{
  "types": [
    "Address",
    "Age",
    "Annotation",
    "Attachment",
    "Availability",
    "BackboneElement",
    "BackboneType",
    "Base",
    "CodeableConcept",
    "CodeableReference",
    "Coding",
    "ContactDetail",
    "ContactPoint",
    "Count",
    "DataRequirement",
    "DataType",
    "Distance",
    "Dosage",
    "DosageCondition",
    "DosageDetails",
    "DosageSafety",
    "Duration",
    "Element",
    "ElementDefinition",
    "Expression",
    "ExtendedContactDetail",
    "Extension",
    "HumanName",
    "Identifier",
    "MarketingStatus",
    "Meta",
    "MonetaryComponent",
    "Money",
    "MoneyQuantity",
    "Narrative",
    "ParameterDefinition",
    "Period",
    "PrimitiveType",
    "ProductShelfLife",
    "Quantity",
    "Range",
    "Ratio",
    "RatioRange",
    "Reference",
    "RelatedArtifact",
    "RelativeTime",
    "SampledData",
    "Signature",
    "SimpleQuantity",
    "Timing",
    "TriggerDefinition",
    "UsageContext",
    "VirtualServiceDetail",
    "base64Binary",
    "boolean",
    "canonical",
    "code",
    "date",
    "dateTime",
    "decimal",
    "id",
    "instant",
    "integer",
    "integer64",
    "markdown",
    "oid",
    "positiveInt",
    "string",
    "time",
    "unsignedInt",
    "uri",
    "url",
    "uuid",
    "xhtml",
    "Contributor",
    "Account",
    "ActivityDefinition",
    "ActorDefinition",
    "AdministrableProductDefinition",
    "AdverseEvent",
    "AllergyIntolerance",
    "Appointment",
    "AppointmentResponse",
    "ArtifactAssessment",
    "AuditEvent",
    "Basic",
    "Binary",
    "BiologicallyDerivedProduct",
    "BodyStructure",
    "Bundle",
    "CanonicalResource",
    "CapabilityStatement",
    "CarePlan",
    "CareTeam",
    "Claim",
    "ClaimResponse",
    "ClinicalUseDefinition",
    "CodeSystem",
    "Communication",
    "CommunicationRequest",
    "CompartmentDefinition",
    "Composition",
    "ConceptMap",
    "Condition",
    "Consent",
    "Contract",
    "Coverage",
    "CoverageEligibilityRequest",
    "CoverageEligibilityResponse",
    "DetectedIssue",
    "Device",
    "DeviceAlert",
    "DeviceAssociation",
    "DeviceDefinition",
    "DeviceMetric",
    "DeviceRequest",
    "DiagnosticReport",
    "DocumentReference",
    "DomainResource",
    "Encounter",
    "Endpoint",
    "EnrollmentRequest",
    "EnrollmentResponse",
    "EpisodeOfCare",
    "EventDefinition",
    "Evidence",
    "EvidenceVariable",
    "ExampleScenario",
    "ExplanationOfBenefit",
    "FamilyMemberHistory",
    "Flag",
    "Goal",
    "Group",
    "GuidanceResponse",
    "HealthcareService",
    "ImagingSelection",
    "ImagingStudy",
    "Immunization",
    "ImplementationGuide",
    "Ingredient",
    "InsurancePlan",
    "InsuranceProduct",
    "Invoice",
    "Library",
    "List",
    "Location",
    "ManufacturedItemDefinition",
    "Measure",
    "MeasureReport",
    "Medication",
    "MedicationAdministration",
    "MedicationDispense",
    "MedicationRequest",
    "MedicationStatement",
    "MedicinalProductDefinition",
    "MessageDefinition",
    "MessageHeader",
    "MetadataResource",
    "NamingSystem",
    "NutritionIntake",
    "NutritionOrder",
    "NutritionProduct",
    "Observation",
    "ObservationDefinition",
    "OperationDefinition",
    "OperationOutcome",
    "Organization",
    "OrganizationAffiliation",
    "PackagedProductDefinition",
    "Parameters",
    "Patient",
    "PaymentNotice",
    "PaymentReconciliation",
    "Person",
    "PlanDefinition",
    "Practitioner",
    "PractitionerRole",
    "Procedure",
    "Provenance",
    "Questionnaire",
    "QuestionnaireResponse",
    "RegulatedAuthorization",
    "RelatedPerson",
    "RequestOrchestration",
    "Requirements",
    "ResearchStudy",
    "ResearchSubject",
    "Resource",
    "RiskAssessment",
    "Schedule",
    "SearchParameter",
    "ServiceRequest",
    "Slot",
    "Specimen",
    "SpecimenDefinition",
    "StructureDefinition",
    "StructureMap",
    "Subscription",
    "SubscriptionStatus",
    "SubscriptionTopic",
    "Substance",
    "SubstanceDefinition",
    "Task",
    "TerminologyCapabilities",
    "ValueSet",
    "VisionPrescription",
    "BiologicallyDerivedProductDispense",
    "ChargeItem",
    "ChargeItemDefinition",
    "Citation",
    "ClinicalImpression",
    "ConditionDefinition",
    "DeviceDispense",
    "DeviceUsage",
    "EncounterHistory",
    "EvidenceReport",
    "FormularyItem",
    "GenomicStudy",
    "GraphDefinition",
    "ImmunizationEvaluation",
    "ImmunizationRecommendation",
    "InventoryItem",
    "InventoryReport",
    "Linkage",
    "MedicationKnowledge",
    "MolecularSequence",
    "Permission",
    "SubstanceNucleicAcid",
    "SubstancePolymer",
    "SubstanceProtein",
    "SubstanceReferenceInformation",
    "SubstanceSourceMaterial",
    "SupplyDelivery",
    "SupplyRequest",
    "TestPlan",
    "TestReport",
    "TestScript",
    "Transport",
    "VerificationResult"
  ],
  "Address": {
    "elements": {
      "Address.use": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/address-use|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/address-use|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Address.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/address-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/address-type|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Age": {
    "status": "no-change"
  },
  "Annotation": {
    "status": "no-change"
  },
  "Attachment": {
    "elements": {
      "Attachment.contentType": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Attachment.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Availability": {
    "elements": {
      "Availability.period": {
        "status": "new"
      },
      "Availability.availableTime.daysOfWeek": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/days-of-week|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/days-of-week|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "BackboneElement": {
    "status": "no-change"
  },
  "BackboneType": {
    "status": "no-change"
  },
  "Base": {
    "status": "no-change"
  },
  "CodeableConcept": {
    "status": "no-change"
  },
  "CodeableReference": {
    "status": "no-change"
  },
  "Coding": {
    "status": "no-change"
  },
  "ContactDetail": {
    "status": "no-change"
  },
  "ContactPoint": {
    "elements": {
      "ContactPoint.system": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-system|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-system|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ContactPoint.use": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-use|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-use|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Count": {
    "status": "no-change"
  },
  "DataRequirement": {
    "elements": {
      "DataRequirement.type": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "Element",
          "BackboneElement",
          "DataType",
          "Address",
          "Annotation",
          "Attachment",
          "Availability",
          "BackboneType",
          "Dosage",
          "ElementDefinition",
          "MarketingStatus",
          "ProductShelfLife",
          "Timing",
          "CodeableConcept",
          "CodeableReference",
          "Coding",
          "ContactDetail",
          "ContactPoint",
          "Contributor",
          "DataRequirement",
          "Expression",
          "ExtendedContactDetail",
          "Extension",
          "HumanName",
          "Identifier",
          "Meta",
          "MonetaryComponent",
          "Money",
          "Narrative",
          "ParameterDefinition",
          "Period",
          "PrimitiveType",
          "base64Binary",
          "boolean",
          "date",
          "dateTime",
          "decimal",
          "instant",
          "integer",
          "positiveInt",
          "unsignedInt",
          "integer64",
          "string",
          "code",
          "id",
          "markdown",
          "time",
          "uri",
          "canonical",
          "oid",
          "url",
          "uuid",
          "Quantity",
          "Age",
          "Count",
          "Distance",
          "Duration",
          "Range",
          "Ratio",
          "RatioRange",
          "Reference",
          "RelatedArtifact",
          "SampledData",
          "Signature",
          "TriggerDefinition",
          "UsageContext",
          "VirtualServiceDetail",
          "xhtml",
          "Resource",
          "Binary",
          "Bundle",
          "DomainResource",
          "Account",
          "ActivityDefinition",
          "ActorDefinition",
          "AdministrableProductDefinition",
          "AdverseEvent",
          "AllergyIntolerance",
          "Appointment",
          "AppointmentResponse",
          "ArtifactAssessment",
          "AuditEvent",
          "Basic",
          "BiologicallyDerivedProduct",
          "BiologicallyDerivedProductDispense",
          "BodyStructure",
          "CanonicalResource",
          "CapabilityStatement",
          "CarePlan",
          "CareTeam",
          "ChargeItem",
          "ChargeItemDefinition",
          "Citation",
          "Claim",
          "ClaimResponse",
          "ClinicalImpression",
          "ClinicalUseDefinition",
          "CodeSystem",
          "Communication",
          "CommunicationRequest",
          "CompartmentDefinition",
          "Composition",
          "ConceptMap",
          "Condition",
          "ConditionDefinition",
          "Consent",
          "Contract",
          "Coverage",
          "CoverageEligibilityRequest",
          "CoverageEligibilityResponse",
          "DetectedIssue",
          "Device",
          "DeviceAssociation",
          "DeviceDefinition",
          "DeviceDispense",
          "DeviceMetric",
          "DeviceRequest",
          "DeviceUsage",
          "DiagnosticReport",
          "DocumentReference",
          "Encounter",
          "EncounterHistory",
          "Endpoint",
          "EnrollmentRequest",
          "EnrollmentResponse",
          "EpisodeOfCare",
          "EventDefinition",
          "Evidence",
          "EvidenceReport",
          "EvidenceVariable",
          "ExampleScenario",
          "ExplanationOfBenefit",
          "FamilyMemberHistory",
          "Flag",
          "FormularyItem",
          "GenomicStudy",
          "Goal",
          "GraphDefinition",
          "Group",
          "GuidanceResponse",
          "HealthcareService",
          "ImagingSelection",
          "ImagingStudy",
          "Immunization",
          "ImmunizationEvaluation",
          "ImmunizationRecommendation",
          "ImplementationGuide",
          "Ingredient",
          "InsurancePlan",
          "InventoryItem",
          "InventoryReport",
          "Invoice",
          "Library",
          "Linkage",
          "List",
          "Location",
          "ManufacturedItemDefinition",
          "Measure",
          "MeasureReport",
          "Medication",
          "MedicationAdministration",
          "MedicationDispense",
          "MedicationKnowledge",
          "MedicationRequest",
          "MedicationStatement",
          "MedicinalProductDefinition",
          "MessageDefinition",
          "MessageHeader",
          "MetadataResource",
          "MolecularSequence",
          "NamingSystem",
          "NutritionIntake",
          "NutritionOrder",
          "NutritionProduct",
          "Observation",
          "ObservationDefinition",
          "OperationDefinition",
          "OperationOutcome",
          "Organization",
          "OrganizationAffiliation",
          "PackagedProductDefinition",
          "Patient",
          "PaymentNotice",
          "PaymentReconciliation",
          "Permission",
          "Person",
          "PlanDefinition",
          "Practitioner",
          "PractitionerRole",
          "Procedure",
          "Provenance",
          "Questionnaire",
          "QuestionnaireResponse",
          "RegulatedAuthorization",
          "RelatedPerson",
          "RequestOrchestration",
          "Requirements",
          "ResearchStudy",
          "ResearchSubject",
          "RiskAssessment",
          "Schedule",
          "SearchParameter",
          "ServiceRequest",
          "Slot",
          "Specimen",
          "SpecimenDefinition",
          "StructureDefinition",
          "StructureMap",
          "Subscription",
          "SubscriptionStatus",
          "SubscriptionTopic",
          "Substance",
          "SubstanceDefinition",
          "SubstanceNucleicAcid",
          "SubstancePolymer",
          "SubstanceProtein",
          "SubstanceReferenceInformation",
          "SubstanceSourceMaterial",
          "SupplyDelivery",
          "SupplyRequest",
          "Task",
          "TerminologyCapabilities",
          "TestPlan",
          "TestReport",
          "TestScript",
          "Transport",
          "ValueSet",
          "VerificationResult",
          "VisionPrescription",
