<?xml version="1.0" encoding="UTF-8"?>
<difference>
   <type name="Address" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Address.use">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Address.type">
         <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"/>
      </element>
   </type>
   <type name="Age" status="no-change"/>
   <type name="Annotation" status="no-change"/>
   <type name="Attachment" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Attachment.contentType">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Attachment.language">
         <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"/>
      </element>
   </type>
   <type name="Availability" status="changed">
      <element path="Availability.period" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Availability.availableTime.daysOfWeek">
         <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"/>
      </element>
   </type>
   <type name="BackboneElement" status="no-change"/>
   <type name="BackboneType" status="no-change"/>
   <type name="Base" status="no-change"/>
   <type name="CodeableConcept" status="no-change"/>
   <type name="CodeableReference" status="no-change"/>
   <type name="Coding" status="no-change"/>
   <type name="ContactDetail" status="no-change"/>
   <type name="ContactPoint" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ContactPoint.system">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ContactPoint.use">
         <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"/>
      </element>
   </type>
   <type name="Count" status="no-change"/>
   <type name="DataRequirement" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DataRequirement.type">
         <removed-code code="Element"/>
         <removed-code code="BackboneElement"/>
         <removed-code code="DataType"/>
         <removed-code code="Address"/>
         <removed-code code="Annotation"/>
         <removed-code code="Attachment"/>
         <removed-code code="Availability"/>
         <removed-code code="BackboneType"/>
         <removed-code code="Dosage"/>
         <removed-code code="ElementDefinition"/>
         <removed-code code="MarketingStatus"/>
         <removed-code code="ProductShelfLife"/>
         <removed-code code="Timing"/>
         <removed-code code="CodeableConcept"/>
         <removed-code code="CodeableReference"/>
         <removed-code code="Coding"/>
         <removed-code code="ContactDetail"/>
         <removed-code code="ContactPoint"/>
         <removed-code code="Contributor"/>
         <removed-code code="DataRequirement"/>
         <removed-code code="Expression"/>
         <removed-code code="ExtendedContactDetail"/>
         <removed-code code="Extension"/>
         <removed-code code="HumanName"/>
         <removed-code code="Identifier"/>
         <removed-code code="Meta"/>
         <removed-code code="MonetaryComponent"/>
         <removed-code code="Money"/>
         <removed-code code="Narrative"/>
         <removed-code code="ParameterDefinition"/>
         <removed-code code="Period"/>
         <removed-code code="PrimitiveType"/>
         <removed-code code="base64Binary"/>
         <removed-code code="boolean"/>
         <removed-code code="date"/>
         <removed-code code="dateTime"/>
         <removed-code code="decimal"/>
         <removed-code code="instant"/>
         <removed-code code="integer"/>
         <removed-code code="positiveInt"/>
         <removed-code code="unsignedInt"/>
         <removed-code code="integer64"/>
         <removed-code code="string"/>
         <removed-code code="code"/>
         <removed-code code="id"/>
         <removed-code code="markdown"/>
         <removed-code code="time"/>
         <removed-code code="uri"/>
         <removed-code code="canonical"/>
         <removed-code code="oid"/>
         <removed-code code="url"/>
         <removed-code code="uuid"/>
         <removed-code code="Quantity"/>
         <removed-code code="Age"/>
         <removed-code code="Count"/>
         <removed-code code="Distance"/>
         <removed-code code="Duration"/>
         <removed-code code="Range"/>
         <removed-code code="Ratio"/>
         <removed-code code="RatioRange"/>
         <removed-code code="Reference"/>
         <removed-code code="RelatedArtifact"/>
         <removed-code code="SampledData"/>
         <removed-code code="Signature"/>
         <removed-code code="TriggerDefinition"/>
         <removed-code code="UsageContext"/>
         <removed-code code="VirtualServiceDetail"/>
         <removed-code code="xhtml"/>
         <removed-code code="Resource"/>
         <removed-code code="Binary"/>
         <removed-code code="Bundle"/>
         <removed-code code="DomainResource"/>
         <removed-code code="Account"/>
         <removed-code code="ActivityDefinition"/>
         <removed-code code="ActorDefinition"/>
         <removed-code code="AdministrableProductDefinition"/>
         <removed-code code="AdverseEvent"/>
         <removed-code code="AllergyIntolerance"/>
         <removed-code code="Appointment"/>
         <removed-code code="AppointmentResponse"/>
         <removed-code code="ArtifactAssessment"/>
         <removed-code code="AuditEvent"/>
         <removed-code code="Basic"/>
         <removed-code code="BiologicallyDerivedProduct"/>
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="BodyStructure"/>
         <removed-code code="CanonicalResource"/>
         <removed-code code="CapabilityStatement"/>
         <removed-code code="CarePlan"/>
         <removed-code code="CareTeam"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="Claim"/>
         <removed-code code="ClaimResponse"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ClinicalUseDefinition"/>
         <removed-code code="CodeSystem"/>
         <removed-code code="Communication"/>
         <removed-code code="CommunicationRequest"/>
         <removed-code code="CompartmentDefinition"/>
         <removed-code code="Composition"/>
         <removed-code code="ConceptMap"/>
         <removed-code code="Condition"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="Consent"/>
         <removed-code code="Contract"/>
         <removed-code code="Coverage"/>
         <removed-code code="CoverageEligibilityRequest"/>
         <removed-code code="CoverageEligibilityResponse"/>
         <removed-code code="DetectedIssue"/>
         <removed-code code="Device"/>
         <removed-code code="DeviceAssociation"/>
         <removed-code code="DeviceDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceMetric"/>
         <removed-code code="DeviceRequest"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="DiagnosticReport"/>
         <removed-code code="DocumentReference"/>
         <removed-code code="Encounter"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="Endpoint"/>
         <removed-code code="EnrollmentRequest"/>
         <removed-code code="EnrollmentResponse"/>
         <removed-code code="EpisodeOfCare"/>
         <removed-code code="EventDefinition"/>
         <removed-code code="Evidence"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="EvidenceVariable"/>
         <removed-code code="ExampleScenario"/>
         <removed-code code="ExplanationOfBenefit"/>
         <removed-code code="FamilyMemberHistory"/>
         <removed-code code="Flag"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="Goal"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="Group"/>
         <removed-code code="GuidanceResponse"/>
         <removed-code code="HealthcareService"/>
         <removed-code code="ImagingSelection"/>
         <removed-code code="ImagingStudy"/>
         <removed-code code="Immunization"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="ImplementationGuide"/>
         <removed-code code="Ingredient"/>
         <removed-code code="InsurancePlan"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Invoice"/>
         <removed-code code="Library"/>
         <removed-code code="Linkage"/>
         <removed-code code="List"/>
         <removed-code code="Location"/>
         <removed-code code="ManufacturedItemDefinition"/>
         <removed-code code="Measure"/>
         <removed-code code="MeasureReport"/>
         <removed-code code="Medication"/>
         <removed-code code="MedicationAdministration"/>
         <removed-code code="MedicationDispense"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MedicationRequest"/>
         <removed-code code="MedicationStatement"/>
         <removed-code code="MedicinalProductDefinition"/>
         <removed-code code="MessageDefinition"/>
         <removed-code code="MessageHeader"/>
         <removed-code code="MetadataResource"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="NamingSystem"/>
         <removed-code code="NutritionIntake"/>
         <removed-code code="NutritionOrder"/>
         <removed-code code="NutritionProduct"/>
         <removed-code code="Observation"/>
         <removed-code code="ObservationDefinition"/>
         <removed-code code="OperationDefinition"/>
         <removed-code code="OperationOutcome"/>
         <removed-code code="Organization"/>
         <removed-code code="OrganizationAffiliation"/>
         <removed-code code="PackagedProductDefinition"/>
         <removed-code code="Patient"/>
         <removed-code code="PaymentNotice"/>
         <removed-code code="PaymentReconciliation"/>
         <removed-code code="Permission"/>
         <removed-code code="Person"/>
         <removed-code code="PlanDefinition"/>
         <removed-code code="Practitioner"/>
         <removed-code code="PractitionerRole"/>
         <removed-code code="Procedure"/>
         <removed-code code="Provenance"/>
         <removed-code code="Questionnaire"/>
