        <definition value="Description: Automobile Information Attachment"/>
      </concept>
      <concept>
        <code value="DOCUMENT"/>
        <abstract value="false"/>
        <display value="document"/>
        <definition value="Description: Document Attachment"/>
      </concept>
      <concept>
        <code value="HEALTHREC"/>
        <abstract value="false"/>
        <display value="health record"/>
        <definition value="Description: Health Record Attachment"/>
      </concept>
      <concept>
        <code value="IMG"/>
        <abstract value="false"/>
        <display value="image attachment"/>
        <definition value="Description: Image Attachment"/>
      </concept>
      <concept>
        <code value="LABRESULTS"/>
        <abstract value="false"/>
        <display value="lab results"/>
        <definition value="Description: Lab Results Attachment"/>
      </concept>
      <concept>
        <code value="MODEL"/>
        <abstract value="false"/>
        <display value="model"/>
        <definition value="Description: Digital Model Attachment"/>
      </concept>
      <concept>
        <code value="WIATTCH"/>
        <abstract value="false"/>
        <display value="work injury report attachment"/>
        <definition value="Description: Work Injury related additional Information Attachment"/>
      </concept>
      <concept>
        <code value="XRAY"/>
        <abstract value="false"/>
        <display value="x-ray"/>
        <definition value="Description: Digital X-Ray Attachment"/>
      </concept>
    </concept>
    <concept>
      <code value="_ActConsentType"/>
      <abstract value="true"/>
      <display value="ActConsentType"/>
      <definition value="Definition: The type of consent directive, e.g., to consent or dissent to collect, access,
         or use in specific ways within an EHRS or for health information exchange; or to disclose
          health information  for purposes such as research."/>
      <concept>
        <code value="ICOL"/>
        <abstract value="false"/>
        <display value="information collection"/>
        <definition value="Definition: Consent to have healthcare information collected in an electronic health record.
            This entails that the information may be used in analysis, modified, updated."/>
      </concept>
      <concept>
        <code value="IDSCL"/>
        <abstract value="false"/>
        <display value="information disclosure"/>
        <definition value="Definition: Consent to have collected healthcare information disclosed."/>
      </concept>
      <concept>
        <code value="INFA"/>
        <abstract value="false"/>
        <display value="information access"/>
        <definition value="Definition: Consent to access healthcare information."/>
        <concept>
          <code value="INFAO"/>
          <abstract value="false"/>
          <display value="access only"/>
          <definition value="Definition: Consent to access or &quot;read&quot; only, which entails that the information
             is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in
             any way.  This level ensures that data which is masked or to which access is restricted
             will not be.                                                      Example: Opened and
             then emailed or screen printed for use outside of the consent directive purpose."/>
        </concept>
        <concept>
          <code value="INFASO"/>
          <abstract value="false"/>
          <display value="access and save only"/>
          <definition value="Definition: Consent to access and save only, which entails that access to the saved copy
             will remain locked."/>
        </concept>
      </concept>
      <concept>
        <code value="IRDSCL"/>
        <abstract value="false"/>
        <display value="information redisclosure"/>
        <definition value="Definition: Information re-disclosed without the patient's consent."/>
      </concept>
      <concept>
        <code value="RESEARCH"/>
        <abstract value="false"/>
        <display value="research information access"/>
        <definition value="Definition: Consent to have healthcare information in an electronic health record accessed
           for research purposes."/>
        <concept>
          <code value="RSDID"/>
          <abstract value="false"/>
          <display value="de-identified information access"/>
          <definition value="Definition: Consent to have de-identified healthcare information in an electronic health
             record that is accessed for research purposes, but without consent to re-identify the
             information under any circumstance."/>
        </concept>
        <concept>
          <code value="RSREID"/>
          <abstract value="false"/>
          <display value="re-identifiable information access"/>
          <definition value="Definition: Consent to have de-identified healthcare information in an electronic health
             record that is accessed for research purposes re-identified under specific circumstances
             outlined in the consent.                                                      Example::
             Where there is a need to inform the subject of potential health issues."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActContainerRegistrationCode"/>
      <abstract value="true"/>
      <display value="ActContainerRegistrationCode"/>
      <definition value="Constrains the ActCode to the domain of Container Registration"/>
      <concept>
        <code value="ID"/>
        <abstract value="false"/>
        <display value="Identified"/>
        <definition value="Used by one system to inform another that it has received a container."/>
      </concept>
      <concept>
        <code value="IP"/>
        <abstract value="false"/>
        <display value="In Position"/>
        <definition value="Used by one system to inform another that the container is in position for specimen transfer
           (e.g., container removal from track, pipetting, etc.)."/>
      </concept>
      <concept>
        <code value="L"/>
        <abstract value="false"/>
        <display value="Left Equipment"/>
        <definition value="Used by one system to inform another that the container has been released from that system."/>
      </concept>
      <concept>
        <code value="M"/>
        <abstract value="false"/>
        <display value="Missing"/>
        <definition value="Used by one system to inform another that the container did not arrive at its next expected
           location."/>
      </concept>
      <concept>
        <code value="O"/>
        <abstract value="false"/>
        <display value="In Process"/>
        <definition value="Used by one system to inform another that the specific container is being processed by
           the equipment. It is useful as a response to a query about Container Status, when the
           specific step of the process is not relevant."/>
      </concept>
      <concept>
        <code value="R"/>
        <abstract value="false"/>
        <display value="Process Completed"/>
        <definition value="Status is used by one system to inform another that the processing has been completed,
           but the container has not been released from that system."/>
      </concept>
      <concept>
        <code value="X"/>
        <abstract value="false"/>
        <display value="Container Unavailable"/>
        <definition value="Used by one system to inform another that the container is no longer available within
           the scope of the system (e.g., tube broken or discarded)."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActControlVariable"/>
      <abstract value="true"/>
      <display value="ActControlVariable"/>
      <definition value="An observation form that determines parameters or attributes of an Act. Examples are the
         settings of a ventilator machine as parameters of a ventilator treatment act; the controls
         on dillution factors of a chemical analyzer as a parameter of a laboratory observation
         act; the settings of a physiologic measurement assembly (e.g., time skew) or the position
         of the body while measuring blood pressure.                          Control variables
         are forms of observations because just as with clinical observations, the Observation.code
         determines the parameter and the Observation.value assigns the value. While control variables
         sometimes can be observed (by noting the control settings or an actually measured feedback
         loop) they are not primary observations, in the sense that a control variable without
         a primary act is of no use (e.g., it makes no sense to record a blood pressure position
         without recording a blood pressure, whereas it does make sense to record a systolic blood
         pressure without a diastolic blood pressure)."/>
      <concept>
        <code value="AUTO"/>
        <abstract value="false"/>
        <display value="auto-repeat permission"/>
        <definition value="Specifies whether or not automatic repeat testing is to be initiated on specimens."/>
      </concept>
      <concept>
        <code value="ENDC"/>
        <abstract value="false"/>
        <display value="endogenous content"/>
        <definition value="A baseline value for the measured test that is inherently contained in the diluent.  In
           the calculation of the actual result for the measured test, this baseline value is normally
           considered."/>
      </concept>
      <concept>
        <code value="REFLEX"/>
        <abstract value="false"/>
        <display value="reflex permission"/>
        <definition value="Specifies whether or not further testing may be automatically or manually initiated on
           specimens."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActCoverageConfirmationCode"/>
      <abstract value="true"/>
      <display value="ActCoverageConfirmationCode"/>
      <definition value="Response to an insurance coverage eligibility query or authorization request."/>
      <concept>
        <code value="_ActCoverageAuthorizationConfirmationCode"/>
        <abstract value="true"/>
        <display value="ActCoverageAuthorizationConfirmationCode"/>
        <definition value="Indication of authorization for healthcare service(s) and/or product(s).  If authorization
           is approved, funds are set aside."/>
        <concept>
          <code value="AUTH"/>
          <abstract value="false"/>
          <display value="Authorized"/>
          <definition value="Authorization approved and funds have been set aside to pay for specified healthcare service(s)
             and/or product(s) within defined criteria for the authorization."/>
        </concept>
        <concept>
          <code value="NAUTH"/>
          <abstract value="false"/>
          <display value="Not Authorized"/>
          <definition value="Authorization for specified healthcare service(s) and/or product(s) denied."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActCoverageLimitCode"/>
      <abstract value="true"/>
      <display value="ActCoverageLimitCode"/>
      <definition value="Criteria that are applicable to the authorized coverage."/>
      <concept>
        <code value="_ActCoverageQuantityLimitCode"/>
        <abstract value="true"/>
        <display value="ActCoverageQuantityLimitCode"/>
        <definition value="Maximum amount paid or maximum number of services/products covered; or maximum amount
           or number covered during a specified time period under the policy or program."/>
        <concept>
          <code value="COVPRD"/>
          <abstract value="false"/>
          <display value="coverage period"/>
          <definition value="Codes representing the time period during which coverage is available; or financial participation
             requirements are in effect."/>
        </concept>
        <concept>
          <code value="LFEMX"/>
          <abstract value="false"/>
          <display value="life time maximum"/>
          <definition value="Definition: Maximum amount paid by payer or covered party; or maximum number of services
             or products covered under the policy or program during a covered party's lifetime."/>
        </concept>
        <concept>
          <code value="NETAMT"/>
          <abstract value="false"/>
          <display value="Net Amount"/>
          <definition value="Maximum net amount that will be covered for the product or service specified."/>
        </concept>
        <concept>
          <code value="PRDMX"/>
          <abstract value="false"/>
          <display value="period maximum"/>
          <definition value="Definition: Maximum amount paid by payer or covered party; or maximum number of services/products
             covered under the policy or program by time period specified by the effective time on
             the act."/>
        </concept>
        <concept>
          <code value="UNITPRICE"/>
          <abstract value="false"/>
          <display value="Unit Price"/>
          <definition value="Maximum unit price that will be covered for the authorized product or service."/>
        </concept>
        <concept>
          <code value="UNITQTY"/>
          <abstract value="false"/>
          <display value="Unit Quantity"/>
          <definition value="Maximum number of items that will be covered of the product or service specified."/>
        </concept>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="LFEMX"/>
        </modifierExtension>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="PRDMX"/>
        </modifierExtension>
        <code value="COVMX"/>
        <abstract value="false"/>
        <display value="coverage maximum"/>
        <definition value="Definition: Codes representing the maximum coverate or financial participation requirements."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActCoverageTypeCode"/>
      <abstract value="true"/>
      <display value="ActCoverageTypeCode"/>
      <definition value="Definition: Set of codes indicating the type of insurance policy or program that pays
         for the cost of benefits provided to covered parties."/>
      <concept>
        <code value="_ActInsurancePolicyCode"/>
        <abstract value="true"/>
        <display value="ActInsurancePolicyCode"/>
        <definition value="Set of codes indicating the type of insurance policy or other source of funds to cover
           healthcare costs."/>
        <concept>
          <code value="EHCPOL"/>
          <abstract value="false"/>
          <display value="extended healthcare"/>
          <definition value="Private insurance policy that provides coverage in addition to other policies (e.g. in
             addition to a Public Healthcare insurance policy)."/>
        </concept>
        <concept>
          <code value="HSAPOL"/>
          <abstract value="false"/>
          <display value="health spending account"/>
          <definition value="Insurance policy that provides for an allotment of funds replenished on a periodic (e.g.
             annual) basis. The use of the funds under this policy is at the  discretion of the covered
             party."/>
        </concept>
        <concept>
          <code value="AUTOPOL"/>
          <abstract value="false"/>
          <display value="automobile"/>
          <definition value="Insurance policy for injuries sustained in an automobile accident.  Will also typically
             covered non-named parties to the policy, such as pedestrians  and passengers."/>
          <concept>
            <code value="COL"/>
            <abstract value="false"/>
            <display value="collision coverage policy"/>
            <definition value="Definition: An automobile insurance policy under which the insurance company will cover
               the cost of damages to an automobile owned by the named insured that are caused by accident
               or intentionally by another party."/>
          </concept>
          <concept>
            <code value="UNINSMOT"/>
            <abstract value="false"/>
            <display value="uninsured motorist policy"/>
            <definition value="Definition: An automobile insurance policy under which the insurance company will indemnify
               a loss for which another motorist is liable if that motorist is unable to pay because
               he or she is uninsured.  Coverage under the policy applies to bodily injury damages only.
                Injuries to the covered party caused by a hit-and-run driver are also covered."/>
          </concept>
        </concept>
        <concept>
          <code value="PUBLICPOL"/>
          <abstract value="false"/>
          <display value="public healthcare"/>
          <definition value="Insurance policy funded by a public health system such as a provincial or national health
             plan.  Examples include BC MSP (British Columbia  Medical Services Plan) OHIP (Ontario
             Health Insurance Plan), NHS (National Health Service)."/>
          <concept>
            <code value="DENTPRG"/>
            <abstract value="false"/>
            <display value="dental program"/>
            <definition value="Definition: A public or government health program that administers and funds coverage
               for dental care to assist program eligible who meet financial and health status criteria."/>
          </concept>
          <concept>
            <code value="DISEASEPRG"/>
            <abstract value="false"/>
            <display value="public health program"/>
            <definition value="Definition: A public or government health program that administers and funds coverage
               for health and social services to assist program eligible who meet financial and health
               status criteria related to a particular disease.                                     
                               Example: Reproductive health, sexually transmitted disease, and end renal
               disease programs."/>
            <concept>
              <code value="CANPRG"/>
              <abstract value="false"/>
              <display value="women's cancer detection program"/>
              <definition value="Definition: A program that provides low-income, uninsured, and underserved women access
                 to timely, high-quality screening and diagnostic services, to detect breast and cervical
                 cancer at the earliest stages.                                                      Example:
                 To improve women's access to screening for breast and cervical cancers, Congress passed
                 the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating
                 the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which  provides
                 access to critical breast and cervical cancer screening services for underserved women
                 in the United States.  An estimated 7 to 10% of U.S. women of screening age are eligible
                 to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct
                 services to uninsured and underinsured women at or below 250% of federal poverty level;
                 ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening."/>
            </concept>
            <concept>
              <code value="ENDRENAL"/>
              <abstract value="false"/>
              <display value="end renal program"/>
              <definition value="Definition: A public or government program that administers publicly funded coverage of
                 kidney dialysis and kidney transplant services.                          Example: In the
                 U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation
                 (NKF) American Kidney Fund (AKF) The Organ Transplant Fund."/>
            </concept>
            <concept>
              <code value="HIVAIDS"/>
              <abstract value="false"/>
              <display value="HIV-AIDS program"/>
              <definition value="Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting
                 financial and health status criteria.  Administration, funding levels, eligibility criteria,
                 covered benefits, provider types, and financial participation are typically set by a regulatory
                 process.  Payer responsibilities for administering the program may be delegated to contractors.
                                                                      Example: In the U.S., the Ryan White
                 program, which is administered by the Health Resources and Services Administration."/>
            </concept>
          </concept>
          <concept>
            <code value="MANDPOL"/>
            <abstract value="false"/>
            <display value="mandatory health program"/>
          </concept>
          <concept>
            <code value="MENTPRG"/>
            <abstract value="false"/>
            <display value="mental health program"/>
            <definition value="Definition: Government administered and funded mental health program for beneficiaries
               meeting financial and mental health status criteria.  Administration, funding levels,
               eligibility criteria, covered benefits, provider types, and financial participation are
               typically set by a regulatory process.  Payer responsibilities for administering the program
               may be delegated to contractors.                                                     
               Example: In the U.S., states receive funding for substance use programs from the Substance
               Abuse Mental Health Administration (SAMHSA)."/>
          </concept>
          <concept>
            <code value="SAFNET"/>
            <abstract value="false"/>
            <display value="safety net clinic program"/>
            <definition value="Definition: Government administered and funded program to support provision of care to
               underserved populations through safety net clinics.                                  
                                  Example: In the U.S., safety net providers such as federally qualified
               health centers (FQHC) receive funding under PHSA Section 330 grants administered by the
               Health Resources and Services Administration."/>
          </concept>
          <concept>
            <code value="SUBPRG"/>
            <abstract value="false"/>
            <display value="substance use program"/>
            <definition value="Definition: Government administered and funded substance use program for beneficiaries
               meeting financial, substance use behavior, and health status criteria.  Beneficiaries
               may be required to enroll as a result of legal proceedings.  Administration, funding levels,
               eligibility criteria, covered benefits, provider types, and financial participation are
               typically set by a regulatory process.  Payer responsibilities for administering the program
               may be delegated to contractors.                                                     
               Example: In the U.S., states receive funding for substance use programs from the Substance
               Abuse Mental Health Administration (SAMHSA)."/>
          </concept>
          <concept>
            <code value="SUBSIDIZ"/>
            <abstract value="false"/>
            <display value="subsidized health program"/>
            <definition value="Definition: A government health program that provides coverage for health services to
               persons meeting eligibility criteria such as income, location of residence, access to
               other coverages, health condition, and age, the cost of which is to some extent subsidized
               by public funds."/>
            <concept>
              <code value="SUBSIDMC"/>
              <abstract value="false"/>
              <display value="subsidized managed care program"/>
              <definition value="Definition: A government health program that provides coverage through managed care contracts
                 for health services to persons meeting eligibility criteria such as income, location of
                 residence, access to other coverages, health condition, and age, the cost of which is
                 to some extent subsidized by public funds.                                           
                            Discussion: The structure and business processes for underwriting and administering
                 a subsidized managed care program is further specified by the Underwriter and Payer Role.class
                 and Role.code."/>
            </concept>
            <concept>
              <code value="SUBSUPP"/>
              <abstract value="false"/>
              <display value="subsidized supplemental health program"/>
              <definition value="Definition: A government health program that provides coverage for health services to
                 persons meeting eligibility criteria for a supplemental health policy or program such
                 as income, location of residence, access to other coverages, health condition, and age,
                 the cost of which is to some extent subsidized by public funds.                      
                                                Example:  Supplemental health coverage program may cover
                 the cost of a health program or policy financial participations, such as the copays and
                 the premiums, and may provide coverage for services in addition to those covered under
                 the supplemented health program or policy.  In the U.S., Medicaid programs may pay the
                 premium for a covered party who is also covered under the  Medicare program or a private
                 health policy.                                                      Discussion: The structure
                 and business processes for underwriting and administering a subsidized supplemental retiree
                 health program is further specified by the Underwriter and Payer Role.class and Role.code."/>
            </concept>
          </concept>
        </concept>
        <concept>
          <code value="WCBPOL"/>
          <abstract value="false"/>
          <display value="worker's compensation"/>
          <definition value="Insurance policy for injuries sustained in the work place or in the course of employment."/>
        </concept>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="AUTOPOL"/>
        </modifierExtension>
        <code value="_ActInsuranceTypeCode"/>
        <abstract value="true"/>
        <display value="ActInsuranceTypeCode"/>
        <definition value="Definition: Set of codes indicating the type of insurance policy.  Insurance, in law and
           economics, is a form of risk management primarily used to hedge against the risk of potential
           financial loss. Insurance is defined as the equitable transfer of the risk of a potential
           loss, from one entity to another, in exchange for a premium and duty of care. A policy
           holder is an individual or an organization enters into a contract with an underwriter
           which stipulates that, in exchange for payment of a sum of money (a premium), one or more
           covered parties (insureds) is guaranteed compensation for losses resulting from certain
           perils under specified conditions.  The underwriter analyzes the risk of loss, makes a
           decision as to whether the risk is insurable, and prices the premium accordingly.  A policy
           provides benefits that indemnify or cover the cost of a loss incurred by a covered party,
           and may include coverage for services required to remediate a loss.  An insurance policy
           contains pertinent facts about the policy holder, the insurance coverage, the covered
           parties, and the insurer.  A policy may include exemptions and provisions specifying the
           extent to which the indemnification clause cannot be enforced for intentional tortious
           conduct of a covered party, e.g., whether the covered parties are jointly or severably
           insured.                                                      Discussion: In contrast
           to programs, an insurance policy has one or more policy holders, who own the policy. 
           The policy holder may be the covered party, a relative of the covered party, a partnership,
           or a corporation, e.g., an employer.  A subscriber of a self-insured health insurance
           policy is a policy holder.  A subscriber of an employer sponsored health insurance policy
           is holds a certificate of coverage, but is not a policy holder; the policy holder is the
           employer.  See CoveredRoleType."/>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="EHCPOL"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="HSAPOL"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="POS"/>
          </modifierExtension>
          <code value="_ActHealthInsuranceTypeCode"/>
          <abstract value="true"/>
          <display value="ActHealthInsuranceTypeCode"/>
          <definition value="Definition: Set of codes indicating the type of health insurance policy that covers health
             services provided to covered parties.  A health insurance policy is a written contract
             for insurance between the insurance company and the policyholder, and contains pertinent
             facts about the policy owner (the policy holder), the health insurance coverage, the insured
             subscribers and dependents, and the insurer.  Health insurance is typically administered
             in accordance with a plan, which specifies (1) the type of health services and health
             conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing
             condition, service must be deemed medically necessary; service must not be experimental;
             service must provided in accordance with a protocol; drug must be on a formulary; service
             must be prior authorized; or be a referral from a primary care provider); (2) the type
             and affiliation of providers (e.g., only allopathic physicians, only in network, only
             providers employed by an HMO); (3) financial participations required of covered parties
             (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which
             services will be paid (e.g., under indemnity or fee-for-service health plans, the covered
             party typically pays out-of-pocket and then file a claim for reimbursement, while health
             plans that have contractual relationships with providers, i.e., network providers, typically
             do not allow the providers to bill the covered party for the cost of the service until
             after filing a claim with the payer and receiving reimbursement)."/>
          <concept>
            <code value="DENTAL"/>
            <abstract value="false"/>
            <display value="dental care policy"/>
            <definition value="Definition: A health insurance policy that that covers benefits for dental services."/>
          </concept>
          <concept>
            <code value="DISEASE"/>
            <abstract value="false"/>
            <display value="disease specific policy"/>
            <definition value="Definition: A health insurance policy that covers benefits for healthcare services provided
               for named conditions under the policy, e.g., cancer, diabetes, or HIV-AIDS."/>
          </concept>
          <concept>
            <code value="DRUGPOL"/>
            <abstract value="false"/>
            <display value="drug policy"/>
            <definition value="Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals,
               and supplies."/>
          </concept>
          <concept>
            <code value="HIP"/>
            <abstract value="false"/>
            <display value="health insurance plan policy"/>
            <definition value="Definition: A health insurance policy that covers healthcare benefits by protecting covered
               parties from medical expenses arising from health conditions, sickness, or accidental
               injury as well as preventive care. Health insurance policies explicitly exclude coverage
               for losses insured under a disability policy, workers' compensation program, liability
               insurance (including automobile insurance); or for medical expenses, coverage for on-site
               medical clinics or for limited dental or vision benefits when these are provided under
               a separate policy.                                                      Discussion: Health
               insurance policies are offered by health insurance plans that typically reimburse providers
               for covered services on a fee-for-service basis, that is, a fee that is the allowable
               amount that a provider may charge.  This is in contrast to managed care plans, which typically
               prepay providers a per-member/per-month amount or capitation as reimbursement for all
               covered services rendered.  Health insurance plans include indemnity and healthcare services
               plans."/>
          </concept>
          <concept>
            <code value="LTC"/>
            <abstract value="false"/>
            <display value="long term care policy"/>
            <definition value="Definition: An insurance policy that covers benefits for long-term care services people
               need when they no longer can care for themselves. This may be due to an accident, disability,
               prolonged illness or the simple process of aging. Long-term care services assist with
               activities of daily living including:                                                
                                                   Help at home with day-to-day activities, such as cooking,
               cleaning, bathing and dressing                                                       
                                               Care in the community, such as in an adult day care facility
                                                                                                    
                Supervised care provided in an assisted living facility                             
                                                                         Skilled care provided in a nursing
               home"/>
          </concept>
          <concept>
            <code value="MCPOL"/>
            <abstract value="false"/>
            <display value="managed care policy"/>
            <definition value="Definition: Government mandated program providing coverage, disability income, and vocational
               rehabilitation for injuries sustained in the work place or in the course of employment.
                Employers may either self-fund the program, purchase commercial coverage, or pay a premium
               to a government entity that administers the program.  Employees may be required to pay
               premiums toward the cost of coverage as well.                          Managed care policies
               specifically exclude coverage for losses insured under a disability policy, workers' compensation
               program, liability insurance (including automobile insurance); or for medical expenses,
               coverage for on-site medical clinics or for limited dental or vision benefits when these
               are provided under a separate policy.                                                
                    Discussion: Managed care policies are offered by managed care plans that contract
               with selected providers or health care organizations to provide comprehensive health care
               at a discount to covered parties and coordinate the financing and delivery of health care.
               Managed care uses medical protocols and procedures agreed on by the medical profession
               to be cost effective, also known as medical practice guidelines. Providers are typically
               reimbursed for covered services by a capitated amount on a per member per month basis
               that may reflect difference in the health status and level of services anticipated to
               be needed by the member."/>
            <concept>
              <code value="POS"/>
              <abstract value="false"/>
              <display value="point of service policy"/>
              <definition value="Definition: A policy for a health plan that has features of both an HMO and a FFS plan.
                  Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees
                 with participating providers, but recognizes that sometimes covered parties want to choose
                 their own provider.  The POS plan allows a covered party to use providers who are not
                 part of the HMO network (non-participating providers).  However, there is a greater cost
                 associated with choosing these non-network providers. A covered party will usually pay
                 deductibles and coinsurances that are substantially higher than the payments when he or
                 she uses a plan provider. Use of non-participating providers often requires the covered
                 party to pay the provider directly and then to file a claim for reimbursement, like in
                 an FFS plan."/>
            </concept>
            <concept>
              <code value="HMO"/>
              <abstract value="false"/>
              <display value="health maintenance organization policy"/>
              <definition value="Definition: A policy for a health plan that provides coverage for health care only through
                 contracted or employed physicians and hospitals located in particular geographic or service
                 areas.  HMOs emphasize prevention and early detection of illness. Eligibility to enroll
                 in an HMO is determined by where a covered party lives or works."/>
            </concept>
            <concept>
              <code value="PPO"/>
              <abstract value="false"/>
              <display value="preferred provider organization policy"/>
              <definition value="Definition: A network-based, managed care plan that allows a covered party to choose any
                 health care provider. However, if care is received from a &quot;preferred&quot; (participating
                 in-network) provider, there are generally higher benefit coverage and lower deductibles."/>
            </concept>
          </concept>
          <concept>
            <code value="MENTPOL"/>
            <abstract value="false"/>
            <display value="mental health policy"/>
            <definition value="Definition: A health insurance policy that covers benefits for mental health services
               and prescriptions."/>
          </concept>
          <concept>
            <code value="SUBPOL"/>
            <abstract value="false"/>
            <display value="substance use policy"/>
            <definition value="Definition: A health insurance policy that covers benefits for substance use services."/>
          </concept>
          <concept>
            <code value="VISPOL"/>
            <abstract value="false"/>
            <display value="vision care policy"/>
            <definition value="Definition: Set of codes for a policy that provides coverage for health care expenses
               arising from vision services.                          A health insurance policy that
               covers benefits for vision care services, prescriptions, and products."/>
          </concept>
        </concept>
        <concept>
          <code value="DIS"/>
          <abstract value="false"/>
          <display value="disability insurance policy"/>
          <definition value="Definition: An insurance policy that provides a regular payment to compensate for income
             lost due to the covered party's inability to work because of illness or injury."/>
        </concept>
        <concept>
          <code value="EWB"/>
          <abstract value="false"/>
          <display value="employee welfare benefit plan policy"/>
          <definition value="Definition: An insurance policy under a benefit plan run by an employer or employee organization
             for the purpose of providing benefits other than pension-related to employees and their
             families. Typically provides health-related benefits, benefits for disability, disease
             or unemployment, or day care and scholarship benefits, among others.  An employer sponsored
             health policy includes coverage of health care expenses arising from sickness or accidental
             injury, coverage for on-site medical clinics or for dental or vision benefits, which are
             typically provided under a separate policy.  Coverage excludes health care expenses covered
             by accident or disability, workers' compensation, liability or automobile insurance."/>
        </concept>
        <concept>
          <code value="FLEXP"/>
          <abstract value="false"/>
          <display value="flexible benefit plan policy"/>
          <definition value="Definition:  An insurance policy that covers qualified benefits under a Flexible Benefit
             plan such as group medical insurance, long and short term disability income insurance,
             group term life insurance for employees only up to $50,000 face amount, specified disease
             coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance,
             accidental death and dismemberment insurance, a medical expense reimbursement plan and
             a dependent care reimbursement plan.                                                 
                  Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as
             a benefit plan that allows employees to choose from several life, health, disability,
             dental, and other insurance plans according to their individual needs. Also known as cafeteria
             plans.  Authorized under Section 125 of the Revenue Act of 1978."/>
        </concept>
        <concept>
          <code value="LIFE"/>
          <abstract value="false"/>
          <display value="life insurance policy"/>
          <definition value="Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence
             of the covered partys death. In return, the policyholder agrees to pay a stipulated amount
             called a premium at regular intervals.  Life insurance indemnifies the beneficiary for
             the loss of the insurable interest that a beneficiary has in the life of a covered party.
              For persons related by blood, a substantial interest established through love and affection,
             and for all other persons, a lawful and substantial economic interest in having the life
             of the insured continue. An insurable interest is required when purchasing life insurance
             on another person. Specific exclusions are often written into the contract to limit the
             liability of the insurer; for example claims resulting from suicide or relating to war,
             riot and civil commotion.                                                      Discussion:A
             life insurance policy may be used by the covered party as a source of health care coverage
             in the case of  a viatical settlement, which is the sale of a life insurance policy by
             the policy owner, before the policy matures. Such a sale, at a price discounted from the
             face amount of the policy but usually in excess of the premiums paid or current cash surrender
             value, provides the seller an immediate cash settlement. Generally, viatical settlements
             involve insured individuals with a life expectancy of less than two years. In countries
             without state-subsidized healthcare and high healthcare costs (e.g. United States), this
             is a practical way to pay extremely high health insurance premiums that severely ill people
             face. Some people are also familiar with life settlements, which are similar transactions
             but involve insureds with longer life expectancies (two to fifteen years)."/>
          <concept>
            <code value="ANNU"/>
            <abstract value="false"/>
            <display value="annuity policy"/>
            <definition value="Definition: A policy that, after an initial premium or premiums, pays out a sum at pre-determined
               intervals.                          For example, a policy holder may pay $10,000, and
               in return receive $150 each month until he dies; or $1,000 for each of 14 years or death
               benefits if he dies before the full term of the annuity has elapsed."/>
          </concept>
          <concept>
            <code value="TLIFE"/>
            <abstract value="false"/>
            <display value="term life insurance policy"/>
            <definition value="Definition: Life insurance under which the benefit is payable only if the insured dies
               during a specified period. If an insured dies during that period, the beneficiary receives
               the death payments. If the insured survives, the policy ends and the beneficiary receives
               nothing."/>
          </concept>
          <concept>
            <code value="ULIFE"/>
            <abstract value="false"/>
            <display value="universal life insurance policy"/>
            <definition value="Definition: Life insurance under which the benefit is payable upon the insuredaTMs death
               or diagnosis of a terminal illness.  If an insured dies during that period, the beneficiary
               receives the death payments. If the insured survives, the policy ends and the beneficiary
               receives nothing"/>
          </concept>
        </concept>
        <concept>
          <code value="PNC"/>
          <abstract value="false"/>
          <display value="property and casualty insurance policy"/>
          <definition value="Definition: A type of insurance that covers damage to or loss of the policyholderaTMs
             property by providing payments for damages to property damage or the injury or death of
             living subjects.  The terms &quot;casualty&quot; and &quot;liability&quot; insurance are
             often used interchangeably. Both cover the policyholder's legal liability for damages
             caused to other persons and/or their property."/>
        </concept>
        <concept>
          <code value="REI"/>
          <abstract value="false"/>
          <display value="reinsurance policy"/>
          <definition value="Definition: An agreement between two or more insurance companies by which the risk of
             loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss
             under a single policy does not fall on one insurance company. Acceptance by an insurer,
             called a reinsurer, of all or part of the risk of loss of another insurance company. 