          "Parameters"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fhir-types|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fhir-types|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DataRequirement.valueFilter.comparator": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/value-filter-comparator|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/value-filter-comparator|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DataRequirement.sort.direction": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/sort-direction|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/sort-direction|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "DataType": {
    "status": "no-change"
  },
  "Distance": {
    "status": "no-change"
  },
  "Dosage": {
    "elements": {
      "Dosage.condition": {
        "status": "new"
      },
      "Dosage.site": {
        "removed-types": [
          "CodeableConcept"
        ],
        "added-types": [
          "CodeableReference"
        ]
      },
      "Dosage.doseAndRate.dose[x]": {
        "added-types": [
          "Expression"
        ]
      },
      "Dosage.doseAndRate.rate[x]": {
        "added-types": [
          "Expression"
        ]
      },
      "Dosage.safety": {
        "status": "new"
      },
      "Dosage.sequence": {
        "status": "deleted"
      },
      "Dosage.maxDosePerPeriod": {
        "status": "deleted"
      },
      "Dosage.maxDosePerAdministration": {
        "status": "deleted"
      },
      "Dosage.maxDosePerLifetime": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "DosageCondition": {
    "status": "new"
  },
  "DosageDetails": {
    "status": "new"
  },
  "DosageSafety": {
    "status": "new"
  },
  "Duration": {
    "status": "no-change"
  },
  "Element": {
    "status": "no-change"
  },
  "ElementDefinition": {
    "elements": {
      "ElementDefinition.representation": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/property-representation|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/property-representation|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.slicing.discriminator.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/discriminator-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/discriminator-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.slicing.rules": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-slicing-rules|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-slicing-rules|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.type.aggregation": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "bundled"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-aggregation-mode|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-aggregation-mode|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.type.versioning": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/reference-version-rules|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/reference-version-rules|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.defaultValue[x]": {
        "added-types": [
          "VirtualServiceDetail"
        ]
      },
      "ElementDefinition.fixed[x]": {
        "added-types": [
          "VirtualServiceDetail"
        ]
      },
      "ElementDefinition.pattern[x]": {
        "added-types": [
          "VirtualServiceDetail"
        ]
      },
      "ElementDefinition.example.value[x]": {
        "added-types": [
          "VirtualServiceDetail"
        ]
      },
      "ElementDefinition.constraint.severity": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/constraint-severity|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/constraint-severity|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.binding.strength": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "added-codes": [
          "descriptive"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/binding-strength|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/binding-strength|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.binding.additional.key": {
        "status": "new"
      },
      "ElementDefinition.binding.additional.purpose": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "preferred",
          "ui",
          "starter",
          "component"
        ],
        "added-codes": [
          "current-extensible",
          "best-practice",
          "open"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/additional-binding-purpose|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/additional-binding-purpose|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ElementDefinition.mapping.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Expression": {
    "status": "no-change"
  },
  "ExtendedContactDetail": {
    "status": "no-change"
  },
  "Extension": {
    "elements": {
      "Extension.value[x]": {
        "added-types": [
          "VirtualServiceDetail"
        ]
      }
    },
    "status": "changed"
  },
  "HumanName": {
    "elements": {
      "HumanName.use": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "maiden"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/name-use|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/name-use|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Identifier": {
    "elements": {
      "Identifier.use": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/identifier-use|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/identifier-use|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
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        "binding-codes-changed": true,
        "removed-codes": [
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          "completed"
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        "added-types": [
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        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"
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      "Claim.originalPrescription": {
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        "added-types": [
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        "added-types": [
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        "added-types": [
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    "status": "changed"
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        "binding-status": "changed",
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        "binding-status": "changed",
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      "ClaimResponse.subject": {
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        "removed-types": [
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        "added-types": [
          "Reference(Patient | Group)"
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      "ClaimResponse.outcome": {
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        "binding-status": "changed",
        "old-binding": {
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          "reference": "http://hl7.org/fhir/ValueSet/claim-outcome|6.0.0-ballot4",
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      },
      "ClaimResponse.supportingInfo": {
        "status": "new"
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      "ClaimResponse.supportingInfo.sequence": {
        "status": "new"
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      "ClaimResponse.supportingInfo.category": {
        "status": "new"
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      "ClaimResponse.supportingInfo.code": {
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      "ClaimResponse.supportingInfo.timing[x]": {
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      "ClaimResponse.supportingInfo.value[x]": {
        "status": "new"
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        "status": "new"
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      "ClaimResponse.item.informationSequence": {
        "status": "new"
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      "ClaimResponse.item.adjudication.decisionDate": {
        "status": "new"
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      "ClaimResponse.addItem.subject": {
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      "ClaimResponse.addItem.informationSequence": {
        "status": "new"
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      "ClaimResponse.addItem.category": {
        "status": "new"
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      "ClaimResponse.addItem.request": {
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          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"
        ],
        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"
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      "ClaimResponse.processNote.class": {
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          "string"
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        "added-types": [
          "markdown"
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      "ClaimResponse.processNote.language": {
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        "binding-status": "changed",
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    "status": "changed"
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      "ClinicalUseDefinition.subject": {
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        "new-min": 1,
        "removed-types": [
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        ],
        "added-types": [
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      "ClinicalUseDefinition.indication.otherTherapy.relationshipType": {
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      "ClinicalUseDefinition.indication.otherTherapy.treatment": {
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      "ClinicalUseDefinition.contraindication.management": {
        "status": "new"
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        "status": "new"
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      "ClinicalUseDefinition.contraindication.otherTherapy.treatment": {
        "status": "deleted"
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    "status": "changed"
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        "binding-status": "changed",
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        "new-binding": {
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      "CodeSystem.jurisdiction": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
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      "CodeSystem.hierarchyMeaning": {
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        "binding-status": "changed",
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      "CodeSystem.filter.operator": {
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        "added-types": [
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    "status": "changed"
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        "binding-codes-changed": true,
        "removed-codes": [
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        "old-name": "version"
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      "Device.endpoint": {
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      "DeviceAssociation.status": {
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        "added-types": [
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        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "implanted",
          "explanted",
          "attached"
        ],
        "added-codes": [
          "active",
          "inactive"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/deviceassociation-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/deviceassociation-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceAssociation.statusReason": {
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/deviceassociation-status-reason|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/deviceassociation-status-reason",
          "strength": "extensible"
        }
      },
      "DeviceAssociation.associationStatus": {
        "status": "new"
      },
      "DeviceAssociation.subject": {
        "removed-types": [
          "Reference(Patient | Group | Practitioner | RelatedPerson | Device)"
        ],
        "added-types": [
          "Reference(BiologicallyDerivedProduct | CareTeam | Device | Group | Location | Medication | NutritionProduct | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance)"
        ]
      },
      "DeviceAssociation.focus": {
        "status": "new"
      },
      "DeviceAssociation.category": {
        "status": "deleted"
      },
      "DeviceAssociation.operation": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "DeviceDefinition": {
    "elements": {
      "DeviceDefinition.url": {
        "status": "new"
      },
      "DeviceDefinition.version": {
        "old-max": "*",
        "new-max": "1",
        "removed-types": [
          "BackboneElement"
        ],
        "added-types": [
          "string"
        ]
      },
      "DeviceDefinition.versionAlgorithm[x]": {
        "status": "new"
      },
      "DeviceDefinition.name": {
        "status": "new"
      },
      "DeviceDefinition.title": {
        "status": "new"
      },