         <removed-code code="QuestionnaireResponse"/>
         <removed-code code="RegulatedAuthorization"/>
         <removed-code code="RelatedPerson"/>
         <removed-code code="RequestOrchestration"/>
         <removed-code code="Requirements"/>
         <removed-code code="ResearchStudy"/>
         <removed-code code="ResearchSubject"/>
         <removed-code code="RiskAssessment"/>
         <removed-code code="Schedule"/>
         <removed-code code="SearchParameter"/>
         <removed-code code="ServiceRequest"/>
         <removed-code code="Slot"/>
         <removed-code code="Specimen"/>
         <removed-code code="SpecimenDefinition"/>
         <removed-code code="StructureDefinition"/>
         <removed-code code="StructureMap"/>
         <removed-code code="Subscription"/>
         <removed-code code="SubscriptionStatus"/>
         <removed-code code="SubscriptionTopic"/>
         <removed-code code="Substance"/>
         <removed-code code="SubstanceDefinition"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="Task"/>
         <removed-code code="TerminologyCapabilities"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="ValueSet"/>
         <removed-code code="VerificationResult"/>
         <removed-code code="VisionPrescription"/>
         <removed-code code="Parameters"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DataRequirement.valueFilter.comparator">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DataRequirement.sort.direction">
         <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"/>
      </element>
   </type>
   <type name="DataType" status="no-change"/>
   <type name="Distance" status="no-change"/>
   <type name="Dosage" status="changed">
      <element path="Dosage.condition" status="new"/>
      <element path="Dosage.site">
         <removed-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="Dosage.doseAndRate.dose[x]">
         <added-type name="Expression"/>
      </element>
      <element path="Dosage.doseAndRate.rate[x]">
         <added-type name="Expression"/>
      </element>
      <element path="Dosage.safety" status="new"/>
      <element path="Dosage.sequence" status="deleted"/>
      <element path="Dosage.maxDosePerPeriod" status="deleted"/>
      <element path="Dosage.maxDosePerAdministration" status="deleted"/>
      <element path="Dosage.maxDosePerLifetime" status="deleted"/>
   </type>
   <type name="DosageCondition" status="new"/>
   <type name="DosageDetails" status="new"/>
   <type name="DosageSafety" status="new"/>
   <type name="Duration" status="no-change"/>
   <type name="Element" status="no-change"/>
   <type name="ElementDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.representation">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.slicing.discriminator.type">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.slicing.rules">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.type.aggregation">
         <removed-code code="bundled"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.type.versioning">
         <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"/>
      </element>
      <element path="ElementDefinition.defaultValue[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element path="ElementDefinition.fixed[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element path="ElementDefinition.pattern[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element path="ElementDefinition.example.value[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.constraint.severity">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.binding.strength">
         <added-code code="descriptive"/>
         <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"/>
      </element>
      <element path="ElementDefinition.binding.additional.key" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.binding.additional.purpose">
         <removed-code code="preferred"/>
         <removed-code code="ui"/>
         <removed-code code="starter"/>
         <removed-code code="component"/>
         <added-code code="current-extensible"/>
         <added-code code="best-practice"/>
         <added-code code="open"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ElementDefinition.mapping.language">
         <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"/>
      </element>
   </type>
   <type name="Expression" status="no-change"/>
   <type name="ExtendedContactDetail" status="no-change"/>
   <type name="Extension" status="changed">
      <element path="Extension.value[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
   </type>
   <type name="HumanName" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="HumanName.use">
         <removed-code code="maiden"/>
         <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"/>
      </element>
   </type>
   <type name="Identifier" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Identifier.use">
         <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"/>
      </element>
   </type>
   <type name="MarketingStatus" status="no-change"/>
   <type name="Meta" status="no-change"/>
   <type name="MonetaryComponent" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="MonetaryComponent.type">
         <removed-code code="deduction"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/price-component-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/price-component-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Money" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Money.currency">
         <old-binding reference="http://hl7.org/fhir/ValueSet/currencies|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/currencies|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="MoneyQuantity" status="no-change"/>
   <type name="Narrative" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Narrative.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/narrative-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/narrative-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="ParameterDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ParameterDefinition.use">
         <old-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-use|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-use|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ParameterDefinition.type">
         <removed-code code="Element"/>
         <removed-code code="BackboneElement"/>
         <removed-code code="DataType"/>
         <removed-code code="Address"/>
         <removed-code code="Annotation"/>
         <removed-code code="Attachment"/>
         <removed-code code="Availability"/>
         <removed-code code="BackboneType"/>
         <removed-code code="Dosage"/>
         <removed-code code="ElementDefinition"/>
         <removed-code code="MarketingStatus"/>
         <removed-code code="ProductShelfLife"/>
         <removed-code code="Timing"/>
         <removed-code code="CodeableConcept"/>
         <removed-code code="CodeableReference"/>
         <removed-code code="Coding"/>
         <removed-code code="ContactDetail"/>
         <removed-code code="ContactPoint"/>
         <removed-code code="Contributor"/>
         <removed-code code="DataRequirement"/>
         <removed-code code="Expression"/>
         <removed-code code="ExtendedContactDetail"/>
         <removed-code code="Extension"/>
         <removed-code code="HumanName"/>
         <removed-code code="Identifier"/>
         <removed-code code="Meta"/>
         <removed-code code="MonetaryComponent"/>
         <removed-code code="Money"/>
         <removed-code code="Narrative"/>
         <removed-code code="ParameterDefinition"/>
         <removed-code code="Period"/>
         <removed-code code="PrimitiveType"/>
         <removed-code code="base64Binary"/>
         <removed-code code="boolean"/>
         <removed-code code="date"/>
         <removed-code code="dateTime"/>
         <removed-code code="decimal"/>
         <removed-code code="instant"/>
         <removed-code code="integer"/>
         <removed-code code="positiveInt"/>
         <removed-code code="unsignedInt"/>
         <removed-code code="integer64"/>
         <removed-code code="string"/>
         <removed-code code="code"/>
         <removed-code code="id"/>
         <removed-code code="markdown"/>
         <removed-code code="time"/>
         <removed-code code="uri"/>
         <removed-code code="canonical"/>
         <removed-code code="oid"/>
         <removed-code code="url"/>
         <removed-code code="uuid"/>
         <removed-code code="Quantity"/>
         <removed-code code="Age"/>
         <removed-code code="Count"/>
         <removed-code code="Distance"/>
         <removed-code code="Duration"/>
         <removed-code code="Range"/>
         <removed-code code="Ratio"/>
         <removed-code code="RatioRange"/>
         <removed-code code="Reference"/>
         <removed-code code="RelatedArtifact"/>
         <removed-code code="SampledData"/>
         <removed-code code="Signature"/>
         <removed-code code="TriggerDefinition"/>
         <removed-code code="UsageContext"/>
         <removed-code code="VirtualServiceDetail"/>
         <removed-code code="xhtml"/>
         <removed-code code="Resource"/>
         <removed-code code="Binary"/>
         <removed-code code="Bundle"/>
         <removed-code code="DomainResource"/>
         <removed-code code="Account"/>
         <removed-code code="ActivityDefinition"/>
         <removed-code code="ActorDefinition"/>
         <removed-code code="AdministrableProductDefinition"/>
         <removed-code code="AdverseEvent"/>
         <removed-code code="AllergyIntolerance"/>
         <removed-code code="Appointment"/>
         <removed-code code="AppointmentResponse"/>