                                                                 Discussion: Reinsurance is a means
             by which an insurance company can protect itself against the risk of losses with other
             insurance companies. Individuals and corporations obtain insurance policies to provide
             protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness
             and death, etc.). Reinsurers, in turn, provide insurance to insurance companies.     
                                 For example, an HMO may purchase a reinsurance policy to protect itself
             from losing too much money from one insured's particularly expensive health care costs.
             An insurance company issuing an automobile liability policy, with a limit of $100,000
             per accident may reinsure its liability in excess of $10,000. A fire insurance company
             which issues a large policy generally reinsures a portion of the risk with one or several
             other companies. Also called risk control insurance or stop-loss insurance."/>
        </concept>
        <concept>
          <code value="SURPL"/>
          <abstract value="false"/>
          <display value="surplus line insurance policy"/>
          <definition value="Definition:                                                                          
                                                 A risk or part of a risk for which there is no normal
             insurance market available.                                                          
                                          Insurance written by unauthorized insurance companies. Surplus
             lines insurance is insurance placed with unauthorized insurance companies through licensed
             surplus lines agents or brokers."/>
        </concept>
        <concept>
          <code value="UMBRL"/>
          <abstract value="false"/>
          <display value="umbrella liability insurance policy"/>
          <definition value="Definition: A form of insurance protection that provides additional liability coverage
             after the limits of your underlying policy are reached. An umbrella liability policy also
             protects you (the insured) in many situations not covered by the usual liability policies."/>
        </concept>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="PUBLICPOL"/>
        </modifierExtension>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="WCBPOL"/>
        </modifierExtension>
        <code value="_ActProgramTypeCode"/>
        <abstract value="true"/>
        <display value="ActProgramTypeCode"/>
        <definition value="Definition: A set of codes used to indicate coverage under a program.  A program is an
           organized structure for administering and funding coverage of a benefit package for covered
           parties meeting eligibility criteria, typically related to employment, health, financial,
           and demographic status. Programs are typically established or permitted by legislation
           with provisions for ongoing government oversight.  Regulations may mandate the structure
           of the program, the manner in which it is funded and administered, covered benefits, provider
           types, eligibility criteria and financial participation. A government agency may be charged
           with implementing the program in accordance to the regulation.  Risk of loss under a program
           in most cases would not meet what an underwriter would consider an insurable risk, i.e.,
           the risk is not random in nature, not financially measurable, and likely requires subsidization
           with government funds.                                                      Discussion:
           Programs do not have policy holders or subscribers.  Program eligibles are enrolled based
           on health status, statutory eligibility, financial status, or age.  Program eligibles
           who are covered parties under the program may be referred to as members, beneficiaries,
           eligibles, or recipients.  Programs risk are underwritten by not for profit organizations
           such as governmental entities, and the beneficiaries typically do not pay for any or some
           portion of the cost of coverage.  See CoveredPartyRoleType."/>
        <concept>
          <code value="CHAR"/>
          <abstract value="false"/>
          <display value="charity program"/>
          <definition value="Definition: A program that covers the cost of services provided directly to a beneficiary
             who typically has no other source of coverage without charge."/>
        </concept>
        <concept>
          <code value="CRIME"/>
          <abstract value="false"/>
          <display value="crime victim program"/>
          <definition value="Definition: A program that covers the cost of services provided to crime victims for injuries
             or losses related to the occurrence of a crime."/>
        </concept>
        <concept>
          <code value="EAP"/>
          <abstract value="false"/>
          <display value="employee assistance program"/>
          <definition value="Definition: An employee assistance program is run by an employer or employee organization
             for the purpose of providing benefits and covering all or part of the cost for employees
             to receive counseling, referrals, and advice in dealing with stressful issues in their
             lives. These may include substance abuse, bereavement, marital problems, weight issues,
             or general wellness issues.  The services are usually provided by a third-party, rather
             than the company itself, and the company receives only summary statistical data from the
             service provider. Employee's names and services received are kept confidential."/>
        </concept>
        <concept>
          <code value="GOVEMP"/>
          <abstract value="false"/>
          <display value="government employee health program"/>
          <definition value="Definition: A set of codes used to indicate a government program that is an organized
             structure for administering and funding coverage of a benefit package for covered parties
             meeting eligibility criteria, typically related to employment, health and financial status.
             Government programs are established or permitted by legislation with provisions for ongoing
             government oversight.  Regulation mandates the structure of the program, the manner in
             which it is funded and administered, covered benefits, provider types, eligibility criteria
             and financial participation. A government agency is charged with implementing the program
             in accordance to the regulation                                                      Example:
             Federal employee health benefit program in the U.S."/>
        </concept>
        <concept>
          <code value="HIRISK"/>
          <abstract value="false"/>
          <display value="high risk pool program"/>
          <definition value="Definition: A government program that provides health coverage to individuals who are
             considered medically uninsurable or high risk, and who have been denied health insurance
             due to a serious health condition. In certain cases, it also applies to those who have
             been quoted very high premiums a&quot; again, due to a serious health condition.  The
             pool charges premiums for coverage.  Because the pool covers high-risk people, it incurs
             a higher level of claims than premiums can cover. The insurance industry pays into the
             pool to make up the difference and help it remain viable."/>
        </concept>
        <concept>
          <code value="IND"/>
          <abstract value="false"/>
          <display value="indigenous peoples health program"/>
          <definition value="Definition: Services provided directly and through contracted and operated indigenous
             peoples health programs.                                                      Example:
             Indian Health Service in the U.S."/>
        </concept>
        <concept>
          <code value="MILITARY"/>
          <abstract value="false"/>
          <display value="military health program"/>
          <definition value="Definition: A government program that provides coverage for health services to military
             personnel, retirees, and dependents.  A covered party who is a subscriber can choose from
             among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or
             Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations.
                                                                  Example: In the U.S., TRICARE, CHAMPUS."/>
        </concept>
        <concept>
          <code value="RETIRE"/>
          <abstract value="false"/>
          <display value="retiree health program"/>
          <definition value="Definition: A government mandated program with specific eligibility requirements based
             on premium contributions made during employment, length of employment, age, and employment
             status, e.g., being retired, disabled, or a dependent of a covered party under this program.
               Benefits typically include ambulatory, inpatient, and long-term care, such as hospice
             care, home health care and respite care."/>
        </concept>
        <concept>
          <code value="SOCIAL"/>
          <abstract value="false"/>
          <display value="social service program"/>
          <definition value="Definition: A social service program funded by a public or governmental entity.      
                                                            Example: Programs providing habilitation,
             food, lodging, medicine, transportation, equipment, devices, products, education, training,
             counseling, alteration of living or work space, and other resources to persons meeting
             eligibility criteria."/>
        </concept>
        <concept>
          <code value="VET"/>
          <abstract value="false"/>
          <display value="veteran health program"/>
          <definition value="Definition: Services provided directly and through contracted and operated veteran health
             programs."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActDetectedIssueManagementCode"/>
      <abstract value="true"/>
      <display value="ActDetectedIssueManagementCode"/>
      <definition value="Codes dealing with the management of Detected Issue observations"/>
      <concept>
        <code value="_ActAdministrativeDetectedIssueManagementCode"/>
        <abstract value="true"/>
        <display value="ActAdministrativeDetectedIssueManagementCode"/>
        <definition value="Codes dealing with the management of Detected Issue observations for the administrative
           and patient administrative acts domains."/>
        <concept>
          <code value="_AuthorizationIssueManagementCode"/>
          <abstract value="true"/>
          <display value="Authorization Issue Management Code"/>
          <concept>
            <code value="EMAUTH"/>
            <abstract value="false"/>
            <display value="emergency authorization override"/>
            <definition value="Used to temporarily override normal authorization rules to gain access to data in a case
               of emergency. Use of this override code will typically be monitored, and a procedure to
               verify its proper use may be triggered when used."/>
            <concept>
              <code value="21"/>
              <abstract value="false"/>
              <display value="authorization confirmed"/>
              <definition value="Description: Indicates that the permissions have been externally verified and the request
                 should be processed."/>
            </concept>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="1"/>
        <abstract value="false"/>
        <display value="Therapy Appropriate"/>
        <definition value="Confirmed drug therapy appropriate"/>
        <concept>
          <code value="19"/>
          <abstract value="false"/>
          <display value="Consulted Supplier"/>
          <definition value="Consulted other supplier/pharmacy, therapy confirmed"/>
        </concept>
        <concept>
          <code value="2"/>
          <abstract value="false"/>
          <display value="Assessed Patient"/>
          <definition value="Assessed patient, therapy is appropriate"/>
        </concept>
        <concept>
          <code value="22"/>
          <abstract value="false"/>
          <display value="appropriate indication or diagnosis"/>
          <definition value="Description: The patient has the appropriate indication or diagnosis for the action to
             be taken."/>
        </concept>
        <concept>
          <code value="23"/>
          <abstract value="false"/>
          <display value="prior therapy documented"/>
          <definition value="Description: It has been confirmed that the appropriate pre-requisite therapy has been
             tried."/>
        </concept>
        <concept>
          <code value="3"/>
          <abstract value="false"/>
          <display value="Patient Explanation"/>
          <definition value="Patient gave adequate explanation"/>
        </concept>
        <concept>
          <code value="4"/>
          <abstract value="false"/>
          <display value="Consulted Other Source"/>
          <definition value="Consulted other supply source, therapy still appropriate"/>
        </concept>
        <concept>
          <code value="5"/>
          <abstract value="false"/>
          <display value="Consulted Prescriber"/>
          <definition value="Consulted prescriber, therapy confirmed"/>
          <concept>
            <code value="6"/>
            <abstract value="false"/>
            <display value="Prescriber Declined Change"/>
            <definition value="Consulted prescriber and recommended change, prescriber declined"/>
          </concept>
        </concept>
        <concept>
          <code value="7"/>
          <abstract value="false"/>
          <display value="Interacting Therapy No Longer Active/Planned"/>
          <definition value="Concurrent therapy triggering alert is no longer on-going or planned"/>
        </concept>
      </concept>
      <concept>
        <code value="14"/>
        <abstract value="false"/>
        <display value="Supply Appropriate"/>
        <definition value="Confirmed supply action appropriate"/>
        <concept>
          <code value="15"/>
          <abstract value="false"/>
          <display value="Replacement"/>
          <definition value="Patient's existing supply was lost/wasted"/>
        </concept>
        <concept>
          <code value="16"/>
          <abstract value="false"/>
          <display value="Vacation Supply"/>
          <definition value="Supply date is due to patient vacation"/>
        </concept>
        <concept>
          <code value="17"/>
          <abstract value="false"/>
          <display value="Weekend Supply"/>
          <definition value="Supply date is intended to carry patient over weekend"/>
        </concept>
        <concept>
          <code value="18"/>
          <abstract value="false"/>
          <display value="Leave of Absence"/>
          <definition value="Supply is intended for use during a leave of absence from an institution."/>
        </concept>
        <concept>
          <code value="20"/>
          <abstract value="false"/>
          <display value="additional quantity on separate dispense"/>
          <definition value="Description: Supply is different than expected as an additional quantity has been supplied
             in a separate dispense."/>
        </concept>
      </concept>
      <concept>
        <code value="8"/>
        <abstract value="false"/>
        <display value="Other Action Taken"/>
        <definition value="Order is performed as issued, but other action taken to mitigate potential adverse effects"/>
        <concept>
          <code value="10"/>
          <abstract value="false"/>
          <display value="Provided Patient Education"/>
          <definition value="Provided education or training to the patient on appropriate therapy use"/>
        </concept>
        <concept>
          <code value="11"/>
          <abstract value="false"/>
          <display value="Added Concurrent Therapy"/>
          <definition value="Instituted an additional therapy to mitigate potential negative effects"/>
        </concept>
        <concept>
          <code value="12"/>
          <abstract value="false"/>
          <display value="Temporarily Suspended Concurrent Therapy"/>
          <definition value="Suspended existing therapy that triggered interaction for the duration of this therapy"/>
        </concept>
        <concept>
          <code value="13"/>
          <abstract value="false"/>
          <display value="Stopped Concurrent Therapy"/>
          <definition value="Aborted existing therapy that triggered interaction."/>
        </concept>
        <concept>
          <code value="9"/>
          <abstract value="false"/>
          <display value="Instituted Ongoing Monitoring Program"/>
          <definition value="Arranged to monitor patient for adverse effects"/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActExposureCode"/>
      <abstract value="true"/>
      <display value="ActExposureCode"/>
      <definition value="Concepts that identify the type or nature of exposure interaction.  Examples include &quot;household
        &quot;, &quot;care giver&quot;, &quot;intimate partner&quot;, &quot;common space&quot;,
         &quot;common substance&quot;, etc. to further describe the nature of interaction."/>
      <concept>
        <code value="CHLDCARE"/>
        <abstract value="false"/>
        <display value="Day care - Child care Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred in a child care setting"/>
      </concept>
      <concept>
        <code value="CONVEYNC"/>
        <abstract value="false"/>
        <display value="Common Conveyance Interaction"/>
        <definition value="Description: An interaction where the exposure participants traveled in/on the same vehicle
           (not necessarily concurrently, e.g. both are passengers of the same plane, but on different
           flights of that plane)."/>
      </concept>
      <concept>
        <code value="HLTHCARE"/>
        <abstract value="false"/>
        <display value="Health Care Interaction - Not Patient Care"/>
        <definition value="Description: Exposure participants' interaction occurred during the course of health care
           delivery or in a health care delivery setting, but did not involve the direct provision
           of care (e.g. a janitor cleaning a patient's hospital room)."/>
      </concept>
      <concept>
        <code value="HOMECARE"/>
        <abstract value="false"/>
        <display value="Care Giver Interaction"/>
        <definition value="Description: Exposure interaction occurred in context of one providing care for the other,
           i.e. a babysitter providing care for a child, a home-care aide providing assistance to
           a paraplegic."/>
      </concept>
      <concept>
        <code value="HOSPPTNT"/>
        <abstract value="false"/>
        <display value="Hospital Patient Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred when both were patients being
           treated in the same (acute) health care delivery facility."/>
      </concept>
      <concept>
        <code value="HOSPVSTR"/>
        <abstract value="false"/>
        <display value="Hospital Visitor Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred when one visited the other who
           was a patient being treated in a health care delivery facility."/>
      </concept>
      <concept>
        <code value="HOUSEHLD"/>
        <abstract value="false"/>
        <display value="Household Interaction"/>
        <definition value="Description: Exposure interaction occurred in context of domestic interaction, i.e. both
           participants reside in the same household."/>
      </concept>
      <concept>
        <code value="INMATE"/>
        <abstract value="false"/>
        <display value="Inmate Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred in the course of one or both
           participants being incarcerated at a correctional facility"/>
      </concept>
      <concept>
        <code value="INTIMATE"/>
        <abstract value="false"/>
        <display value="Intimate Interaction"/>
        <definition value="Description: Exposure interaction was intimate, i.e. participants are intimate companions
           (e.g. spouses, domestic partners)."/>
      </concept>
      <concept>
        <code value="LTRMCARE"/>
        <abstract value="false"/>
        <display value="Long Term Care Facility Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred in the course of one or both
           participants being resident at a long term care facility (second participant may be a
           visitor, worker, resident or a physical place or object within the facility)."/>
      </concept>
      <concept>
        <code value="PLACE"/>
        <abstract value="false"/>
        <display value="Common Space Interaction"/>
        <definition value="Description: An interaction where the exposure participants were both present in the same
           location/place/space."/>
      </concept>
      <concept>
        <code value="PTNTCARE"/>
        <abstract value="false"/>
        <display value="Health Care Interaction - Patient Care"/>
        <definition value="Description: Exposure participants' interaction occurred during the course of  health
           care delivery by a provider (e.g. a physician treating a patient in her office)."/>
      </concept>
      <concept>
        <code value="SCHOOL2"/>
        <abstract value="false"/>
        <display value="School Interaction"/>
        <definition value="Description: Exposure participants' interaction occurred in an academic setting (e.g.,
           participants are fellow students, or student and teacher)."/>
      </concept>
      <concept>
        <code value="SOCIAL2"/>
        <abstract value="false"/>
        <display value="Social/Extended Family Interaction"/>
        <definition value="Description: An interaction where the exposure participants are social associates or members
           of the same extended family"/>
      </concept>
      <concept>
        <code value="SUBSTNCE"/>
        <abstract value="false"/>
        <display value="Common Substance Interaction"/>
        <definition value="Description: An interaction where the exposure participants shared or co-used a common
           substance (e.g. drugs, needles, or common food item)."/>
      </concept>
      <concept>
        <code value="TRAVINT"/>
        <abstract value="false"/>
        <display value="Common Travel Interaction"/>
        <definition value="Description: An interaction where the exposure participants traveled together in/on the
           same vehicle/trip (e.g. concurrent co-passengers)."/>
      </concept>
      <concept>
        <code value="WORK2"/>
        <abstract value="false"/>
        <display value="Work Interaction"/>
        <definition value="Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActFinancialTransactionCode"/>
      <abstract value="true"/>
      <display value="ActFinancialTransactionCode"/>
      <concept>
        <code value="CHRG"/>
        <abstract value="false"/>
        <display value="Standard Charge"/>
        <definition value="A type of transaction that represents a charge for a service or product.  Expressed in
           monetary terms."/>
      </concept>
      <concept>
        <code value="REV"/>
        <abstract value="false"/>
        <display value="Standard Charge Reversal"/>
        <definition value="A type of transaction that represents a reversal of a previous charge for a service or
           product. Expressed in monetary terms.  It has the opposite effect of a standard charge."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActIncidentCode"/>
      <abstract value="true"/>
      <display value="ActIncidentCode"/>
      <definition value="Set of codes indicating the type of incident or accident."/>
      <concept>
        <code value="MVA"/>
        <abstract value="false"/>
        <display value="Motor vehicle accident"/>
        <definition value="Incident or accident as the result of a motor vehicle accident"/>
      </concept>
      <concept>
        <code value="SCHOOL"/>
        <abstract value="false"/>
        <display value="School Accident"/>
        <definition value="Incident or accident is the result of a school place accident."/>
      </concept>
      <concept>
        <code value="SPT"/>
        <abstract value="false"/>
        <display value="Sporting Accident"/>
        <definition value="Incident or accident is the result of a sporting accident."/>
      </concept>
      <concept>
        <code value="WPA"/>
        <abstract value="false"/>
        <display value="Workplace accident"/>
        <definition value="Incident or accident is the result of a work place accident"/>
      </concept>
    </concept>
    <concept>
      <code value="_ActInformationAccessCode"/>
      <abstract value="true"/>
      <display value="ActInformationAccessCode"/>
      <definition value="Description: The type of health information to which the subject of the information or
         the subject's delegate consents or dissents."/>
      <concept>
        <code value="ACADR"/>
        <abstract value="false"/>
        <display value="adverse drug reaction access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access adverse drug reaction
           information for a patient."/>
      </concept>
      <concept>
        <code value="ACALL"/>
        <abstract value="false"/>
        <display value="all access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access all information for
           a patient."/>
      </concept>
      <concept>
        <code value="ACALLG"/>
        <abstract value="false"/>
        <display value="allergy access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access allergy information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACCONS"/>
        <abstract value="false"/>
        <display value="informational consent access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access informational consent
           information for a patient."/>
      </concept>
      <concept>
        <code value="ACDEMO"/>
        <abstract value="false"/>
        <display value="demographics access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access demographics information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACDI"/>
        <abstract value="false"/>
        <display value="diagnostic imaging access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access diagnostic imaging information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACIMMUN"/>
        <abstract value="false"/>
        <display value="immunization access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access immunization information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACLAB"/>
        <abstract value="false"/>
        <display value="lab test result access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access lab test result information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACMED"/>
        <abstract value="false"/>
        <display value="medication access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access medical condition information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACMEDC"/>
        <abstract value="false"/>
        <display value="medical condition access"/>
        <definition value="Definition: Provide consent to view or access medical condition information for a patient."/>
      </concept>
      <concept>
        <code value="ACMEN"/>
        <abstract value="false"/>
        <display value="mental health access"/>
        <definition value="Description:Provide consent to collect, use, disclose, or access mental health information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACOBS"/>
        <abstract value="false"/>
        <display value="common observations access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access common observation information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACPOLPRG"/>
        <abstract value="false"/>
        <display value="policy or program information access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access coverage policy or program
           for a patient."/>
      </concept>
      <concept>
        <code value="ACPROV"/>
        <abstract value="false"/>
        <display value="provider information access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access provider information
           for a patient."/>
      </concept>
      <concept>
        <code value="ACPSERV"/>
        <abstract value="false"/>
        <display value="professional service access"/>
        <definition value="Description: Provide consent to collect, use, disclose, or access professional service
           information for a patient."/>
      </concept>
      <concept>
        <code value="ACSUBSTAB"/>
        <abstract value="false"/>
        <display value="substance abuse access"/>
        <definition value="Description:Provide consent to collect, use, disclose, or access substance abuse information
           for a patient."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActInformationAccessContextCode"/>
      <abstract value="true"/>
      <display value="ActInformationAccessContextCode"/>
      <definition value="Concepts conveying the context in which consent to transfer specified patient health information
         for collection, access, use or disclosure applies."/>
      <concept>
        <code value="INFAUT"/>
        <abstract value="false"/>
        <display value="authorized information transfer"/>
        <definition value="Description: Information transfer in accordance with subjectaTMs consent directive."/>
      </concept>
      <concept>
        <code value="INFCON"/>
        <abstract value="false"/>
        <display value="after explicit consent"/>
        <definition value="Consent to collect, access, use, or disclose specified patient health information only
           after explicit consent."/>
      </concept>
      <concept>
        <code value="INFCRT"/>
        <abstract value="false"/>
        <display value="only on court order"/>
        <definition value="Description: Information transfer in accordance with judicial system protocol."/>
      </concept>
      <concept>
        <code value="INFDNG"/>
        <abstract value="false"/>
        <display value="only if danger to others"/>
        <definition value="Consent to collect, access, use, or disclose specified patient health information only
           if necessary to avert potential danger to other persons."/>
      </concept>
      <concept>
        <code value="INFEMER"/>
        <abstract value="false"/>
        <display value="only in an emergency"/>
        <definition value="Description: Information transfer in accordance with emergency information transfer protocol."/>
      </concept>
      <concept>
        <code value="INFPWR"/>
        <abstract value="false"/>
        <display value="only if public welfare risk"/>
        <definition value="Consent to collect, access, use, or disclose specified patient health information only
           if necessary to avert potential public welfare risk."/>
      </concept>
      <concept>
        <code value="INFREG"/>
        <abstract value="false"/>
        <display value="regulatory information transfer"/>
        <definition value="Description: Information transfer in accordance with regulatory protocol, e.g., for public
           health, welfare, and safety."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActInformationCategoryCode"/>
      <abstract value="true"/>
      <display value="ActInformationCategoryCode"/>
      <definition value="Definition:Indicates the set of information types which may be manipulated or referenced,
         such as for recommending access restrictions."/>
      <concept>
        <code value="ALLCAT"/>
        <abstract value="false"/>
        <display value="all categories"/>
        <definition value="Description: All patient information."/>
      </concept>
      <concept>
        <code value="ALLGCAT"/>
        <abstract value="false"/>
        <display value="allergy category"/>
        <definition value="Definition:All information pertaining to a patient's allergy and intolerance records."/>
      </concept>
      <concept>
        <code value="ARCAT"/>
        <abstract value="false"/>
        <display value="adverse drug reaction category"/>
        <definition value="Description: All information pertaining to a patient's adverse drug reactions."/>
      </concept>
      <concept>
        <code value="COBSCAT"/>
        <abstract value="false"/>
        <display value="common observation category"/>
        <definition value="Definition:All information pertaining to a patient's common observation records (height,
           weight, blood pressure, temperature, etc.)."/>
      </concept>
      <concept>
        <code value="DEMOCAT"/>
        <abstract value="false"/>
        <display value="demographics category"/>
        <definition value="Definition:All information pertaining to a patient's demographics (such as name, date
           of birth, gender, address, etc)."/>
      </concept>
      <concept>
        <code value="DICAT"/>
        <abstract value="false"/>
        <display value="diagnostic image category"/>
        <definition value="Definition:All information pertaining to a patient's diagnostic image records (orders
           &amp; results)."/>
      </concept>
      <concept>
        <code value="IMMUCAT"/>
        <abstract value="false"/>
        <display value="immunization category"/>
        <definition value="Definition:All information pertaining to a patient's vaccination records."/>
      </concept>
      <concept>
        <code value="LABCAT"/>
        <abstract value="false"/>
        <display value="lab test category"/>
        <definition value="Description: All information pertaining to a patient's lab test records (orders &amp;
           results)"/>
      </concept>
      <concept>
        <code value="MEDCCAT"/>
        <abstract value="false"/>
        <display value="medical condition category"/>
        <definition value="Definition:All information pertaining to a patient's medical condition records."/>
      </concept>
      <concept>
        <code value="MENCAT"/>
        <abstract value="false"/>
        <display value="mental health category"/>
        <definition value="Description: All information pertaining to a patient's mental health records."/>
      </concept>
      <concept>
        <code value="PSVCCAT"/>
        <abstract value="false"/>
        <display value="professional service category"/>
        <definition value="Definition:All information pertaining to a patient's professional service records (such
           as smoking cessation, counseling, medication review, mental health)."/>
      </concept>
      <concept>
        <code value="RXCAT"/>
        <abstract value="false"/>
        <display value="medication category"/>
        <definition value="Definition:All information pertaining to a patient's medication records (orders, dispenses
           and other active medications)."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActInvoiceElementCode"/>
      <abstract value="true"/>
      <display value="ActInvoiceElementCode"/>
      <definition value="Type of invoice element that is used to assist in describing an Invoice that is either
         submitted for adjudication or for which is returned on adjudication results."/>
      <concept>
        <code value="_ActInvoiceAdjudicationPaymentCode"/>
        <abstract value="true"/>
        <display value="ActInvoiceAdjudicationPaymentCode"/>
        <definition value="Codes representing a grouping of invoice elements (totals, sub-totals), reported through
           a Payment Advice or a Statement of Financial Activity (SOFA).  The code can represent
           summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment
           and transaction fees."/>
        <concept>
          <code value="_ActInvoiceAdjudicationPaymentGroupCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceAdjudicationPaymentGroupCode"/>
          <definition value="Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee,
             etc."/>
          <concept>
            <code value="ALEC"/>
            <abstract value="false"/>
            <display value="alternate electronic"/>
            <definition value="Payment initiated by the payor as the result of adjudicating a submitted invoice that
               arrived to the payor from an electronic source that did not provide a conformant set of
               HL7 messages (e.g. web claim submission)."/>
          </concept>
          <concept>
            <code value="BONUS"/>
            <abstract value="false"/>
            <display value="bonus"/>
            <definition value="Bonus payments based on performance, volume, etc. as agreed to by the payor."/>
          </concept>
          <concept>
            <code value="CFWD"/>
            <abstract value="false"/>
            <display value="carry forward adjusment"/>
            <definition value="An amount still owing to the payor but the payment is 0$ and this cannot be settled until
               a future payment is made."/>
          </concept>
          <concept>
            <code value="EDU"/>
            <abstract value="false"/>
            <display value="education fees"/>
            <definition value="Fees deducted on behalf of a payee for tuition and continuing education."/>
          </concept>
          <concept>
            <code value="EPYMT"/>
            <abstract value="false"/>
            <display value="early payment fee"/>
            <definition value="Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e.
               next day versus biweekly payments."/>
          </concept>
          <concept>
            <code value="GARN"/>
            <abstract value="false"/>
            <display value="garnishee"/>
            <definition value="Fees deducted on behalf of a payee for charges based on a per-transaction or time-period
               (e.g. monthly) fee."/>
          </concept>
          <concept>
            <code value="INVOICE"/>
            <abstract value="false"/>
            <display value="submitted invoice"/>
            <definition value="Payment is based on a payment intent for a previously submitted Invoice, based on formal
               adjudication results.."/>
          </concept>
          <concept>
            <code value="PINV"/>
            <abstract value="false"/>
            <display value="paper invoice"/>
            <definition value="Payment initiated by the payor as the result of adjudicating a paper (original, may have
               been faxed) invoice."/>
          </concept>
          <concept>
            <code value="PPRD"/>
            <abstract value="false"/>
            <display value="prior period adjustment"/>
            <definition value="An amount that was owed to the payor as indicated, by a carry forward adjusment, in a
               previous payment advice"/>
          </concept>
          <concept>
            <code value="PROA"/>
            <abstract value="false"/>
            <display value="professional association deduction"/>
            <definition value="Professional association fee that is collected by the payor from the practitioner/provider
               on behalf of the association"/>
          </concept>
          <concept>
            <code value="RECOV"/>
            <abstract value="false"/>
            <display value="recovery"/>
            <definition value="Retroactive adjustment such as fee rate adjustment due to contract negotiations."/>
          </concept>
          <concept>
            <code value="RETRO"/>
            <abstract value="false"/>
            <display value="retro adjustment"/>
            <definition value="Bonus payments based on performance, volume, etc. as agreed to by the payor."/>
          </concept>
          <concept>
            <code value="TRAN"/>
            <abstract value="false"/>
            <display value="transaction fee"/>
            <definition value="Fees deducted on behalf of a payee for charges based on a per-transaction or time-period
               (e.g. monthly) fee."/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="CONT"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="DAY"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="LOC"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="MONTH"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="PERIOD"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="PROV"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="WEEK"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="YEAR"/>
          </modifierExtension>
          <code value="_ActInvoiceAdjudicationPaymentSummaryCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceAdjudicationPaymentSummaryCode"/>
          <definition value="Codes representing a grouping of invoice elements (totals, sub-totals), reported through
             a Payment Advice or a Statement of Financial Activity (SOFA).  The code can represent
             summaries by day, location, payee, etc."/>
          <concept>
            <code value="INVTYPE"/>
            <abstract value="false"/>
            <display value="invoice type"/>
            <definition value="Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)"/>
          </concept>
          <concept>
            <code value="PAYEE"/>
            <abstract value="false"/>
            <display value="payee"/>
            <definition value="Transaction counts and value totals by each instance of an invoice payee."/>
          </concept>
          <concept>
            <code value="PAYOR"/>
            <abstract value="false"/>
            <display value="payor"/>
            <definition value="Transaction counts and value totals by each instance of an invoice payor."/>
          </concept>
          <concept>
            <code value="SENDAPP"/>
            <abstract value="false"/>
            <display value="sending application"/>
            <definition value="Transaction counts and value totals by each instance of a messaging application on a single
               processor. It is a registered identifier known to the receivers."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_ActInvoiceDetailCode"/>
        <abstract value="true"/>
        <display value="ActInvoiceDetailCode"/>
        <definition value="Codes representing a service or product that is being invoiced (billed).  The code can
           represent such concepts as &quot;office visit&quot;, &quot;drug X&quot;, &quot;wheelchair&quot;
           and other billable items such as taxes, service charges and discounts."/>
        <concept>
          <code value="_ActInvoiceDetailClinicalProductCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceDetailClinicalProductCode"/>
          <definition value="An identifying data string for healthcare products."/>
          <concept>
            <code value="UNSPSC"/>
            <abstract value="false"/>
            <display value="United Nations Standard Products and Services Classification"/>
            <definition value="Description:United Nations Standard Products and Services Classification, managed by Uniform
               Code Council (UCC): www.unspsc.org"/>
          </concept>
        </concept>
        <concept>
          <code value="_ActInvoiceDetailDrugProductCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceDetailDrugProductCode"/>
          <definition value="An identifying data string for A substance used as a medication or in the preparation
             of medication."/>
          <concept>
            <code value="GTIN"/>
            <abstract value="false"/>
            <display value="Global Trade Item Number"/>
            <definition value="Description:Global Trade Item Number is an identifier for trade items developed by GS1
               (comprising the former EAN International and Uniform Code Council)."/>
          </concept>
          <concept>
            <code value="UPC"/>
            <abstract value="false"/>
            <display value="Universal Product Code"/>
            <definition value="Description:Universal Product Code is one of a wide variety of bar code languages widely
               used in the United States and Canada for items in stores."/>
          </concept>
        </concept>
        <concept>
          <code value="_ActInvoiceDetailGenericCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceDetailGenericCode"/>
          <definition value="The detail item codes to identify charges or changes to the total billing of a claim due
             to insurance rules and payments."/>
          <concept>
            <code value="_ActInvoiceDetailGenericAdjudicatorCode"/>
            <abstract value="true"/>
            <display value="ActInvoiceDetailGenericAdjudicatorCode"/>
            <definition value="The billable item codes to identify adjudicator specified components to the total billing
               of a claim."/>
            <concept>
              <code value="COIN"/>
              <abstract value="false"/>
              <display value="coinsurance"/>
              <definition value="That portion of the eligible charges which a covered party must pay for each service and/or
                 product. It is a percentage of the eligible amount for the service/product that is typically
                 charged after the covered party has met the policy deductible.  This amount represents
                 the covered party's coinsurance that is applied to a particular adjudication result. It
                 is expressed as a negative dollar amount in adjudication results."/>
            </concept>
            <concept>
              <code value="COPAYMENT"/>
              <abstract value="false"/>
              <display value="patient co-pay"/>
              <definition value="That portion of the eligible charges which a covered party must pay for each service and/or
                 product. It is a defined amount per service/product of the eligible amount for the service/product.