      "DeviceDefinition.status": {
        "status": "new"
      },
      "DeviceDefinition.experimental": {
        "status": "new"
      },
      "DeviceDefinition.date": {
        "status": "new"
      },
      "DeviceDefinition.publisher": {
        "status": "new"
      },
      "DeviceDefinition.contact": {
        "removed-types": [
          "ContactPoint"
        ],
        "added-types": [
          "ContactDetail"
        ]
      },
      "DeviceDefinition.useContext": {
        "status": "new"
      },
      "DeviceDefinition.jurisdiction": {
        "status": "new"
      },
      "DeviceDefinition.purpose": {
        "status": "new"
      },
      "DeviceDefinition.copyright": {
        "status": "new"
      },
      "DeviceDefinition.copyrightLabel": {
        "status": "new"
      },
      "DeviceDefinition.approvalDate": {
        "status": "new"
      },
      "DeviceDefinition.lastReviewDate": {
        "status": "new"
      },
      "DeviceDefinition.effectivePeriod": {
        "status": "new"
      },
      "DeviceDefinition.udiDeviceIdentifier.deviceIdentifierSystem": {
        "status": "new"
      },
      "DeviceDefinition.regulatoryIdentifier.type": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/devicedefinition-regulatory-identifier-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/devicedefinition-regulatory-identifier-type",
          "strength": "extensible"
        }
      },
      "DeviceDefinition.regulatoryIdentifier.identifier": {
        "old-name": "deviceIdentifier"
      },
      "DeviceDefinition.regulatoryIdentifier.identifierSystem": {
        "status": "new"
      },
      "DeviceDefinition.deviceName.type": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-nametype|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-nametype",
          "strength": "extensible"
        }
      },
      "DeviceDefinition.hasPart.definition[x]": {
        "old-name": "reference",
        "removed-types": [
          "Reference(DeviceDefinition)"
        ],
        "added-types": [
          "canonical(DeviceDefinition)",
          "CodeableConcept"
        ]
      },
      "DeviceDefinition.deviceVersion": {
        "status": "new"
      },
      "DeviceDefinition.outputLanguage": {
        "old-name": "languageCode",
        "removed-types": [
          "CodeableConcept"
        ],
        "added-types": [
          "code"
        ],
        "binding-status": "added",
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceDefinition.link.relatedDevice[x]": {
        "old-name": "relatedDevice",
        "removed-types": [
          "CodeableReference"
        ],
        "added-types": [
          "canonical(DeviceDefinition)",
          "CodeableConcept"
        ]
      },
      "DeviceDefinition.productionIdentifierInUDI": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-productidentifierinudi|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-productidentifierinudi",
          "strength": "extensible"
        }
      },
      "DeviceDefinition.correctiveAction.scope": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-correctiveactionscope|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/device-correctiveactionscope|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceDefinition.owner": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "DeviceMetric": {
    "elements": {
      "DeviceMetric.status": {
        "status": "new"
      },
      "DeviceMetric.operationalStatus": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "entered-in-error"
        ],
        "added-codes": [
          "unknown"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-operational-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-operational-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceMetric.category": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-category|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-category",
          "strength": "extensible"
        }
      },
      "DeviceMetric.color": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/color-codes|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/color-codes|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceMetric.availability": {
        "status": "new"
      },
      "DeviceMetric.calibration.type": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-strength-changed": true,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-calibration-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-calibration-type",
          "strength": "extensible"
        }
      },
      "DeviceMetric.calibration.state": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-calibration-state|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/metric-calibration-state|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "DeviceRequest": {
    "elements": {
      "DeviceRequest.status": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "revoked",
          "completed"
        ],
        "added-codes": [
          "ended"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceRequest.intent": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "original-order",
          "reflex-order",
          "filler-order",
          "instance-order"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-intent|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-intent|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceRequest.priority": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DeviceRequest.product[x]": {
        "old-name": "code",
        "removed-types": [
          "CodeableReference"
        ],
        "added-types": [
          "CodeableConcept",
          "Reference(Device)",
          "canonical(DeviceDefinition)"
        ]
      },
      "DeviceRequest.requester": {
        "removed-types": [
          "Reference(Device | Practitioner | PractitionerRole | Organization)"
        ],
        "added-types": [
          "Reference(Device | Practitioner | PractitionerRole | Organization | CareTeam | Group | Patient | RelatedPerson)"
        ]
      },
      "DeviceRequest.location": {
        "status": "new"
      },
      "DeviceRequest.instantiatesCanonical": {
        "status": "deleted"
      },
      "DeviceRequest.instantiatesUri": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "DiagnosticReport": {
    "elements": {
      "DiagnosticReport.basedOn": {
        "removed-types": [
          "Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | MedicationRequest | NutritionOrder | ServiceRequest)"
        ]
      },
      "DiagnosticReport.status": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "preliminary",
          "modified",
          "corrected",
          "appended"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/diagnostic-report-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DiagnosticReport.relatesTo": {
        "status": "new"
      },
      "DiagnosticReport.issued": {
        "removed-types": [
          "instant"
        ],
        "added-types": [
          "dateTime"
        ]
      },
      "DiagnosticReport.procedure": {
        "status": "new"
      },
      "DiagnosticReport.performer": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Device | Patient | RelatedPerson)"
        ]
      },
      "DiagnosticReport.resultsInterpreter": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"
        ]
      },
      "DiagnosticReport.study": {
        "removed-types": [
          "Reference(GenomicStudy | ImagingStudy)"
        ],
        "added-types": [
          "Reference(ImagingStudy)"
        ]
      },
      "DiagnosticReport.supportingInfo.reference": {
        "removed-types": [
          "Reference(Procedure | Observation | DiagnosticReport | Citation)"
        ],
        "added-types": [
          "Reference(ImagingStudy | Procedure | Observation | DiagnosticReport | FamilyMemberHistory | AllergyIntolerance | Condition | DocumentReference)"
        ]
      },
      "DiagnosticReport.conclusionCode": {
        "removed-types": [
          "CodeableConcept"
        ],
        "added-types": [
          "CodeableReference"
        ]
      },
      "DiagnosticReport.recomendation": {
        "status": "new"
      },
      "DiagnosticReport.communication": {
        "status": "new"
      },
      "DiagnosticReport.comparison": {
        "status": "new"
      }
    },
    "status": "changed"
  },
  "DocumentReference": {
    "elements": {
      "DocumentReference.basedOn": {
        "removed-types": [
          "Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)"
        ],
        "added-types": [
          "Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | VisionPrescription)"
        ]
      },
      "DocumentReference.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/document-reference-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "DocumentReference.docStatus": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "preliminary",
          "corrected",
          "appended"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/composition-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/composition-status|6.0.0-ballot4",
          "strength": "required"
        },
        "modifier": "added"
      },
      "DocumentReference.related": {
        "status": "new"
      },
      "DocumentReference.bodyStructure": {
        "old-name": "bodySite"
      },
      "DocumentReference.date": {
        "removed-types": [
          "instant"
        ],
        "added-types": [
          "dateTime"
        ]
      },
      "DocumentReference.author": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam | Group)"
        ]
      },
      "DocumentReference.attester.party": {
        "removed-types": [
          "Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)"
        ],
        "added-types": [
          "Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization | Group)"
        ]
      }
    },
    "status": "changed"
  },
  "DomainResource": {
    "status": "no-change"
  },
  "Encounter": {
    "elements": {
      "Encounter.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/encounter-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/encounter-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Encounter.businessStatus": {
        "status": "new"
      },
      "Encounter.businessStatus.code": {
        "status": "new"
      },
      "Encounter.businessStatus.type": {
        "status": "new"
      },
      "Encounter.businessStatus.effectiveDate": {
        "status": "new"
      },
      "Encounter.basedOn": {
        "removed-types": [
          "Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest | RequestOrchestration | NutritionOrder | VisionPrescription)"
        ]
      },
      "Encounter.location.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/encounter-location-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/encounter-location-status|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Endpoint": {
    "elements": {
      "Endpoint.status": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "added-codes": [
          "limited"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/endpoint-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/endpoint-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Endpoint.availability": {
        "status": "new"
      },
      "Endpoint.payload.mimeType": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/mimetypes|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Endpoint.payload.profileCanonical": {
        "status": "new"
      },
      "Endpoint.payload.profileUri": {
        "status": "new"
      }
    },
    "status": "changed"
  },
  "EnrollmentRequest": {
    "elements": {
      "EnrollmentRequest.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fm-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fm-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "EnrollmentRequest.candidate": {
        "removed-types": [
          "Reference(Patient)"
        ],
        "added-types": [
          "Reference(Patient | Group)"
        ]
      }
    },
    "status": "changed"
  },
  "EnrollmentResponse": {
    "elements": {
      "EnrollmentResponse.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fm-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/fm-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "EnrollmentResponse.outcome": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/enrollment-outcome|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/enrollment-outcome|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "EnrollmentResponse.candidate": {
        "status": "new"
      }
    },
    "status": "changed"
  },
  "EpisodeOfCare": {
    "elements": {
      "EpisodeOfCare.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/episode-of-care-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/episode-of-care-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "EpisodeOfCare.statusHistory.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/episode-of-care-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/episode-of-care-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "EpisodeOfCare.reason.use": {
        "old-max": "1",