         <removed-code code="ArtifactAssessment"/>
         <removed-code code="AuditEvent"/>
         <removed-code code="Basic"/>
         <removed-code code="BiologicallyDerivedProduct"/>
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="BodyStructure"/>
         <removed-code code="CanonicalResource"/>
         <removed-code code="CapabilityStatement"/>
         <removed-code code="CarePlan"/>
         <removed-code code="CareTeam"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="Claim"/>
         <removed-code code="ClaimResponse"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ClinicalUseDefinition"/>
         <removed-code code="CodeSystem"/>
         <removed-code code="Communication"/>
         <removed-code code="CommunicationRequest"/>
         <removed-code code="CompartmentDefinition"/>
         <removed-code code="Composition"/>
         <removed-code code="ConceptMap"/>
         <removed-code code="Condition"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="Consent"/>
         <removed-code code="Contract"/>
         <removed-code code="Coverage"/>
         <removed-code code="CoverageEligibilityRequest"/>
         <removed-code code="CoverageEligibilityResponse"/>
         <removed-code code="DetectedIssue"/>
         <removed-code code="Device"/>
         <removed-code code="DeviceAssociation"/>
         <removed-code code="DeviceDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceMetric"/>
         <removed-code code="DeviceRequest"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="DiagnosticReport"/>
         <removed-code code="DocumentReference"/>
         <removed-code code="Encounter"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="Endpoint"/>
         <removed-code code="EnrollmentRequest"/>
         <removed-code code="EnrollmentResponse"/>
         <removed-code code="EpisodeOfCare"/>
         <removed-code code="EventDefinition"/>
         <removed-code code="Evidence"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="EvidenceVariable"/>
         <removed-code code="ExampleScenario"/>
         <removed-code code="ExplanationOfBenefit"/>
         <removed-code code="FamilyMemberHistory"/>
         <removed-code code="Flag"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="Goal"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="Group"/>
         <removed-code code="GuidanceResponse"/>
         <removed-code code="HealthcareService"/>
         <removed-code code="ImagingSelection"/>
         <removed-code code="ImagingStudy"/>
         <removed-code code="Immunization"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="ImplementationGuide"/>
         <removed-code code="Ingredient"/>
         <removed-code code="InsurancePlan"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Invoice"/>
         <removed-code code="Library"/>
         <removed-code code="Linkage"/>
         <removed-code code="List"/>
         <removed-code code="Location"/>
         <removed-code code="ManufacturedItemDefinition"/>
         <removed-code code="Measure"/>
         <removed-code code="MeasureReport"/>
         <removed-code code="Medication"/>
         <removed-code code="MedicationAdministration"/>
         <removed-code code="MedicationDispense"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MedicationRequest"/>
         <removed-code code="MedicationStatement"/>
         <removed-code code="MedicinalProductDefinition"/>
         <removed-code code="MessageDefinition"/>
         <removed-code code="MessageHeader"/>
         <removed-code code="MetadataResource"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="NamingSystem"/>
         <removed-code code="NutritionIntake"/>
         <removed-code code="NutritionOrder"/>
         <removed-code code="NutritionProduct"/>
         <removed-code code="Observation"/>
         <removed-code code="ObservationDefinition"/>
         <removed-code code="OperationDefinition"/>
         <removed-code code="OperationOutcome"/>
         <removed-code code="Organization"/>
         <removed-code code="OrganizationAffiliation"/>
         <removed-code code="PackagedProductDefinition"/>
         <removed-code code="Patient"/>
         <removed-code code="PaymentNotice"/>
         <removed-code code="PaymentReconciliation"/>
         <removed-code code="Permission"/>
         <removed-code code="Person"/>
         <removed-code code="PlanDefinition"/>
         <removed-code code="Practitioner"/>
         <removed-code code="PractitionerRole"/>
         <removed-code code="Procedure"/>
         <removed-code code="Provenance"/>
         <removed-code code="Questionnaire"/>
         <removed-code code="QuestionnaireResponse"/>
         <removed-code code="RegulatedAuthorization"/>
         <removed-code code="RelatedPerson"/>
         <removed-code code="RequestOrchestration"/>
         <removed-code code="Requirements"/>
         <removed-code code="ResearchStudy"/>
         <removed-code code="ResearchSubject"/>
         <removed-code code="RiskAssessment"/>
         <removed-code code="Schedule"/>
         <removed-code code="SearchParameter"/>
         <removed-code code="ServiceRequest"/>
         <removed-code code="Slot"/>
         <removed-code code="Specimen"/>
         <removed-code code="SpecimenDefinition"/>
         <removed-code code="StructureDefinition"/>
         <removed-code code="StructureMap"/>
         <removed-code code="Subscription"/>
         <removed-code code="SubscriptionStatus"/>
         <removed-code code="SubscriptionTopic"/>
         <removed-code code="Substance"/>
         <removed-code code="SubstanceDefinition"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="Task"/>
         <removed-code code="TerminologyCapabilities"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="ValueSet"/>
         <removed-code code="VerificationResult"/>
         <removed-code code="VisionPrescription"/>
         <removed-code code="Parameters"/>
         <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"/>
      </element>
   </type>
   <type name="Period" status="no-change"/>
   <type name="PrimitiveType" status="no-change"/>
   <type name="ProductShelfLife" status="no-change"/>
   <type name="Quantity" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Quantity.comparator">
         <old-binding reference="http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/quantity-comparator|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Range" status="no-change"/>
   <type name="Ratio" status="no-change"/>
   <type name="RatioRange" status="no-change"/>
   <type name="Reference" status="no-change"/>
   <type name="RelatedArtifact" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RelatedArtifact.type">
         <removed-code code="amends"/>
         <removed-code code="amended-with"/>
         <removed-code code="appends"/>
         <removed-code code="appended-with"/>
         <removed-code code="cites"/>
         <removed-code code="cited-by"/>
         <removed-code code="comments-on"/>
         <removed-code code="comment-in"/>
         <removed-code code="contains"/>
         <removed-code code="contained-in"/>
         <removed-code code="corrects"/>
         <removed-code code="correction-in"/>
         <removed-code code="replaces"/>
         <removed-code code="replaced-with"/>
         <removed-code code="retracts"/>
         <removed-code code="retracted-by"/>
         <removed-code code="signs"/>
         <removed-code code="similar-to"/>
         <removed-code code="supports"/>
         <removed-code code="supported-with"/>
         <removed-code code="transforms"/>
         <removed-code code="transformed-into"/>
         <removed-code code="transformed-with"/>
         <removed-code code="documents"/>
         <removed-code code="specification-of"/>
         <removed-code code="created-with"/>
         <removed-code code="cite-as"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/related-artifact-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/related-artifact-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="RelatedArtifact.artifact[x]" status="new"/>
      <element path="RelatedArtifact.classifier" status="deleted"/>
      <element path="RelatedArtifact.publicationStatus" status="deleted"/>
      <element path="RelatedArtifact.publicationDate" status="deleted"/>
   </type>
   <type name="RelativeTime" status="new"/>
   <type name="SampledData" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SampledData.intervalUnit">
         <old-binding reference="http://hl7.org/fhir/ValueSet/ucum-units|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/ucum-units|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Signature" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Signature.targetFormat">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Signature.sigFormat">
         <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"/>
      </element>
   </type>
   <type name="SimpleQuantity" status="no-change"/>
   <type name="Timing" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Timing.repeat.durationUnit">
         <old-binding reference="http://hl7.org/fhir/ValueSet/units-of-time|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/units-of-time|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Timing.repeat.periodUnit">
         <old-binding reference="http://hl7.org/fhir/ValueSet/units-of-time|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/units-of-time|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Timing.repeat.startOffset" status="new"/>
      <element path="Timing.repeat.endOffset" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Timing.repeat.dayOfWeek">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Timing.repeat.when">