                 This amount represents the covered party's copayment that is applied to a particular adjudication
                 result. It is expressed as a negative dollar amount in adjudication results."/>
            </concept>
            <concept>
              <code value="DEDUCTIBLE"/>
              <abstract value="false"/>
              <display value="deductible"/>
              <definition value="That portion of the eligible charges which a covered party must pay in a particular period
                 (e.g. annual) before the benefits are payable by the adjudicator. This amount represents
                 the covered party's deductible that is applied to a particular adjudication result. It
                 is expressed as a negative dollar amount in adjudication results."/>
            </concept>
            <concept>
              <code value="PAY"/>
              <abstract value="false"/>
              <display value="payment"/>
              <definition value="The guarantor, who may be the patient, pays the entire charge for a service. Reasons for
                 such action may include: there is no insurance coverage for the service (e.g. cosmetic
                 surgery); the patient wishes to self-pay for the service; or the insurer denies payment
                 for the service due to contractual provisions such as the need for prior authorization."/>
            </concept>
            <concept>
              <code value="SPEND"/>
              <abstract value="false"/>
              <display value="spend down"/>
              <definition value="That total amount of the eligible charges which a covered party must periodically pay
                 for services and/or products prior to the Medicaid program providing any coverage. This
                 amount represents the covered party's spend down that is applied to a particular adjudication
                 result. It is expressed as a negative dollar amount in adjudication results"/>
            </concept>
          </concept>
          <concept>
            <code value="_ActInvoiceDetailGenericModifierCode"/>
            <abstract value="true"/>
            <display value="ActInvoiceDetailGenericModifierCode"/>
            <definition value="The billable item codes to identify modifications to a billable item charge. As for example
               after hours increase in the office visit fee."/>
            <concept>
              <code value="AFTHRS"/>
              <abstract value="false"/>
              <display value="non-normal hours"/>
              <definition value="Premium paid on service fees in compensation for practicing outside of normal working
                 hours."/>
            </concept>
            <concept>
              <code value="ISOL"/>
              <abstract value="false"/>
              <display value="isolation allowance"/>
              <definition value="Premium paid on service fees in compensation for practicing in a remote location."/>
            </concept>
            <concept>
              <code value="OOO"/>
              <abstract value="false"/>
              <display value="out of office"/>
              <definition value="Premium paid on service fees in compensation for practicing at a location other than normal
                 working location."/>
            </concept>
          </concept>
          <concept>
            <code value="_ActInvoiceDetailGenericProviderCode"/>
            <abstract value="true"/>
            <display value="ActInvoiceDetailGenericProviderCode"/>
            <definition value="The billable item codes to identify provider supplied charges or changes to the total
               billing of a claim."/>
            <concept>
              <code value="CANCAPT"/>
              <abstract value="false"/>
              <display value="cancelled appointment"/>
              <definition value="A charge to compensate the provider when a patient cancels an appointment with insufficient
                 time for the provider to make another appointment with another patient."/>
            </concept>
            <concept>
              <code value="DSC"/>
              <abstract value="false"/>
              <display value="discount"/>
              <definition value="A reduction in the amount charged as a percentage of the amount. For example a 5% discount
                 for volume purchase."/>
            </concept>
            <concept>
              <code value="ESA"/>
              <abstract value="false"/>
              <display value="extraordinary service assessment"/>
              <definition value="A premium on a service fee is requested because, due to extenuating circumstances, the
                 service took an extraordinary amount of time or supplies."/>
            </concept>
            <concept>
              <code value="FFSTOP"/>
              <abstract value="false"/>
              <display value="fee for service top off"/>
              <definition value="Under agreement between the parties (payor and provider), a guaranteed level of income
                 is established for the provider over a specific, pre-determined period of time. The normal
                 course of business for the provider is submission of fee-for-service claims. Should the
                 fee-for-service income during the specified period of time be less than the agreed to
                 amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service
                 total and the guaranteed income amount for that period of time. The details of the agreement
                 may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service
                 income exceeds the guaranteed amount."/>
            </concept>
            <concept>
              <code value="FNLFEE"/>
              <abstract value="false"/>
              <display value="final fee"/>
              <definition value="Anticipated or actual final fee associated with treating a patient."/>
            </concept>
            <concept>
              <code value="FRSTFEE"/>
              <abstract value="false"/>
              <display value="first fee"/>
              <definition value="Anticipated or actual initial fee associated with treating a patient."/>
            </concept>
            <concept>
              <code value="MARKUP"/>
              <abstract value="false"/>
              <display value="markup or up-charge"/>
              <definition value="An increase in the amount charged as a percentage of the amount. For example, 12% markup
                 on product cost."/>
            </concept>
            <concept>
              <code value="MISSAPT"/>
              <abstract value="false"/>
              <display value="missed appointment"/>
              <definition value="A charge to compensate the provider when a patient does not show for an appointment."/>
            </concept>
            <concept>
              <code value="PERFEE"/>
              <abstract value="false"/>
              <display value="periodic fee"/>
              <definition value="Anticipated or actual periodic fee associated with treating a patient. For example, expected
                 billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly)
                 is specified in the unit quantity of the Invoice Element."/>
            </concept>
            <concept>
              <code value="PERMBNS"/>
              <abstract value="false"/>
              <display value="performance bonus"/>
              <definition value="The amount for a performance bonus that is being requested from a payor for the performance
                 of certain services (childhood immunizations, influenza immunizations, mammograms, pap
                 smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of
                 $2200/yr. An invoice is created at the end of the service period (one year) and a code
                 is submitted indicating the percentage achieved and the dollar amount claimed."/>
            </concept>
            <concept>
              <code value="RESTOCK"/>
              <abstract value="false"/>
              <display value="restocking fee"/>
              <definition value="A charge is requested because the patient failed to pick up the item and it took an amount
                 of time to return it to stock for future use."/>
            </concept>
            <concept>
              <code value="TRAVEL"/>
              <abstract value="false"/>
              <display value="travel"/>
              <definition value="A charge to cover the cost of travel time and/or cost in conjuction with providing a service
                 or product. It may be charged per kilometer or per hour based on the effective agreement."/>
            </concept>
            <concept>
              <code value="URGENT"/>
              <abstract value="false"/>
              <display value="urgent"/>
              <definition value="Premium paid on service fees in compensation for providing an expedited response to an
                 urgent situation."/>
            </concept>
          </concept>
          <concept>
            <code value="_ActInvoiceDetailTaxCode"/>
            <abstract value="true"/>
            <display value="ActInvoiceDetailTaxCode"/>
            <definition value="The billable item codes to identify modifications to a billable item charge by a tax factor
               applied to the amount. As for example 7% provincial sales tax."/>
            <concept>
              <code value="FST"/>
              <abstract value="false"/>
              <display value="federal sales tax"/>
              <definition value="Federal tax on transactions such as the Goods and Services Tax (GST)"/>
            </concept>
            <concept>
              <code value="HST"/>
              <abstract value="false"/>
              <display value="harmonized sales Tax"/>
              <definition value="Joint Federal/Provincial Sales Tax"/>
            </concept>
            <concept>
              <code value="PST"/>
              <abstract value="false"/>
              <display value="provincial/state sales tax"/>
              <definition value="Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax"/>
            </concept>
          </concept>
        </concept>
        <concept>
          <code value="_ActInvoiceDetailPreferredAccommodationCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceDetailPreferredAccommodationCode"/>
          <definition value="An identifying data string for medical facility accommodations."/>
          <concept>
            <code value="_ActEncounterAccommodationCode"/>
            <abstract value="true"/>
            <display value="ActEncounterAccommodationCode"/>
            <definition value="Accommodation type.  In Intent mood, represents the accommodation type requested.  In
               Event mood, represents accommodation assigned/used.  In Definition mood, represents the
               available accommodation type."/>
            <concept>
              <code value="_HL7AccommodationCode"/>
              <abstract value="true"/>
              <display value="HL7AccommodationCode"/>
              <definition value="Description:Accommodation type. In Intent mood, represents the accommodation type requested.
                 In Event mood, represents accommodation assigned/used. In Definition mood, represents
                 the available accommodation type."/>
              <concept>
                <code value="I"/>
                <abstract value="false"/>
                <display value="Isolation"/>
                <definition value="Accommodations used in the care of diseases that are transmitted through casual contact
                   or respiratory transmission."/>
              </concept>
              <concept>
                <code value="P"/>
                <abstract value="false"/>
                <display value="Private"/>
                <definition value="Accommodations in which there is only 1 bed."/>
              </concept>
              <concept>
                <code value="S"/>
                <abstract value="false"/>
                <display value="Suite"/>
                <definition value="Uniquely designed and elegantly decorated accommodations with many amenities available
                   for an additional charge."/>
              </concept>
              <concept>
                <code value="SP"/>
                <abstract value="false"/>
                <display value="Semi-private"/>
                <definition value="Accommodations in which there are 2 beds."/>
              </concept>
              <concept>
                <code value="W"/>
                <abstract value="false"/>
                <display value="Ward"/>
                <definition value="Accommodations in which there are 3 or more beds."/>
              </concept>
            </concept>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_ActInvoiceGroupCode"/>
        <abstract value="true"/>
        <display value="ActInvoiceGroupCode"/>
        <definition value="Type of invoice element that is used to assist in describing an Invoice that is either
           submitted for adjudication or for which is returned on adjudication results.         
                           Invoice elements of this type signify a grouping of one or more children
           (detail) invoice elements.  They do not have intrinsic costing associated with them, but
           merely reflect the sum of all costing for it's immediate children invoice elements."/>
        <concept>
          <code value="_ActInvoiceInterGroupCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceInterGroupCode"/>
          <definition value="Type of invoice element that is used to assist in describing an Invoice that is either
             submitted for adjudication or for which is returned on adjudication results.         
                             Invoice elements of this type signify a grouping of one or more children
             (detail) invoice elements.  They do not have intrinsic costing associated with them, but
             merely reflect the sum of all costing for it's immediate children invoice elements.  
                                    The domain is only specified for an intermediate invoice element
             group (non-root or non-top level) for an Invoice."/>
          <concept>
            <code value="CPNDDRGING"/>
            <abstract value="false"/>
            <display value="compound drug invoice group"/>
            <definition value="A grouping of invoice element groups and details including the ones specifying the compound
               ingredients being invoiced. It may also contain generic detail items such as markup."/>
          </concept>
          <concept>
            <code value="CPNDINDING"/>
            <abstract value="false"/>
            <display value="compound ingredient invoice group"/>
            <definition value="A grouping of invoice element details including the one specifying an ingredient drug
               being invoiced. It may also contain generic detail items such as tax or markup."/>
          </concept>
          <concept>
            <code value="CPNDSUPING"/>
            <abstract value="false"/>
            <display value="compound supply invoice group"/>
            <definition value="A grouping of invoice element groups and details including the ones specifying the compound
               supplies being invoiced. It may also contain generic detail items such as markup."/>
          </concept>
          <concept>
            <code value="DRUGING"/>
            <abstract value="false"/>
            <display value="drug invoice group"/>
            <definition value="A grouping of invoice element details including the one specifying the drug being invoiced.
               It may also contain generic detail items such as markup."/>
          </concept>
          <concept>
            <code value="FRAMEING"/>
            <abstract value="false"/>
            <display value="frame invoice group"/>
            <definition value="A grouping of invoice element details including the ones specifying the frame fee and
               the frame dispensing cost that are being invoiced."/>
          </concept>
          <concept>
            <code value="LENSING"/>
            <abstract value="false"/>
            <display value="lens invoice group"/>
            <definition value="A grouping of invoice element details including the ones specifying the lens fee and the
               lens dispensing cost that are being invoiced."/>
          </concept>
          <concept>
            <code value="PRDING"/>
            <abstract value="false"/>
            <display value="product invoice group"/>
            <definition value="A grouping of invoice element details including the one specifying the product (good or
               supply) being invoiced. It may also contain generic detail items such as tax or discount."/>
          </concept>
        </concept>
        <concept>
          <code value="_ActInvoiceRootGroupCode"/>
          <abstract value="true"/>
          <display value="ActInvoiceRootGroupCode"/>
          <definition value="Type of invoice element that is used to assist in describing an Invoice that is either
             submitted for adjudication or for which is returned on adjudication results.         
                             Invoice elements of this type signify a grouping of one or more children
             (detail) invoice elements.  They do not have intrinsic costing associated with them, but
             merely reflect the sum of all costing for it's immediate children invoice elements.  
                                    Codes from this domain reflect the type of Invoice such as Pharmacy
             Dispense, Clinical Service and Clinical Product.  The domain is only specified for the
             root (top level) invoice element group for an Invoice."/>
          <concept>
            <code value="CPINV"/>
            <abstract value="false"/>
            <display value="clinical product invoice"/>
            <definition value="Clinical product invoice where the Invoice Grouping contains one or more billable item
               and is supported by clinical product(s).                          For example, a crutch
               or a wheelchair."/>
          </concept>
          <concept>
            <code value="CSINV"/>
            <abstract value="false"/>
            <display value="clinical service invoice"/>
            <definition value="Clinical Services Invoice which can be used to describe a single service, multiple services
               or repeated services.                          [1] Single Clinical services invoice where
               the Invoice Grouping contains one billable item and is supported by one clinical service.
                                        For example, a single service for an office visit or simple clinical
               procedure (e.g. knee mobilization).                          [2] Multiple Clinical services
               invoice where the Invoice Grouping contains more than one billable item, supported by
               one or more clinical services.  The services can be distinct and over multiple dates,
               but for the same patient. This type of invoice includes a series of treatments which must
               be adjudicated together.                          For example, an adjustment and ultrasound
               for a chiropractic session where fees are associated for each of the services and adjudicated
               (invoiced) together.                          [3] Repeated Clinical services invoice where
               the Invoice Grouping contains one or more billable item, supported by the same clinical
               service repeated over a period of time.                          For example, the same
               Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over
               a period of time at the discretion of the provider (e.g. month)."/>
          </concept>
          <concept>
            <code value="CSPINV"/>
            <abstract value="false"/>
            <display value="clinical service and product"/>
            <definition value="A clinical Invoice Grouping consisting of one or more services and one or more product.
                Billing for these service(s) and product(s) are supported by multiple clinical billable
               events (acts).                          All items in the Invoice Grouping must be adjudicated
               together to be acceptable to the Adjudicator.                          For example , a
               brace (product) invoiced together with the fitting (service)."/>
          </concept>
          <concept>
            <code value="FININV"/>
            <abstract value="false"/>
            <display value="financial invoice"/>
            <definition value="Invoice Grouping without clinical justification.  These will not require identification
               of participants and associations from a clinical context such as patient and provider.
                                        Examples are interest charges and mileage."/>
          </concept>
          <concept>
            <code value="OHSINV"/>
            <abstract value="false"/>
            <display value="oral health service"/>
            <definition value="A clinical Invoice Grouping consisting of one or more oral health services. Billing for
               these service(s) are supported by multiple clinical billable events (acts).          
                              All items in the Invoice Grouping must be adjudicated together to be acceptable
               to the Adjudicator."/>
          </concept>
          <concept>
            <code value="PAINV"/>
            <abstract value="false"/>
            <display value="preferred accommodation invoice"/>
            <definition value="HealthCare facility preferred accommodation invoice."/>
          </concept>
          <concept>
            <code value="RXCINV"/>
            <abstract value="false"/>
            <display value="Rx compound invoice"/>
            <definition value="Pharmacy dispense invoice for a compound."/>
          </concept>
          <concept>
            <code value="RXDINV"/>
            <abstract value="false"/>
            <display value="Rx dispense invoice"/>
            <definition value="Pharmacy dispense invoice not involving a compound"/>
          </concept>
          <concept>
            <code value="SBFINV"/>
            <abstract value="false"/>
            <display value="sessional or block fee invoice"/>
            <definition value="Clinical services invoice where the Invoice Group contains one billable item for multiple
               clinical services in one or more sessions."/>
          </concept>
          <concept>
            <code value="VRXINV"/>
            <abstract value="false"/>
            <display value="vision dispense invoice"/>
            <definition value="Vision dispense invoice for up to 2 lens (left and right), frame and optional discount.
                Eye exams are invoiced as a clinical service invoice."/>
          </concept>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActInvoiceElementSummaryCode"/>
      <abstract value="true"/>
      <display value="ActInvoiceElementSummaryCode"/>
      <definition value="Identifies the different types of summary information that can be reported by queries
         dealing with Statement of Financial Activity (SOFA).  The summary information is generally
         used to help resolve balance discrepancies between providers and payors."/>
      <concept>
        <code value="_InvoiceElementAdjudicated"/>
        <abstract value="true"/>
        <display value="InvoiceElementAdjudicated"/>
        <definition value="Total counts and total net amounts adjudicated for all  Invoice Groupings that were adjudicated
           within a time period based on the adjudication date of the Invoice Grouping."/>
        <concept>
          <code value="ADNFPPELAT"/>
          <abstract value="false"/>
          <display value="adjud. nullified prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNFPPELCT"/>
          <abstract value="false"/>
          <display value="adjud. nullified prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNFPPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. nullified prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNFPPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. nullified prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNFSPELAT"/>
          <abstract value="false"/>
          <display value="adjud. nullified same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date), subsequently nullified
             in the specified period and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNFSPELCT"/>
          <abstract value="false"/>
          <display value="adjud. nullified same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date), subsequently nullified
             in the specified period and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNFSPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. nullified same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNFSPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. nullified same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date), subsequently cancelled
             in the specified period and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNPPPELAT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNPPPELCT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNPPPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNPPPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNPSPELAT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNPSPELCT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADNPSPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADNPSPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. non-payee payable same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that do not match a specified
             payee (e.g. pay patient) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADPPPPELAT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that match a specified
             payee (e.g. pay provider) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADPPPPELCT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that match a specified
             payee (e.g. pay provider) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADPPPPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable prior-period manual amout"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that match a specified
             payee (e.g. pay provider) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADPPPPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             prior to the specified time period (based on adjudication date) that match a specified
             payee (e.g. pay provider) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADPPSPELAT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that match a specified payee
             (e.g. pay provider) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADPPSPELCT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that match a specified payee
             (e.g. pay provider) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADPPSPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that match a specified payee
             (e.g. pay provider) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADPPSPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. payee payable same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as payable
             during the specified time period (based on adjudication date) that match a specified payee
             (e.g. pay provider) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADRFPPELAT"/>
          <abstract value="false"/>
          <display value="adjud. refused prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as refused
             prior to the specified time period (based on adjudication date) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADRFPPELCT"/>
          <abstract value="false"/>
          <display value="adjud. refused prior-period electronic count"/>
          <definition value="Identifies the  total number of all  Invoice Groupings that were adjudicated as refused
             prior to the specified time period (based on adjudication date) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADRFPPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. refused prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as refused
             prior to the specified time period (based on adjudication date) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADRFPPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. refused prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as refused
             prior to the specified time period (based on adjudication date) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADRFSPELAT"/>
          <abstract value="false"/>
          <display value="adjud. refused same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as refused
             during the specified time period (based on adjudication date) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADRFSPELCT"/>
          <abstract value="false"/>
          <display value="adjud. refused same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as refused
             during the specified time period (based on adjudication date) and submitted electronically."/>
        </concept>
        <concept>
          <code value="ADRFSPMNAT"/>
          <abstract value="false"/>
          <display value="adjud. refused same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were adjudicated as refused
             during the specified time period (based on adjudication date) and submitted manually."/>
        </concept>
        <concept>
          <code value="ADRFSPMNCT"/>
          <abstract value="false"/>
          <display value="adjud. refused same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were adjudicated as refused
             during the specified time period (based on adjudication date) and submitted manually."/>
        </concept>
      </concept>
      <concept>
        <code value="_InvoiceElementPaid"/>
        <abstract value="true"/>
        <display value="InvoiceElementPaid"/>
        <definition value="Total counts and total net amounts paid for all  Invoice Groupings that were paid within
           a time period based on the payment date."/>
        <concept>
          <code value="PDNFPPELAT"/>
          <abstract value="false"/>
          <display value="paid nullified prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date), subsequently nullified in the specified
             period and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNFPPELCT"/>
          <abstract value="false"/>
          <display value="paid nullified prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date), subsequently nullified in the specified period and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNFPPMNAT"/>
          <abstract value="false"/>
          <display value="paid nullified prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date), subsequently nullified in the specified
             period and submitted manually."/>
        </concept>
        <concept>
          <code value="PDNFPPMNCT"/>
          <abstract value="false"/>
          <display value="paid nullified prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date), subsequently nullified in the specified period and
             submitted manually."/>
        </concept>
        <concept>
          <code value="PDNFSPELAT"/>
          <abstract value="false"/>
          <display value="paid nullified same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date), subsequently nullified in the specified period and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNFSPELCT"/>
          <abstract value="false"/>
          <display value="paid nullified same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date), subsequently cancelled in the specified period and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNFSPMNAT"/>
          <abstract value="false"/>
          <display value="paid nullified same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date), subsequently nullified in the specified period and
             submitted manually."/>
        </concept>
        <concept>
          <code value="PDNFSPMNCT"/>
          <abstract value="false"/>
          <display value="paid nullified same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date), subsequently nullified in the specified period and
             submitted manually."/>
        </concept>
        <concept>
          <code value="PDNPPPELAT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date) that do not match a specified payee (e.g.
             pay patient) and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNPPPELCT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNPPPMNAT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date) that do not match a specified payee (e.g.
             pay patient) and submitted manually."/>
        </concept>
        <concept>
          <code value="PDNPPPMNCT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted manually."/>
        </concept>
        <concept>
          <code value="PDNPSPELAT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNPSPELCT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDNPSPMNAT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted manually."/>
        </concept>
        <concept>
          <code value="PDNPSPMNCT"/>
          <abstract value="false"/>
          <display value="paid non-payee payable same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that do not match a specified payee (e.g. pay patient)
             and submitted manually."/>
        </concept>
        <concept>
          <code value="PDPPPPELAT"/>
          <abstract value="false"/>
          <display value="paid payee payable prior-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date) that match a specified payee (e.g. pay provider)
             and submitted electronically."/>
        </concept>
        <concept>
          <code value="PDPPPPELCT"/>
          <abstract value="false"/>
          <display value="paid payee payable prior-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDPPPPMNAT"/>
          <abstract value="false"/>
          <display value="paid payee payable prior-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid prior to the
             specified time period (based on payment date) that match a specified payee (e.g. pay provider)
             and submitted manually."/>
        </concept>
        <concept>
          <code value="PDPPPPMNCT"/>
          <abstract value="false"/>
          <display value="paid payee payable prior-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid prior to the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted manually."/>
        </concept>
        <concept>
          <code value="PDPPSPELAT"/>
          <abstract value="false"/>
          <display value="paid payee payable same-period electronic amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDPPSPELCT"/>
          <abstract value="false"/>
          <display value="paid payee payable same-period electronic count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted electronically."/>
        </concept>
        <concept>
          <code value="PDPPSPMNAT"/>
          <abstract value="false"/>
          <display value="paid payee payable same-period manual amount"/>
          <definition value="Identifies the total net amount of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted manually."/>
        </concept>
        <concept>
          <code value="PDPPSPMNCT"/>
          <abstract value="false"/>
          <display value="paid payee payable same-period manual count"/>
          <definition value="Identifies the total number of all  Invoice Groupings that were paid during the specified
             time period (based on payment date) that match a specified payee (e.g. pay provider) and
             submitted manually."/>
        </concept>
      </concept>
      <concept>
        <code value="_InvoiceElementSubmitted"/>
        <abstract value="true"/>
        <display value="InvoiceElementSubmitted"/>
        <definition value="Total counts and total net amounts billed for all Invoice Groupings that were submitted
           within a time period.  Adjudicated invoice elements are included."/>
        <concept>
          <code value="SBBLELAT"/>
          <abstract value="false"/>
          <display value="submitted billed electronic amount"/>
          <definition value="Identifies the total net amount billed for all submitted Invoice Groupings within a time
             period and submitted electronically.  Adjudicated invoice elements are included."/>
        </concept>
        <concept>
          <code value="SBBLELCT"/>
          <abstract value="false"/>
          <display value="submitted billed electronic count"/>
          <definition value="Identifies the total number of submitted Invoice Groupings within a time period and submitted
             electronically.  Adjudicated invoice elements are included."/>
        </concept>
        <concept>
          <code value="SBNFELAT"/>
          <abstract value="false"/>
          <display value="submitted nullified electronic amount"/>
          <definition value="Identifies the total net amount billed for all submitted  Invoice Groupings that were
             nullified within a time period and submitted electronically.  Adjudicated invoice elements
             are included."/>
        </concept>
        <concept>
          <code value="SBNFELCT"/>
          <abstract value="false"/>
          <display value="submitted cancelled electronic count"/>
          <definition value="Identifies the total number of submitted  Invoice Groupings that were nullified within
             a time period and submitted electronically.  Adjudicated invoice elements are included."/>
        </concept>
        <concept>
          <code value="SBPDELAT"/>
          <abstract value="false"/>
          <display value="submitted pending electronic amount"/>
          <definition value="Identifies the total net amount billed for all submitted  Invoice Groupings that are pended
             or held by the payor, within a time period and submitted electronically.  Adjudicated
             invoice elements are not included."/>
        </concept>
        <concept>
          <code value="SBPDELCT"/>
          <abstract value="false"/>
          <display value="submitted pending electronic count"/>
          <definition value="Identifies the total number of submitted  Invoice Groupings that are pended or held by
             the payor, within a time period and submitted electronically.  Adjudicated invoice elements
             are not included."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActInvoiceOverrideCode"/>
      <abstract value="true"/>
      <display value="ActInvoiceOverrideCode"/>
      <definition value="Includes coded responses that will occur as a result of the adjudication of an electronic
         invoice at a summary level and provides guidance on interpretation of the referenced adjudication
         results."/>
      <concept>
        <code value="COVGE"/>
        <abstract value="false"/>
        <display value="coverage problem"/>
        <definition value="Insurance coverage problems have been encountered. Additional explanation information
           to be supplied."/>
      </concept>
      <concept>
        <code value="EFORM"/>
        <abstract value="false"/>
        <display value="electronic form to follow"/>
        <definition value="Electronic form with supporting or additional information to follow."/>
      </concept>
      <concept>
        <code value="FAX"/>
        <abstract value="false"/>
        <display value="fax to follow"/>
        <definition value="Fax with supporting or additional information to follow."/>
      </concept>
      <concept>
        <code value="GFTH"/>
        <abstract value="false"/>
        <display value="good faith indicator"/>
        <definition value="The medical service was provided to a patient in good faith that they had medical coverage,
           although no evidence of coverage was available before service was rendered."/>
      </concept>
      <concept>
        <code value="LATE"/>
        <abstract value="false"/>
        <display value="late invoice"/>
        <definition value="Knowingly over the payor's published time limit for this invoice possibly due to a previous
           payor's delays in processing. Additional reason information will be supplied."/>
      </concept>
      <concept>
        <code value="MANUAL"/>
        <abstract value="false"/>
        <display value="manual review"/>
        <definition value="Manual review of the invoice is requested.  Additional information to be supplied.  This
           may be used in the case of an appeal."/>
      </concept>
      <concept>
        <code value="OOJ"/>
        <abstract value="false"/>
        <display value="out of jurisdiction"/>
        <definition value="The medical service and/or product was provided to a patient that has coverage in another
           jurisdiction."/>
      </concept>
      <concept>
        <code value="ORTHO"/>
        <abstract value="false"/>
        <display value="orthodontic service"/>
        <definition value="The service provided is required for orthodontic purposes. If the covered party has orthodontic
           coverage, then the service may be paid."/>
      </concept>
      <concept>
        <code value="PAPER"/>
        <abstract value="false"/>
        <display value="paper documentation to follow"/>
        <definition value="Paper documentation (or other physical format) with supporting or additional information
           to follow."/>
      </concept>
      <concept>
        <code value="PIE"/>
        <abstract value="false"/>
        <display value="public insurance exhausted"/>
        <definition value="Public Insurance has been exhausted.  Invoice has not been sent to Public Insuror and
           therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission."/>
      </concept>
      <concept>
        <code value="PYRDELAY"/>
        <abstract value="false"/>
        <display value="delayed by a previous payor"/>
        <definition value="Allows provider to explain lateness of invoice to a subsequent payor."/>
      </concept>
      <concept>
        <code value="REFNR"/>
        <abstract value="false"/>
        <display value="referral not required"/>
        <definition value="Rules of practice do not require a physician's referral for the provider to perform a
           billable service."/>
      </concept>
      <concept>
        <code value="REPSERV"/>
        <abstract value="false"/>
        <display value="repeated service"/>
        <definition value="The same service was delivered within a time period that would usually indicate a duplicate
           billing.  However, the repeated service is a medical  necessity and therefore not a duplicate."/>
      </concept>
      <concept>
        <code value="UNRELAT"/>
        <abstract value="false"/>
        <display value="unrelated service"/>
        <definition value="The service provided is not related to another billed service. For example, 2 unrelated
           services provided on the same day to the same patient which may normally result in a refused
           payment for one of the items."/>
      </concept>
      <concept>
        <code value="VERBAUTH"/>
        <abstract value="false"/>
        <display value="verbal authorization"/>
        <definition value="The provider has received a verbal permission from an authoritative source to perform
           the service or supply the item being invoiced."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActListCode"/>
      <abstract value="true"/>
      <display value="ActListCode"/>
      <definition value="Provides codes associated with ActClass value of LIST (working list)"/>
      <concept>
        <code value="_ActObservationList"/>
        <abstract value="true"/>
        <display value="ActObservationList"/>
        <concept>
          <code value="CARELIST"/>
          <abstract value="false"/>
          <display value="care plan"/>
          <definition value="List of acts representing a care plan.  The acts can be in a varierty of moods including
             event (EVN) to record acts that have been carried out as part of the care plan."/>
        </concept>
        <concept>
          <code value="CONDLIST"/>
          <abstract value="false"/>
          <display value="condition list"/>
          <definition value="List of condition observations."/>
          <concept>
            <code value="INTOLIST"/>
            <abstract value="false"/>
            <display value="intolerance list"/>
            <definition value="List of intolerance observations."/>
          </concept>
          <concept>
            <code value="PROBLIST"/>
            <abstract value="false"/>
            <display value="problem list"/>
            <definition value="List of problem observations."/>
          </concept>
          <concept>
            <code value="RISKLIST"/>
            <abstract value="false"/>
            <display value="risk factors"/>
            <definition value="List of risk factor observations."/>
          </concept>
        </concept>
        <concept>
          <code value="GOALLIST"/>
          <abstract value="false"/>
          <display value="goal list"/>
          <definition value="List of observations in goal mood."/>
        </concept>
      </concept>
      <concept>
        <code value="_ActTherapyDurationWorkingListCode"/>
        <abstract value="true"/>
        <display value="ActTherapyDurationWorkingListCode"/>
        <definition value="Codes used to identify different types of 'duration-based' working lists.  Examples include
           &quot;Continuous/Chronic&quot;, &quot;Short-Term&quot; and &quot;As-Needed&quot;."/>
        <concept>
          <code value="_ActMedicationTherapyDurationWorkingListCode"/>
          <abstract value="true"/>
          <display value="act medication therapy duration working list"/>
          <definition value="Definition:A collection of concepts that identifies different types of 'duration-based'
             mediation working lists.                                                      Examples:&quot;Continu
            ous/Chronic&quot; &quot;Short-Term&quot; and &quot;As Needed&quot;"/>
          <concept>
            <code value="ACU"/>
            <abstract value="false"/>
            <display value="short term/acute"/>
            <definition value="Definition:A list of medications which the patient is only expected to consume for the
               duration of the current order or limited set of orders and which is not expected to be
               renewed."/>
          </concept>
          <concept>
            <code value="CHRON"/>
            <abstract value="false"/>
            <display value="continuous/chronic"/>
            <definition value="Definition:A list of medications which are expected to be continued beyond the present
               order and which the patient should be assumed to be taking unless explicitly stopped."/>
          </concept>
          <concept>
            <code value="ONET"/>
            <abstract value="false"/>
            <display value="one time"/>
            <definition value="Definition:A list of medications which the patient is intended to be administered only
               once."/>
          </concept>
          <concept>
            <code value="PRN"/>
            <abstract value="false"/>
            <display value="as needed"/>
            <definition value="Definition:A list of medications which the patient will consume intermittently based on
               the behavior of the condition for which the medication is indicated."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="MEDLIST"/>
        <abstract value="false"/>
        <display value="medication list"/>
        <definition value="List of medications."/>
        <concept>
          <code value="CURMEDLIST"/>
          <abstract value="false"/>
          <display value="current medication list"/>
          <definition value="List of current medications."/>
        </concept>
        <concept>
          <code value="DISCMEDLIST"/>
          <abstract value="false"/>
          <display value="discharge medication list"/>
          <definition value="List of discharge medications."/>
        </concept>
        <concept>
          <code value="HISTMEDLIST"/>
          <abstract value="false"/>
          <display value="medication history"/>
          <definition value="Historical list of medications."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActMonitoringProtocolCode"/>
      <abstract value="true"/>
      <display value="ActMonitoringProtocolCode"/>
      <definition value="Identifies types of monitoring programs"/>
      <concept>
        <code value="CTLSUB"/>
        <abstract value="false"/>
        <display value="Controlled Substance"/>
        <definition value="A monitoring program that focuses on narcotics and/or commonly abused substances that
           are subject to legal restriction."/>
      </concept>
      <concept>
        <code value="INV"/>
        <abstract value="false"/>
        <display value="investigational"/>
        <definition value="Definition:A monitoring program that focuses on a drug which is under investigation and
           has not received regulatory approval for the condition being investigated"/>
      </concept>
      <concept>
        <code value="LU"/>
        <abstract value="false"/>
        <display value="limited use"/>
        <definition value="Description:A drug that can be prescribed (and reimbursed) only if it meets certain criteria."/>
      </concept>
      <concept>
        <code value="OTC"/>
        <abstract value="false"/>
        <display value="non prescription medicine"/>
        <definition value="Medicines designated in this way may be supplied for patient use without a prescription.