        "new-max": "*"
      },
      "EpisodeOfCare.diagnosis.use": {
        "old-max": "1",
        "new-max": "*"
      },
      "EpisodeOfCare.subject": {
        "old-name": "patient",
        "removed-types": [
          "Reference(Patient)"
        ],
        "added-types": [
          "Reference(Patient | Group)"
        ]
      }
    },
    "status": "changed"
  },
  "EventDefinition": {
    "elements": {
      "EventDefinition.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot4",
          "strength": "required"
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        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
        }
      }
    },
    "status": "changed"
  },
  "Evidence": {
    "elements": {
      "Evidence.citeAs": {
        "old-name": "citeAs[x]",
        "removed-types": [
          "Reference(Citation)"
        ]
      },
      "Evidence.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
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        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot4",
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      "Evidence.recorder": {
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      "Evidence.relatesTo": {
        "status": "new"
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      "Evidence.relatesTo.type": {
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      },
      "Evidence.relatesTo.target[x]": {
        "status": "new"
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      "Evidence.variableDefinition": {
        "old-min": 1,
        "new-min": 0
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      "Evidence.variableDefinition.variableRole": {
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        "added-types": [
          "code"
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        "binding-strength-changed": true,
        "binding-valueset-changed": true,
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          "strength": "required"
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      "Evidence.variableDefinition.roleSubtype": {
        "status": "new"
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      "Evidence.variableDefinition.comparatorCategory": {
        "status": "new"
      },
      "Evidence.variableDefinition.directnessMatch": {
        "binding-status": "removed",
        "old-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/directness",
          "strength": "extensible"
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      "Evidence.synthesisType": {
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        "new-max": "*",
        "binding-status": "removed",
        "old-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/synthesis-type",
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      "Evidence.statistic.statisticType": {
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        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/statistic-type",
          "strength": "extensible"
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      "Evidence.statistic.sampleSize.numberAnalyzed": {
        "status": "new"
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      "Evidence.statistic.attributeEstimate.type": {
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        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/attribute-estimate-type",
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          "reference": "http://hl7.org/fhir/ValueSet/statistic-model-code",
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        "old-name": "value",
        "added-types": [
          "Range",
          "CodeableConcept"
        ]
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      "Evidence.statistic.modelCharacteristic.intended": {
        "status": "new"
      },
      "Evidence.statistic.modelCharacteristic.applied": {
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        "added-types": [
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        "binding-status": "removed",
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      "Evidence.statistic.modelCharacteristic.attribute": {
        "old-name": "attributeEstimate"
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      "Evidence.certainty.type": {
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        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/certainty-type",
          "strength": "extensible"
        }
      },
      "Evidence.certainty.rating": {
        "binding-status": "removed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/certainty-rating",
          "strength": "extensible"
        }
      },
      "Evidence.certainty.rater": {
        "old-max": "1",
        "new-max": "*"
      },
      "Evidence.relatedArtifact": {
        "status": "deleted"
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    },
    "status": "changed"
  },
  "EvidenceVariable": {
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        "status": "new"
      },
      "EvidenceVariable.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
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        },
        "new-binding": {
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      },
      "EvidenceVariable.recorder": {
        "status": "new"
      },
      "EvidenceVariable.relatesTo": {
        "status": "new"
      },
      "EvidenceVariable.relatesTo.type": {
        "status": "new"
      },
      "EvidenceVariable.relatesTo.target[x]": {
        "status": "new"
      },
      "EvidenceVariable.definition": {
        "status": "new"
      },
      "EvidenceVariable.definitionModifier": {
        "status": "new"
      },
      "EvidenceVariable.definitionModifier.code": {
        "status": "new"
      },
      "EvidenceVariable.definitionModifier.value[x]": {
        "status": "new"
      },
      "EvidenceVariable.handling": {
        "removed-types": [
          "code"
        ],
        "added-types": [
          "CodeableConcept"
        ],
        "binding-status": "removed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/variable-handling|5.0.0",
          "strength": "required"
        }
      },
      "EvidenceVariable.category.value[x]": {
        "added-types": [
          "Reference(Group)"
        ]
      },
      "EvidenceVariable.conditional": {
        "status": "new"
      },
      "EvidenceVariable.classifier": {
        "status": "new"
      },
      "EvidenceVariable.dataStorage": {
        "status": "new"
      },
      "EvidenceVariable.dataStorage.datatype": {
        "status": "new"
      },
      "EvidenceVariable.dataStorage.path": {
        "status": "new"
      },
      "EvidenceVariable.dataStorage.delimiter": {
        "status": "new"
      },
      "EvidenceVariable.dataStorage.component": {
        "status": "new"
      },
      "EvidenceVariable.timing": {
        "status": "new"
      },
      "EvidenceVariable.period": {
        "status": "new"
      },
      "EvidenceVariable.constraint": {
        "status": "new"
      },
      "EvidenceVariable.constraint.conditional": {
        "status": "new"
      },
      "EvidenceVariable.constraint.minimumQuantity": {
        "status": "new"
      },
      "EvidenceVariable.constraint.maximumQuantity": {
        "status": "new"
      },
      "EvidenceVariable.constraint.earliestDateTime": {
        "status": "new"
      },
      "EvidenceVariable.constraint.latestDateTime": {
        "status": "new"
      },
      "EvidenceVariable.constraint.minimumStringLength": {
        "status": "new"
      },
      "EvidenceVariable.constraint.maximumStringLength": {
        "status": "new"
      },
      "EvidenceVariable.constraint.code": {
        "status": "new"
      },
      "EvidenceVariable.constraint.expression": {
        "status": "new"
      },
      "EvidenceVariable.constraint.expectedValueSet": {
        "status": "new"
      },
      "EvidenceVariable.constraint.expectedUnitsValueSet": {
        "status": "new"
      },
      "EvidenceVariable.constraint.anyValueAllowed": {
        "status": "new"
      },
      "EvidenceVariable.missingDataMeaning": {
        "status": "new"
      },
      "EvidenceVariable.unacceptableDataHandling": {
        "status": "new"
      },
      "EvidenceVariable.relatedArtifact": {
        "status": "deleted"
      },
      "EvidenceVariable.characteristic": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "ExampleScenario": {
    "elements": {
      "ExampleScenario.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExampleScenario.jurisdiction": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
        }
      },
      "ExampleScenario.actor.type": {
        "old-min": 1,
        "new-min": 0,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/examplescenario-actor-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/actordefinition-actor-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExampleScenario.actor.definition": {
        "status": "new"
      },
      "ExampleScenario.process.step.operation.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/testscript-operation-codes",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/examplescenario-operation-codes",
          "strength": "extensible"
        }
      }
    },
    "status": "changed"
  },
  "ExplanationOfBenefit": {
    "elements": {
      "ExplanationOfBenefit.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExplanationOfBenefit.statusReason": {
        "status": "new"
      },
      "ExplanationOfBenefit.use": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/claim-use|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/claim-use|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExplanationOfBenefit.subject": {
        "old-name": "patient",
        "removed-types": [
          "Reference(Patient)"
        ],
        "added-types": [
          "Reference(Patient | Group)"
        ]
      },
      "ExplanationOfBenefit.related.claim": {
        "removed-types": [
          "Reference(Claim)"
        ],
        "added-types": [
          "Reference(Claim | ExplanationOfBenefit)"
        ]
      },
      "ExplanationOfBenefit.prescription": {
        "removed-types": [
          "Reference(MedicationRequest | VisionPrescription)"
        ],
        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"
        ]
      },
      "ExplanationOfBenefit.originalPrescription": {
        "removed-types": [
          "Reference(MedicationRequest)"
        ],
        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"
        ]
      },
      "ExplanationOfBenefit.outcome": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/claim-outcome|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/claim-outcome|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExplanationOfBenefit.supportingInfo.timing[x]": {
        "removed-types": [
          "date"
        ],
        "added-types": [
          "dateTime",
          "Timing"
        ]
      },
      "ExplanationOfBenefit.supportingInfo.value[x]": {
        "added-types": [
          "base64Binary",
          "canonical",
          "code",
          "date",
          "dateTime",
          "decimal",
          "id",
          "instant",
          "integer",
          "integer64",
          "markdown",
          "oid",
          "positiveInt",
          "time",
          "unsignedInt",
          "uri",
          "url",
          "uuid",
          "Address",
          "Age",
          "Annotation",
          "CodeableConcept",
          "CodeableReference",
          "Coding",
          "ContactPoint",
          "Count",
          "Distance",
          "Duration",
          "HumanName",
          "Money",
          "Period",
          "Range",
          "Ratio",
          "RatioRange",
          "SampledData",
          "Signature",
          "Timing",
          "ContactDetail",
          "DataRequirement",
          "Expression",
          "ParameterDefinition",
          "RelatedArtifact",
          "TriggerDefinition",
          "UsageContext",
          "Availability",
          "ExtendedContactDetail",
          "VirtualServiceDetail",
          "Dosage",
          "Meta"
        ]
      },
      "ExplanationOfBenefit.item.subject": {
        "status": "new"
      },
      "ExplanationOfBenefit.item.request": {
        "removed-types": [
          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"
        ],
        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"
        ]
      },
      "ExplanationOfBenefit.item.adjudication.decisionDate": {
        "status": "new"
      },
      "ExplanationOfBenefit.addItem.subject": {
        "status": "new"
      },
      "ExplanationOfBenefit.addItem.informationSequence": {
        "status": "new"
      },
      "ExplanationOfBenefit.addItem.category": {
        "status": "new"
      },
      "ExplanationOfBenefit.addItem.request": {
        "removed-types": [
          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"
        ],
        "added-types": [
          "Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"
        ]
      },