         <old-binding reference="http://hl7.org/fhir/ValueSet/event-timing|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/event-timing|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="TriggerDefinition" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="TriggerDefinition.type">
         <removed-code code="data-added"/>
         <removed-code code="data-modified"/>
         <removed-code code="data-removed"/>
         <added-code code="subscription-topic"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/trigger-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/trigger-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="TriggerDefinition.timing[x]">
         <removed-type name="Reference(Schedule)"/>
      </element>
   </type>
   <type name="UsageContext" status="no-change"/>
   <type name="VirtualServiceDetail" status="no-change"/>
   <type name="base64Binary" status="no-change"/>
   <type name="boolean" status="no-change"/>
   <type name="canonical" status="no-change"/>
   <type name="code" status="no-change"/>
   <type name="date" status="no-change"/>
   <type name="dateTime" status="no-change"/>
   <type name="decimal" status="no-change"/>
   <type name="id" status="no-change"/>
   <type name="instant" status="no-change"/>
   <type name="integer" status="no-change"/>
   <type name="integer64" status="no-change"/>
   <type name="markdown" status="no-change"/>
   <type name="oid" status="no-change"/>
   <type name="positiveInt" status="no-change"/>
   <type name="string" status="no-change"/>
   <type name="time" status="no-change"/>
   <type name="unsignedInt" status="no-change"/>
   <type name="uri" status="no-change"/>
   <type name="url" status="no-change"/>
   <type name="uuid" status="no-change"/>
   <type name="xhtml" status="no-change"/>
   <type name="Contributor" status="deleted"/>
   <type name="Account" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Account.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/account-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/account-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Account.covers" status="new"/>
      <element new-min="0" old-min="1" path="Account.guarantor.party"/>
      <element new-min="0" old-min="1" path="Account.guarantor.account"/>
      <element path="Account.guarantor.responsibility" status="new"/>
      <element path="Account.guarantor.limit" status="new"/>
      <element path="Account.guarantor.rank" status="new"/>
      <element path="Account.parent" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Account.currency">
         <old-binding reference="http://hl7.org/fhir/ValueSet/currencies|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/currencies|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Account.relatedAccount" status="deleted"/>
   </type>
   <type name="ActivityDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.kind">
         <removed-code code="AppointmentResponse"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="Transport"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/request-resource-types|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/request-resource-types|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.priority">
         <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"/>
      </element>
      <element path="ActivityDefinition.timing[x]">
         <added-type name="RelativeTime"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActivityDefinition.participant.type">
         <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"/>
      </element>
      <element path="ActivityDefinition.participant.typeCanonical">
         <removed-type name="canonical(CapabilityStatement)"/>
         <added-type name="canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"/>
      </element>
      <element path="ActivityDefinition.participant.typeReference">
         <removed-type name="Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
         <added-type name="Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"/>
      </element>
   </type>
   <type name="ActorDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActorDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActorDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ActorDefinition.type">
         <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"/>
      </element>
      <element path="ActorDefinition.category" status="new"/>
      <element old-name="derivedFrom" path="ActorDefinition.baseDefinition"/>
      <element path="ActorDefinition.capabilities" status="deleted"/>
   </type>
   <type name="AdministrableProductDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AdministrableProductDefinition.status">
         <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"/>
      </element>
      <element path="AdministrableProductDefinition.code" status="new"/>
      <element path="AdministrableProductDefinition.property.value[x]">
         <added-type name="Range"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AdministrableProductDefinition.property.status">
         <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"/>
      </element>
   </type>
   <type name="AdverseEvent" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AdverseEvent.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/adverse-event-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/adverse-event-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AdverseEvent.actuality">
         <old-binding reference="http://hl7.org/fhir/ValueSet/adverse-event-actuality|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/adverse-event-actuality|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="AdverseEvent.subject">
         <removed-type name="Reference(Patient | Group | Practitioner | RelatedPerson | ResearchSubject)"/>
         <added-type name="Reference(Patient | Group | Practitioner | RelatedPerson)"/>
      </element>
      <element old-name="occurrence[x]" path="AdverseEvent.effect[x]">
         <removed-type name="Timing"/>
      </element>
      <element path="AdverseEvent.resultingEffect">
         <removed-type name="Reference(Condition | Observation)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.recorder">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | ResearchSubject)"/>
         <added-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
      </element>
      <element path="AdverseEvent.participant.actor">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | ResearchSubject)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | Group)"/>
      </element>
      <element old-name="instance[x]" path="AdverseEvent.suspectEntity.instance">
         <removed-type name="CodeableConcept"/>
         <removed-type name="Reference(Immunization | Procedure | Substance | Medication | MedicationAdministration | MedicationStatement | Device | BiologicallyDerivedProduct | ResearchStudy)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.suspectEntity.causality.author">
         <removed-type name="Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | ResearchSubject)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)"/>
      </element>
      <element path="AdverseEvent.suspectEntity.occurrence[x]" status="new"/>
      <element path="AdverseEvent.contributingFactor">
         <removed-type name="BackboneElement"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.preventiveAction">
         <removed-type name="BackboneElement"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.mitigatingAction">
         <removed-type name="BackboneElement"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.supportingInfo">
         <removed-type name="BackboneElement"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="AdverseEvent.contributingFactor.item[x]" status="deleted"/>
      <element path="AdverseEvent.preventiveAction.item[x]" status="deleted"/>
      <element path="AdverseEvent.mitigatingAction.item[x]" status="deleted"/>
      <element path="AdverseEvent.supportingInfo.item[x]" status="deleted"/>
   </type>
   <type name="AllergyIntolerance" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="AllergyIntolerance.clinicalStatus">
         <removed-code code="resolved"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="AllergyIntolerance.verificationStatus">
         <removed-code code="presumed"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/allergyintolerance-verification|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/allergyintolerance-verification|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AllergyIntolerance.category">
         <old-binding reference="http://hl7.org/fhir/ValueSet/allergy-intolerance-category|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/allergy-intolerance-category|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AllergyIntolerance.criticality">
         <old-binding reference="http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="AllergyIntolerance.recorder" status="new"/>
      <element path="AllergyIntolerance.asserter" status="new"/>
      <element old-name="lastOccurrence"
               path="AllergyIntolerance.lastReactionOccurrence"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AllergyIntolerance.reaction.severity">
         <old-binding reference="http://hl7.org/fhir/ValueSet/reaction-event-severity|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/reaction-event-severity|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="AllergyIntolerance.participant" status="deleted"/>
   </type>
   <type name="Appointment" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Appointment.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/appointmentstatus|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/appointmentstatus|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Appointment.basedOn">