            The exact form of categorisation will vary in different realms."/>
      </concept>
      <concept>
        <code value="RX"/>
        <abstract value="false"/>
        <display value="prescription only medicine"/>
        <definition value="Some form of prescription is required before the related medicine can be supplied for
           a patient.  The exact form of regulation will vary in different realms."/>
      </concept>
      <concept>
        <code value="SA"/>
        <abstract value="false"/>
        <display value="special authorization"/>
        <definition value="Definition:A drug that requires prior approval (to be reimbursed) before being dispensed"/>
      </concept>
      <concept>
        <code value="SAC"/>
        <abstract value="false"/>
        <display value="special access"/>
        <definition value="Description:A drug that requires special access permission to be prescribed and dispensed."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActNonObservationIndicationCode"/>
      <abstract value="true"/>
      <display value="ActNonObservationIndicationCode"/>
      <definition value="Description:Concepts representing indications (reasons for clinical action) other than
         diagnosis and symptoms."/>
      <concept>
        <code value="IND01"/>
        <abstract value="false"/>
        <display value="imaging study requiring contrast"/>
        <definition value="Description:Contrast agent required for imaging study."/>
      </concept>
      <concept>
        <code value="IND02"/>
        <abstract value="false"/>
        <display value="colonoscopy prep"/>
        <definition value="Description:Provision of prescription or direction to consume a product for purposes of
           bowel clearance in preparation for a colonoscopy."/>
      </concept>
      <concept>
        <code value="IND03"/>
        <abstract value="false"/>
        <display value="prophylaxis"/>
        <definition value="Description:Provision of medication as a preventative measure during a treatment or other
           period of increased risk."/>
      </concept>
      <concept>
        <code value="IND04"/>
        <abstract value="false"/>
        <display value="surgical prophylaxis"/>
        <definition value="Description:Provision of medication during pre-operative phase; e.g., antibiotics before
           dental surgery or bowel prep before colon surgery."/>
      </concept>
      <concept>
        <code value="IND05"/>
        <abstract value="false"/>
        <display value="pregnancy prophylaxis"/>
        <definition value="Description:Provision of medication for pregnancy --e.g., vitamins, antibiotic treatments
           for vaginal tract colonization, etc."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActObservationVerificationType"/>
      <abstract value="true"/>
      <display value="act observation verification"/>
      <definition value="Identifies the type of verification investigation being undertaken with respect to the
         subject of the verification activity.                                                
              Examples:                                                                       
                                               Verification of eligibility for coverage under a
         policy or program - aka enrolled/covered by a policy or program                      
                                                                          Verification of record
         - e.g., person has record in an immunization registry                                
                                                                Verification of enumeration - e.g.
         NPI                                                                                  
              Verification of Board Certification - provider specific                         
                                                                       Verification of Certification
         - e.g. JAHCO, NCQA, URAC                                                             
                                   Verification of Conformance - e.g. entity use with HIPAA, conformant
         to the CCHIT EHR system criteria                                                     
                                           Verification of Provider Credentials               
                                                                                 Verification of
         no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection
         Data Base (HIPDB)"/>
      <concept>
        <code value="VFPAPER"/>
        <abstract value="false"/>
        <display value="verify paper"/>
        <definition value="Definition:Indicates that the paper version of the record has, should be or is being verified
           against the electronic version."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActPaymentCode"/>
      <abstract value="true"/>
      <display value="ActPaymentCode"/>
      <definition value="Code identifying the method or the movement of payment instructions.                 
                 Codes are drawn from X12 data element 591 (PaymentMethodCode)"/>
      <concept>
        <code value="ACH"/>
        <abstract value="false"/>
        <display value="Automated Clearing House"/>
        <definition value="Automated Clearing House (ACH)."/>
      </concept>
      <concept>
        <code value="CHK"/>
        <abstract value="false"/>
        <display value="Cheque"/>
        <definition value="A written order to a bank to pay the amount specified from funds on deposit."/>
      </concept>
      <concept>
        <code value="DDP"/>
        <abstract value="false"/>
        <display value="Direct Deposit"/>
        <definition value="Electronic Funds Transfer (EFT) deposit into the payee's bank account"/>
      </concept>
      <concept>
        <code value="NON"/>
        <abstract value="false"/>
        <display value="Non-Payment Data"/>
        <definition value="Non-Payment Data."/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
        <valueCode value="UD"/>
      </modifierExtension>
      <code value="_ActPharmacySupplyType"/>
      <abstract value="true"/>
      <display value="ActPharmacySupplyType"/>
      <definition value="Identifies types of dispensing events"/>
      <concept>
        <code value="DF"/>
        <abstract value="false"/>
        <display value="Daily Fill"/>
        <definition value="A fill providing sufficient supply for one day"/>
      </concept>
      <concept>
        <code value="EM"/>
        <abstract value="false"/>
        <display value="Emergency Supply"/>
        <definition value="A supply action where there is no 'valid' order for the supplied medication.  E.g. Emergency
           vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)"/>
        <concept>
          <code value="SO"/>
          <abstract value="false"/>
          <display value="Script Owing"/>
          <definition value="An emergency supply where the expectation is that a formal order authorizing the supply
             will be provided at a later date."/>
        </concept>
      </concept>
      <concept>
        <code value="FF"/>
        <abstract value="false"/>
        <display value="First Fill"/>
        <definition value="The initial fill against an order.  (This includes initial fills against refill orders.)"/>
        <concept>
          <code value="FFC"/>
          <abstract value="false"/>
          <display value="First Fill - Complete"/>
          <definition value="A first fill where the quantity supplied is equal to one full repetition of the ordered
             amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the
             full 90 tablets)."/>
          <concept>
            <code value="FFCS"/>
            <abstract value="false"/>
            <display value="first fill complete, partial strength"/>
            <definition value="A first fill where the quantity supplied is equal to one full repetition of the ordered
               amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the
               full 90 tablets) and also where the strength supplied is less than the ordered strength
               (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
        <concept>
          <code value="FFP"/>
          <abstract value="false"/>
          <display value="First Fill - Part Fill"/>
          <definition value="A first fill where the quantity supplied is less than one full repetition of the ordered
             amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only
             30 tablets.)"/>
        </concept>
        <concept>
          <code value="FFPS"/>
          <abstract value="false"/>
          <display value="first fill, part fill, partial strength"/>
          <definition value="A first fill where the quantity supplied is less than one full repetition of the ordered
             amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only
             30 tablets.) and also where the strength supplied is less than the ordered strength (e.g.
             10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)"/>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="FFPS"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="FFCS"/>
          </modifierExtension>
          <code value="FFSS"/>
          <abstract value="false"/>
          <display value="first fill, partial strength"/>
          <definition value="A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg
             for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          <concept>
            <code value="TFS"/>
            <abstract value="false"/>
            <display value="trial fill partial strength"/>
            <definition value="A fill where a small portion is provided to allow for determination of the therapy effectiveness
               and patient tolerance and also where the strength supplied is less than the ordered strength
               (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="TFS"/>
          </modifierExtension>
          <code value="TF"/>
          <abstract value="false"/>
          <display value="Trial Fill"/>
          <definition value="A fill where a small portion is provided to allow for determination of the therapy effectiveness
             and patient tolerance."/>
        </concept>
      </concept>
      <concept>
        <code value="FS"/>
        <abstract value="false"/>
        <display value="Floor stock"/>
        <definition value="A supply action to restock a smaller more local dispensary."/>
      </concept>
      <concept>
        <code value="MS"/>
        <abstract value="false"/>
        <display value="Manufacturer Sample"/>
        <definition value="A supply of a manufacturer sample"/>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
          <valueCode value="DF"/>
        </modifierExtension>
        <code value="RF"/>
        <abstract value="false"/>
        <display value="Refill"/>
        <definition value="A fill against an order that has already been filled (or partially filled) at least once."/>
        <concept>
          <code value="UD"/>
          <abstract value="false"/>
          <display value="Unit Dose"/>
          <definition value="A supply action that provides sufficient material for a single dose."/>
        </concept>
        <concept>
          <code value="RFC"/>
          <abstract value="false"/>
          <display value="Refill - Complete"/>
          <definition value="A refill where the quantity supplied is equal to one full repetition of the ordered amount.
             (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90
             tablets.)"/>
          <concept>
            <code value="RFCS"/>
            <abstract value="false"/>
            <display value="refill complete partial strength"/>
            <definition value="A refill where the quantity supplied is equal to one full repetition of the ordered amount.
               (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90
               tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg
               for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
        <concept>
          <code value="RFF"/>
          <abstract value="false"/>
          <display value="Refill (First fill this facility)"/>
          <definition value="The first fill against an order that has already been filled at least once at another
             facility."/>
          <concept>
            <code value="RFFS"/>
            <abstract value="false"/>
            <display value="refill partial strength (first fill this facility)"/>
            <definition value="The first fill against an order that has already been filled at least once at another
               facility and where the strength supplied is less than the ordered strength (e.g. 10mg
               for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
        <concept>
          <code value="RFP"/>
          <abstract value="false"/>
          <display value="Refill - Part Fill"/>
          <definition value="A refill where the quantity supplied is less than one full repetition of the ordered amount.
             (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)"/>
          <concept>
            <code value="RFPS"/>
            <abstract value="false"/>
            <display value="refill part fill partial strength"/>
            <definition value="A refill where the quantity supplied is less than one full repetition of the ordered amount.
               (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)
               and where the strength supplied is less than the ordered strength (e.g. 10mg for an order
               of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
        <concept>
          <code value="RFS"/>
          <abstract value="false"/>
          <display value="refill partial strength"/>
          <definition value="A fill against an order that has already been filled (or partially filled) at least once
             and where the strength supplied is less than the ordered strength (e.g. 10mg for an order
             of 50mg where a subsequent fill will dispense 40mg tablets)."/>
        </concept>
        <concept>
          <code value="TB"/>
          <abstract value="false"/>
          <display value="Trial Balance"/>
          <definition value="A fill where the remainder of a 'complete' fill is provided after a trial fill has been
             provided."/>
          <concept>
            <code value="TBS"/>
            <abstract value="false"/>
            <display value="trial balance partial strength"/>
            <definition value="A fill where the remainder of a 'complete' fill is provided after a trial fill has been
               provided and where the strength supplied is less than the ordered strength (e.g. 10mg
               for an order of 50mg where a subsequent fill will dispense 40mg tablets)."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="UDE"/>
        <abstract value="false"/>
        <display value="unit dose equivalent"/>
        <definition value="A supply action that provides sufficient material for a single dose via multiple products.
            E.g. 2 50mg tablets for a 100mg unit dose."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActPolicyType"/>
      <abstract value="true"/>
      <display value="ActPolicyType"/>
      <definition value="Description:Types of policies that further specify the ActClassPolicy value set."/>
      <concept>
        <code value="_ActPrivacyPolicy"/>
        <abstract value="true"/>
        <display value="ActPrivacyPolicy"/>
        <definition value="A policy deeming certain information to be private to an individual or organization. 
                                                               Definition: A mandate, obligation,
           requirement, rule, or expectation relating to privacy.                               
                                 Discussion: ActPrivacyPolicyType codes support the designation of
           the 1..* policies that are applicable to an Act such as a Consent Directive, a Role such
           as a VIP Patient, or an Entity such as a patient who is a minor.  1..* ActPrivacyPolicyType
           values may be associated with an Act or Role to indicate the policies that govern the
           assignment of an Act or Role confidentialityCode.  Use of multiple ActPrivacyPolicyType
           values enables fine grain specification of applicable policies, but must be carefully
           assigned to ensure cogency and avoid creation of conflicting policy mandates.        
                                                        Usage Note: Statutory title may be named
           in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced."/>
        <concept>
          <code value="_ActConsentDirective"/>
          <abstract value="true"/>
          <display value="ActConsentDirective"/>
          <definition value="Definition: Specifies the type of consent directive indicated by an ActClassPolicy e.g.,
             a 3rd party authorization to disclose or consent for a substitute decision maker (SDM)
             or a notice of privacy policy.                                                      Usage
             Note: ActConsentDirective codes are used to specify the type of Consent Directive to which
             a Consent Directive Act conforms."/>
          <concept>
            <code value="EMRGONLY"/>
            <abstract value="false"/>
            <display value="emergency only"/>
            <definition value="This general consent directive specifically limits disclosure of health information for
               purpose of emergency treatment. Additional parameters may further limit the disclosure
               to specific users, roles, duration, types of information, and impose uses obligations.
                                                                    Definition: Opt-in to disclosure
               of health information for emergency only consent directive."/>
          </concept>
          <concept>
            <code value="NOPP"/>
            <abstract value="false"/>
            <display value="notice of privacy practices"/>
            <definition value="Acknowledgement of custodian notice of privacy practices.                            
                                        Usage Notes: This type of consent directive acknowledges a custodian's
               notice of privacy practices including its permitted collection, access, use and disclosure
               of health information to users and for purposes of use specified."/>
          </concept>
          <concept>
            <code value="OPTIN"/>
            <abstract value="false"/>
            <display value="opt-in"/>
            <definition value="This general consent directive permits disclosure of health information.  Additional parameter
               may limit authorized users, purpose of use, user obligations, duration, or information
               types permitted to be disclosed, and impose uses obligations.                        
                                            Definition: Opt-in to disclosure of health information consent
               directive."/>
          </concept>
          <concept>
            <code value="OPTOUT"/>
            <abstract value="false"/>
            <display value="op-out"/>
            <definition value="This general consent directive prohibits disclosure of health information.  Additional
               parameters may permit access to some information types by certain users, roles, purposes
               of use, durations and impose user obligations.                                       
                             Definition: Opt-out of disclosure of health information consent directive."/>
          </concept>
        </concept>
        <concept>
          <code value="_InformationSensitivityPolicy"/>
          <abstract value="true"/>
          <display value="InformationSensitivityPolicy"/>
          <definition value="A mandate, obligation, requirement, rule, or expectation characterizing the value or importance
             of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability
             of personally identifiable sensitive information may be based on concerns that the unauthorized
             disclosure may result in social stigmatization or discrimination.) Description:  Types
             of Sensitivity policy that apply to Acts or Roles.  A sensitivity policy is adopted by
             an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement
             that stipulates the value, importance, and vulnerability of information. A sensitivity
             code representing a sensitivity policy may be associated with criteria such as categories
             of information or sets of information identifiers (e.g., a value set of clinical codes
             or branch in a code system hierarchy).   These criteria may in turn be used for the Policy
             Decision Point in a Security Engine.  A sensitivity code may be used to set the confidentiality
             code used on information about Acts and Roles to trigger the security mechanisms required
             to control how security principals (i.e., a person, a machine, a software application)
             may act on the information (e.g., collection, access, use, or disclosure). Sensitivity
             codes are never assigned to the transport or business envelope containing patient specific
             information being exchanged outside of a policy domain as this would disclose the information
             intended to be protected by the policy.  When sensitive information is exchanged with
             others outside of a policy domain, the confidentiality code on the transport or business
             envelope conveys the receiver's responsibilities and indicates the how the information
             is to be safeguarded without unauthorized disclosure of the sensitive information.  This
             ensures that sensitive information is treated by receivers as the sender intends, accomplishing
             interoperability without point to point negotiations.                                
                                  Usage Note: Sensitivity codes are not useful for interoperability
             outside of a policy domain because sensitivity policies are typically localized and vary
             drastically across policy domains even for the same information category because of differing
             organizational business rules, security policies, and jurisdictional requirements.  For
             example, an employee's sensitivity code would make little sense for use outside of a policy
             domain.   'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional
             requirements requiring that a provider disclose sensitive information to a patient directly.
              Sensitivity codes may be more appropriate in a legacy system's Master Files in order
             to notify those who access a patient's orders and observations about the sensitivity policies
             that apply.  Newer systems may have a security engine that uses a sensitivity policy's
             criteria directly.  The specializable InformationSensitivityPolicy Act.code may be useful
             in some scenarios if used in combination with a sensitivity identifier and/or Act.title."/>
          <concept>
            <code value="_ActInformationSensitivityPolicy"/>
            <abstract value="true"/>
            <display value="ActInformationSensitivityPolicy"/>
            <definition value="Types of sensitivity policies that apply to Acts.  Act.confidentialityCode is defined
               in the RIM as &quot;constraints around appropriate disclosure of information about this
               Act, regardless of mood.&quot;                                                      Usage
               Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode
               according to local sensitivity policy so that those confidentiality codes can then govern
               its handling across enterprises.  Internally to a policy domain, however, local policies
               guide the access control system on how end users in that policy domain are  able to use
               information tagged with these sensitivity values."/>
            <concept>
              <code value="ETH"/>
              <abstract value="false"/>
              <display value="substance abuse information sensitivity"/>
              <definition value="Policy for handling alcohol or drug-abuse information, which will be afforded heightened
                 confidentiality.  Information handling protocols based on organizational policies related
                 to alcohol or drug-abuse information that is deemed sensitive.                       
                                               Usage Note: If there is a jurisdictional mandate, then use
                 the applicable ActPrivacyLaw code system, and specify the law rather than or in addition
                 to this more generic code."/>
            </concept>
            <concept>
              <code value="GDIS"/>
              <abstract value="false"/>
              <display value="genetic disease information sensitivity"/>
              <definition value="Policy for handling genetic disease information, which will be afforded heightened confidentiality.
                 Information handling protocols based on organizational policies related to genetic disease
                 information that is deemed sensitive.                                                
                      Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw
                 code system, and specify the law rather than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="HIV"/>
              <abstract value="false"/>
              <display value="HIV/AIDS information sensitivity"/>
              <definition value="Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality.
                 Information handling protocols based on organizational policies related to HIV or AIDS
                 information that is deemed sensitive.                                                
                      Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw
                 code system, and specify the law rather than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="PSY"/>
              <abstract value="false"/>
              <display value="psychiatry information sensitivity"/>
              <definition value="Policy for handling psychiatry information, which will be afforded heightened confidentiality.
                 Information handling protocols based on organizational policies related to psychiatry
                 information that is deemed sensitive.                                                
                      Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw
                 code system, and specify the law rather than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="SCA"/>
              <abstract value="false"/>
              <display value="sickle cell anemia"/>
              <definition value="Policy for handling sickle cell disease information, which is afforded heightened confidentiality.
                  Information handling protocols are based on organizational policies related to sickle
                 cell disease information, which is deemed sensitive.                                 
                                     Usage Note: If there is a jurisdictional mandate, then the Act valued
                 with this ActCode should be associated with an Act valued with any applicable laws from
                 the ActPrivacyLaw code system."/>
            </concept>
            <concept>
              <code value="SDV"/>
              <abstract value="false"/>
              <display value="sexual assault, abuse, or domestic violence information sensitivity"/>
              <definition value="Policy for handling sexual assault, abuse, or domestic violence information, which will
                 be afforded heightened confidentiality. Information handling protocols based on organizational
                 policies related to sexual assault, abuse, or domestic violence information that is deemed
                 sensitive.                                                      Usage Note: If there is
                 a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify
                 the law rather than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="SEX"/>
              <abstract value="false"/>
              <display value="sexuality and reproductive health information sensitivity"/>
              <definition value="Policy for handling sexuality and reproductive health information, which will be afforded
                 heightened confidentiality.  Information handling protocols based on organizational policies
                 related to sexuality and reproductive health information that is deemed sensitive.   
                                                                   Usage Note: If there is a jurisdictional
                 mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather
                 than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="STD"/>
              <abstract value="false"/>
              <display value="sexually transmitted disease information sensitivity"/>
              <definition value="Policy for handling sexually transmitted disease information, which will be afforded heightened
                 confidentiality.  Information handling protocols based on organizational policies related
                 to sexually transmitted disease information that is deemed sensitive.                
                                                      Usage Note: If there is a jurisdictional mandate,
                 then use the applicable ActPrivacyLaw code system, and specify the law rather than or
                 in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="TBOO"/>
              <abstract value="false"/>
              <display value="taboo"/>
              <definition value="Policy for handling information not to be initially disclosed or discussed with patient
                 except by a physician assigned to patient in this case. Information handling protocols
                 based on organizational policies related to sensitive patient information that must be
                 initially discussed with the patient by an attending physician before being disclosed
                 to the patient.                                                      Usage Note: If there
                 is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify
                 the law rather than or in addition to this more generic code.                        
                                              Open Issue: This definition conflates a rule and a characteristic,
                 and there may be a similar issue with ts sibling codes."/>
            </concept>
          </concept>
          <concept>
            <code value="_EntitySensitivityPolicyType"/>
            <abstract value="true"/>
            <display value="EntityInformationSensitivityPolicy"/>
            <definition value="Types of sensitivity policies that may apply to a sensitive attribute on an Entity.  
                                                                  Usage Note: EntitySensitivity codes
               are used to convey a policy that is applicable to sensitive information conveyed by an
               entity attribute.  May be used to bind a Role.confidentialityCode associated with an Entity
               per organizational policy.  Role.confidentialityCode is defined in the RIM as &quot;an
               indication of the appropriate disclosure of information about this Role with respect to
               the playing Entity.&quot;"/>
            <concept>
              <code value="DEMO"/>
              <abstract value="false"/>
              <display value="all demographic information sensitivity"/>
              <definition value="Policy for handling all demographic information about an information subject, which will
                 be afforded heightened confidentiality. Policies may govern sensitivity of information
                 related to all demographic about an information subject, the disclosure of which could
                 impact the privacy, well-being, or safety of that subject.                           
                                           Usage Note: If there is a jurisdictional mandate, then use the
                 applicable ActPrivacyLaw code system, and specify the law rather than or in addition to
                 this more generic code."/>
            </concept>
            <concept>
              <code value="DOB"/>
              <abstract value="false"/>
              <display value="date of birth information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's date of birth, which
                 will be afforded heightened confidentiality.Policies may govern sensitivity of information
                 related to an information subject's date of birth, the disclosure of which could impact
                 the privacy, well-being, or safety of that subject.                                  
                                    Usage Note: If there is a jurisdictional mandate, then use the applicable
                 ActPrivacyLaw code system, and specify the law rather than or in addition to this more
                 generic code."/>
            </concept>
            <concept>
              <code value="GENDER"/>
              <abstract value="false"/>
              <display value="gender and sexual orientation information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's gender and sexual
                 orientation, which will be afforded heightened confidentiality.  Policies may govern sensitivity
                 of information related to an information subject's gender and sexual orientation, the
                 disclosure of which could impact the privacy, well-being, or safety of that subject. 
                                                                     Usage Note: If there is a jurisdictional
                 mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather
                 than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="LIVARG"/>
              <abstract value="false"/>
              <display value="living arrangement information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's living arrangement,
                 which will be afforded heightened confidentiality.  Policies may govern sensitivity of
                 information related to an information subject's living arrangement, the disclosure of
                 which could impact the privacy, well-being, or safety of that subject.               
                                                       Usage Note: If there is a jurisdictional mandate,
                 then use the applicable ActPrivacyLaw code system, and specify the law rather than or
                 in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="MARST"/>
              <abstract value="false"/>
              <display value="marital status information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's marital status, which
                 will be afforded heightened confidentiality. Policies may govern sensitivity of information
                 related to an information subject's marital status, the disclosure of which could impact
                 the privacy, well-being, or safety of that subject.                                  
                                    Usage Note: If there is a jurisdictional mandate, then use the applicable
                 ActPrivacyLaw code system, and specify the law rather than or in addition to this more
                 generic code."/>
            </concept>
            <concept>
              <code value="RACE"/>
              <abstract value="false"/>
              <display value="race information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's race, which will be
                 afforded heightened confidentiality.  Policies may govern sensitivity of information related
                 to an information subject's race, the disclosure of which could impact the privacy, well-being,
                 or safety of that subject.                                                      Usage
                 Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code
                 system, and specify the law rather than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="REL"/>
              <abstract value="false"/>
              <display value="religion information sensitivity"/>
              <definition value="Policy for handling information related to an information subject's religious affiliation,
                 which will be afforded heightened confidentiality.  Policies may govern sensitivity of
                 information related to an information subject's religion, the disclosure of which could
                 impact the privacy, well-being, or safety of that subject.                           
                                           Usage Notes: If there is a jurisdictional mandate, then use
                 the applicable ActPrivacyLaw code system, and specify the law rather than or in addition
                 to this more generic code."/>
            </concept>
          </concept>
          <concept>
            <code value="_RoleInformationSensitivityPolicy"/>
            <abstract value="true"/>
            <display value="RoleInformationSensitivityPolicy"/>
            <definition value="Types of sensitivity policies that apply to Roles.                                   
                                 Usage Notes: RoleSensitivity codes are used to bind information to a
               Role.confidentialityCode per organizational policy.  Role.confidentialityCode is defined
               in the RIM as &quot;an indication of the appropriate disclosure of information about this
               Role with respect to the playing Entity.&quot;"/>
            <concept>
              <code value="B"/>
              <abstract value="false"/>
              <display value="business information sensitivity"/>
              <definition value="Policy for handling trade secrets such as financial information or intellectual property,
                 which will be afforded heightened confidentiality.  Description:  Since the service class
                 can represent knowledge structures that may be considered a trade or business secret,
                 there is sometimes (though rarely) the need to flag those items as of business level confidentiality
                .                                                      Usage Notes: No patient related
                 information may ever be of this confidentiality level.   If there is a jurisdictional
                 mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather
                 than or in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="EMPL"/>
              <abstract value="false"/>
              <display value="employer information sensitivity"/>
              <definition value="Policy for handling information related to an employer which is deemed classified to protect
                 an employee who is the information subject, and which will be afforded heightened confidentiality.