      "ExplanationOfBenefit.processNote.class": {
        "status": "new"
      },
      "ExplanationOfBenefit.processNote.text": {
        "removed-types": [
          "string"
        ],
        "added-types": [
          "markdown"
        ]
      },
      "ExplanationOfBenefit.processNote.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "ExplanationOfBenefit.careTeam.responsible": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "FamilyMemberHistory": {
    "elements": {
      "FamilyMemberHistory.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/history-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/history-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "FamilyMemberHistory.recorder": {
        "status": "new"
      },
      "FamilyMemberHistory.asserter": {
        "status": "new"
      },
      "FamilyMemberHistory.instantiatesCanonical": {
        "status": "deleted"
      },
      "FamilyMemberHistory.instantiatesUri": {
        "status": "deleted"
      },
      "FamilyMemberHistory.participant": {
        "status": "deleted"
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    },
    "status": "changed"
  },
  "Flag": {
    "elements": {
      "Flag.status": {
        "old-min": 1,
        "new-min": 0,
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
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        "new-binding": {
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      },
      "Flag.supportingInfo": {
        "status": "new"
      }
    },
    "status": "changed"
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  "Goal": {
    "elements": {
      "Goal.lifecycleStatus": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
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          "completed"
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        "binding-status": "changed",
        "old-binding": {
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      "Goal.acceptance": {
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      "Goal.acceptance.participant": {
        "status": "new"
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      "Goal.acceptance.status": {
        "status": "new"
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      "Goal.acceptance.priority": {
        "status": "new"
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      "Goal.statusReason": {
        "old-max": "1",
        "new-max": "*",
        "removed-types": [
          "string"
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        "added-types": [
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      "Goal.recorder": {
        "status": "new"
      },
      "Goal.source": {
        "removed-types": [
          "Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam)"
        ],
        "added-types": [
          "Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam | Group)"
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      },
      "Goal.addresses": {
        "removed-types": [
          "Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure)"
        ],
        "added-types": [
          "Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure | NutritionIntake)"
        ]
      },
      "Goal.outcome": {
        "status": "deleted"
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    },
    "status": "changed"
  },
  "Group": {
    "elements": {
      "Group.url": {
        "status": "new"
      },
      "Group.version": {
        "status": "new"
      },
      "Group.versionAlgorithm[x]": {
        "status": "new"
      },
      "Group.title": {
        "status": "new"
      },
      "Group.status": {
        "status": "new"
      },
      "Group.experimental": {
        "status": "new"
      },
      "Group.date": {
        "status": "new"
      },
      "Group.publisher": {
        "status": "new"
      },
      "Group.contact": {
        "status": "new"
      },
      "Group.useContext": {
        "status": "new"
      },
      "Group.purpose": {
        "status": "new"
      },
      "Group.copyright": {
        "status": "new"
      },
      "Group.copyrightLabel": {
        "status": "new"
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        "new-min": 0,
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "added-codes": [
          "medication",
          "medicinalproductdefinition",
          "substance",
          "substancedefinition",
          "biologicallyDerivedProduct",
          "nutritionProduct"
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        "binding-status": "changed",
        "old-binding": {
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          "strength": "required"
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      },
      "Group.membership": {
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        "binding-codes-changed": true,
        "added-codes": [
          "conceptual"
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        "binding-status": "changed",
        "old-binding": {
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          "strength": "required"
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      },
      "Group.code": {
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        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/group-code",
          "strength": "extensible"
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      },
      "Group.combinationMethod": {
        "status": "new"
      },
      "Group.combinationThreshold": {
        "status": "new"
      },
      "Group.characteristic.value[x]": {
        "added-types": [
          "uri",
          "Expression"
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      "Group.characteristic.description": {
        "status": "new"
      },
      "Group.characteristic.method": {
        "status": "new"
      },
      "Group.characteristic.formula": {
        "status": "new"
      },
      "Group.characteristic.determiner": {
        "status": "new"
      },
      "Group.characteristic.offset": {
        "status": "new"
      },
      "Group.characteristic.instances[x]": {
        "status": "new"
      },
      "Group.characteristic.duration[x]": {
        "status": "new"
      },
      "Group.characteristic.timing": {
        "status": "new"
      },
      "Group.member.entity": {
        "removed-types": [
          "Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen)"
        ],
        "added-types": [
          "Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Medication | MedicinalProductDefinition | Substance | SubstanceDefinition | BiologicallyDerivedProduct | NutritionProduct)"
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      },
      "Group.member.involvement": {
        "status": "new"
      },
      "Group.active": {
        "status": "deleted"
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    },
    "status": "changed"
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  "GuidanceResponse": {
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        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/guidance-response-status|5.0.0",
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        "status": "new"
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          "Ratio"
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        "status": "new"
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        "status": "new"
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    "status": "changed"
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        "added-types": [
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    "status": "changed"
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        "added-types": [
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    "status": "changed"
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        "binding-codes-changed": true,
        "removed-codes": [
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          "DeviceUsage",
          "EncounterHistory",
          "EvidenceReport",
          "FormularyItem",
          "GenomicStudy",
          "GraphDefinition",
          "ImmunizationEvaluation",
          "ImmunizationRecommendation",
          "InventoryItem",
          "InventoryReport",
          "Linkage",
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          "MolecularSequence",
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          "SubstanceNucleicAcid",
          "SubstancePolymer",
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      "MessageHeader.destination.receiver": {
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        "added-types": [
          "Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"
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      "MessageHeader.source.sender": {
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        "added-types": [
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      "MessageHeader.author": {
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      "MessageHeader.responsible": {
        "status": "deleted"
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        "binding-status": "changed",
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        "binding-status": "changed",
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          "strength": "required"
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
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          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
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      "NamingSystem.uniqueId.type": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/namingsystem-identifier-type|5.0.0",
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          "strength": "required"
        }
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    "status": "changed"
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    "elements": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/event-status|5.0.0",
          "strength": "required"
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      "NutritionIntake.nutritionItem.type": {
        "status": "new"
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      "NutritionIntake.nutritionItem.nutritionProduct": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.consumedItem": {
        "status": "new"
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      "NutritionIntake.nutritionItem.consumedItem.schedule": {
        "status": "new"
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      "NutritionIntake.nutritionItem.consumedItem.amount": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.consumedItem.rate[x]": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.consumedItem.totalIntake": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.consumedItem.totalIntake.nutrient": {
        "status": "new"
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      "NutritionIntake.nutritionItem.consumedItem.totalIntake.amount": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.consumedItem.totalIntake.energy": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.notConsumedItem": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.notConsumedItem.reason": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.notConsumedItem.schedule": {
        "status": "new"
      },
      "NutritionIntake.nutritionItem.notConsumedItem.amount": {
        "status": "new"
      },
      "NutritionIntake.performer.actor": {
        "removed-types": [
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        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | Group)"
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      },
      "NutritionIntake.instantiatesCanonical": {
        "status": "deleted"
      },
      "NutritionIntake.instantiatesUri": {
        "status": "deleted"
      },
      "NutritionIntake.consumedItem": {
        "status": "deleted"
      },
      "NutritionIntake.ingredientLabel": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
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      "NutritionOrder.basedOn": {
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          "Reference(CarePlan | NutritionOrder | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration)"
        ]
      },
      "NutritionOrder.status": {
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        "binding-codes-changed": true,
        "removed-codes": [
          "revoked",
          "completed"
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        "added-codes": [
          "ended"
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-status|5.0.0",
          "strength": "required"
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        "new-binding": {
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          "strength": "required"
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      "NutritionOrder.intent": {
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        "binding-codes-changed": true,
        "removed-codes": [
          "original-order",
          "reflex-order",
          "filler-order",