         <removed-type name="Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest | RequestOrchestration | NutritionOrder | VisionPrescription)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Appointment.participant.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/participationstatus|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/participationstatus|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Appointment.recurrenceTemplate.timezone">
         <old-binding reference="http://hl7.org/fhir/ValueSet/timezones|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/timezones|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Appointment.recurrenceTemplate.monthlyTemplate.nthWeekOfMonth">
         <old-binding reference="http://hl7.org/fhir/ValueSet/week-of-month|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/week-of-month|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Appointment.recurrenceTemplate.monthlyTemplate.dayOfWeek">
         <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"/>
      </element>
   </type>
   <type name="AppointmentResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AppointmentResponse.participantStatus">
         <old-binding reference="http://hl7.org/fhir/ValueSet/appointmentresponse-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/appointmentresponse-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="ArtifactAssessment" status="changed">
      <element old-name="citeAs[x]" path="ArtifactAssessment.citeAs">
         <removed-type name="Reference(Citation)"/>
      </element>
      <element path="ArtifactAssessment.relatesTo" status="new"/>
      <element path="ArtifactAssessment.relatesTo.type" status="new"/>
      <element path="ArtifactAssessment.relatesTo.target[x]" status="new"/>
      <element new-max="*" old-max="1" path="ArtifactAssessment.content.author"/>
      <element path="ArtifactAssessment.content.relatesTo" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ArtifactAssessment.workflowStatus">
         <old-binding reference="http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/artifactassessment-workflow-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ArtifactAssessment.disposition">
         <old-binding reference="http://hl7.org/fhir/ValueSet/artifactassessment-disposition|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/artifactassessment-disposition|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ArtifactAssessment.content.informationType" status="deleted"/>
      <element path="ArtifactAssessment.content.relatedArtifact" status="deleted"/>
   </type>
   <type name="AuditEvent" status="changed">
      <element new-max="1"
               new-min="1"
               old-max="*"
               old-min="0"
               old-name="category"
               path="AuditEvent.type"/>
      <element new-max="*"
               new-min="0"
               old-max="1"
               old-min="1"
               old-name="code"
               path="AuditEvent.subtype"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AuditEvent.action">
         <old-binding reference="http://hl7.org/fhir/ValueSet/audit-event-action|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/audit-event-action|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="AuditEvent.severity">
         <old-binding reference="http://hl7.org/fhir/ValueSet/audit-event-severity|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/audit-event-severity|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="AuditEvent.basedOn">
         <removed-type name="Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task)"/>
         <added-type name="Reference(Resource)"/>
      </element>
      <element path="AuditEvent.agent.who">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | DeviceDefinition | RelatedPerson | Group | HealthcareService)"/>
      </element>
      <element path="AuditEvent.entity.description" status="new"/>
   </type>
   <type name="Basic" status="changed">
      <element binding-status="added" path="Basic.code">
         <new-binding reference="http://hl7.org/fhir/ValueSet/version-independent-resource-types"
                      strength="extensible"/>
      </element>
   </type>
   <type name="Binary" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Binary.contentType">
         <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"/>
      </element>
   </type>
   <type name="BiologicallyDerivedProduct" status="changed">
      <element new-max="*"
               old-max="1"
               path="BiologicallyDerivedProduct.productCategory">
         <removed-type name="Coding"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="BiologicallyDerivedProduct.therapyIdentifier" status="new"/>
      <element path="BiologicallyDerivedProduct.collection.sourcePatient" status="new"/>
      <element path="BiologicallyDerivedProduct.collection.sourceOrganization"
               status="new"/>
      <element path="BiologicallyDerivedProduct.collection.procedure" status="new"/>
      <element path="BiologicallyDerivedProduct.collection.source" status="deleted"/>
   </type>
   <type name="BodyStructure" status="changed">
      <element path="BodyStructure.includedStructure.image" status="new"/>
      <element new-min="0" old-min="1" path="BodyStructure.patient"/>
   </type>
   <type name="Bundle" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Bundle.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/bundle-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/bundle-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Bundle.link.relation">
         <old-binding reference="http://hl7.org/fhir/ValueSet/iana-link-relations|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/iana-link-relations|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Bundle.entry.search.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-entry-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-entry-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Bundle.entry.request.method">
         <old-binding reference="http://hl7.org/fhir/ValueSet/http-verb|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/http-verb|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Bundle.entry.response.outcome">
         <removed-type name="Resource"/>
         <added-type name="Resource(http://hl7.org/fhir/StructureDefinition/OperationOutcome)"/>
      </element>
   </type>
   <type name="CanonicalResource" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CanonicalResource.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CanonicalResource.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
   </type>
   <type name="CapabilityStatement" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.status">
         <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"/>
      </element>
      <element path="CapabilityStatement.actorDefinition" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/capability-statement-kind|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/capability-statement-kind|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.fhirVersion">
         <removed-code code="0.0.80"/>
         <removed-code code="0.0.81"/>
         <removed-code code="0.0.82"/>
         <removed-code code="0.4.0"/>
         <removed-code code="0.5.0"/>
         <removed-code code="1.0.0"/>
         <removed-code code="1.0.1"/>
         <removed-code code="1.0.2"/>
         <removed-code code="1.1.0"/>
         <removed-code code="1.4.0"/>
         <removed-code code="1.6.0"/>
         <removed-code code="1.8.0"/>
         <removed-code code="3.0.0"/>
         <removed-code code="3.0.1"/>
         <removed-code code="3.0.2"/>
         <removed-code code="3.3.0"/>
         <removed-code code="3.5.0"/>
         <removed-code code="4.0.0"/>
         <removed-code code="4.0.1"/>
         <removed-code code="4.1.0"/>
         <removed-code code="4.2.0"/>
         <removed-code code="4.3.0"/>
         <removed-code code="4.3.0-cibuild"/>
         <removed-code code="4.3.0-snapshot1"/>
         <removed-code code="4.4.0"/>
         <removed-code code="4.5.0"/>
         <removed-code code="4.6.0"/>
         <removed-code code="5.0.0"/>
         <removed-code code="5.0.0-cibuild"/>
         <removed-code code="5.0.0-snapshot1"/>
         <removed-code code="5.0.0-snapshot2"/>
         <removed-code code="5.0.0-ballot"/>
         <removed-code code="5.0.0-snapshot3"/>
         <removed-code code="5.0.0-draft-final"/>
         <added-code code="6.0"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.format">
         <old-binding reference="http://hl7.org/fhir/ValueSet/mimetypes|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/supplemented-mimetypes|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.patchFormat">
         <old-binding reference="http://hl7.org/fhir/ValueSet/mimetypes|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/patchmimetypes|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.acceptLanguage">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/restful-capability-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/restful-capability-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.type">
         <removed-type name="code"/>
         <added-type name="uri"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/resource-types|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/extended-resource-types"
                      strength="extensible"/>
      </element>
      <element path="CapabilityStatement.rest.resource.definition" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.interaction.code">