                  Description:  Policies may govern sensitivity of information related to an employer,
                 such as law enforcement or national security, the identity of which could impact the privacy,
                 well-being, or safety of an information subject who is an employee.                  
                                                    Usage Notes: If there is a jurisdictional mandate,
                 then use the applicable ActPrivacyLaw code system, and specify the law rather than or
                 in addition to this more generic code."/>
            </concept>
            <concept>
              <code value="LOCIS"/>
              <abstract value="false"/>
              <display value="location information sensitivity"/>
              <definition value="Policy for handling information related to the location of the information subject, which
                 will be afforded heightened confidentiality.  Description:  Policies may govern sensitivity
                 of information related to the location of the information subject, the disclosure of which
                 could impact the privacy, well-being, or safety of that subject.                     
                                                 Usage Notes: If there is a jurisdictional mandate, then
                 use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition
                 to this more generic code."/>
            </concept>
            <concept>
              <code value="SSP"/>
              <abstract value="false"/>
              <display value="sensitive service provider information sensitivity"/>
              <definition value="Policy for handling information related to a provider of sensitive services, which will
                 be afforded heightened confidentiality.  Description:  Policies may govern sensitivity
                 of information related to providers who deliver sensitive healthcare services in order
                 to protect the privacy, well-being, and safety of the provider and of patients receiving
                 sensitive services.                                                      Usage Notes:
                 If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system,
                 and specify the law rather than or in addition to this more generic code."/>
            </concept>
          </concept>
          <concept>
            <code value="ADOL"/>
            <abstract value="false"/>
            <display value="adolescent information sensitivity"/>
            <definition value="Policy for handling information related to an adolescent, which will be afforded heightened
               confidentiality per applicable organizational or jurisdictional policy.  An enterprise
               may have a policy that requires that adolescent patient information be provided heightened
               confidentiality.  Information deemed sensitive typically includes health information and
               patient role information including patient status, demographics, next of kin, and location.
                                                                    Usage Note: For use within an enterprise
               in which an adolescent is the information subject.  If there is a jurisdictional mandate,
               then use the applicable ActPrivacyLaw code system, and specify the law rather than or
               in addition to this more generic code."/>
          </concept>
          <concept>
            <code value="CEL"/>
            <abstract value="false"/>
            <display value="celebrity information sensitivity"/>
            <definition value="Policy for handling information related to a celebrity (people of public interest (VIP),
               which will be afforded heightened confidentiality.  Celebrities are people of public interest
               (VIP) about whose information an enterprise may have a policy that requires heightened
               confidentiality.  Information deemed sensitive may include health information and patient
               role information including patient status, demographics, next of kin, and location.  
                                                                  Usage Note:  For use within an enterprise
               in which the information subject is deemed a celebrity or very important person.  If there
               is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify
               the law rather than or in addition to this more generic code."/>
          </concept>
          <concept>
            <code value="DIA"/>
            <abstract value="false"/>
            <display value="diagnosis information sensitivity"/>
            <definition value="Policy for handling information related to a diagnosis, health condition or health problem,
               which will be afforded heightened confidentiality.  Diagnostic, health condition or health
               problem related information may be deemed sensitive by organizational policy, and require
               heightened confidentiality.                                                      Usage
               Note: For use within an enterprise that provides heightened confidentiality to  diagnostic,
               health condition or health problem related information deemed sensitive.   If there is
               a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify
               the law rather than or in addition to this more generic code."/>
          </concept>
          <concept>
            <code value="DRGIS"/>
            <abstract value="false"/>
            <display value="drug information sensitivity"/>
            <definition value="Policy for handling information related to a drug, which will be afforded heightened confidentiality
              . Drug information may be deemed sensitive by organizational policy, and require heightened
               confidentiality.                                                      Usage Note: For
               use within an enterprise that provides heightened confidentiality to drug information
               deemed sensitive.   If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw
               code system, and specify the law rather than or in addition to this more generic code."/>
          </concept>
          <concept>
            <code value="EMP"/>
            <abstract value="false"/>
            <display value="employee information sensitivity"/>
            <definition value="Policy for handling information related to an employee, which will be afforded heightened
               confidentiality. When a patient is an employee, an enterprise may have a policy that requires
               heightened confidentiality.  Information deemed sensitive typically includes health information
               and patient role information including patient status, demographics, next of kin, and
               location.                                                      Usage Note: Policy for
               handling information related to an employee, which will be afforded heightened confidentiality.
                Description:  When a patient is an employee, an enterprise may have a policy that requires
               heightened confidentiality.  Information deemed sensitive typically includes health information
               and patient role information including patient status, demographics, next of kin, and
               location."/>
          </concept>
          <concept>
            <code value="PDS"/>
            <abstract value="false"/>
            <display value="patient default sensitivity"/>
            <definition value="Policy for handling information reported by the patient about another person, e.g., a
               family member, which will be afforded heightened confidentiality. Sensitive information
               reported by the patient about another person, e.g., family members may be deemed sensitive
               by default.  The flag may be set or cleared on patient's request.                    
                                                  Usage Note: For sensitive information relayed by or
               about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless
               of whether the patient requested that the information be deemed sensitive.)   If there
               is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify
               the law rather than or in addition to this more generic code."/>
          </concept>
          <concept>
            <code value="PRS"/>
            <abstract value="false"/>
            <display value="patient requested sensitivity"/>
            <definition value="For sensitive information relayed by or about a patient, which is deemed sensitive within
               the enterprise (i.e., by default regardless of whether the patient requested that the
               information be deemed sensitive.)   If there is a jurisdictional mandate, then use the
               applicable ActPrivacyLaw code system, and specify the law rather than or in addition to
               this more generic code.                                                      Usage Note:
               For use within an enterprise that provides heightened confidentiality to certain types
               of information designated by a patient as sensitive.   If there is a jurisdictional mandate,
               then use the applicable ActPrivacyLaw code system, and specify the law rather than or
               in addition to this more generic code."/>
          </concept>
        </concept>
        <concept>
          <code value="COMPT"/>
          <abstract value="false"/>
          <display value="compartment"/>
          <definition value="This is the healthcare analog to the US Intelligence Community's concept of a Special
             Access Program.  Compartment codes may be used in as a field value in an initiator's clearance
             to indicate permission to access and use an IT Resource with a security label having the
             same compartment value in security category label field.                          Map:
             Aligns with ISO 2382-8 definition of Compartment - &quot;A division of data into isolated
             blocks with separate security controls for the purpose of reducing risk.&quot;"/>
          <concept>
            <code value="HRCOMPT"/>
            <abstract value="false"/>
            <display value="human resource compartment"/>
            <definition value="A security category label field value, which indicates that access and use of an IT resource
               is restricted to members of human resources department or workflow."/>
          </concept>
          <concept>
            <code value="RESCOMPT"/>
            <abstract value="false"/>
            <display value="research project compartment"/>
            <definition value="A security category label field value, which indicates that access and use of an IT resource
               is restricted to members of a research project."/>
          </concept>
          <concept>
            <code value="RMGTCOMPT"/>
            <abstract value="false"/>
            <display value="records management compartment"/>
            <definition value="A security category label field value, which indicates that access and use of an IT resource
               is restricted to members of records management department or workflow."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="ActTrustPolicyType"/>
        <abstract value="true"/>
        <display value="trust policy"/>
        <definition value="A mandate, obligation, requirement, rule, or expectation conveyed as security metadata
           between senders and receivers required to establish the reliability, authenticity, and
           trustworthiness of their transactions.                          Trust security metadata
           are observation made about aspects of trust applicable to an IT resource (data, information
           object, service, or system capability).                          Trust applicable to IT
           resources is established and maintained in and among security domains, and may be comprised
           of observations about the domain's trust authority, trust framework, trust policy, trust
           interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms
           that enforce trust, and quality and reliability measures of assurance in those mechanisms.
           [Based on ISO IEC 10181-1 and NIST SP 800-63-2]                          For example,
           identity proofing , level of assurance, and Trust Framework."/>
        <concept>
          <code value="TRSTACCRD"/>
          <abstract value="false"/>
          <display value="trust accreditation"/>
          <definition value="Type of security metadata about the formal declaration by an authority or neutral third
             party that validates the technical, security, trust, and business practice conformance
             of Trust Agents to facilitate security, interoperability, and trust among participants
             within a security domain or trust framework."/>
        </concept>
        <concept>
          <code value="TRSTAGRE"/>
          <abstract value="false"/>
          <display value="trust agreement"/>
          <definition value="Type of security metadata about privacy and security requirements with which a security
             domain must comply. [ISO IEC 10181-1]"/>
        </concept>
        <concept>
          <code value="TRSTASSUR"/>
          <abstract value="false"/>
          <display value="trust assurance"/>
          <definition value="Type of security metadata about the digital quality or reliability of a trust assertion,
             activity, capability, information exchange, mechanism, process, or protocol."/>
        </concept>
        <concept>
          <code value="TRSTCERT"/>
          <abstract value="false"/>
          <display value="trust certificate"/>
          <definition value="Type of security metadata about a set of security-relevant data issued by a security authority
             or trusted third party, together with security information which is used to provide the
             integrity and data origin authentication services for an IT resource (data, information
             object, service, or system capability). [Based on ISO IEC 10181-1]"/>
        </concept>
        <concept>
          <code value="TRSTFWK"/>
          <abstract value="false"/>
          <display value="trust framework"/>
          <definition value="Type of security metadata about a complete set of contracts, regulations, or commitments
             that enable participating actors to rely on certain assertions by other actors to fulfill
             their information security requirements. [Kantara Initiative]"/>
        </concept>
        <concept>
          <code value="TRSTMEC"/>
          <abstract value="false"/>
          <display value="trust mechanism"/>
          <definition value="Type of security metadata about a security architecture system component that supports
             enforcement of security policies."/>
        </concept>
      </concept>
      <concept>
        <code value="COVPOL"/>
        <abstract value="false"/>
        <display value="benefit policy"/>
        <definition value="Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed
           on benefit coverage under a policy or program by a sponsor, underwriter or payor on: 
                                                                                              The
           activity of another party                                                            
                                      The behavior of another party                             
                                                                     The manner in which an act is
           executed                                                                             
                                        Examples:A clinical protocol imposed by a payer to which
           a provider must adhere in order to be paid for providing the service.  A formulary from
           which a provider must select prescribed drugs in order for the patient to incur a lower
           copay."/>
      </concept>
      <concept>
        <code value="SecurityPolicy"/>
        <abstract value="false"/>
        <display value="security policy"/>
        <definition value="Types of security policies that further specify the ActClassPolicy value set.        
                                                        Examples:                               
                                                          obligation to encrypt                 
                     refrain from redisclosure without consent"/>
        <concept>
          <code value="ObligationPolicy"/>
          <abstract value="false"/>
          <display value="obligation policy"/>
          <definition value="Conveys the mandated workflow action that an information custodian, receiver, or user
             must perform.                                                        Usage Notes: Per
             ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be
             performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model:
              This value set refers to the action required to receive the permission specified in the
             privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or
             policy that is performed in conjunction with the enforcement of an access control decision."/>
          <concept>
            <code value="ANONY"/>
            <abstract value="false"/>
            <display value="anonymize"/>
            <definition value="Custodian system must remove any information that could result in identifying the information
               subject."/>
          </concept>
          <concept>
            <code value="AOD"/>
            <abstract value="false"/>
            <display value="accounting of disclosure"/>
            <definition value="Custodian system must make available to an information subject upon request an accounting
               of certain disclosures of the individual’s protected health information over a period
               of time.  Policy may dictate that the accounting include information about the information
               disclosed,  the date of disclosure, the identification of the receiver, the purpose of
               the disclosure, the time in which the disclosing entity must provide a response and the
               time period for which accountings of disclosure can be requested."/>
          </concept>
          <concept>
            <code value="AUDIT"/>
            <abstract value="false"/>
            <display value="audit"/>
            <definition value="Custodian system must monitor systems to ensure that all users are authorized to operate
               on information objects."/>
          </concept>
          <concept>
            <code value="AUDTR"/>
            <abstract value="false"/>
            <display value="audit trail"/>
            <definition value="Custodian system must monitor and maintain retrievable log for each user and operation
               on information."/>
          </concept>
          <concept>
            <code value="CPLYCC"/>
            <abstract value="false"/>
            <display value="comply with confidentiality code"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with the information handling
               directions of the Confidentiality Code associated with an information target."/>
          </concept>
          <concept>
            <code value="CPLYCD"/>
            <abstract value="false"/>
            <display value="comply with consent directive"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with applicable information
               subject consent directives."/>
          </concept>
          <concept>
            <code value="CPLYJPP"/>
            <abstract value="false"/>
            <display value="comply with jurisdictional privacy policy"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional
               privacy policies associated with the target information."/>
          </concept>
          <concept>
            <code value="CPLYOPP"/>
            <abstract value="false"/>
            <display value="comply with organizational privacy policy"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with applicable organizational
               privacy policies associated with the target information."/>
          </concept>
          <concept>
            <code value="CPLYOSP"/>
            <abstract value="false"/>
            <display value="comply with organizational security policy"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with the organizational
               security policies associated with the target information."/>
          </concept>
          <concept>
            <code value="CPLYPOL"/>
            <abstract value="false"/>
            <display value="comply with policy"/>
            <definition value="Custodian security system must retrieve, evaluate, and comply with applicable policies
               associated with the target information."/>
          </concept>
          <concept>
            <code value="DEID"/>
            <abstract value="false"/>
            <display value="deidentify"/>
            <definition value="Custodian system must strip information of data that would allow the identification of
               the source of the information or the information subject."/>
          </concept>
          <concept>
            <code value="DELAU"/>
            <abstract value="false"/>
            <display value="delete after use"/>
            <definition value="Custodian system must remove target information from access after use."/>
          </concept>
          <concept>
            <code value="ENCRYPT"/>
            <abstract value="false"/>
            <display value="encrypt"/>
            <definition value="Custodian system must render information unreadable by algorithmically transforming plaintext
               into ciphertext.                                                                     
                           Usage Notes: A mathematical transposition of a file or data stream so that
               it cannot be deciphered at the receiving end without the proper key. Encryption is a security
               feature that assures that only the parties who are supposed to be participating in a videoconference
               or data transfer are able to do so. It can include a password, public and private keys,
               or a complex combination of all.  (Per Infoway.)"/>
            <concept>
              <code value="ENCRYPTR"/>
              <abstract value="false"/>
              <display value="encrypt at rest"/>
              <definition value="Custodian system must render information unreadable and unusable by algorithmically transforming
                 plaintext into ciphertext when &quot;at rest&quot; or in storage."/>
            </concept>
            <concept>
              <code value="ENCRYPTT"/>
              <abstract value="false"/>
              <display value="encrypt in transit"/>
              <definition value="Custodian system must render information unreadable and unusable by algorithmically transforming
                 plaintext into ciphertext while &quot;in transit&quot; or being transported by any means."/>
            </concept>
            <concept>
              <code value="ENCRYPTU"/>
              <abstract value="false"/>
              <display value="encrypt in use"/>
              <definition value="Custodian system must render information unreadable and unusable by algorithmically transforming
                 plaintext into ciphertext while in use such that operations permitted on the target information
                 are limited by the license granted to the end user."/>
            </concept>
          </concept>
          <concept>
            <code value="HUAPRV"/>
            <abstract value="false"/>
            <display value="human approval"/>
            <definition value="Custodian system must require human review and approval for permission requested."/>
          </concept>
          <concept>
            <code value="MASK"/>
            <abstract value="false"/>
            <display value="mask"/>
            <definition value="Custodian system must render information unreadable and unusable by algorithmically transforming
               plaintext into ciphertext.  User may be provided a key to decrypt per license or &quot;shared
               secret&quot;."/>
          </concept>
          <concept>
            <code value="MINEC"/>
            <abstract value="false"/>
            <display value="minimum necessary"/>
            <definition value="Custodian must limit access and disclosure to the minimum information required to support
               an authorized user's purpose of use.                                                 
                     Usage Note: Limiting the information available for access and disclosure to that
               an authorized user or receiver &quot;needs to know&quot; in order to perform permitted
               workflow or purpose of use."/>
          </concept>
          <concept>
            <code value="PRIVMARK"/>
            <abstract value="false"/>
            <display value="privacy mark"/>
            <definition value="Custodian must create and/or maintain human readable security label tags as required by
               policy.                          Map:  Aligns with ISO 22600-3 Section A.3.4.3 description
               of privacy mark:  &quot;If present, the privacy-mark is not used for access control. The
               content of the privacy-mark may be defined by the security policy in force (identified
               by the security-policy-identifier) which may define a list of values to be used. Alternately,
               the value may be determined by the originator of the security-label.&quot;"/>
          </concept>
          <concept>
            <code value="PSEUD"/>
            <abstract value="false"/>
            <display value="pseudonymize"/>
            <definition value="Custodian system must strip information of data that would allow the identification of
               the source of the information or the information subject.  Custodian may retain a key
               to relink data necessary to reidentify the information subject."/>
          </concept>
          <concept>
            <code value="REDACT"/>
            <abstract value="false"/>
            <display value="redact"/>
            <definition value="Custodian system must remove information, which is not authorized to be access, used,
               or disclosed from records made available to otherwise authorized users."/>
          </concept>
        </concept>
        <concept>
          <code value="RefrainPolicy"/>
          <abstract value="false"/>
          <display value="refrain policy"/>
          <definition value="Conveys prohibited actions which an information custodian, receiver, or user is not permitted
             to perform unless otherwise authorized or permitted under specified circumstances.   
                                                                                         Usage Notes:
             ISO 22600-2 species that a Refrain Policy &quot;defines actions the subjects must refrain
             from performing&quot;.  Per HL7 Composite Security and Privacy Domain Analysis Model:
              May be used to indicate that a specific action is prohibited based on specific access
             control attributes e.g., purpose of use, information type, user role, etc."/>
          <concept>
            <code value="NOAUTH"/>
            <abstract value="false"/>
            <display value="no disclosure without subject authorization"/>
            <definition value="Prohibition on disclosure without information subject's authorization."/>
          </concept>
          <concept>
            <code value="NOCOLLECT"/>
            <abstract value="false"/>
            <display value="no collection"/>
            <definition value="Prohibition on collection or storage of the information."/>
          </concept>
          <concept>
            <code value="NODSCLCD"/>
            <abstract value="false"/>
            <display value="no disclosure without consent directive"/>
            <definition value="Prohibition on disclosure without organizational approved patient restriction."/>
          </concept>
          <concept>
            <code value="NODSCLCDS"/>
            <abstract value="false"/>
            <display value="no disclosure without information subject's consent directive"/>
            <definition value="Prohibition on disclosure without a consent directive from the information subject."/>
          </concept>
          <concept>
            <code value="NOINTEGRATE"/>
            <abstract value="false"/>
            <display value="no integration"/>
            <definition value="Prohibition on Integration into other records."/>
          </concept>
          <concept>
            <code value="NOLIST"/>
            <abstract value="false"/>
            <display value="no unlisted entity disclosure"/>
            <definition value="Prohibition on disclosure except to entities on specific access list."/>
          </concept>
          <concept>
            <code value="NOMOU"/>
            <abstract value="false"/>
            <display value="no disclosure without MOU"/>
            <definition value="Prohibition on disclosure without an interagency service agreement or memorandum of understanding
               (MOU)."/>
          </concept>
          <concept>
            <code value="NOORGPOL"/>
            <abstract value="false"/>
            <display value="no disclosure without organizational authorization"/>
            <definition value="Prohibition on disclosure without organizational authorization."/>
          </concept>
          <concept>
            <code value="NOPAT"/>
            <abstract value="false"/>
            <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/>
            <definition value="Prohibition on disclosing information to patient, family or caregivers without attending
               provider's authorization.                                                      Usage Note:
               The information may be labeled with the ActInformationSensitivity TBOO code, triggering
               application of this RefrainPolicy code as a handling caveat controlling access.      
                                  Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when
               the alert records information on patient abuse or non-compliance.                    
                    FHIR print name is &quot;keep information from patient&quot;. Maps to the French
               realm - code: INVISIBLE_PATIENT.                                                     
               displayName: Document non visible par le patient                            codingScheme:
               1.2.250.1.213.1.1.4.13                                                  French use case:
                A label for documents that the author  chose to hide from the patient until the content
               can be disclose to the patient in a face to face meeting between a healthcare professional
               and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must
               be announced to the patient by a healthcare professional and should not be find out by
               the patient alone)."/>
          </concept>
          <concept>
            <code value="NOPERSISTP"/>
            <abstract value="false"/>
            <display value="no collection beyond purpose of use"/>
            <definition value="Prohibition on collection of the information beyond time necessary to accomplish authorized
               purpose of use is prohibited."/>
          </concept>
          <concept>
            <code value="NORDSCLCD"/>
            <abstract value="false"/>
            <display value="no redisclosure without consent directive"/>
            <definition value="Prohibition on redisclosure without patient consent directive."/>
          </concept>
          <concept>
            <code value="NORDSCLCDS"/>
            <abstract value="false"/>
            <display value="no redisclosure without information subject's consent directive"/>
            <definition value="Prohibition on redisclosure without a consent directive from the information subject."/>
          </concept>
          <concept>
            <code value="NORDSCLW"/>
            <abstract value="false"/>
            <display value="no disclosure without jurisdictional authorization"/>
            <definition value="Prohibition on disclosure without authorization under jurisdictional law."/>
          </concept>
          <concept>
            <code value="NORELINK"/>
            <abstract value="false"/>
            <display value="no relinking"/>
            <definition value="Prohibition on associating de-identified or pseudonymized information with other information
               in a manner that could or does result in disclosing information intended to be masked."/>
          </concept>
          <concept>
            <code value="NOREUSE"/>
            <abstract value="false"/>
            <display value="no reuse beyond purpose of use"/>
            <definition value="Prohibition on use of the information beyond the purpose of use initially authorized."/>
          </concept>
          <concept>
            <code value="NOVIP"/>
            <abstract value="false"/>
            <display value="no unauthorized VIP disclosure"/>
            <definition value="Prohibition on disclosure except to principals with access permission to specific VIP
               information."/>
          </concept>
          <concept>
            <code value="ORCON"/>
            <abstract value="false"/>
            <display value="no disclosure without originator authorization"/>
            <definition value="Prohibition on disclosure except as permitted by the information originator."/>
          </concept>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActProductAcquisitionCode"/>
      <abstract value="true"/>
      <display value="ActProductAcquisitionCode"/>
      <definition value="The method that a product is obtained for use by the subject of the supply act (e.g. patient).
          Product examples are consumable or durable goods."/>
      <concept>
        <code value="LOAN"/>
        <abstract value="false"/>
        <display value="Loan"/>
        <definition value="Temporary supply of a product without transfer of ownership for the product."/>
        <concept>
          <code value="RENT"/>
          <abstract value="false"/>
          <display value="Rent"/>
          <definition value="Temporary supply of a product with financial compensation, without transfer of ownership
             for the product."/>
        </concept>
      </concept>
      <concept>
        <code value="TRANSFER"/>
        <abstract value="false"/>
        <display value="Transfer"/>
        <definition value="Transfer of ownership for a product."/>
        <concept>
          <code value="SALE"/>
          <abstract value="false"/>
          <display value="Sale"/>
          <definition value="Transfer of ownership for a product for financial compensation."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActSpecimenTransportCode"/>
      <abstract value="true"/>
      <display value="ActSpecimenTransportCode"/>
      <definition value="Transportation of a specimen."/>
      <concept>
        <code value="SREC"/>
        <abstract value="false"/>
        <display value="specimen received"/>
        <definition value="Description:Specimen has been received by the participating organization/department."/>
      </concept>
      <concept>
        <code value="SSTOR"/>
        <abstract value="false"/>
        <display value="specimen in storage"/>
        <definition value="Description:Specimen has been placed into storage at a participating location."/>
      </concept>
      <concept>
        <code value="STRAN"/>
        <abstract value="false"/>
        <display value="specimen in transit"/>
        <definition value="Description:Specimen has been put in transit to a participating receiver."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActSpecimenTreatmentCode"/>
      <abstract value="true"/>
      <display value="ActSpecimenTreatmentCode"/>
      <definition value="Set of codes related to specimen treatments"/>
      <concept>
        <code value="ACID"/>
        <abstract value="false"/>
        <display value="Acidification"/>
        <definition value="The lowering of specimen pH through the addition of an acid"/>
      </concept>
      <concept>
        <code value="ALK"/>
        <abstract value="false"/>
        <display value="Alkalization"/>
        <definition value="The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities."/>
      </concept>
      <concept>
        <code value="DEFB"/>
        <abstract value="false"/>
        <display value="Defibrination"/>
        <definition value="The removal of fibrin from whole blood or plasma through physical or chemical means"/>
      </concept>
      <concept>
        <code value="FILT"/>
        <abstract value="false"/>
        <display value="Filtration"/>
        <definition value="The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum
           (suction)."/>
      </concept>
      <concept>
        <code value="LDLP"/>
        <abstract value="false"/>
        <display value="LDL Precipitation"/>
      </concept>
      <concept>
        <code value="NEUT"/>
        <abstract value="false"/>
        <display value="Neutralization"/>
        <definition value="The act or process by which an acid and a base are combined in such proportions that the
           resulting compound is neutral."/>
      </concept>
      <concept>
        <code value="RECA"/>
        <abstract value="false"/>
        <display value="Recalcification"/>
        <definition value="The addition of calcium back to a specimen after it was removed by chelating agents"/>
      </concept>
      <concept>
        <code value="UFIL"/>
        <abstract value="false"/>
        <display value="Ultrafiltration"/>
        <definition value="The filtration of a colloidal substance through a semipermeable medium that allows only
           the passage of small molecules."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActSubstanceAdministrationCode"/>
      <abstract value="true"/>
      <display value="ActSubstanceAdministrationCode"/>
      <definition value="Description: Describes the type of substance administration being performed.  This should
         not be used to carry codes for identification of products.  Use an associated role or
         entity to carry such information."/>
      <concept>
        <code value="DRUG"/>
        <abstract value="false"/>
        <display value="Drug therapy"/>
        <definition value="The introduction of a drug into a subject with the intention of altering its biologic
           state with the intent of improving its health status."/>
      </concept>
      <concept>
        <code value="FD"/>
        <abstract value="false"/>
        <display value="food"/>
        <definition value="Description: The introduction of material into a subject with the intent of providing
           nutrition or other dietary supplements (e.g. minerals or vitamins)."/>
      </concept>
      <concept>
        <code value="IMMUNIZ"/>
        <abstract value="false"/>
        <display value="Immunization"/>
        <definition value="The introduction of an immunogen with the intent of stimulating an immune response, aimed
           at preventing subsequent infections by more viable agents."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActTaskCode"/>
      <abstract value="true"/>
      <display value="ActTaskCode"/>
      <definition value="Description: A task or action that a user may perform in a clinical information system
         (e.g., medication order entry, laboratory test results review, problem list entry)."/>
      <concept>
        <code value="OE"/>
        <abstract value="false"/>
        <display value="order entry task"/>
        <definition value="A clinician creates a request for a service to be performed for a given patient."/>
        <concept>
          <code value="LABOE"/>
          <abstract value="false"/>
          <display value="laboratory test order entry task"/>
          <definition value="A clinician creates a request for a laboratory test to be done for a given patient."/>
        </concept>
        <concept>
          <code value="MEDOE"/>
          <abstract value="false"/>
          <display value="medication order entry task"/>
          <definition value="A clinician creates a request for the administration of one or more medications to a given
             patient."/>
        </concept>
      </concept>
      <concept>
        <code value="PATDOC"/>
        <abstract value="false"/>
        <display value="patient documentation task"/>
        <definition value="A person enters documentation about a given patient."/>
        <concept>
          <code value="ALLERLREV"/>
          <abstract value="false"/>
          <display value="allergy list review"/>
          <definition value="Description: A person reviews a list of known allergies of a given patient."/>
        </concept>
        <concept>
          <code value="CLINNOTEE"/>
          <abstract value="false"/>
          <display value="clinical note entry task"/>
          <definition value="A clinician enters a clinical note about a given patient"/>
          <concept>
            <code value="DIAGLISTE"/>
            <abstract value="false"/>
            <display value="diagnosis list entry task"/>
            <definition value="A clinician enters a diagnosis for a given patient."/>
          </concept>
          <concept>
            <code value="DISCHINSTE"/>
            <abstract value="false"/>
            <display value="discharge instruction entry"/>
            <definition value="A person provides a discharge instruction to a patient."/>
          </concept>
          <concept>
            <code value="DISCHSUME"/>
            <abstract value="false"/>
            <display value="discharge summary entry task"/>
            <definition value="A clinician enters a discharge summary for a given patient."/>
          </concept>
          <concept>
            <code value="PATEDUE"/>
            <abstract value="false"/>
            <display value="patient education entry"/>
            <definition value="A person provides a patient-specific education handout to a patient."/>
          </concept>
          <concept>
            <code value="PATREPE"/>
            <abstract value="false"/>
            <display value="pathology report entry task"/>
            <definition value="A pathologist enters a report for a given patient."/>
          </concept>
          <concept>
            <code value="PROBLISTE"/>
            <abstract value="false"/>
            <display value="problem list entry task"/>
            <definition value="A clinician enters a problem for a given patient."/>
          </concept>
          <concept>
            <code value="RADREPE"/>
            <abstract value="false"/>
            <display value="radiology report entry task"/>
            <definition value="A radiologist enters a report for a given patient."/>
          </concept>
        </concept>
        <concept>
          <code value="IMMLREV"/>
          <abstract value="false"/>
          <display value="immunization list review"/>
          <definition value="Description: A person reviews a list of immunizations due or received for a given patient."/>
        </concept>
        <concept>
          <code value="REMLREV"/>
          <abstract value="false"/>
          <display value="reminder list review"/>
          <definition value="Description: A person reviews a list of health care reminders for a given patient."/>
          <concept>
            <code value="WELLREMLREV"/>
            <abstract value="false"/>
            <display value="wellness reminder list review"/>
            <definition value="Description: A person reviews a list of wellness or preventive care reminders for a given
               patient."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="PATINFO"/>
        <abstract value="false"/>
        <display value="patient information review task"/>
        <definition value="A person (e.g., clinician, the patient herself) reviews patient information in the electronic
           medical record."/>
        <concept>
          <code value="ALLERLE"/>
          <abstract value="false"/>
          <display value="allergy list entry"/>
          <definition value="Description: A person enters a known allergy for a given patient."/>
        </concept>
        <concept>
          <code value="CDSREV"/>
          <abstract value="false"/>
          <display value="clinical decision support intervention review"/>
          <definition value="A person reviews a recommendation/assessment provided automatically by a clinical decision
             support application for a given patient."/>
        </concept>
        <concept>
          <code value="CLINNOTEREV"/>
          <abstract value="false"/>
          <display value="clinical note review task"/>
          <definition value="A person reviews a clinical note of a given patient."/>
          <concept>
            <code value="DISCHSUMREV"/>
            <abstract value="false"/>
            <display value="discharge summary review task"/>
            <definition value="A person reviews a discharge summary of a given patient."/>
          </concept>
        </concept>
        <concept>
          <code value="DIAGLISTREV"/>
          <abstract value="false"/>
          <display value="diagnosis list review task"/>
          <definition value="A person reviews a list of diagnoses of a given patient."/>
        </concept>
        <concept>
          <code value="IMMLE"/>
          <abstract value="false"/>
          <display value="immunization list entry"/>
          <definition value="Description: A person enters an immunization due or received for a given patient."/>
        </concept>
        <concept>
          <code value="LABRREV"/>
          <abstract value="false"/>
          <display value="laboratory results review task"/>
          <definition value="A person reviews a list of laboratory results of a given patient."/>
        </concept>
        <concept>
          <code value="MICRORREV"/>
          <abstract value="false"/>
          <display value="microbiology results review task"/>
          <definition value="A person reviews a list of microbiology results of a given patient."/>
          <concept>
            <code value="MICROORGRREV"/>
            <abstract value="false"/>
            <display value="microbiology organisms results review task"/>
            <definition value="A person reviews organisms of microbiology results of a given patient."/>
          </concept>
          <concept>
            <code value="MICROSENSRREV"/>
            <abstract value="false"/>
            <display value="microbiology sensitivity test results review task"/>
            <definition value="A person reviews the sensitivity test of microbiology results of a given patient."/>
          </concept>
        </concept>
        <concept>
          <code value="MLREV"/>
          <abstract value="false"/>
          <display value="medication list review task"/>
          <definition value="A person reviews a list of medication orders submitted to a given patient"/>
          <concept>
            <code value="MARWLREV"/>
            <abstract value="false"/>
            <display value="medication administration record work list review task"/>
            <definition value="A clinician reviews a work list of medications to be administered to a given patient."/>
          </concept>
        </concept>
        <concept>
          <code value="OREV"/>
          <abstract value="false"/>
          <display value="orders review task"/>
          <definition value="A person reviews a list of orders submitted to a given patient."/>
        </concept>
        <concept>
          <code value="PATREPREV"/>
          <abstract value="false"/>
          <display value="pathology report review task"/>
          <definition value="A person reviews a pathology report of a given patient."/>
        </concept>
        <concept>
          <code value="PROBLISTREV"/>
          <abstract value="false"/>
          <display value="problem list review task"/>
          <definition value="A person reviews a list of problems of a given patient."/>
        </concept>
        <concept>
          <code value="RADREPREV"/>
          <abstract value="false"/>
          <display value="radiology report review task"/>
          <definition value="A person reviews a radiology report of a given patient."/>
        </concept>
        <concept>
          <code value="REMLE"/>
          <abstract value="false"/>
          <display value="reminder list entry"/>
          <definition value="Description: A person enters a health care reminder for a given patient."/>
          <concept>
            <code value="WELLREMLE"/>
            <abstract value="false"/>
            <display value="wellness reminder list entry"/>
            <definition value="Description: A person enters a wellness or preventive care reminder for a given patient."/>
          </concept>
        </concept>
        <concept>
          <code value="RISKASSESS"/>
          <abstract value="false"/>
          <display value="risk assessment instrument task"/>
          <definition value="A person reviews a Risk Assessment Instrument report of a given patient."/>
          <concept>
            <code value="FALLRISK"/>
            <abstract value="false"/>
            <display value="falls risk assessment instrument task"/>
            <definition value="A person reviews a Falls Risk Assessment Instrument report of a given patient."/>
          </concept>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActTransportationModeCode"/>
      <abstract value="true"/>
      <display value="ActTransportationModeCode"/>
      <definition value="Characterizes how a transportation act was or will be carried out.                   