          "instance-order"
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-intent|5.0.0",
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        },
        "new-binding": {
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          "strength": "required"
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      },
      "NutritionOrder.priority": {
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        "binding-status": "changed",
        "old-binding": {
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          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|6.0.0",
          "strength": "required"
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      },
      "NutritionOrder.requester": {
        "old-name": "orderer"
      },
      "NutritionOrder.oralDiet.nutrient.amount": {
        "removed-types": [
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        ],
        "added-types": [
          "Quantity"
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      "NutritionOrder.oralDiet.texture.type": {
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      "NutritionOrder.oralDiet.caloricDensity": {
        "status": "new"
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      "NutritionOrder.supplement.quantity": {
        "removed-types": [
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        "added-types": [
          "Quantity"
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      },
      "NutritionOrder.supplement.caloricDensity": {
        "status": "new"
      },
      "NutritionOrder.enteralFormula.type": {
        "old-name": "baseFormulaType"
      },
      "NutritionOrder.enteralFormula.productName": {
        "old-name": "baseFormulaProductName"
      },
      "NutritionOrder.enteralFormula.deliveryDevice[x]": {
        "old-name": "deliveryDevice",
        "old-max": "*",
        "new-max": "1",
        "removed-types": [
          "CodeableReference"
        ],
        "added-types": [
          "CodeableConcept",
          "canonical(DeviceDefinition)"
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      },
      "NutritionOrder.enteralFormula.caloricDensity": {
        "removed-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ],
        "added-types": [
          "Quantity"
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      },
      "NutritionOrder.enteralFormula.routeOfAdministration": {
        "old-max": "1",
        "new-max": "*"
      },
      "NutritionOrder.enteralFormula.administration.quantity": {
        "removed-types": [
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        "added-types": [
          "Quantity"
        ]
      },
      "NutritionOrder.enteralFormula.administration.rate[x]": {
        "removed-types": [
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        ]
      },
      "NutritionOrder.enteralFormula.maxVolumeToAdminister": {
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        "removed-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ],
        "added-types": [
          "Quantity"
        ]
      },
      "NutritionOrder.additive": {
        "status": "new"
      },
      "NutritionOrder.additive.modularType": {
        "status": "new"
      },
      "NutritionOrder.additive.productName": {
        "status": "new"
      },
      "NutritionOrder.additive.quantity": {
        "status": "new"
      },
      "NutritionOrder.additive.routeOfAdministration": {
        "status": "new"
      },
      "NutritionOrder.instantiatesCanonical": {
        "status": "deleted"
      },
      "NutritionOrder.instantiatesUri": {
        "status": "deleted"
      },
      "NutritionOrder.instantiates": {
        "status": "deleted"
      },
      "NutritionOrder.oralDiet.fluidConsistencyType": {
        "status": "deleted"
      },
      "NutritionOrder.enteralFormula.additive": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
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    "elements": {
      "NutritionProduct.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/nutritionproduct-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/nutritionproduct-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "NutritionProduct.manufacturer": {
        "removed-types": [
          "Reference(Organization)"
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        "added-types": [
          "Reference(Organization | RelatedPerson)"
        ]
      },
      "NutritionProduct.nutrient.item": {
        "old-min": 0,
        "new-min": 1
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      "NutritionProduct.nutrient.amount[x]": {
        "old-name": "amount",
        "old-max": "*",
        "new-max": "1",
        "added-types": [
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      "NutritionProduct.ingredientSummary": {
        "status": "new"
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      "NutritionProduct.ingredient.amount[x]": {
        "old-name": "amount",
        "old-max": "*",
        "new-max": "1",
        "added-types": [
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      },
      "NutritionProduct.ingredient.allergen": {
        "status": "new"
      },
      "NutritionProduct.energy": {
        "status": "new"
      },
      "NutritionProduct.knownAllergen": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "Observation": {
    "elements": {
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        "removed-types": [
          "Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest)"
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      },
      "Observation.triggeredBy.type": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0",
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        "new-binding": {
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      },
      "Observation.partOf": {
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        ],
        "added-types": [
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      "Observation.status": {
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        "binding-codes-changed": true,
        "removed-codes": [
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        "added-codes": [
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          "cannot-be-obtained"
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        "binding-status": "changed",
        "old-binding": {
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      "Observation.focus": {
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      "Observation.organizer": {
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      "Observation.performer": {
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        ],
        "added-types": [
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      "Observation.value[x]": {
        "removed-types": [
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      "Observation.interpretationContext": {
        "status": "new"
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      "Observation.bodyStructure": {
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        "added-types": [
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      "Observation.referenceRange.low": {
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      "Observation.referenceRange.high": {
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        "added-types": [
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      "Observation.referenceRange.normalValue": {
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          "strength": "extensible"
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      "Observation.hasMember": {
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        "added-types": [
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      "Observation.derivedFrom": {
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        "added-types": [
          "Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation)"
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      "Observation.component.value[x]": {
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      "Observation.instantiates[x]": {
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    "status": "changed"
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        "new-max": "*"
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        "binding-status": "changed",
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      "ObservationDefinition.bodyStructure": {
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        "removed-types": [
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        "added-types": [
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      "ObservationDefinition.device[x]": {
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        "added-types": [
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      "OperationDefinition.synchronicity": {
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      "OperationDefinition.resource": {
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        "binding-codes-changed": true,
        "removed-codes": [
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          "ChargeItem",
          "ChargeItemDefinition",
          "Citation",
          "ClinicalImpression",
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          "DeviceDispense",
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          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
        }
      },
      "PlanDefinition.actor.option.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-participant-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-participant-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.actor.option.typeCanonical": {
        "removed-types": [
          "canonical(CapabilityStatement)"
        ],
        "added-types": [
          "canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"
        ]
      },
      "PlanDefinition.actor.option.typeReference": {
        "removed-types": [
          "Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"
        ],
        "added-types": [
          "Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"
        ]
      },
      "PlanDefinition.action.priority": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.goalId": {
        "removed-types": [
          "id"
        ],
        "added-types": [
          "string"
        ]
      },
      "PlanDefinition.action.condition.kind": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-condition-kind|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-condition-kind|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.input.relatedData": {
        "removed-types": [
          "id"
        ],
        "added-types": [
          "string"
        ]
      },
      "PlanDefinition.action.relatedAction.targetId": {
        "removed-types": [
          "id"
        ],
        "added-types": [
          "string"
        ]
      },
      "PlanDefinition.action.relatedAction.relationship": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "before-start",
          "before-end",
          "concurrent-with-start",
          "concurrent-with-end",
          "after-start",
          "after-end"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.relatedAction.endRelationship": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "before-start",
          "before-end",
          "concurrent-with-start",
          "concurrent-with-end",
          "after-start",
          "after-end"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.timing[x]": {
        "added-types": [
          "RelativeTime"
        ]
      },
      "PlanDefinition.action.participant.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-participant-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-participant-type|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.participant.typeCanonical": {
        "removed-types": [
          "canonical(CapabilityStatement)"
        ],
        "added-types": [
          "canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"
        ]
      },
      "PlanDefinition.action.participant.typeReference": {
        "removed-types": [
          "Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"
        ],
        "added-types": [
          "Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"
        ]
      },
      "PlanDefinition.action.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-type",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/action-type",
          "strength": "extensible"
        }
      },
      "PlanDefinition.action.applicabilityBehavior": {
        "status": "new"
      },