         <added-code code="update-conditional"/>
         <added-code code="patch-conditional"/>
         <added-code code="delete-conditional-single"/>
         <added-code code="delete-conditional-multiple"/>
         <added-code code="delete-history"/>
         <added-code code="delete-history-version"/>
         <added-code code="create-conditional"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/type-restful-interaction|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/type-restful-interaction|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.versioning">
         <old-binding reference="http://hl7.org/fhir/ValueSet/versioning-policy|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/versioning-policy|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.conditionalRead">
         <old-binding reference="http://hl7.org/fhir/ValueSet/conditional-read-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conditional-read-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.conditionalDelete">
         <old-binding reference="http://hl7.org/fhir/ValueSet/conditional-delete-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conditional-delete-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.referencePolicy">
         <old-binding reference="http://hl7.org/fhir/ValueSet/reference-handling-policy|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/reference-handling-policy|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.resource.searchParam.type">
         <added-code code="resource"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-param-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-param-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.rest.interaction.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/system-restful-interaction|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/system-restful-interaction|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.messaging.supportedMessage.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/event-capability-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/event-capability-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CapabilityStatement.document.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/document-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/document-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="CarePlan" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CarePlan.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CarePlan.intent">
         <old-binding reference="http://hl7.org/fhir/ValueSet/care-plan-intent|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/care-plan-intent|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="CarePlan.activity.plannedActivityReference">
         <removed-type name="Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestOrchestration | ImmunizationRecommendation | SupplyRequest)"/>
         <added-type name="Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestOrchestration)"/>
      </element>
      <element path="CarePlan.instantiatesCanonical" status="deleted"/>
      <element path="CarePlan.instantiatesUri" status="deleted"/>
   </type>
   <type name="CareTeam" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CareTeam.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/care-team-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/care-team-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="CareTeam.participant.member">
         <removed-type name="Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam | Group | HealthcareService)"/>
      </element>
      <element path="CareTeam.participant.onBehalfOf">
         <removed-type name="Reference(Organization)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam | Group | HealthcareService)"/>
      </element>
      <element old-name="coverage[x]" path="CareTeam.participant.effective[x]"/>
      <element path="CareTeam.participant.supportingInfo" status="new"/>
   </type>
   <type name="Claim" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Claim.status">
         <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"/>
      </element>
      <element path="Claim.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Claim.use">
         <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"/>
      </element>
      <element old-name="patient" path="Claim.subject">
         <removed-type name="Reference(Patient)"/>
         <added-type name="Reference(Patient | Group)"/>
      </element>
      <element path="Claim.prescription">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="Claim.originalPrescription">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="Claim.supportingInfo.subCategory" status="new"/>
      <element path="Claim.supportingInfo.timing[x]">
         <removed-type name="date"/>
         <added-type name="dateTime"/>
         <added-type name="Timing"/>
      </element>
      <element path="Claim.supportingInfo.value[x]">
         <added-type name="base64Binary"/>
         <added-type name="canonical"/>
         <added-type name="code"/>
         <added-type name="date"/>
         <added-type name="dateTime"/>
         <added-type name="decimal"/>
         <added-type name="id"/>
         <added-type name="instant"/>
         <added-type name="integer"/>
         <added-type name="integer64"/>
         <added-type name="markdown"/>
         <added-type name="oid"/>
         <added-type name="positiveInt"/>
         <added-type name="time"/>
         <added-type name="unsignedInt"/>
         <added-type name="uri"/>
         <added-type name="url"/>
         <added-type name="uuid"/>
         <added-type name="Address"/>
         <added-type name="Age"/>
         <added-type name="Annotation"/>
         <added-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
         <added-type name="Coding"/>
         <added-type name="ContactPoint"/>
         <added-type name="Count"/>
         <added-type name="Distance"/>
         <added-type name="Duration"/>
         <added-type name="HumanName"/>
         <added-type name="Money"/>
         <added-type name="Period"/>
         <added-type name="Range"/>
         <added-type name="Ratio"/>
         <added-type name="RatioRange"/>
         <added-type name="SampledData"/>
         <added-type name="Signature"/>
         <added-type name="Timing"/>
         <added-type name="ContactDetail"/>
         <added-type name="DataRequirement"/>
         <added-type name="Expression"/>
         <added-type name="ParameterDefinition"/>
         <added-type name="RelatedArtifact"/>
         <added-type name="TriggerDefinition"/>
         <added-type name="UsageContext"/>
         <added-type name="Availability"/>
         <added-type name="ExtendedContactDetail"/>
         <added-type name="VirtualServiceDetail"/>
         <added-type name="Dosage"/>
         <added-type name="Meta"/>
      </element>
      <element path="Claim.item.subject" status="new"/>
      <element path="Claim.item.request">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="Claim.careTeam.responsible" status="deleted"/>
   </type>
   <type name="ClaimResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ClaimResponse.status">
         <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"/>
      </element>
      <element path="ClaimResponse.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ClaimResponse.use">
         <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"/>
      </element>
      <element old-name="patient" path="ClaimResponse.subject">
         <removed-type name="Reference(Patient)"/>
         <added-type name="Reference(Patient | Group)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ClaimResponse.outcome">
         <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"/>
      </element>
      <element path="ClaimResponse.supportingInfo" status="new"/>
      <element path="ClaimResponse.supportingInfo.sequence" status="new"/>
      <element path="ClaimResponse.supportingInfo.category" status="new"/>
      <element path="ClaimResponse.supportingInfo.code" status="new"/>
      <element path="ClaimResponse.supportingInfo.timing[x]" status="new"/>
      <element path="ClaimResponse.supportingInfo.value[x]" status="new"/>
      <element path="ClaimResponse.supportingInfo.reason" status="new"/>
      <element path="ClaimResponse.item.informationSequence" status="new"/>
      <element path="ClaimResponse.item.adjudication.decisionDate" status="new"/>
      <element path="ClaimResponse.addItem.subject" status="new"/>
      <element path="ClaimResponse.addItem.informationSequence" status="new"/>
      <element path="ClaimResponse.addItem.category" status="new"/>
      <element path="ClaimResponse.addItem.request">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="ClaimResponse.processNote.class" status="new"/>
      <element path="ClaimResponse.processNote.text">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ClaimResponse.processNote.language">
         <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"/>
      </element>
   </type>
   <type name="ClinicalUseDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ClinicalUseDefinition.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/clinical-use-definition-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element new-min="1" old-min="0" path="ClinicalUseDefinition.subject">
         <removed-type name="Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance | NutritionProduct | BiologicallyDerivedProduct)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element modifier="added" path="ClinicalUseDefinition.status"/>
      <element path="ClinicalUseDefinition.undesirableEffect.management" status="new"/>
      <element new-max="*"