                                           Examples: Via private transport, via public transit,
         via courier."/>
      <concept>
        <code value="_ActPatientTransportationModeCode"/>
        <abstract value="true"/>
        <display value="ActPatientTransportationModeCode"/>
        <definition value="Definition: Characterizes how a patient was or will be transported to the site of a patient
           encounter.                                                      Examples: Via ambulance,
           via public transit, on foot."/>
        <concept>
          <code value="AFOOT"/>
          <abstract value="false"/>
          <display value="pedestrian transport"/>
        </concept>
        <concept>
          <code value="AMBT"/>
          <abstract value="false"/>
          <display value="ambulance transport"/>
          <concept>
            <code value="AMBAIR"/>
            <abstract value="false"/>
            <display value="fixed-wing ambulance transport"/>
          </concept>
          <concept>
            <code value="AMBGRND"/>
            <abstract value="false"/>
            <display value="ground ambulance transport"/>
          </concept>
          <concept>
            <code value="AMBHELO"/>
            <abstract value="false"/>
            <display value="helicopter ambulance transport"/>
          </concept>
        </concept>
        <concept>
          <code value="LAWENF"/>
          <abstract value="false"/>
          <display value="law enforcement transport"/>
        </concept>
        <concept>
          <code value="PRVTRN"/>
          <abstract value="false"/>
          <display value="private transport"/>
        </concept>
        <concept>
          <code value="PUBTRN"/>
          <abstract value="false"/>
          <display value="public transport"/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ObservationType"/>
      <abstract value="true"/>
      <display value="ObservationType"/>
      <definition value="Identifies the kinds of observations that can be performed"/>
      <concept>
        <code value="_ActSpecObsCode"/>
        <abstract value="true"/>
        <display value="ActSpecObsCode"/>
        <definition value="Identifies the type of observation that is made about a specimen that may affect its processing,
           analysis or further result interpretation"/>
        <concept>
          <code value="ARTBLD"/>
          <abstract value="false"/>
          <display value="ActSpecObsArtBldCode"/>
          <definition value="Describes the artificial blood identifier that is associated with the specimen."/>
        </concept>
        <concept>
          <code value="DILUTION"/>
          <abstract value="false"/>
          <display value="ActSpecObsDilutionCode"/>
          <definition value="An observation that reports the dilution of a sample."/>
          <concept>
            <code value="AUTO-HIGH"/>
            <abstract value="false"/>
            <display value="Auto-High Dilution"/>
            <definition value="The dilution of a sample performed by automated equipment.  The value is specified by
               the equipment"/>
          </concept>
          <concept>
            <code value="AUTO-LOW"/>
            <abstract value="false"/>
            <display value="Auto-Low Dilution"/>
            <definition value="The dilution of a sample performed by automated equipment.  The value is specified by
               the equipment"/>
          </concept>
          <concept>
            <code value="PRE"/>
            <abstract value="false"/>
            <display value="Pre-Dilution"/>
            <definition value="The dilution of the specimen made prior to being loaded onto analytical equipment"/>
          </concept>
          <concept>
            <code value="RERUN"/>
            <abstract value="false"/>
            <display value="Rerun Dilution"/>
            <definition value="The value of the dilution of a sample after it had been analyzed at a prior dilution value"/>
          </concept>
        </concept>
        <concept>
          <code value="EVNFCTS"/>
          <abstract value="false"/>
          <display value="ActSpecObsEvntfctsCode"/>
          <definition value="Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)"/>
        </concept>
        <concept>
          <code value="INTFR"/>
          <abstract value="false"/>
          <display value="ActSpecObsInterferenceCode"/>
          <definition value="An observation that relates to factors that may potentially cause interference with the
             observation"/>
          <concept>
            <code value="FIBRIN"/>
            <abstract value="false"/>
            <display value="Fibrin"/>
            <definition value="The Fibrin Index of the specimen. In the case of only differentiating between Absent and
               Present, recommend using 0 and 1"/>
          </concept>
          <concept>
            <code value="HEMOLYSIS"/>
            <abstract value="false"/>
            <display value="Hemolysis"/>
            <definition value="An observation of the hemolysis index of the specimen in g/L"/>
          </concept>
          <concept>
            <code value="ICTERUS"/>
            <abstract value="false"/>
            <display value="Icterus"/>
            <definition value="An observation that describes the icterus index of the specimen.  It is recommended to
               use mMol/L of bilirubin"/>
          </concept>
          <concept>
            <code value="LIPEMIA"/>
            <abstract value="false"/>
            <display value="Lipemia"/>
            <definition value="An observation used to describe the Lipemia Index of the specimen. It is recommended to
               use the optical turbidity at 600 nm (in absorbance units)."/>
          </concept>
        </concept>
        <concept>
          <code value="VOLUME"/>
          <abstract value="false"/>
          <display value="ActSpecObsVolumeCode"/>
          <definition value="An observation that reports the volume of a sample."/>
          <concept>
            <code value="AVAILABLE"/>
            <abstract value="false"/>
            <display value="Available Volume"/>
            <definition value="The available quantity of specimen.   This is the current quantity minus any planned consumption
               (e.g., tests that are planned)"/>
          </concept>
          <concept>
            <code value="CONSUMPTION"/>
            <abstract value="false"/>
            <display value="Consumption Volume"/>
            <definition value="The quantity of specimen that is used each time the equipment uses this substance"/>
          </concept>
          <concept>
            <code value="CURRENT"/>
            <abstract value="false"/>
            <display value="Current Volume"/>
            <definition value="The current quantity of the specimen, i.e., initial quantity minus what has been actually
               used."/>
          </concept>
          <concept>
            <code value="INITIAL"/>
            <abstract value="false"/>
            <display value="Initial Volume"/>
            <definition value="The initial quantity of the specimen in inventory"/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_AnnotationType"/>
        <abstract value="true"/>
        <display value="AnnotationType"/>
        <concept>
          <code value="_ActPatientAnnotationType"/>
          <abstract value="false"/>
          <display value="ActPatientAnnotationType"/>
          <definition value="Description:Provides a categorization for annotations recorded directly against the patient
             ."/>
          <concept>
            <code value="ANNDI"/>
            <abstract value="false"/>
            <display value="diagnostic image note"/>
            <definition value="Description:A note that is specific to a patient's diagnostic images, either historical,
               current or planned."/>
          </concept>
          <concept>
            <code value="ANNGEN"/>
            <abstract value="false"/>
            <display value="general note"/>
            <definition value="Description:A general or uncategorized note."/>
          </concept>
          <concept>
            <code value="ANNIMM"/>
            <abstract value="false"/>
            <display value="immunization note"/>
            <definition value="A note that is specific to a patient's immunizations, either historical, current or planned."/>
          </concept>
          <concept>
            <code value="ANNLAB"/>
            <abstract value="false"/>
            <display value="laboratory note"/>
            <definition value="Description:A note that is specific to a patient's laboratory results, either historical,
               current or planned."/>
          </concept>
          <concept>
            <code value="ANNMED"/>
            <abstract value="false"/>
            <display value="medication note"/>
            <definition value="Description:A note that is specific to a patient's medications, either historical, current
               or planned."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_GeneticObservationType"/>
        <abstract value="true"/>
        <display value="GeneticObservationType"/>
        <definition value="Description: None provided"/>
        <concept>
          <code value="GENE"/>
          <abstract value="false"/>
          <display value="gene"/>
          <definition value="Description: A DNA segment that contributes to phenotype/function. In the absence of demonstrated
             function a gene may be characterized by sequence, transcription or homology"/>
        </concept>
      </concept>
      <concept>
        <code value="_ImmunizationObservationType"/>
        <abstract value="false"/>
        <display value="ImmunizationObservationType"/>
        <definition value="Description: Observation codes which describe characteristics of the immunization material."/>
        <concept>
          <code value="OBSANTC"/>
          <abstract value="false"/>
          <display value="antigen count"/>
          <definition value="Description: Indicates the valid antigen count."/>
        </concept>
        <concept>
          <code value="OBSANTV"/>
          <abstract value="false"/>
          <display value="antigen validity"/>
          <definition value="Description: Indicates whether an antigen is valid or invalid."/>
        </concept>
      </concept>
      <concept>
        <code value="_IndividualCaseSafetyReportType"/>
        <abstract value="true"/>
        <display value="Individual Case Safety Report Type"/>
        <definition value="A code that is used to indicate the type of case safety report received from sender. The
           current code example reference is from the International Conference on Harmonisation (ICH)
           Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission
           of Individual Case Safety Reports. The unknown/unavailable option allows the transmission
           of information from a secondary sender where the initial sender did not specify the type
           of report.                          Example concepts include: Spontaneous, Report from
           study, Other."/>
        <concept>
          <code value="PAT_ADV_EVNT"/>
          <abstract value="false"/>
          <display value="patient adverse event"/>
          <definition value="Indicates that the ICSR is describing problems that a patient experienced after receiving
             a vaccine product."/>
        </concept>
        <concept>
          <code value="VAC_PROBLEM"/>
          <abstract value="false"/>
          <display value="vaccine product problem"/>
          <definition value="Indicates that the ICSR is describing a problem with the actual vaccine product such as
             physical defects (cloudy, particulate matter) or inability to confer immunity."/>
        </concept>
      </concept>
      <concept>
        <code value="_LOINCObservationActContextAgeType"/>
        <abstract value="true"/>
        <display value="LOINCObservationActContextAgeType"/>
        <definition value="Definition:The set of LOINC codes for the act of determining the period of time that has
           elapsed since an entity was born or created."/>
        <concept>
          <code value="21611-9"/>
          <abstract value="false"/>
          <display value="age patient qn est"/>
          <definition value="Definition:Estimated age."/>
        </concept>
        <concept>
          <code value="21612-7"/>
          <abstract value="false"/>
          <display value="age patient qn reported"/>
          <definition value="Definition:Reported age."/>
        </concept>
        <concept>
          <code value="29553-5"/>
          <abstract value="false"/>
          <display value="age patient qn calc"/>
          <definition value="Definition:Calculated age."/>
        </concept>
        <concept>
          <code value="30525-0"/>
          <abstract value="false"/>
          <display value="age patient qn definition"/>
          <definition value="Definition:General specification of age with no implied method of determination."/>
        </concept>
        <concept>
          <code value="30972-4"/>
          <abstract value="false"/>
          <display value="age at onset of adverse event"/>
          <definition value="Definition:Age at onset of associated adverse event; no implied method of determination."/>
        </concept>
      </concept>
      <concept>
        <code value="_MedicationObservationType"/>
        <abstract value="true"/>
        <display value="MedicationObservationType"/>
        <concept>
          <code value="REP_HALF_LIFE"/>
          <abstract value="false"/>
          <display value="representative half-life"/>
          <definition value="Description:This observation represents an 'average' or 'expected' half-life typical of
             the product."/>
        </concept>
        <concept>
          <code value="SPLCOATING"/>
          <abstract value="false"/>
          <display value="coating"/>
          <definition value="Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating
             whether it has one or more coatings such as sugar coating, film coating, or enteric coating.
              Only coatings to the external surface or the dosage form should be considered (for example,
             coatings to individual pellets or granules inside a capsule or tablet are excluded from
             consideration).                                                      Constraints: The
             Observation.value must be a Boolean (BL) with true for the presence or false for the absence
             of one or more coatings on a solid dosage form."/>
        </concept>
        <concept>
          <code value="SPLCOLOR"/>
          <abstract value="false"/>
          <display value="color"/>
          <definition value="Definition:  A characteristic of an oral solid dosage form of a medicinal product, specifying
             the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR
             is not an FDA specification for the actual color of solid dosage forms or the names of
             colors that can appear in labeling.                                                  
                Constraints: The Observation.value must be a single coded value or a list of multiple
             coded values, specifying one or more distinct colors that approximate of the color(s)
             of distinct areas of the solid dosage form, such as the different sides of a tablet or
             one-part capsule, or the different halves of a two-part capsule.  Bands on banded capsules,
             regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the
             dosage form, regardless of their color are not considered when assigning an SPLCOLOR.
             If more than one color exists on a particular side or half, then the most predominant
             color on that side or half is recorded.  If the gelatin capsule shell is colorless and
             transparent, use the predominant color of the contents that appears through the colorless
             and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Ora
            nge;Brown;Blue;Turquoise."/>
        </concept>
        <concept>
          <code value="SPLIMAGE"/>
          <abstract value="false"/>
          <display value="image"/>
          <definition value="Description: A characteristic representing a single file reference that contains two or
             more views of the same dosage form of the product; in most cases this should represent
             front and back views of the dosage form, but occasionally additional views might be needed
             in order to capture all of the important physical characteristics of the dosage form.
              Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally
             need to rotate the image in order to read it.  Images that are submitted with SPL should
             be included in the same directory as the SPL file."/>
        </concept>
        <concept>
          <code value="SPLIMPRINT"/>
          <abstract value="false"/>
          <display value="imprint"/>
          <definition value="Definition:  A characteristic of an oral solid dosage form of a medicinal product, specifying
             the alphanumeric text that appears on the solid dosage form, including text that is embossed,
             debossed, engraved or printed with ink. The presence of other non-textual distinguishing
             marks or symbols is recorded by SPLSYMBOL.                                           
                       Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands
             of banded capsules and logos and other symbols that can be interpreted as letters or numbers.
                                                                  Constraints: The Observation.value
             must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external
             cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when
             referring to a registered trademark) and the letters 'TM' (when referring to a 'trade
             mark').  To record text, begin on either side or part of the dosage form. Start at the
             top left and progress as one would normally read a book.  Enter a semicolon to show separation
             between words or line divisions."/>
        </concept>
        <concept>
          <code value="SPLSCORING"/>
          <abstract value="false"/>
          <display value="scoring"/>
          <definition value="Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying
             the number of equal pieces that the solid dosage form can be divided into using score
             line(s).                                                       Example: One score line
             creating two equal pieces is given a value of 2, two parallel score lines creating three
             equal pieces is given a value of 3.                                                  
                Constraints: Whether three parallel score lines create four equal pieces or two intersecting
             score lines create two equal pieces using one score line and four equal pieces using both
             score lines, both have the scoring value of 4. Solid dosage forms that are not scored
             are given a value of 1. Solid dosage forms that can only be divided into unequal pieces
             are given a null-value with nullFlavor other (OTH)."/>
        </concept>
        <concept>
          <code value="SPLSHAPE"/>
          <abstract value="false"/>
          <display value="shape"/>
          <definition value="Description: A characteristic of an oral solid dosage form of a medicinal product, specifying
             the two dimensional representation of the solid dose form, in terms of the outside perimeter
             of a solid dosage form when the dosage form, resting on a flat surface, is viewed from
             directly above, including slight rounding of corners. SPLSHAPE does not include embossing,
             scoring, debossing, or internal cut-outs.  SPLSHAPE is independent of the orientation
             of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle;
             Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear;
             Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform."/>
        </concept>
        <concept>
          <code value="SPLSIZE"/>
          <abstract value="false"/>
          <display value="size"/>
          <definition value="Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying
             the longest single dimension of the solid dosage form as a physical quantity in the dimension
             of length (e.g., 3 mm). The length is should be specified in millimeters and should be
             rounded to the nearest whole millimeter.                                             
                     Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for
             a round shaped tablet is the diameter."/>
        </concept>
        <concept>
          <code value="SPLSYMBOL"/>
          <abstract value="false"/>
          <display value="symbol"/>
          <definition value="Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe
             whether or not the medicinal product has a mark or symbol appearing on it for easy and
             definite recognition.  Score lines, letters, numbers, and internal and external cut-outs
             are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics.
                                                                  Constraints: The Observation.value
             must be a Boolean (BL) with &lt;u&gt;true&lt;/u&gt; indicating the presence and &lt;u&gt;false&lt;/u
            &gt; for the absence of marks or symbols.                                             
                     Example:"/>
        </concept>
      </concept>
      <concept>
        <code value="_ObservationIssueTriggerCodedObservationType"/>
        <abstract value="true"/>
        <display value="ObservationIssueTriggerCodedObservationType"/>
        <definition value="Distinguishes the kinds of coded observations that could be the trigger for clinical issue
           detection. These are observations that are not measurable, but instead can be defined
           with codes. Coded observation types include: Allergy, Intolerance, Medical Condition,
           Pregnancy status, etc."/>
        <concept>
          <code value="_CaseTransmissionMode"/>
          <abstract value="true"/>
          <display value="case transmission mode"/>
          <definition value="Code for the mechanism by which disease was acquired by the living subject involved in
             the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne,
             foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure,
             indeterminate."/>
          <concept>
            <code value="AIRTRNS"/>
            <abstract value="false"/>
            <display value="airborne transmission"/>
            <definition value="Communication of an agent from a living subject or environmental source to a living subject
               through indirect contact via oral or nasal inhalation."/>
          </concept>
          <concept>
            <code value="ANANTRNS"/>
            <abstract value="false"/>
            <display value="animal to animal transmission"/>
            <definition value="Communication of an agent from one animal to another proximate animal."/>
          </concept>
          <concept>
            <code value="ANHUMTRNS"/>
            <abstract value="false"/>
            <display value="animal to human transmission"/>
            <definition value="Communication of an agent from an animal to a proximate person."/>
          </concept>
          <concept>
            <code value="BDYFLDTRNS"/>
            <abstract value="false"/>
            <display value="body fluid contact transmission"/>
            <definition value="Communication of an agent from one living subject to another living subject through direct
               contact with any body fluid."/>
          </concept>
          <concept>
            <code value="BLDTRNS"/>
            <abstract value="false"/>
            <display value="blood borne transmission"/>
            <definition value="Communication of an agent to a living subject through direct contact with blood or blood
               products whether the contact with blood is part of  a therapeutic procedure or not."/>
          </concept>
          <concept>
            <code value="DERMTRNS"/>
            <abstract value="false"/>
            <display value="transdermal transmission"/>
            <definition value="Communication of an agent from a living subject or environmental source to a living subject
               via agent migration through intact skin."/>
          </concept>
          <concept>
            <code value="ENVTRNS"/>
            <abstract value="false"/>
            <display value="environmental exposure transmission"/>
            <definition value="Communication of an agent from an environmental surface or source to a living subject
               by direct contact."/>
          </concept>
          <concept>
            <code value="FECTRNS"/>
            <abstract value="false"/>
            <display value="fecal-oral transmission"/>
            <definition value="Communication of an agent from a living subject or environmental source to a living subject
               through oral contact with material contaminated by person or animal fecal material."/>
          </concept>
          <concept>
            <code value="FOMTRNS"/>
            <abstract value="false"/>
            <display value="fomite transmission"/>
            <definition value="Communication of an agent from an non-living material to a living subject through direct
               contact."/>
          </concept>
          <concept>
            <code value="FOODTRNS"/>
            <abstract value="false"/>
            <display value="food-borne transmission"/>
            <definition value="Communication of an agent from a food source to a living subject via oral consumption."/>
          </concept>
          <concept>
            <code value="HUMHUMTRNS"/>
            <abstract value="false"/>
            <display value="human to human transmission"/>
            <definition value="Communication of an agent from a person to a proximate person."/>
          </concept>
          <concept>
            <code value="INDTRNS"/>
            <abstract value="false"/>
            <display value="indeterminate disease transmission mode"/>
            <definition value="Communication of an agent to a living subject via an undetermined route."/>
          </concept>
          <concept>
            <code value="LACTTRNS"/>
            <abstract value="false"/>
            <display value="lactation transmission"/>
            <definition value="Communication of an agent from one living subject to another living subject through direct
               contact with mammalian milk or colostrum."/>
          </concept>
          <concept>
            <code value="NOSTRNS"/>
            <abstract value="false"/>
            <display value="nosocomial transmission"/>
            <definition value="Communication of an agent from any entity to a living subject while the living subject
               is in the patient role in a healthcare facility."/>
          </concept>
          <concept>
            <code value="PARTRNS"/>
            <abstract value="false"/>
            <display value="parenteral transmission"/>
            <definition value="Communication of an agent from a living subject or environmental source to a living subject
               where the acquisition of the agent is not via the alimentary canal."/>
          </concept>
          <concept>
            <code value="PLACTRNS"/>
            <abstract value="false"/>
            <display value="transplacental transmission"/>
            <definition value="Communication of an agent from a living subject to the progeny of that living subject
               via agent migration across the maternal-fetal placental membranes while in utero."/>
          </concept>
          <concept>
            <code value="SEXTRNS"/>
            <abstract value="false"/>
            <display value="sexual transmission"/>
            <definition value="Communication of an agent from one living subject to another living subject through direct
               contact with genital or oral tissues as part of a sexual act."/>
          </concept>
          <concept>
            <code value="TRNSFTRNS"/>
            <abstract value="false"/>
            <display value="transfusion transmission"/>
            <definition value="Communication of an agent from one living subject to another living subject through direct
               contact with blood or blood products where the contact with blood is part of  a therapeutic
               procedure."/>
          </concept>
          <concept>
            <code value="VECTRNS"/>
            <abstract value="false"/>
            <display value="vector-borne transmission"/>
            <definition value="Communication of an agent from a living subject acting as a required intermediary in the
               agent transmission process to a recipient living subject via direct contact."/>
          </concept>
          <concept>
            <code value="WATTRNS"/>
            <abstract value="false"/>
            <display value="water-borne transmission"/>
            <definition value="Communication of an agent from a contaminated water source to a living subject whether
               the water is ingested as a food or not. The route of entry of the water may be through
               any bodily orifice."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_ObservationQualityMeasureAttribute"/>
        <abstract value="false"/>
        <display value="ObservationQualityMeasureAttribute"/>
        <definition value="Codes used to define various metadata aspects of a health quality measure."/>
        <concept>
          <code value="AGGREGATE"/>
          <abstract value="false"/>
          <display value="aggregate measure observation"/>
          <definition value="Indicates that the observation is carrying out an aggregation calculation, contained in
             the value element."/>
        </concept>
        <concept>
          <code value="COPY"/>
          <abstract value="false"/>
          <display value="copyright"/>
          <definition value="Identifies the organization(s) who own the intellectual property represented by the eMeasure."/>
        </concept>
        <concept>
          <code value="CRS"/>
          <abstract value="false"/>
          <display value="clinical recommendation statement"/>
          <definition value="Summary of relevant clinical guidelines or other clinical recommendations supporting this
             eMeasure."/>
        </concept>
        <concept>
          <code value="DEF"/>
          <abstract value="false"/>
          <display value="definition"/>
          <definition value="Description of individual terms, provided as needed."/>
        </concept>
        <concept>
          <code value="DISC"/>
          <abstract value="false"/>
          <display value="disclaimer"/>
          <definition value="Disclaimer information for the eMeasure."/>
        </concept>
        <concept>
          <code value="FINALDT"/>
          <abstract value="false"/>
          <display value="finalized date/time"/>
          <definition value="The timestamp when the eMeasure was last packaged in the Measure Authoring Tool."/>
        </concept>
        <concept>
          <code value="GUIDE"/>
          <abstract value="false"/>
          <display value="guidance"/>
          <definition value="Used to allow measure developers to provide additional guidance for implementers to understand
             greater specificity than could be provided in the logic for data criteria."/>
        </concept>
        <concept>
          <code value="IDUR"/>
          <abstract value="false"/>
          <display value="improvement notation"/>
          <definition value="Information on whether an increase or decrease in score is the preferred result  (e.g.,
             a higher score indicates better quality OR a lower score indicates better quality OR quality
             is within a range)."/>
        </concept>
        <concept>
          <code value="ITMCNT"/>
          <abstract value="false"/>
          <display value="items counted"/>
          <definition value="Describes the items counted by the measure (e.g., patients, encounters, procedures, etc.)"/>
        </concept>
        <concept>
          <code value="KEY"/>
          <abstract value="false"/>
          <display value="keyword"/>
          <definition value="A significant word that aids in discoverability."/>
        </concept>
        <concept>
          <code value="MEDT"/>
          <abstract value="false"/>
          <display value="measurement end date"/>
          <definition value="The end date of the measurement period."/>
        </concept>
        <concept>
          <code value="MSD"/>
          <abstract value="false"/>
          <display value="measurement start date"/>
          <definition value="The start date of the measurement period."/>
        </concept>
        <concept>
          <code value="MSRADJ"/>
          <abstract value="false"/>
          <display value="risk adjustment"/>
          <definition value="The method of adjusting for clinical severity and conditions present at the start of care
             that can influence patient outcomes for making valid comparisons of outcome measures across
             providers. Indicates whether an eMeasure is subject to the statistical process for reducing,
             removing, or clarifying the influences of confounding factors to allow more useful comparisons."/>
        </concept>
        <concept>
          <code value="MSRAGG"/>
          <abstract value="false"/>
          <display value="rate aggregation"/>
          <definition value="Describes how to combine information calculated based on logic in each of several populations
             into one summarized result. It can also be used to describe how to risk adjust the data
             based on supplemental data elements described in the eMeasure. (e.g., pneumonia hospital
             measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two).