      "PlanDefinition.action.groupingBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-grouping-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-grouping-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.selectionBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-selection-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-selection-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.requiredBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-required-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-required-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.precheckBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-precheck-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-precheck-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PlanDefinition.action.cardinalityBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-cardinality-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-cardinality-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Practitioner": {
    "elements": {
      "Practitioner.gender": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Practitioner.deceased[x]": {
        "modifier": "added"
      },
      "Practitioner.qualification.status": {
        "status": "new"
      },
      "Practitioner.communication.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "PractitionerRole": {
    "elements": {
      "PractitionerRole.network": {
        "status": "new"
      },
      "PractitionerRole.display": {
        "status": "new"
      },
      "PractitionerRole.communication": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "PractitionerRole.availability": {
        "old-max": "*",
        "new-max": "1"
      }
    },
    "status": "changed"
  },
  "Procedure": {
    "elements": {
      "Procedure.basedOn": {
        "removed-types": [
          "Reference(CarePlan | ServiceRequest)"
        ],
        "added-types": [
          "Reference(CarePlan | ServiceRequest | MedicationRequest)"
        ]
      },
      "Procedure.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/event-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/event-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Procedure.focus": {
        "modifier": "added"
      },
      "Procedure.bodyStructure": {
        "status": "new"
      },
      "Procedure.outcome": {
        "old-max": "1",
        "new-max": "*",
        "removed-types": [
          "CodeableConcept"
        ],
        "added-types": [
          "CodeableReference"
        ]
      },
      "Procedure.report": {
        "removed-types": [
          "Reference(DiagnosticReport | DocumentReference | Composition)"
        ],
        "added-types": [
          "Reference(DiagnosticReport | DocumentReference | Composition | Bundle)"
        ]
      },
      "Procedure.followUp": {
        "removed-types": [
          "CodeableConcept"
        ],
        "added-types": [
          "CodeableReference"
        ]
      },
      "Procedure.instantiatesCanonical": {
        "status": "deleted"
      },
      "Procedure.instantiatesUri": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
  "Provenance": {
    "elements": {
      "Provenance.why": {
        "status": "new"
      },
      "Provenance.basedOn": {
        "removed-types": [
          "Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task)"
        ],
        "added-types": [
          "Reference(Resource)"
        ]
      },
      "Provenance.agent.who": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | Group | HealthcareService)"
        ]
      },
      "Provenance.agent.onBehalfOf": {
        "removed-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient)"
        ],
        "added-types": [
          "Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Group | HealthcareService)"
        ]
      },
      "Provenance.entity.role": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/provenance-entity-role|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/provenance-entity-role|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "Questionnaire": {
    "elements": {
      "Questionnaire.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.subjectType": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "BiologicallyDerivedProductDispense",
          "ChargeItem",
          "ChargeItemDefinition",
          "Citation",
          "ClinicalImpression",
          "ConditionDefinition",
          "DeviceDispense",
          "DeviceUsage",
          "EncounterHistory",
          "EvidenceReport",
          "FormularyItem",
          "GenomicStudy",
          "GraphDefinition",
          "ImmunizationEvaluation",
          "ImmunizationRecommendation",
          "InventoryItem",
          "InventoryReport",
          "Linkage",
          "MedicationKnowledge",
          "MolecularSequence",
          "Permission",
          "SubstanceNucleicAcid",
          "SubstancePolymer",
          "SubstanceProtein",
          "SubstanceReferenceInformation",
          "SubstanceSourceMaterial",
          "SupplyDelivery",
          "SupplyRequest",
          "TestPlan",
          "TestReport",
          "TestScript",
          "Transport",
          "VerificationResult"
        ],
        "added-codes": [
          "DeviceAlert",
          "InsuranceProduct"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-types|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/resource-types|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.jurisdiction": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
        },
        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
          "strength": "extensible"
        }
      },
      "Questionnaire.item.definition": {
        "old-max": "1",
        "new-max": "*"
      },
      "Questionnaire.item.type": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/item-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/item-type-useable|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.item.enableWhen.operator": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.item.enableWhen.answer[x]": {
        "added-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)",
          "uri",
          "Attachment"
        ]
      },
      "Questionnaire.item.enableBehavior": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.item.disabledDisplay": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-disabled-display|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-disabled-display|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.item.answerConstraint": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answer-constraint|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answer-constraint|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "Questionnaire.item.answerOption.value[x]": {
        "added-types": [
          "decimal",
          "dateTime",
          "uri",
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ]
      },
      "Questionnaire.item.initial.value[x]": {
        "added-types": [
          "Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"
        ]
      }
    },
    "status": "changed"
  },
  "QuestionnaireResponse": {
    "elements": {
      "QuestionnaireResponse.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "QuestionnaireResponse.author": {
        "removed-types": [
          "Reference(Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)"
        ],
        "added-types": [
          "Reference(Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization | Group)"
        ]
      },
      "QuestionnaireResponse.item.definition": {
        "old-max": "1",
        "new-max": "*"
      }
    },
    "status": "changed"
  },
  "RegulatedAuthorization": {
    "elements": {
      "RegulatedAuthorization.status": {
        "modifier": "added"
      }
    },
    "status": "changed"
  },
  "RelatedPerson": {
    "elements": {
      "RelatedPerson.role": {
        "status": "new"
      },
      "RelatedPerson.gender": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RelatedPerson.communication.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4",
          "strength": "required"
        }
      }
    },
    "status": "changed"
  },
  "RequestOrchestration": {
    "elements": {
      "RequestOrchestration.status": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "revoked",
          "completed"
        ],
        "added-codes": [
          "ended"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-status|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-status|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RequestOrchestration.intent": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "original-order",
          "reflex-order",
          "filler-order",
          "instance-order"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-intent|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-intent|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RequestOrchestration.priority": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RequestOrchestration.action.priority": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/request-priority|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RequestOrchestration.action.condition.kind": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-condition-kind|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-condition-kind|6.0.0-ballot4",
          "strength": "required"
        }
      },
      "RequestOrchestration.action.relatedAction.relationship": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "removed-codes": [
          "before-start",
          "before-end",
          "concurrent-with-start",
          "concurrent-with-end",
          "after-start",
          "after-end"
        ],
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|5.0.0",
          "strength": "required"
        },
        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/action-relationship-type|6.0.0-ballot4",
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        "added-types": [
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      "ServiceRequest.performer": {
        "removed-types": [
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        ],
        "added-types": [
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      },
      "ServiceRequest.bodyStructure": {
        "removed-types": [
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        "added-types": [
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      "ServiceRequest.instantiatesCanonical": {
        "status": "deleted"
      },
      "ServiceRequest.instantiatesUri": {
        "status": "deleted"
      },
      "ServiceRequest.specimen": {
        "status": "deleted"
      },
      "ServiceRequest.bodySite": {
        "status": "deleted"
      }
    },
    "status": "changed"
  },
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    "elements": {
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        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/slotstatus|5.0.0",
          "strength": "required"
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        "new-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/slotstatus|6.0.0-ballot4",
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      }
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    "status": "changed"
  },
  "Specimen": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/specimen-status|5.0.0",
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          "strength": "required"
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      },
      "Specimen.subject": {
        "removed-types": [
          "Reference(Patient | Group | Device | BiologicallyDerivedProduct | Substance | Location)"
        ],
        "added-types": [
          "Reference(Patient | Group | Device | BiologicallyDerivedProduct | Substance | Location | NutritionProduct)"
        ]
      },
      "Specimen.combined": {
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        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/specimen-combined|5.0.0",
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      },
      "Specimen.collection.collector": {
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        ],
        "added-types": [
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      "Specimen.collection.device[x]": {
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        "removed-types": [
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        "added-types": [
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          "Reference(Device)",
          "canonical(DeviceDefinition)"
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      "Specimen.processing.performer": {
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      "Specimen.processing.device[x]": {
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      "Specimen.processing.additive": {
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        "added-types": [
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      "Specimen.processing.time[x]": {
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        ]
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      "Specimen.container.device[x]": {
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        "added-types": [
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          "canonical(DeviceDefinition)"
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      "Specimen.condition": {
        "binding-status": "removed",
        "old-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/v2-0493",