               old-max="1"
               path="ClinicalUseDefinition.indication.intendedEffect"/>
      <element path="ClinicalUseDefinition.indication.undesirableEffect">
         <removed-type name="Reference(ClinicalUseDefinition)"/>
      </element>
      <element path="ClinicalUseDefinition.indication.otherTherapy.relationshipType"
               status="new"/>
      <element path="ClinicalUseDefinition.indication.otherTherapy.treatment"
               status="new"/>
      <element path="ClinicalUseDefinition.contraindication.indication">
         <removed-type name="Reference(ClinicalUseDefinition)"/>
      </element>
      <element path="ClinicalUseDefinition.contraindication.management" status="new"/>
      <element path="ClinicalUseDefinition.contraindication.otherTherapy">
         <removed-type name="BackboneElement"/>
      </element>
      <element path="ClinicalUseDefinition.interaction.interactant.route" status="new"/>
      <element path="ClinicalUseDefinition.interaction.severity" status="new"/>
      <element path="ClinicalUseDefinition.contraindication.otherTherapy.relationshipType"
               status="deleted"/>
      <element path="ClinicalUseDefinition.contraindication.otherTherapy.treatment"
               status="deleted"/>
   </type>
   <type name="CodeSystem" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.hierarchyMeaning">
         <old-binding reference="http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.content">
         <old-binding reference="http://hl7.org/fhir/ValueSet/codesystem-content-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/codesystem-content-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.filter.operator">
         <old-binding reference="http://hl7.org/fhir/ValueSet/filter-operator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/filter-operator|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.property.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/concept-property-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/concept-property-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CodeSystem.concept.designation.language">
         <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"/>
      </element>
   </type>
   <type name="Communication" status="changed">
      <element path="Communication.basedOn">
         <removed-type name="Reference(Resource)"/>
         <added-type name="Reference(CarePlan | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | Task | VisionPrescription)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Communication.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Communication.priority">
         <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"/>
      </element>
      <element path="Communication.instantiatesCanonical" status="deleted"/>
      <element path="Communication.instantiatesUri" status="deleted"/>
   </type>
   <type name="CommunicationRequest" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CommunicationRequest.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CommunicationRequest.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CommunicationRequest.priority">
         <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"/>
      </element>
      <element path="CommunicationRequest.requester">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group)"/>
      </element>
      <element path="CommunicationRequest.informationProvider">
         <removed-type name="Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint)"/>
         <added-type name="Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint | Group)"/>
      </element>
   </type>
   <type name="CompartmentDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CompartmentDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CompartmentDefinition.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/compartment-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/compartment-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="CompartmentDefinition.resource.code">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <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"/>
      </element>
      <element path="CompartmentDefinition.resource.documentation" status="deleted"/>
   </type>
   <type name="Composition" status="changed">
      <element path="Composition.consent" status="new"/>
      <element path="Composition.basedOn" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Composition.status">
         <removed-code code="preliminary"/>
         <removed-code code="corrected"/>
         <removed-code code="appended"/>
         <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"/>
      </element>
      <element new-min="0" old-min="1" path="Composition.author">
         <removed-type name="Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | CareTeam | Device | Patient | RelatedPerson | Organization)"/>
      </element>
      <element path="Composition.participant" status="new"/>
      <element path="Composition.participant.type" status="new"/>
      <element path="Composition.participant.function" status="new"/>
      <element path="Composition.participant.time" status="new"/>
      <element path="Composition.participant.party" status="new"/>
      <element new-min="0" old-min="1" path="Composition.title"/>
      <element path="Composition.attester.party">
         <removed-type name="Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)"/>
         <added-type name="Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization | Group)"/>
      </element>
      <element path="Composition.custodian">
         <removed-type name="Reference(Organization)"/>
         <added-type name="Reference(Organization | Patient | Group)"/>
      </element>
      <element path="Composition.relatesTo">
         <removed-type name="RelatedArtifact"/>
         <added-type name="BackboneElement"/>
      </element>
      <element path="Composition.relatesTo.type" status="new"/>
      <element path="Composition.relatesTo.target[x]" status="new"/>
      <element path="Composition.section.author">
         <removed-type name="Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | CareTeam | Device | Patient | RelatedPerson | Organization)"/>
      </element>
      <element path="Composition.section.note" status="new"/>
   </type>
   <type name="ConceptMap" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.property.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-property-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-property-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.additionalAttribute.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-attribute-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-attribute-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ConceptMap.group.element.comment" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.group.element.target.relationship">
         <removed-code code="equivalent"/>
         <removed-code code="source-is-narrower-than-target"/>
         <removed-code code="source-is-broader-than-target"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/concept-map-relationship|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/concept-map-relationship|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.group.unmapped.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-unmapped-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conceptmap-unmapped-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ConceptMap.group.unmapped.comment" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ConceptMap.group.unmapped.relationship">
         <removed-code code="equivalent"/>
         <removed-code code="source-is-narrower-than-target"/>
         <removed-code code="source-is-broader-than-target"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/concept-map-relationship|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/concept-map-relationship|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Condition" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Condition.clinicalStatus">
         <removed-code code="recurrence"/>
         <removed-code code="relapse"/>
         <removed-code code="remission"/>
         <removed-code code="resolved"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/condition-clinical|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/condition-clinical|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Condition.verificationStatus">
         <removed-code code="provisional"/>
         <removed-code code="differential"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/condition-ver-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/condition-ver-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Condition.bodyStructure" status="new"/>
      <element path="Condition.recorder" status="new"/>
      <element path="Condition.asserter" status="new"/>
      <element path="Condition.stage.assessment">
         <removed-type name="Reference(ClinicalImpression | DiagnosticReport | Observation)"/>
         <added-type name="Reference(DiagnosticReport | Observation)"/>
      </element>
      <element path="Condition.participant" status="deleted"/>
   </type>
   <type name="Consent" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Consent.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/consent-state-codes|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/consent-state-codes|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Consent.subject">
         <removed-type name="Reference(Patient | Practitioner | Group)"/>
         <added-type name="Reference(Patient | Practitioner | ResearchSubject | Group)"/>
      </element>
      <element path="Consent.grantor">