                                                                   Open Issue: The description does
             NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition,
             and the possible distinction of MSRAGG as a child of AGGREGATE."/>
        </concept>
        <concept>
          <code value="MSRIMPROV"/>
          <abstract value="false"/>
          <display value="health quality measure improvement notation"/>
          <definition value="Information on whether an increase or decrease in score is the preferred result. This
             should reflect information on which way is better, an increase or decrease in score."/>
        </concept>
        <concept>
          <code value="MSRJUR"/>
          <abstract value="false"/>
          <display value="jurisdiction"/>
          <definition value="The list of jurisdiction(s) for which the measure applies."/>
        </concept>
        <concept>
          <code value="MSRRPTR"/>
          <abstract value="false"/>
          <display value="reporter type"/>
          <definition value="Type of person or organization that is expected to report the issue."/>
        </concept>
        <concept>
          <code value="MSRRPTTIME"/>
          <abstract value="false"/>
          <display value="timeframe for reporting"/>
          <definition value="The maximum time that may elapse following completion of the measure until the measure
             report must be sent to the receiver."/>
        </concept>
        <concept>
          <code value="MSRSCORE"/>
          <abstract value="false"/>
          <display value="measure scoring"/>
          <definition value="Indicates how the calculation is performed for the eMeasure  (e.g., proportion, continuous
             variable, ratio)"/>
        </concept>
        <concept>
          <code value="MSRSET"/>
          <abstract value="false"/>
          <display value="health quality measure care setting"/>
          <definition value="Location(s) in which care being measured is rendered                          Usage Note:
             MSRSET is used rather than RoleCode because the setting applies to what is being measured,
             as opposed to participating directly in the health quality measure documantion itself)."/>
        </concept>
        <concept>
          <code value="MSRTOPIC"/>
          <abstract value="false"/>
          <display value="health quality measure topic type"/>
        </concept>
        <concept>
          <code value="MSRTP"/>
          <abstract value="false"/>
          <display value="measurement period"/>
          <definition value="The time period for which the eMeasure applies."/>
        </concept>
        <concept>
          <code value="MSRTYPE"/>
          <abstract value="false"/>
          <display value="measure type"/>
          <definition value="Indicates whether the eMeasure is used to examine a process or an outcome over time  (e.g.,
             Structure, Process, Outcome)."/>
        </concept>
        <concept>
          <code value="RAT"/>
          <abstract value="false"/>
          <display value="rationale"/>
          <definition value="Succinct statement of the need for the measure. Usually includes statements pertaining
             to Importance criterion: impact, gap in care and evidence."/>
        </concept>
        <concept>
          <code value="REF"/>
          <abstract value="false"/>
          <display value="reference"/>
          <definition value="Identifies bibliographic citations or references to clinical practice guidelines, sources
             of evidence, or other relevant materials supporting the intent and rationale of the eMeasure."/>
        </concept>
        <concept>
          <code value="SDE"/>
          <abstract value="false"/>
          <display value="supplemental data elements"/>
          <definition value="Comparison of results across strata can be used to show where disparities exist or where
             there is a need to expose differences in results. For example, Centers for Medicare &amp;
             Medicaid Services (CMS) in the U.S. defines four required Supplemental Data Elements (payer,
             ethnicity, race, and gender), which are variables used to aggregate data into various
             subgroups. Additional supplemental data elements required for risk adjustment or other
             purposes of data aggregation can be included in the Supplemental Data Element section."/>
        </concept>
        <concept>
          <code value="STRAT"/>
          <abstract value="false"/>
          <display value="stratification"/>
          <definition value="Describes the strata for which the measure is to be evaluated. There are three examples
             of reasons for stratification based on existing work. These include: (1) evaluate the
             measure based on different age groupings within the population described in the measure
             (e.g., evaluate the whole [age 14-25] and each sub-stratum [14-19] and [20-25]); (2) evaluate
             the eMeasure based on either a specific condition, a specific discharge location, or both;
             (3) evaluate the eMeasure based on different locations within a facility (e.g., evaluate
             the overall rate for all intensive care units and also some strata include additional
             findings [specific birth weights for neonatal intensive care units])."/>
        </concept>
        <concept>
          <code value="TRANF"/>
          <abstract value="false"/>
          <display value="transmission format"/>
          <definition value="Can be a URL or hyperlinks that link to the transmission formats that are specified for
             a particular reporting program."/>
        </concept>
        <concept>
          <code value="USE"/>
          <abstract value="false"/>
          <display value="notice of use"/>
          <definition value="Usage notes."/>
        </concept>
      </concept>
      <concept>
        <code value="_ObservationSequenceType"/>
        <abstract value="true"/>
        <display value="ObservationSequenceType"/>
        <concept>
          <code value="TIME_ABSOLUTE"/>
          <abstract value="false"/>
          <display value="absolute time sequence"/>
          <definition value="A sequence of values in the &quot;absolute&quot; time domain.  This is the same time domain
             that all HL7 timestamps use.  It is time as measured by the Gregorian calendar"/>
        </concept>
        <concept>
          <code value="TIME_RELATIVE"/>
          <abstract value="false"/>
          <display value="relative time sequence"/>
          <definition value="A sequence of values in a &quot;relative&quot; time domain.  The time is measured relative
             to the earliest effective time in the Observation Series containing this sequence."/>
        </concept>
      </concept>
      <concept>
        <code value="_ObservationSeriesType"/>
        <abstract value="true"/>
        <display value="ObservationSeriesType"/>
        <concept>
          <code value="_ECGObservationSeriesType"/>
          <abstract value="true"/>
          <display value="ECGObservationSeriesType"/>
          <concept>
            <code value="REPRESENTATIVE_BEAT"/>
            <abstract value="false"/>
            <display value="ECG representative beat waveforms"/>
            <definition value="This Observation Series type contains waveforms of a &quot;representative beat&quot; (a.k.a.
               &quot;median beat&quot; or &quot;average beat&quot;).  The waveform samples are measured
               in relative time, relative to the beginning of the beat as defined by the Observation
               Series effective time.  The waveforms are not directly acquired from the subject, but
               rather algorithmically derived from the &quot;rhythm&quot; waveforms."/>
          </concept>
          <concept>
            <code value="RHYTHM"/>
            <abstract value="false"/>
            <display value="ECG rhythm waveforms"/>
            <definition value="This Observation type contains ECG &quot;rhythm&quot; waveforms.  The waveform samples
               are measured in absolute time (a.k.a. &quot;subject time&quot; or &quot;effective time&quot;).
                These waveforms are usually &quot;raw&quot; with some minimal amount of noise reduction
               and baseline filtering applied."/>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_PatientImmunizationRelatedObservationType"/>
        <abstract value="false"/>
        <display value="PatientImmunizationRelatedObservationType"/>
        <definition value="Description: Reporting codes that are related to an immunization event."/>
        <concept>
          <code value="CLSSRM"/>
          <abstract value="false"/>
          <display value="classroom"/>
          <definition value="Description: The class room associated with the patient during the immunization event."/>
        </concept>
        <concept>
          <code value="GRADE"/>
          <abstract value="false"/>
          <display value="grade"/>
          <definition value="Description: The school grade or level the patient was in when immunized."/>
        </concept>
        <concept>
          <code value="SCHL"/>
          <abstract value="false"/>
          <display value="school"/>
          <definition value="Description: The school the patient attended when immunized."/>
        </concept>
        <concept>
          <code value="SCHLDIV"/>
          <abstract value="false"/>
          <display value="school division"/>
          <definition value="Description: The school division or district associated with the patient during the immunization
             event."/>
        </concept>
        <concept>
          <code value="TEACHER"/>
          <abstract value="false"/>
          <display value="teacher"/>
          <definition value="Description: The patient's teacher when immunized."/>
        </concept>
      </concept>
      <concept>
        <code value="_PopulationInclusionObservationType"/>
        <abstract value="true"/>
        <display value="PopulationInclusionObservationType"/>
        <definition value="Observation types for specifying criteria used to assert that a subject is included in
           a particular population."/>
        <concept>
          <code value="DENEX"/>
          <abstract value="false"/>
          <display value="denominator exclusions"/>
          <definition value="Criteria which specify subjects who should be removed from the eMeasure population and
             denominator before determining if numerator criteria are met. Denominator exclusions are
             used in proportion and ratio measures to help narrow the denominator."/>
        </concept>
        <concept>
          <code value="DENEXCEP"/>
          <abstract value="false"/>
          <display value="denominator exceptions"/>
          <definition value="Criteria which specify the removal of a subject, procedure or unit of measurement from
             the denominator, only if the numerator criteria are not met. Denominator exceptions allow
             for adjustment of the calculated score for those providers with higher risk populations.
             Denominator exceptions are used only in proportion eMeasures. They are not appropriate
             for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise
             of clinical judgment and should be specifically defined where capturing the information
             in a structured manner fits the clinical workflow. Generic denominator exception reasons
             used in proportion eMeasures fall into three general categories:                     
                                             Medical reasons                            Patient (or
             subject) reasons                            System reasons"/>
        </concept>
        <concept>
          <code value="DENOM"/>
          <abstract value="false"/>
          <display value="denominator"/>
          <definition value="Criteria for specifying the entities to be evaluated by a specific quality measure, based
             on a shared common set of characteristics (within a specific measurement set to which
             a given measure belongs).  The denominator can be the same as the initial population,
             or it may be a subset of the initial population to further constrain it for the purpose
             of the eMeasure. Different measures within an eMeasure set may have different denominators.
             Continuous Variable eMeasures do not have a denominator, but instead define a measure
             population."/>
        </concept>
        <concept>
          <code value="IPOP"/>
          <abstract value="false"/>
          <display value="initial population"/>
          <definition value="Criteria for specifying the entities to be evaluated by a specific quality measure, based
             on a shared common set of characteristics (within a specific measurement set to which
             a given measure belongs)."/>
          <concept>
            <code value="IPPOP"/>
            <abstract value="false"/>
            <display value="initial patient population"/>
            <definition value="Criteria for specifying the patients to be evaluated by a specific quality measure, based
               on a shared common set of characteristics (within a specific measurement set to which
               a given measure belongs). Details often include information based upon specific age groups,
               diagnoses, diagnostic and procedure codes, and enrollment periods."/>
          </concept>
        </concept>
        <concept>
          <code value="MSRPOPL"/>
          <abstract value="false"/>
          <display value="measure population"/>
          <definition value="Criteria for specifying the measure population as a narrative description (e.g., all patients
             seen in the Emergency Department during the measurement period).  This is used only in
             continuous variable eMeasures."/>
        </concept>
        <concept>
          <code value="MSRPOPLEX"/>
          <abstract value="false"/>
          <display value="measure population exclusions"/>
          <definition value="Criteria for specifying subjects who should be removed from the eMeasure's Initial Population
             and Measure Population. Measure Population Exclusions are used in Continuous Variable
             measures to help narrow the Measure Population before determining the value(s) of the
             continuous variable(s)."/>
        </concept>
        <concept>
          <code value="NUMER"/>
          <abstract value="false"/>
          <display value="numerator"/>
          <definition value="Criteria for specifying the processes or outcomes expected for each patient, procedure,
             or other unit of measurement defined in the denominator for proportion measures, or related
             to (but not directly derived from) the denominator for ratio measures (e.g., a numerator
             listing the number of central line blood stream infections and a denominator indicating
             the days per thousand of central line usage in a specific time period)."/>
        </concept>
        <concept>
          <code value="NUMEX"/>
          <abstract value="false"/>
          <display value="numerator exclusions"/>
          <definition value="Criteria for specifying instances that should not be included in the numerator data. (e.g.,
             if the number of central line blood stream infections per 1000 catheter days were to exclude
             infections with a specific bacterium, that bacterium would be listed as a numerator exclusion).
              Numerator Exclusions are used only in ratio eMeasures."/>
        </concept>
      </concept>
      <concept>
        <code value="_PreferenceObservationType"/>
        <abstract value="true"/>
        <display value="_PreferenceObservationType"/>
        <definition value="Types of observations that can be made about Preferences."/>
        <concept>
          <code value="PREFSTRENGTH"/>
          <abstract value="false"/>
          <display value="preference strength"/>
          <definition value="An observation about how important a preference is to the target of the preference."/>
        </concept>
      </concept>
      <concept>
        <code value="ADVERSE_REACTION"/>
        <abstract value="false"/>
        <display value="Adverse Reaction"/>
        <definition value="Indicates that the observation is of an unexpected negative occurrence in the subject
           suspected to result from the subject's exposure to one or more agents.  Observation values
           would be the symptom resulting from the reaction."/>
      </concept>
      <concept>
        <code value="ASSERTION"/>
        <abstract value="false"/>
        <display value="Assertion"/>
        <definition value="Description:Refines classCode OBS to indicate an observation in which observation.value
           contains a finding or other nominalized statement, where the encoded information in Observation.valu
          e is not altered by Observation.code.  For instance, observation.code=&quot;ASSERTION&quot;
           and observation.value=&quot;fracture of femur present&quot; is an assertion of a clinical
           finding of femur fracture."/>
      </concept>
      <concept>
        <code value="CASESER"/>
        <abstract value="false"/>
        <display value="case seriousness criteria"/>
        <definition value="Definition:An observation that provides a characterization of the level of harm to an
           investigation subject as a result of a reaction or event."/>
      </concept>
      <concept>
        <code value="CDIO"/>
        <abstract value="false"/>
        <display value="case disease imported observation"/>
        <definition value="An observation that states whether the disease was likely acquired outside the jurisdiction
           of observation, and if so, the nature of the inter-jurisdictional relationship.      
                                                          OpenIssue: This code could be moved to
           LOINC if it can be done before there are significant implemenations using it."/>
      </concept>
      <concept>
        <code value="CRIT"/>
        <abstract value="false"/>
        <display value="criticality"/>
        <definition value="An observation representing a clinical judgment as to the worst case result of a future
           occurrence or the evolution of a current occurrence.  It would be based on the severity
           of past occurrences, the details of what produced the past occurrences, and the life-threatening
           or organ system threatening potential of the observation type."/>
      </concept>
      <concept>
        <code value="CTMO"/>
        <abstract value="false"/>
        <display value="case transmission mode observation"/>
        <definition value="An observation that states the mechanism by which disease was acquired by the living subject
           involved in the public health case.                                                  
              OpenIssue: This code could be moved to LOINC if it can be done before there are significant
           implemenations using it."/>
      </concept>
      <concept>
        <code value="DX"/>
        <abstract value="false"/>
        <display value="ObservationDiagnosisTypes"/>
        <definition value="Includes all codes defining types of indications such as diagnosis, symptom and other
           indications such as contrast agents for lab tests."/>
        <concept>
          <code value="ADMDX"/>
          <abstract value="false"/>
          <display value="admitting diagnosis"/>
          <definition value="Admitting diagnosis are the diagnoses documented  for administrative purposes as the basis
             for a hospital admission."/>
        </concept>
        <concept>
          <code value="DISDX"/>
          <abstract value="false"/>
          <display value="discharge diagnosis"/>
          <definition value="Discharge diagnosis are the diagnoses documented for administrative purposes as the time
             of hospital discharge."/>
        </concept>
        <concept>
          <code value="INTDX"/>
          <abstract value="false"/>
          <display value="intermediate diagnosis"/>
          <definition value="Intermediate diagnoses are those diagnoses documented for administrative purposes during
             the course of a hospital stay."/>
        </concept>
        <concept>
          <code value="NOI"/>
          <abstract value="false"/>
          <display value="nature of injury"/>
          <definition value="The type of injury that the injury coding specifies."/>
        </concept>
      </concept>
      <concept>
        <code value="GISTIER"/>
        <abstract value="false"/>
        <display value="GIS tier"/>
        <definition value="Description: Accuracy determined as per the GIS tier code system."/>
      </concept>
      <concept>
        <code value="HHOBS"/>
        <abstract value="false"/>
        <display value="household situation observation"/>
        <definition value="Indicates that the observation is of a person’s living situation in a household including
           the household composition and circumstances."/>
      </concept>
      <concept>
        <code value="ISSUE"/>
        <abstract value="false"/>
        <display value="detected issue"/>
        <definition value="There is a clinical issue for the therapy that makes continuation of the therapy inappropriate.
                                                                Open Issue: The definition of this
           code does not correctly represent the concept space of its specializations (children)"/>
        <concept>
          <code value="_ActAdministrativeDetectedIssueCode"/>
          <abstract value="true"/>
          <display value="ActAdministrativeDetectedIssueCode"/>
          <definition value="Identifies types of detectyed issues for Act class &quot;ALRT&quot; for the administrative
             and patient administrative acts domains."/>
          <concept>
            <code value="_ActAdministrativeAuthorizationDetectedIssueCode"/>
            <abstract value="true"/>
            <display value="ActAdministrativeAuthorizationDetectedIssueCode"/>
            <concept>
              <code value="NAT"/>
              <abstract value="false"/>
              <display value="Insufficient authorization"/>
              <definition value="The requesting party has insufficient authorization to invoke the interaction."/>
            </concept>
            <concept>
              <code value="SUPPRESSED"/>
              <abstract value="false"/>
              <display value="record suppressed"/>
              <definition value="Description: One or more records in the query response have been suppressed due to consent
                 or privacy restrictions."/>
            </concept>
            <concept>
              <code value="VALIDAT"/>
              <abstract value="false"/>
              <display value="validation issue"/>
              <definition value="Description:The specified element did not pass business-rule validation."/>
              <concept>
                <code value="KEY204"/>
                <abstract value="false"/>
                <display value="Unknown key identifier"/>
                <definition value="The ID of the patient, order, etc., was not found. Used for transactions other than additions,
                   e.g. transfer of a non-existent patient."/>
              </concept>
              <concept>
                <code value="KEY205"/>
                <abstract value="false"/>
                <display value="Duplicate key identifier"/>
                <definition value="The ID of the patient, order, etc., already exists. Used in response to addition transactions
                   (Admit, New Order, etc.)."/>
              </concept>
              <concept>
                <code value="COMPLY"/>
                <abstract value="false"/>
                <display value="Compliance Alert"/>
                <definition value="There may be an issue with the patient complying with the intentions of the proposed therapy"/>
                <concept>
                  <code value="DUPTHPY"/>
                  <abstract value="false"/>
                  <display value="Duplicate Therapy Alert"/>
                  <definition value="The proposed therapy appears to duplicate an existing therapy"/>
                  <concept>
                    <code value="DUPTHPCLS"/>
                    <abstract value="false"/>
                    <display value="duplicate therapeutic alass alert"/>
                    <definition value="Description:The proposed therapy appears to have the same intended therapeutic benefit
                       as an existing therapy, though the specific mechanisms of action vary."/>
                  </concept>
                  <concept>
                    <code value="DUPTHPGEN"/>
                    <abstract value="false"/>
                    <display value="duplicate generic alert"/>
                    <definition value="Description:The proposed therapy appears to have the same intended therapeutic benefit
                       as an existing therapy and uses the same mechanisms of action as the existing therapy."/>
                  </concept>
                </concept>
                <concept>
                  <code value="ABUSE"/>
                  <abstract value="false"/>
                  <display value="commonly abused/misused alert"/>
                  <definition value="Description:The proposed therapy is frequently misused or abused and therefore should
                     be used with caution and/or monitoring."/>
                </concept>
                <concept>
                  <code value="FRAUD"/>
                  <abstract value="false"/>
                  <display value="potential fraud"/>
                  <definition value="Description:The request is suspected to have a fraudulent basis."/>
                </concept>
                <concept>
                  <code value="PLYDOC"/>
                  <abstract value="false"/>
                  <display value="Poly-orderer Alert"/>
                  <definition value="A similar or identical therapy was recently ordered by a different practitioner."/>
                </concept>
                <concept>
                  <code value="PLYPHRM"/>
                  <abstract value="false"/>
                  <display value="Poly-supplier Alert"/>
                  <definition value="This patient was recently supplied a similar or identical therapy from a different pharmacy
                     or supplier."/>
                </concept>
              </concept>
              <concept>
                <code value="DOSE"/>
                <abstract value="false"/>
                <display value="Dosage problem"/>
                <definition value="Proposed dosage instructions for therapy differ from standard practice."/>
                <concept>
                  <code value="DOSECOND"/>
                  <abstract value="false"/>
                  <display value="dosage-condition alert"/>
                  <definition value="Description:Proposed dosage is inappropriate due to patient's medical condition."/>
                </concept>
                <concept>
                  <code value="DOSEDUR"/>
                  <abstract value="false"/>
                  <display value="Dose-Duration Alert"/>
                  <definition value="Proposed length of therapy differs from standard practice."/>
                  <concept>
                    <code value="DOSEDURH"/>
                    <abstract value="false"/>
                    <display value="Dose-Duration High Alert"/>
                    <definition value="Proposed length of therapy is longer than standard practice"/>
                    <concept>
                      <code value="DOSEDURHIND"/>
                      <abstract value="false"/>
                      <display value="Dose-Duration High for Indication Alert"/>
                      <definition value="Proposed length of therapy is longer than standard practice for the identified indication
                         or diagnosis"/>
                    </concept>
                  </concept>
                  <concept>
                    <code value="DOSEDURL"/>
                    <abstract value="false"/>
                    <display value="Dose-Duration Low Alert"/>
                    <definition value="Proposed length of therapy is shorter than that necessary for therapeutic effect"/>
                    <concept>
                      <code value="DOSEDURLIND"/>
                      <abstract value="false"/>
                      <display value="Dose-Duration Low for Indication Alert"/>
                      <definition value="Proposed length of therapy is shorter than standard practice for the identified indication
                         or diagnosis"/>
                    </concept>
                  </concept>
                </concept>
                <concept>
                  <code value="DOSEH"/>
                  <abstract value="false"/>
                  <display value="High Dose Alert"/>
                  <definition value="Proposed dosage exceeds standard practice"/>
                  <concept>
                    <code value="DOSEHINDA"/>
                    <abstract value="false"/>
                    <display value="High Dose for Age Alert"/>
                    <definition value="Proposed dosage exceeds standard practice for the patient's age"/>
                  </concept>
                  <concept>
                    <code value="DOSEHIND"/>
                    <abstract value="false"/>
                    <display value="High Dose for Indication Alert"/>
                  </concept>
                  <concept>
                    <code value="DOSEHINDSA"/>
                    <abstract value="false"/>
                    <display value="High Dose for Height/Surface Area Alert"/>
                    <definition value="Proposed dosage exceeds standard practice for the patient's height or body surface area"/>
                  </concept>
                  <concept>
                    <code value="DOSEHINDW"/>
                    <abstract value="false"/>
                    <display value="High Dose for Weight Alert"/>
                    <definition value="Proposed dosage exceeds standard practice for the patient's weight"/>
                  </concept>
                </concept>
                <concept>
                  <code value="DOSEIVL"/>
                  <abstract value="false"/>
                  <display value="Dose-Interval Alert"/>
                  <definition value="Proposed dosage interval/timing differs from standard practice"/>
                  <concept>
                    <code value="DOSEIVLIND"/>
                    <abstract value="false"/>
                    <display value="Dose-Interval for Indication Alert"/>
                    <definition value="Proposed dosage interval/timing differs from standard practice for the identified indication
                       or diagnosis"/>
                  </concept>
                </concept>
                <concept>
                  <code value="DOSEL"/>
                  <abstract value="false"/>
                  <display value="Low Dose Alert"/>
                  <definition value="Proposed dosage is below suggested therapeutic levels"/>
                  <concept>
                    <code value="DOSELINDA"/>
                    <abstract value="false"/>
                    <display value="Low Dose for Age Alert"/>
                    <definition value="Proposed dosage is below suggested therapeutic levels for the patient's age"/>
                  </concept>
                  <concept>
                    <code value="DOSELIND"/>
                    <abstract value="false"/>
                    <display value="Low Dose for Indication Alert"/>
                  </concept>
                  <concept>
                    <code value="DOSELINDSA"/>
                    <abstract value="false"/>
                    <display value="Low Dose for Height/Surface Area Alert"/>
                    <definition value="Proposed dosage is below suggested therapeutic levels for the patient's height or body
                       surface area"/>
                  </concept>
                  <concept>
                    <code value="DOSELINDW"/>
                    <abstract value="false"/>
                    <display value="Low Dose for Weight Alert"/>
                    <definition value="Proposed dosage is below suggested therapeutic levels for the patient's weight"/>
                  </concept>
                </concept>
                <concept>
                  <code value="MDOSE"/>
                  <abstract value="false"/>
                  <display value="maximum dosage reached"/>
                  <definition value="Description:The maximum quantity of this drug allowed to be administered within a particular
                     time-range (month, year, lifetime) has been reached or exceeded."/>
                </concept>
              </concept>
              <concept>
                <code value="OBSA"/>
                <abstract value="false"/>
                <display value="Observation Alert"/>
                <definition value="Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics
                   of the patient"/>
                <concept>
                  <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
                    <valueCode value="DOSEHINDA"/>
                  </modifierExtension>
                  <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
                    <valueCode value="DOSELINDA"/>
                  </modifierExtension>
                  <code value="AGE"/>
                  <abstract value="false"/>
                  <display value="Age Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated due to patient age"/>
                  <concept>
                    <code value="ADALRT"/>
                    <abstract value="false"/>
                    <display value="adult alert"/>
                    <definition value="Proposed therapy is outside of the standard practice for an adult patient."/>
                  </concept>
                  <concept>
                    <code value="GEALRT"/>
                    <abstract value="false"/>
                    <display value="geriatric alert"/>
                    <definition value="Proposed therapy is outside of standard practice for a geriatric patient."/>
                  </concept>
                  <concept>
                    <code value="PEALRT"/>
                    <abstract value="false"/>
                    <display value="pediatric alert"/>
                    <definition value="Proposed therapy is outside of the standard practice for a pediatric patient."/>
                  </concept>
                </concept>
                <concept>
                  <code value="COND"/>
                  <abstract value="false"/>
                  <display value="Condition Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient
                     condition or diagnosis"/>
                  <concept>
                    <code value="HGHT"/>
                    <abstract value="false"/>
                  </concept>
                  <concept>
                    <code value="LACT"/>
                    <abstract value="false"/>
                    <display value="Lactation Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated when breast-feeding"/>
                  </concept>
                  <concept>
                    <code value="PREG"/>
                    <abstract value="false"/>
                    <display value="Pregnancy Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated during pregnancy"/>
                  </concept>
                  <concept>
                    <code value="WGHT"/>
                    <abstract value="false"/>
                  </concept>
                </concept>
                <concept>
                  <code value="CREACT"/>
                  <abstract value="false"/>
                  <display value="common reaction alert"/>
                  <definition value="Description:Proposed therapy may be inappropriate or contraindicated because of a common
                     but non-patient specific reaction to the product.                                    