          "strength": "extensible"
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      "Specimen.accessionIdentifier": {
        "status": "deleted"
      },
      "Specimen.container.location": {
        "status": "deleted"
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    },
    "status": "changed"
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        "old-max": "1",
        "new-max": "*"
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      "SpecimenDefinition.status": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/publication-status|5.0.0",
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      "SpecimenDefinition.jurisdiction": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/jurisdiction",
          "strength": "extensible"
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        "new-binding": {
          "reference": "http://terminology.hl7.org/ValueSet/jurisdiction",
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        }
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      "SpecimenDefinition.typeTested.preference": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/specimen-contained-preference|5.0.0",
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      }
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    "status": "changed"
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        "binding-status": "changed",
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        "binding-status": "changed",
        "old-binding": {
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        "new-binding": {
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        "binding-codes-changed": true,
        "removed-codes": [
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        "added-codes": [
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        "binding-status": "changed",
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        "binding-status": "changed",
        "old-binding": {
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      "StructureDefinition.derivation": {
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        "added-types": [
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        "binding-status": "changed",
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    "status": "changed"
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        "binding-status": "changed",
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          "reference": "http://hl7.org/fhir/ValueSet/subscription-status|5.0.0",
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      "Subscription.managingEntity": {
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        "added-types": [
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      "Subscription.filterBy.resource": {
        "old-name": "resourceType"
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        "binding-status": "changed",
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        "old-binding": {
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      "Subscription.filterBy.event": {
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      "Subscription.contentType": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
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      "Subscription.content": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/subscription-payload-content|5.0.0",
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        "binding-status": "changed",
        "old-binding": {
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      "SubscriptionStatus.type": {
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        "binding-status": "changed",
        "old-binding": {
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      "SubscriptionStatus.notificationEvent.relatedQuery.queryType": {
        "status": "new"
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      "SubscriptionStatus.notificationEvent.relatedQuery.query": {
        "status": "new"
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      "SubscriptionStatus.notificationEvent.authorizationHint": {
        "status": "new"
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      "SubscriptionStatus.notificationEvent.authorizationHint.authorizationType": {
        "status": "new"
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      "SubscriptionStatus.notificationEvent.authorizationHint.value": {
        "status": "new"
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    },
    "status": "changed"
  },
  "SubscriptionTopic": {
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        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
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        "binding-status": "changed",
        "old-binding": {
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      },
      "SubscriptionTopic.trigger": {
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      "SubscriptionTopic.trigger.resource": {
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      "SubscriptionTopic.trigger.supportedInteraction": {
        "status": "new"
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      "SubscriptionTopic.trigger.queryCriteria.resultForCreate": {
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        "binding-status": "changed",
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          "reference": "http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|5.0.0",
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      },
      "SubscriptionTopic.trigger.queryCriteria.resultForDelete": {
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          "reference": "http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|5.0.0",
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      "SubscriptionTopic.trigger.event": {
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      "SubscriptionTopic.trigger.canFilterBy.comparator": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
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      },
      "SubscriptionTopic.trigger.canFilterBy.modifier": {
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        "binding-status": "changed",
        "old-binding": {
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      },
      "SubscriptionTopic.trigger.notificationShape.include": {
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      "SubscriptionTopic.trigger.notificationShape.relatedQuery": {
        "status": "new"
      },
      "SubscriptionTopic.trigger.notificationShape.relatedQuery.queryType": {
        "status": "new"
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      "SubscriptionTopic.trigger.notificationShape.relatedQuery.query": {
        "status": "new"
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      "SubscriptionTopic.resourceTrigger.description": {
        "status": "deleted"
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      "SubscriptionTopic.resourceTrigger.resource": {
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      "SubscriptionTopic.resourceTrigger.supportedInteraction": {
        "status": "deleted"
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      "SubscriptionTopic.eventTrigger": {
        "status": "deleted"
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      "SubscriptionTopic.notificationShape.include": {
        "status": "deleted"
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    },
    "status": "changed"
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        "binding-status": "changed",
        "old-binding": {
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      "Substance.instance": {
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      "Substance.ingredient": {
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    "status": "changed"
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  "SubstanceDefinition": {
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      "SubstanceDefinition.status": {
        "modifier": "added"
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      "SubstanceDefinition.property.value[x]": {
        "added-types": [
          "Range"
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      "SubstanceDefinition.name.language": {
        "binding-valueset-changed": true,
        "binding-status": "changed",
        "old-binding": {
          "reference": "http://hl7.org/fhir/ValueSet/all-languages|5.0.0",
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        "new-binding": {
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      },
      "SubstanceDefinition.sourceMaterial.countryOfOrigin": {
        "binding-valueset-changed": true,
        "binding-codes-changed": true,
        "added-codes": [
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        "status": "deleted"
      },
      "SubstanceDefinition.referenceInformation": {
        "status": "deleted"
      },
      "SubstanceDefinition.nucleicAcid": {
        "status": "deleted"
      },
      "SubstanceDefinition.polymer": {
        "status": "deleted"
      },
      "SubstanceDefinition.protein": {
        "status": "deleted"
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        "binding-status": "changed",
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        "added-types": [
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      "Task.instantiatesUri": {
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        "binding-status": "changed",
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        "binding-status": "changed",
        "old-binding": {
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        "binding-status": "changed",
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        "binding-status": "changed",
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        "status": "new"
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      "TerminologyCapabilities.supplements.globals": {
        "status": "new"
      },
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        "added-types": [
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      "TerminologyCapabilities.codeSearch": {
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        "binding-status": "changed",
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          "reference": "http://hl7.org/fhir/ValueSet/code-search-support|5.0.0",
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        "binding-status": "changed",
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    "status": "changed"
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        "binding-status": "changed",
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  "ChargeItem": {
    "status": "deleted"
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  "ChargeItemDefinition": {
    "status": "deleted"
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  "Citation": {
    "status": "deleted"
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  "ClinicalImpression": {
    "status": "deleted"
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  "ConditionDefinition": {
    "status": "deleted"
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  "DeviceUsage": {
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  "EncounterHistory": {
    "status": "deleted"
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  "EvidenceReport": {
    "status": "deleted"
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  "FormularyItem": {
    "status": "deleted"
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  "GenomicStudy": {
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  "GraphDefinition": {
    "status": "deleted"
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    "status": "deleted"
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  "ImmunizationRecommendation": {
    "status": "deleted"
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  "InventoryItem": {
    "status": "deleted"
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  "InventoryReport": {
    "status": "deleted"
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    "status": "deleted"
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  "MedicationKnowledge": {
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    "status": "deleted"
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  "SubstanceNucleicAcid": {
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  "SubstancePolymer": {
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  "SubstanceSourceMaterial": {
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  "SupplyDelivery": {
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  "SupplyRequest": {
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  "TestReport": {
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  "TestScript": {
    "status": "deleted"
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    "status": "deleted"
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  "VerificationResult": {
    "status": "deleted"
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}