                                      Example:There is no record of a specific sensitivity for the patient,
                     but the presence of the sensitivity is common and therefore caution is warranted."/>
                </concept>
                <concept>
                  <code value="GEN"/>
                  <abstract value="false"/>
                  <display value="Genetic Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators."/>
                </concept>
                <concept>
                  <code value="GEND"/>
                  <abstract value="false"/>
                  <display value="Gender Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated due to patient gender."/>
                </concept>
                <concept>
                  <code value="LAB"/>
                  <abstract value="false"/>
                  <display value="Lab Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated due to recent lab test results"/>
                </concept>
                <concept>
                  <code value="REACT"/>
                  <abstract value="false"/>
                  <display value="Reaction Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated based on the potential for a
                     patient reaction to the proposed product"/>
                  <concept>
                    <code value="ALGY"/>
                    <abstract value="false"/>
                    <display value="Allergy Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated because of a recorded patient
                       allergy to the proposed product.  (Allergies are immune based reactions.)"/>
                  </concept>
                  <concept>
                    <code value="INT"/>
                    <abstract value="false"/>
                    <display value="Intolerance Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated because of a recorded patient
                       intolerance to the proposed product.  (Intolerances are non-immune based sensitivities.)"/>
                  </concept>
                </concept>
                <concept>
                  <code value="RREACT"/>
                  <abstract value="false"/>
                  <display value="Related Reaction Alert"/>
                  <definition value="Proposed therapy may be inappropriate or contraindicated because of a potential patient
                     reaction to a cross-sensitivity related product."/>
                  <concept>
                    <code value="RALG"/>
                    <abstract value="false"/>
                    <display value="Related Allergy Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated because of a recorded patient
                       allergy to a cross-sensitivity related product.  (Allergies are immune based reactions.)"/>
                  </concept>
                  <concept>
                    <code value="RAR"/>
                    <abstract value="false"/>
                    <display value="Related Prior Reaction Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse
                       reaction to a cross-sensitivity related product."/>
                  </concept>
                  <concept>
                    <code value="RINT"/>
                    <abstract value="false"/>
                    <display value="Related Intolerance Alert"/>
                    <definition value="Proposed therapy may be inappropriate or contraindicated because of a recorded patient
                       intolerance to a cross-sensitivity related product.  (Intolerances are non-immune based
                       sensitivities.)"/>
                  </concept>
                </concept>
              </concept>
              <concept>
                <code value="BUS"/>
                <abstract value="false"/>
                <display value="business constraint violation"/>
                <definition value="Description:A local business rule relating multiple elements has been violated."/>
              </concept>
              <concept>
                <code value="CODE_INVAL"/>
                <abstract value="false"/>
                <display value="code is not valid"/>
                <definition value="Description:The specified code is not valid against the list of codes allowed for the
                   element."/>
                <concept>
                  <code value="CODE_DEPREC"/>
                  <abstract value="false"/>
                  <display value="code has been deprecated"/>
                  <definition value="Description:The specified code has been deprecated and should no longer be used.  Select
                     another code from the code system."/>
                </concept>
              </concept>
              <concept>
                <code value="FORMAT"/>
                <abstract value="false"/>
                <display value="invalid format"/>
                <definition value="Description:The element does not follow the formatting or type rules defined for the field."/>
              </concept>
              <concept>
                <code value="ILLEGAL"/>
                <abstract value="false"/>
                <display value="illegal"/>
                <definition value="Description:The request is missing elements or contains elements which cause it to not
                   meet the legal standards for actioning."/>
              </concept>
              <concept>
                <code value="LEN_RANGE"/>
                <abstract value="false"/>
                <display value="length out of range"/>
                <definition value="Description:The length of the data specified falls out of the range defined for the element."/>
                <concept>
                  <code value="LEN_LONG"/>
                  <abstract value="false"/>
                  <display value="length is too long"/>
                  <definition value="Description:The length of the data specified is greater than the maximum length defined
                     for the element."/>
                </concept>
                <concept>
                  <code value="LEN_SHORT"/>
                  <abstract value="false"/>
                  <display value="length is too short"/>
                  <definition value="Description:The length of the data specified is less than the minimum length defined for
                     the element."/>
                </concept>
              </concept>
              <concept>
                <code value="MISSCOND"/>
                <abstract value="false"/>
                <display value="conditional element missing"/>
                <definition value="Description:The specified element must be specified with a non-null value under certain
                   conditions.  In this case, the conditions are true but the element is still missing or
                   null."/>
              </concept>
              <concept>
                <code value="MISSMAND"/>
                <abstract value="false"/>
                <display value="mandatory element missing"/>
                <definition value="Description:The specified element is mandatory and was not included in the instance."/>
              </concept>
              <concept>
                <code value="NODUPS"/>
                <abstract value="false"/>
                <display value="duplicate values are not permitted"/>
                <definition value="Description:More than one element with the same value exists in the set.  Duplicates not
                   permission in this set in a set."/>
              </concept>
              <concept>
                <code value="NOPERSIST"/>
                <abstract value="false"/>
                <display value="element will not be persisted"/>
                <definition value="Description: Element in submitted message will not persist in data storage based on detected
                   issue."/>
              </concept>
              <concept>
                <code value="REP_RANGE"/>
                <abstract value="false"/>
                <display value="repetitions out of range"/>
                <definition value="Description:The number of repeating elements falls outside the range of the allowed number
                   of repetitions."/>
                <concept>
                  <code value="MAXOCCURS"/>
                  <abstract value="false"/>
                  <display value="repetitions above maximum"/>
                  <definition value="Description:The number of repeating elements is above the maximum number of repetitions
                     allowed."/>
                </concept>
                <concept>
                  <code value="MINOCCURS"/>
                  <abstract value="false"/>
                  <display value="repetitions below minimum"/>
                  <definition value="Description:The number of repeating elements is below the minimum number of repetitions
                     allowed."/>
                </concept>
              </concept>
            </concept>
          </concept>
          <concept>
            <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
              <valueCode value="KEY204"/>
            </modifierExtension>
            <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
              <valueCode value="KEY205"/>
            </modifierExtension>
            <code value="_ActAdministrativeRuleDetectedIssueCode"/>
            <abstract value="true"/>
            <display value="ActAdministrativeRuleDetectedIssueCode"/>
            <concept>
              <code value="KEY206"/>
              <abstract value="false"/>
              <display value="non-matching identification"/>
              <definition value="Description: Metadata associated with the identification (e.g. name or gender) does not
                 match the identification being verified."/>
            </concept>
            <concept>
              <code value="OBSOLETE"/>
              <abstract value="false"/>
              <display value="obsolete record returned"/>
              <definition value="Description: One or more records in the query response have a status of 'obsolete'."/>
            </concept>
          </concept>
        </concept>
        <concept>
          <code value="_ActSuppliedItemDetectedIssueCode"/>
          <abstract value="true"/>
          <display value="ActSuppliedItemDetectedIssueCode"/>
          <definition value="Identifies types of detected issues regarding the administration or supply of an item
             to a patient."/>
          <concept>
            <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
              <valueCode value="COMPLY"/>
            </modifierExtension>
            <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
              <valueCode value="DOSE"/>
            </modifierExtension>
            <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
              <valueCode value="DUPTHPY"/>
            </modifierExtension>
            <code value="_AdministrationDetectedIssueCode"/>
            <abstract value="true"/>
            <display value="AdministrationDetectedIssueCode"/>
            <definition value="Administration of the proposed therapy may be inappropriate or contraindicated as proposed"/>
            <concept>
              <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
                <valueCode value="OBSA"/>
              </modifierExtension>
              <code value="_AppropriatenessDetectedIssueCode"/>
              <abstract value="true"/>
              <display value="AppropriatenessDetectedIssueCode"/>
              <concept>
                <code value="_InteractionDetectedIssueCode"/>
                <abstract value="true"/>
                <display value="InteractionDetectedIssueCode"/>
                <concept>
                  <code value="FOOD"/>
                  <abstract value="false"/>
                  <display value="Food Interaction Alert"/>
                  <definition value="Proposed therapy may interact with certain foods"/>
                </concept>
                <concept>
                  <code value="TPROD"/>
                  <abstract value="false"/>
                  <display value="Therapeutic Product Alert"/>
                  <definition value="Proposed therapy may interact with an existing or recent therapeutic product"/>
                  <concept>
                    <code value="DRG"/>
                    <abstract value="false"/>
                    <display value="Drug Interaction Alert"/>
                    <definition value="Proposed therapy may interact with an existing or recent drug therapy"/>
                  </concept>
                  <concept>
                    <code value="NHP"/>
                    <abstract value="false"/>
                    <display value="Natural Health Product Alert"/>
                    <definition value="Proposed therapy may interact with existing or recent natural health product therapy"/>
                  </concept>
                  <concept>
                    <code value="NONRX"/>
                    <abstract value="false"/>
                    <display value="Non-Prescription Interaction Alert"/>
                    <definition value="Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)"/>
                  </concept>
                </concept>
              </concept>
              <concept>
                <code value="PREVINEF"/>
                <abstract value="false"/>
                <display value="previously ineffective"/>
                <definition value="Definition:The same or similar treatment has previously been attempted with the patient
                   without achieving a positive effect."/>
              </concept>
            </concept>
            <concept>
              <code value="DACT"/>
              <abstract value="false"/>
              <display value="drug action detected issue"/>
              <definition value="Description:Proposed therapy may be contraindicated or ineffective based on an existing
                 or recent drug therapy."/>
            </concept>
            <concept>
              <code value="TIME"/>
              <abstract value="false"/>
              <display value="timing detected issue"/>
              <definition value="Description:Proposed therapy may be inappropriate or ineffective based on the proposed
                 start or end time."/>
              <concept>
                <code value="ALRTENDLATE"/>
                <abstract value="false"/>
                <display value="end too late alert"/>
                <definition value="Definition:Proposed therapy may be inappropriate or ineffective because the end of administration
                   is too close to another planned therapy."/>
              </concept>
              <concept>
                <code value="ALRTSTRTLATE"/>
                <abstract value="false"/>
                <display value="start too late alert"/>
                <definition value="Definition:Proposed therapy may be inappropriate or ineffective because the start of administration
                   is too late after the onset of the condition."/>
              </concept>
            </concept>
          </concept>
          <concept>
            <code value="_SupplyDetectedIssueCode"/>
            <abstract value="true"/>
            <display value="SupplyDetectedIssueCode"/>
            <definition value="Supplying the product at this time may be inappropriate or indicate compliance issues
               with the associated therapy"/>
            <concept>
              <code value="ALLDONE"/>
              <abstract value="false"/>
              <display value="already performed"/>
              <definition value="Definition:The requested action has already been performed and so this request has no
                 effect"/>
            </concept>
            <concept>
              <code value="FULFIL"/>
              <abstract value="false"/>
              <display value="fulfillment alert"/>
              <definition value="Definition:The therapy being performed is in some way out of alignment with the requested
                 therapy."/>
              <concept>
                <code value="NOTACTN"/>
                <abstract value="false"/>
                <display value="no longer actionable"/>
                <definition value="Definition:The status of the request being fulfilled has changed such that it is no longer
                   actionable.  This may be because the request has expired, has already been completely
                   fulfilled or has been otherwise stopped or disabled.  (Not used for 'suspended' orders.)"/>
              </concept>
              <concept>
                <code value="NOTEQUIV"/>
                <abstract value="false"/>
                <display value="not equivalent alert"/>
                <definition value="Definition:The therapy being performed is not sufficiently equivalent to the therapy which
                   was requested."/>
                <concept>
                  <code value="NOTEQUIVGEN"/>
                  <abstract value="false"/>
                  <display value="not generically equivalent alert"/>
                  <definition value="Definition:The therapy being performed is not generically equivalent (having the identical
                     biological action) to the therapy which was requested."/>
                </concept>
                <concept>
                  <code value="NOTEQUIVTHER"/>
                  <abstract value="false"/>
                  <display value="not therapeutically equivalent alert"/>
                  <definition value="Definition:The therapy being performed is not therapeutically equivalent (having the same
                     overall patient effect) to the therapy which was requested."/>
                </concept>
              </concept>
              <concept>
                <code value="TIMING"/>
                <abstract value="false"/>
                <display value="event timing incorrect alert"/>
                <definition value="Definition:The therapy is being performed at a time which diverges from the time the therapy
                   was requested"/>
                <concept>
                  <code value="INTERVAL"/>
                  <abstract value="false"/>
                  <display value="outside requested time"/>
                  <definition value="Definition:The therapy action is being performed outside the bounds of the time period
                     requested"/>
                </concept>
                <concept>
                  <code value="MINFREQ"/>
                  <abstract value="false"/>
                  <display value="too soon within frequency based on the usage"/>
                  <definition value="Definition:The therapy action is being performed too soon after the previous occurrence
                     based on the requested frequency"/>
                </concept>
              </concept>
            </concept>
            <concept>
              <code value="HELD"/>
              <abstract value="false"/>
              <display value="held/suspended alert"/>
              <definition value="Definition:There should be no actions taken in fulfillment of a request that has been
                 held or suspended."/>
            </concept>
            <concept>
              <code value="TOOLATE"/>
              <abstract value="false"/>
              <display value="Refill Too Late Alert"/>
              <definition value="The patient is receiving a subsequent fill significantly later than would be expected
                 based on the amount previously supplied and the therapy dosage instructions"/>
            </concept>
            <concept>
              <code value="TOOSOON"/>
              <abstract value="false"/>
              <display value="Refill Too Soon Alert"/>
              <definition value="The patient is receiving a subsequent fill significantly earlier than would be expected
                 based on the amount previously supplied and the therapy dosage instructions"/>
            </concept>
          </concept>
          <concept>
            <code value="HISTORIC"/>
            <abstract value="false"/>
            <display value="record recorded as historical"/>
            <definition value="Description: While the record was accepted in the repository, there is a more recent version
               of a record of this type."/>
          </concept>
          <concept>
            <code value="PATPREF"/>
            <abstract value="false"/>
            <display value="violates stated preferences"/>
            <definition value="Definition:The proposed therapy goes against preferences or consent constraints recorded
               in the patient's record."/>
            <concept>
              <code value="PATPREFALT"/>
              <abstract value="false"/>
              <display value="violates stated preferences, alternate available"/>
              <definition value="Definition:The proposed therapy goes against preferences or consent constraints recorded
                 in the patient's record.  An alternate therapy meeting those constraints is available."/>
            </concept>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="KSUBJ"/>
        <abstract value="false"/>
        <display value="knowledge subject"/>
        <definition value="Categorization of types of observation that capture the main clinical knowledge subject
           which may be a medication, a laboratory test, a disease."/>
      </concept>
      <concept>
        <code value="KSUBT"/>
        <abstract value="false"/>
        <display value="knowledge subtopic"/>
        <definition value="Categorization of types of observation that capture a knowledge subtopic which might be
           treatment, etiology, or prognosis."/>
      </concept>
      <concept>
        <code value="OINT"/>
        <abstract value="false"/>
        <display value="intolerance"/>
        <definition value="Hypersensitivity resulting in an adverse reaction upon exposure to an agent."/>
        <concept>
          <code value="ALG"/>
          <abstract value="false"/>
          <display value="Allergy"/>
          <definition value="Hypersensitivity to an agent caused by an immunologic response to an initial exposure"/>
          <concept>
            <code value="DALG"/>
            <abstract value="false"/>
            <display value="Drug Allergy"/>
            <definition value="An allergy to a pharmaceutical product."/>
          </concept>
          <concept>
            <code value="EALG"/>
            <abstract value="false"/>
            <display value="Environmental Allergy"/>
            <definition value="An allergy to a substance other than a drug or a food.  E.g. Latex, pollen, etc."/>
          </concept>
          <concept>
            <code value="FALG"/>
            <abstract value="false"/>
            <display value="Food Allergy"/>
            <definition value="An allergy to a substance generally consumed for nutritional purposes."/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="DALG"/>
          </modifierExtension>
          <code value="DINT"/>
          <abstract value="false"/>
          <display value="Drug Intolerance"/>
          <definition value="Hypersensitivity resulting in an adverse reaction upon exposure to a drug."/>
          <concept>
            <code value="DNAINT"/>
            <abstract value="false"/>
            <display value="Drug Non-Allergy Intolerance"/>
            <definition value="Hypersensitivity to an agent caused by a mechanism other than an immunologic response
               to an initial exposure"/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="EALG"/>
          </modifierExtension>
          <code value="EINT"/>
          <abstract value="false"/>
          <display value="Environmental Intolerance"/>
          <definition value="Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions."/>
          <concept>
            <code value="ENAINT"/>
            <abstract value="false"/>
            <display value="Environmental Non-Allergy Intolerance"/>
            <definition value="Hypersensitivity to an agent caused by a mechanism other than an immunologic response
               to an initial exposure"/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="FALG"/>
          </modifierExtension>
          <code value="FINT"/>
          <abstract value="false"/>
          <display value="Food Intolerance"/>
          <definition value="Hypersensitivity resulting in an adverse reaction upon exposure to food."/>
          <concept>
            <code value="FNAINT"/>
            <abstract value="false"/>
            <display value="Food Non-Allergy Intolerance"/>
            <definition value="Hypersensitivity to an agent caused by a mechanism other than an immunologic response
               to an initial exposure"/>
          </concept>
        </concept>
        <concept>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="DNAINT"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="ENAINT"/>
          </modifierExtension>
          <modifierExtension url="http://hl7.org/fhir/ExtensionDefinition/valueset-subsumes">
            <valueCode value="FNAINT"/>
          </modifierExtension>
          <code value="NAINT"/>
          <abstract value="false"/>
          <display value="Non-Allergy Intolerance"/>
          <definition value="Hypersensitivity to an agent caused by a mechanism other than an immunologic response
             to an initial exposure"/>
        </concept>
      </concept>
      <concept>
        <code value="SEV"/>
        <abstract value="false"/>
        <display value="Severity Observation"/>
        <definition value="Indicates a subjective evaluation of the criticality associated with another observation."/>
      </concept>
    </concept>
    <concept>
      <code value="_ROIOverlayShape"/>
      <abstract value="true"/>
      <display value="ROIOverlayShape"/>
      <definition value="Shape of the region on the object being referenced"/>
      <concept>
        <code value="CIRCLE"/>
        <abstract value="false"/>
        <display value="circle"/>
        <definition value="A circle defined by two (column,row) pairs. The first point is the center of the circle
           and the second point is a point on the perimeter of the circle."/>
      </concept>
      <concept>
        <code value="ELLIPSE"/>
        <abstract value="false"/>
        <display value="ellipse"/>
        <definition value="An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints
           of the major axis and the second two points specifying the endpoints of the minor axis."/>
      </concept>
      <concept>
        <code value="POINT"/>
        <abstract value="false"/>
        <display value="point"/>
        <definition value="A single point denoted by a single (column,row) pair, or multiple points each denoted
           by a (column,row) pair."/>
      </concept>
      <concept>
        <code value="POLY"/>
        <abstract value="false"/>
        <display value="polyline"/>
        <definition value="A series of connected line segments with ordered vertices denoted by (column,row) pairs;
           if the first and last vertices are the same, it is a closed polygon."/>
      </concept>
    </concept>
    <concept>
      <code value="C"/>
      <abstract value="false"/>
      <display value="corrected"/>
      <definition value="Description:Indicates that result data has been corrected."/>
    </concept>
    <concept>
      <code value="DIET"/>
      <abstract value="false"/>
      <display value="Diet"/>
      <definition value="Code set to define specialized/allowed diets"/>
      <concept>
        <code value="BR"/>
        <abstract value="false"/>
        <display value="breikost (GE)"/>
        <definition value="A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat
           and digest."/>
      </concept>
      <concept>
        <code value="DM"/>
        <abstract value="false"/>
        <display value="diabetes mellitus diet"/>
        <definition value="A diet that uses carbohydrates sparingly.  Typically with a restriction in daily energy
           content (e.g. 1600-2000 kcal)."/>
      </concept>
      <concept>
        <code value="FAST"/>
        <abstract value="false"/>
        <display value="fasting"/>
        <definition value="No enteral intake of foot or liquids  whatsoever, no smoking.  Typically 6 to 8 hours
           before anesthesia."/>
      </concept>
      <concept>
        <code value="FORMULA"/>
        <abstract value="false"/>
        <display value="formula diet"/>
        <definition value="A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition
           either orally or through the gastrointestinal tract via tube, catheter or stoma."/>
      </concept>
      <concept>
        <code value="GF"/>
        <abstract value="false"/>
        <display value="gluten free"/>
        <definition value="Gluten free diet for celiac disease."/>
      </concept>
      <concept>
        <code value="LF"/>
        <abstract value="false"/>
        <display value="low fat"/>
        <definition value="A diet low in fat, particularly to patients with hepatic diseases."/>
      </concept>
      <concept>
        <code value="LP"/>
        <abstract value="false"/>
        <display value="low protein"/>
        <definition value="A low protein diet for patients with renal failure."/>
      </concept>
      <concept>
        <code value="LQ"/>
        <abstract value="false"/>
        <display value="liquid"/>
        <definition value="A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may
           not contain fiber.  Used before enteral surgeries."/>
      </concept>
      <concept>
        <code value="LS"/>
        <abstract value="false"/>
        <display value="low sodium"/>
        <definition value="A diet low in sodium for patients with congestive heart failure and/or renal failure."/>
      </concept>
      <concept>
        <code value="N"/>
        <abstract value="false"/>
        <display value="normal diet"/>
        <definition value="A normal diet, i.e. no special preparations or restrictions for medical reasons. This
           is notwithstanding any preferences the patient might have regarding special foods, such
           as vegetarian, kosher, etc."/>
      </concept>
      <concept>
        <code value="NF"/>
        <abstract value="false"/>
        <display value="no fat"/>
        <definition value="A no fat diet for acute hepatic diseases."/>
      </concept>
      <concept>
        <code value="PAF"/>
        <abstract value="false"/>
        <display value="phenylalanine free"/>
        <definition value="Phenylketonuria diet."/>
      </concept>
      <concept>
        <code value="PAR"/>
        <abstract value="false"/>
        <display value="parenteral"/>
        <definition value="Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications."/>
      </concept>
      <concept>
        <code value="RD"/>
        <abstract value="false"/>
        <display value="reduction diet"/>
        <definition value="A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal)."/>
      </concept>
      <concept>
        <code value="SCH"/>
        <abstract value="false"/>
        <display value="schonkost (GE)"/>
        <definition value="A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive
           fat, avoid too much fiber (cabbage, peas, beans)."/>
      </concept>
      <concept>
        <code value="SUPPLEMENT"/>
        <abstract value="false"/>
        <display value="nutritional supplement"/>
        <definition value="A diet that is not intended to be complete but is added to other diets."/>
      </concept>
      <concept>
        <code value="T"/>
        <abstract value="false"/>
        <display value="tea only"/>
        <definition value="This is not really a diet, since it contains little nutritional value, but is essentially
           just water.  Used before coloscopy examinations."/>
      </concept>
      <concept>
        <code value="VLI"/>
        <abstract value="false"/>
        <display value="low valin, leucin, isoleucin"/>
        <definition value="Diet with low content of the amino-acids valin, leucin, and isoleucin, for &quot;maple
           syrup disease.&quot;"/>
      </concept>
    </concept>
    <concept>
      <code value="DRUGPRG"/>
      <abstract value="false"/>
      <display value="drug program"/>
      <definition value="Definition: A public or government health program that administers and funds coverage
         for prescription drugs to assist program eligible who meet financial and health status
         criteria."/>
    </concept>
    <concept>
      <code value="F"/>
      <abstract value="false"/>
      <display value="final"/>
      <definition value="Description:Indicates that a result is complete.  No further results are to come.  This
         maps to the 'complete' state in the observation result status code."/>
    </concept>
    <concept>
      <code value="PRLMN"/>
      <abstract value="false"/>
      <display value="preliminary"/>
      <definition value="Description:Indicates that a result is incomplete.  There are further results to come.
          This maps to the 'active' state in the observation result status code."/>
    </concept>
    <concept>
      <code value="SECOBS"/>
      <abstract value="true"/>
      <display value="SecurityObservationType"/>
      <definition value="An observation identifying security metadata about an IT resource (data, information object,
         service, or system capability), which may be used to make access control decisions.  Security
         metadata are used to name security labels.                                           
                     Rationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING,
         Security label matching compares the initiator's clearance to the target's security label.
          All of the following must be true for authorization to be granted:                  
                                            The security policy identifiers shall be identical
                                    The classification level of the initiator shall be greater
         than or equal to that of the target (that is, there shall be at least one value in the
         classification list of the clearance greater than or equal to the classification of the
         target), and                             For each security category in the target label,
         there shall be a security category of the same type in the initiator's clearance and the
         initiator's classification level shall dominate that of the target.                  
                                                                    Examples: SecurityObservationType
          security label fields include:                                                      Confidentiality
         classification                            Compartment category                       
             Sensitivity category                            Security mechanisms used to ensure
         data integrity or to perform authorized data transformation                          
          Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or
         provenance.                                                                          
            Usage Note: SecurityObservationType codes designate security label field types, which
         are valued with an applicable SecurityObservationValue code as the &quot;security label
         tag&quot;."/>
      <concept>
        <code value="SECCATOBS"/>
        <abstract value="false"/>
        <display value="security category observation"/>
        <definition value="Type of security metadata observation made about the category of an IT resource (data,
           information object, service, or system capability), which may be used to make access control
           decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995
           as: &quot;A nonhierarchical grouping of sensitive information used to control access to
           data more finely than with hierarchical security classification alone.&quot;         
                                                       Rationale: A security category observation
           supports requirement to specify the type of IT resource to facilitate application of appropriate
           levels of information security according to a range of levels of impact or consequences
           that might result from the unauthorized disclosure, modification, or use of the information
           or information system.  A resource is assigned to a specific category of information (e.g.,
           privacy, medical, proprietary, financial, investigative, contractor sensitive, security
           management) defined by an organization or in some instances, by a specific law, Executive
           Order, directive, policy, or regulation. [FIPS 199]                                  
                              Examples: Types of security categories include:                   
                                             Compartment:  A division of data into isolated blocks
           with separate security controls for the purpose of reducing risk. (ISO 2382-8).  A security
           label tag that &quot;segments&quot; an IT resource by indicating that access and use is
           restricted to members of a defined community or project. (HL7 Healthcare Classification
           System)                              Sensitivity:  The characteristic of an IT resource
           which implies its value or importance and may include its vulnerability. (ISO 7492-2)
            Privacy metadata for information perceived as undesirable to share.  (HL7 Healthcare
           Classification System)"/>
      </concept>
      <concept>
        <code value="SECCLASSOBS"/>
        <abstract value="false"/>
        <display value="security classification observation"/>
        <definition value="Type of security metadata observation made about the classification of an IT resource
           (data, information object, service, or system capability), which may be used to make access
           control decisions.  Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995
           as: &quot;The determination of which specific degree of protection against access the
           data or information requires, together with a designation of that degree of protection.&quot;
            Security classification metadata is based on an analysis of applicable policies and the
           risk of financial, reputational, or other harm that could result from unauthorized disclosure.
                                                                Rationale: A security classification
           observation may indicate that the confidentiality level indicated by an Act or Role confidentiality
           attribute has been overridden by the entity responsible for ascribing the SecurityClassificationObse
          rvationValue.  This supports the business requirement for increasing or decreasing the
           level of confidentiality (classification or declassification) based on parameters beyond
           the original assignment of an Act or Role confidentiality.                           
                                     Examples: Types of security classification include: HL7 Confidentiality
           Codes such as very restricted, unrestricted, and normal.  Intelligence community examples
           include top secret, secret, and confidential.                                        
                        Usage Note: Security classification observation type codes designate security
           label field types, which are valued with an applicable SecurityClassificationObservationValue
           code as the &quot;security label tag&quot;."/>
      </concept>
      <concept>
        <code value="SECCONOBS"/>
        <abstract value="false"/>
        <display value="security control observation"/>
        <definition value="Type of security metadata observation made about the control of an IT resource (data,
           information object, service, or system capability), which may be used to make access control
           decisions.  Security control metadata convey instructions to users and receivers for secure
           distribution, transmission, and storage; dictate obligations or mandated actions; specify
           any action prohibited by refrain policy such as dissemination controls; and stipulate
           the permissible purpose of use of an IT resource.                                    
                              Rationale: A security control observation supports requirement to specify
           applicable management, operational, and technical controls (i.e., safeguards or countermeasures)
           prescribed for an information system to protect the confidentiality, integrity, and availability
           of the system and its information. [FIPS 199]                                        
                        Examples: Types of security control metadata include:                   
                                              handling caveats                            dissemination
           controls                            obligations                            refrain policies
                                      purpose of use constraints"/>
      </concept>
      <concept>
        <code value="SECINTOBS"/>
        <abstract value="false"/>
        <display value="security integrity observation"/>
        <definition value="Type of security metadata observation made about the integrity of an IT resource (data,
           information object, service, or system capability), which may be used to make access control
           decisions.                                                      Rationale: A security
           integrity observation supports the requirement to guard against improper information modification
           or destruction, and includes ensuring information non-repudiation and authenticity. (44
           U.S.C., SEC. 3542)                                                      Examples: Types
           of security integrity metadata include:                                              
                   Integrity status, which indicates the completeness or workflow status of an IT
           resource (data, information object, service, or system capability)                   
                   Integrity confidence, which indicates the reliability and trustworthiness of an
           IT resource                            Integrity control, which indicates pertinent handling
           caveats, obligations, refrain policies, and purpose of use for  the resource         
                             Data integrity, which indicate the security mechanisms used to ensure
           that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS
           2382-8)                            Alteration integrity, which indicate the security mechanisms
           used for authorized transformations of the resource                            Integrity
           provenance, which indicates the entity responsible for a report or assertion relayed &quot;second-ha
          nd&quot; about an IT resource"/>
        <concept>
          <code value="SECALTINTOBS"/>
          <abstract value="false"/>
          <display value="security alteration integrity observation"/>
          <definition value="Type of security metadata observation made about the alteration integrity of an IT resource
             (data, information object, service, or system capability), which indicates the mechanism
             used for authorized transformations of the resource.                                 
                                 Examples: Types of security alteration integrity observation metadata,
             which may value the observation with a code used to indicate the mechanism used for authorized
             transformation of an IT resource, including:                                         
                          translation                            syntactic transformation         
                               semantic mapping                            redaction              
                          masking                            pseudonymization                     
                   anonymization"/>
        </concept>
        <concept>
          <code value="SECDATINTOBS"/>
          <abstract value="false"/>
          <display value="security data integrity observation"/>
          <definition value="Type of security metadata observation made about the data integrity of an IT resource
             (data, information object, service, or system capability), which indicates the security
             mechanism used to preserve resource accuracy and consistency.  Data integrity is defined
             by ISO 22600-23.3.21 as: &quot;The property that data has not been altered or destroyed
             in an unauthorized manner&quot;, and by ISO/IEC 2382-8:  The property of data whose accuracy
             and consistency are preserved regardless of changes made.&quot;                      
                                            Examples: Types of security data integrity observation
             metadata, which may value the observation, include cryptographic hash function and digital
             signature."/>
        </concept>
        <concept>
          <code value="SECINTCONOBS"/>
          <abstract value="false"/>
          <display value="security integrity confidence observation"/>
          <definition value="Type of security metadata observation made about the integrity confidence of an IT resource
             (data, information object, service, or system capability), which may be used to make access
             control decisions.                                                      Examples: Types
             of security integrity confidence observation metadata, which may value the observation,
             include highly reliable, uncertain reliability, and not reliable.                    
                                              Usage Note: A security integrity confidence observation
             on an Act may indicate that a valued Act.uncertaintycode attribute has been overridden
             by the entity responsible for ascribing the SecurityIntegrityConfidenceObservationValue.
              This supports the business requirements for increasing or decreasing the assessment of
             the reliability or trustworthiness of an IT resource based on parameters beyond the original
             assignment of an Act statement level of uncertainty."/>
        </concept>
        <concept>
          <code value="SECINTPRVOBS"/>
          <abstract value="true"/>
          <display value="security integrity provenance observation"/>
          <definition value="Type of security metadata observation made about the provenance integrity of an IT resource
             (data, information object, service, or system capability), which indicates the lifecycle
             completeness of an IT resource in terms of workflow status such as its creation, modification,
             suspension, and deletion; locations in which the resource has been collected or archived,
             from which it may be retrieved, and the history of its distribution and disclosure.  Integrity
             provenance metadata about an IT resource may be used to assess its veracity, reliability,
             and trustworthiness.                                                      Examples: Types
             of security integrity provenance observation metadata, which may value the observation
             about an IT resource, include:                                                       completeness
             or workflow status, such as authentication                            the entity responsible
             for original authoring or informing about an IT resource                            the
             entity responsible for a report or assertion about an IT resource relayed “second-hand�
                                        the entity responsible for excerpting, transforming, or compiling
             an IT resource"/>
          <concept>
            <code value="SECINTPRVABOBS"/>
            <abstract value="false"/>
            <display value="security integrity provenance asserted by observation"/>
            <definition value="Type of security metadata observation made about the integrity provenance of an IT resource
               (data, information object, service, or system capability), which indicates the entity
               that made assertions about the resource.  The asserting entity may not be the original
               informant about the resource.                                                      Examples:
               Types of security integrity provenance asserted by observation metadata, which may value
               the observation, including:                                                       assertions
               about an IT resource by a patient                            assertions about an IT resource
               by a clinician                            assertions about an IT resource by a device"/>
          </concept>
          <concept>
            <code value="SECINTPRVRBOBS"/>
            <abstract value="false"/>
            <display value="security integrity provenance reported by observation"/>
            <definition value="Type of security metadata observation made about the integrity provenance of an IT resource
               (data, information object, service, or system capability), which indicates the entity
               that reported the existence of the resource.  The reporting entity may not be the original
               author of the resource.                                                      Examples:
               Types of security integrity provenance reported by observation metadata, which may value
               the observation, include:                                                       reports
               about an IT resource by a patient                            reports about an IT resource
               by a clinician                            reports about an IT resource by a device"/>
          </concept>
        </concept>
        <concept>
          <code value="SECINTSTOBS"/>
          <abstract value="false"/>
          <display value="security integrity status observation"/>
          <definition value="Type of security metadata observation made about the integrity status of an IT resource
             (data, information object, service, or system capability), which may be used to make access
             control decisions.  Indicates the completeness of an IT resource in terms of workflow
             status, which may impact users that are authorized to access and use the resource.   
                                                               Examples: Types of security integrity
             status observation metadata, which may value the observation, include codes from the HL7
             DocumentCompletion code system such as legally authenticated, in progress, and incomplete."/>
        </concept>
      </concept>
      <concept>
        <code value="SECTRSTOBS"/>
        <abstract value="true"/>
        <display value="SECTRSTOBS"/>
        <definition value="An observation identifying trust metadata about an IT resource (data, information object,
           service, or system capability), which may be used as a trust attribute to populate a computable
           trust policy, trust credential, trust assertion, or trust label field in a security label
           or trust policy, which are principally used for authentication, authorization, and access
           control decisions."/>
        <concept>
          <code value="TRSTACCRDOBS"/>
          <abstract value="false"/>
          <display value="trust accreditation observation"/>
          <definition value="Type of security metadata observation made about the formal declaration by an authority
             or neutral third party that validates the technical, security, trust, and business practice
             conformance of Trust Agents to facilitate security, interoperability, and trust among
             participants within a security domain or trust framework."/>
        </concept>
        <concept>
          <code value="TRSTAGREOBS"/>
          <abstract value="false"/>
          <display value="trust agreement observation"/>
          <definition value="Type of security metadata observation made about privacy and security requirements with
             which a security domain must comply. [ISO IEC 10181-1]"/>
        </concept>
        <concept>
          <code value="TRSTCERTOBS"/>
          <abstract value="false"/>
          <display value="trust certificate observation"/>
          <definition value="Type of security metadata observation made about a set of security-relevant data issued
             by a security authority or trusted third party, together with security information which
             is used to provide the integrity and data origin authentication services for an IT resource
             (data, information object, service, or system capability). [Based on ISO IEC 10181-1]
                                                                  For example,                    
                                                                       A Certificate Policy (CP), which
             is a named set of rules that indicates the applicability of a certificate to a particular
             community and/or class of application with common security requirements. For example,
             a particular Certificate Policy might indicate the applicability of a type of certificate
             to the authentication of electronic data interchange transactions for the trading of goods
             within a given price range. [Trust Service Principles and Criteria for Certification Authorities
             Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants.
                                        A Certificate Practice Statement (CSP), which is a statement
             of the practices which an Authority employs in issuing and managing certificates. [Trust
             Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright
             2011 by Canadian Institute of Chartered Accountants.]"/>
        </concept>
        <concept>
          <code value="TRSTFWKOBS"/>
          <abstract value="false"/>
          <display value="trust framework observation"/>
          <definition value="Type of security metadata observation made about a complete set of contracts, regulations
             or commitments that enable participating actors to rely on certain assertions by other
             actors to fulfill their information security requirements. [Kantara Initiative]"/>
        </concept>
        <concept>
          <code value="TRSTLOAOBS"/>
          <abstract value="false"/>
          <display value="trust assurance observation"/>
          <definition value="Type of security metadata observation made about the digital quality or reliability of
             a trust assertion, activity, capability, information exchange, mechanism, process, or
             protocol."/>
        </concept>
        <concept>
          <code value="TRSTMECOBS"/>
          <abstract value="false"/>
          <display value="trust mechanism observation"/>
          <definition value="Type of security metadata observation made about a security architecture system component
             that supports enforcement of security policies."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="SUBSIDFFS"/>
      <abstract value="false"/>
      <display value="subsidized fee for service program"/>
      <definition value="Definition: A government health program that provides coverage on a fee for service basis
         for health services to persons meeting eligibility criteria such as income, location of
         residence, access to other coverages, health condition, and age, the cost of which is
         to some extent subsidized by public funds.                                           
                   Discussion: The structure and business processes for underwriting and administering
         a subsidized fee for service program is further specified by the Underwriter and Payer
         Role.class and Role.code."/>
    </concept>
    <concept>
      <code value="WRKCOMP"/>
      <abstract value="false"/>
      <display value="(workers compensation program"/>
      <definition value="Definition: Government mandated program providing coverage, disability income, and vocational
         rehabilitation for injuries sustained in the work place or in the course of employment.
          Employers may either self-fund the program, purchase commercial coverage, or pay a premium
         to a government entity that administers the program.  Employees may be required to pay
         premiums toward the cost of coverage as well."/>
    </concept>
  </define>
</ValueSet>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.