         <removed-type name="Reference(CareTeam | HealthcareService | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)"/>
         <added-type name="Reference(CareTeam | Group | HealthcareService | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)"/>
      </element>
      <element path="Consent.grantee">
         <removed-type name="Reference(CareTeam | HealthcareService | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)"/>
         <added-type name="Reference(CareTeam | Group | HealthcareService | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)"/>
      </element>
      <element old-name="url" path="Consent.policyBasis.uri">
         <removed-type name="url"/>
         <added-type name="uri"/>
      </element>
      <element old-name="verificationType" path="Consent.verification.type"/>
      <element path="Consent.verification.verifiedWith">
         <removed-type name="Reference(Patient | RelatedPerson)"/>
         <added-type name="Reference(Patient | RelatedPerson | Group)"/>
      </element>
      <element old-name="verificationDate" path="Consent.verification.date"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Consent.decision">
         <old-binding reference="http://hl7.org/fhir/ValueSet/consent-provision-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/consent-provision-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Consent.provision.data.meaning">
         <old-binding reference="http://hl7.org/fhir/ValueSet/consent-data-meaning|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/consent-data-meaning|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Contract" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Contract.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/contract-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/contract-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Contract.author">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | Organization)"/>
         <added-type name="Reference(Patient | Practitioner | PractitionerRole | Organization | RelatedPerson)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Contract.contentDefinition.publicationStatus">
         <old-binding reference="http://hl7.org/fhir/ValueSet/contract-publicationstatus|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/contract-publicationstatus|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Contract.term.text">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
   </type>
   <type name="Coverage" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Coverage.status">
         <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"/>
      </element>
      <element path="Coverage.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Coverage.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/coverage-kind|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="CoverageEligibilityRequest" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CoverageEligibilityRequest.status">
         <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"/>
      </element>
      <element path="CoverageEligibilityRequest.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CoverageEligibilityRequest.purpose">
         <old-binding reference="http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="CoverageEligibilityResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CoverageEligibilityResponse.status">
         <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"/>
      </element>
      <element path="CoverageEligibilityResponse.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CoverageEligibilityResponse.purpose">
         <old-binding reference="http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element new-min="0" old-min="1" path="CoverageEligibilityResponse.request"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="CoverageEligibilityResponse.outcome">
         <old-binding reference="http://hl7.org/fhir/ValueSet/eligibility-outcome|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/eligibility-outcome|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="CoverageEligibilityResponse.insurance.item.description">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
   </type>
   <type name="DetectedIssue" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DetectedIssue.status">
         <added-code code="unknown"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/detectedissue-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/detectedissue-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="removed" path="DetectedIssue.severity">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/detectedissue-severity|5.0.0"
                      strength="required"/>
      </element>
      <element path="DetectedIssue.identified[x]">
         <added-type name="Timing"/>
      </element>
      <element path="DetectedIssue.qualityOfEvidence" status="new"/>
      <element path="DetectedIssue.expectedOnsetType" status="new"/>
      <element path="DetectedIssue.medicationClass" status="new"/>
      <element path="DetectedIssue.managementCode" status="new"/>
   </type>
   <type name="Device" status="changed">
      <element path="Device.definition">
         <removed-type name="CodeableReference"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element path="Device.udiCarrier.deviceIdentifierSystem" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Device.udiCarrier.entryType">
         <old-binding reference="http://hl7.org/fhir/ValueSet/udi-entry-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/udi-entry-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Device.status">
         <added-code code="unknown"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/device-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/device-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="Device.name.type">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element modifier="removed" path="Device.name.display"/>
      <element old-name="version" path="Device.deviceVersion"/>
      <element path="Device.additive" status="new"/>
      <element path="Device.additive.type" status="new"/>
      <element path="Device.additive.quantity" status="new"/>
      <element path="Device.displayName" status="deleted"/>
      <element path="Device.mode" status="deleted"/>
      <element path="Device.cycle" status="deleted"/>
      <element path="Device.duration" status="deleted"/>
      <element path="Device.owner" status="deleted"/>
      <element path="Device.url" status="deleted"/>
      <element path="Device.endpoint" status="deleted"/>
      <element path="Device.gateway" status="deleted"/>
   </type>
   <type name="DeviceAlert" status="new"/>
   <type name="DeviceAssociation" status="changed">
      <element path="DeviceAssociation.relationship" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceAssociation.status">
         <removed-type name="CodeableConcept"/>
         <added-type name="code"/>
         <removed-code code="implanted"/>
         <removed-code code="explanted"/>
         <removed-code code="attached"/>
         <added-code code="active"/>
         <added-code code="inactive"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceAssociation.statusReason">
         <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"/>
      </element>
      <element path="DeviceAssociation.associationStatus" status="new"/>
      <element path="DeviceAssociation.subject">
         <removed-type name="Reference(Patient | Group | Practitioner | RelatedPerson | Device)"/>
         <added-type name="Reference(BiologicallyDerivedProduct | CareTeam | Device | Group | Location | Medication | NutritionProduct | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance)"/>
      </element>
      <element path="DeviceAssociation.focus" status="new"/>
      <element path="DeviceAssociation.category" status="deleted"/>
      <element path="DeviceAssociation.operation" status="deleted"/>
   </type>
   <type name="DeviceDefinition" status="changed">
      <element path="DeviceDefinition.url" status="new"/>
      <element new-max="1" old-max="*" path="DeviceDefinition.version">
         <removed-type name="BackboneElement"/>
         <added-type name="string"/>
      </element>
      <element path="DeviceDefinition.versionAlgorithm[x]" status="new"/>
      <element path="DeviceDefinition.name" status="new"/>
      <element path="DeviceDefinition.title" status="new"/>
      <element path="DeviceDefinition.status" status="new"/>
      <element path="DeviceDefinition.experimental" status="new"/>
      <element path="DeviceDefinition.date" status="new"/>
      <element path="DeviceDefinition.publisher" status="new"/>
      <element path="DeviceDefinition.contact">
         <removed-type name="ContactPoint"/>
         <added-type name="ContactDetail"/>
      </element>
      <element path="DeviceDefinition.useContext" status="new"/>
      <element path="DeviceDefinition.jurisdiction" status="new"/>
      <element path="DeviceDefinition.purpose" status="new"/>
      <element path="DeviceDefinition.copyright" status="new"/>
      <element path="DeviceDefinition.copyrightLabel" status="new"/>
      <element path="DeviceDefinition.approvalDate" status="new"/>
      <element path="DeviceDefinition.lastReviewDate" status="new"/>
      <element path="DeviceDefinition.effectivePeriod" status="new"/>
      <element path="DeviceDefinition.udiDeviceIdentifier.deviceIdentifierSystem"
               status="new"/>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceDefinition.regulatoryIdentifier.type">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element old-name="deviceIdentifier"
               path="DeviceDefinition.regulatoryIdentifier.identifier"/>
      <element path="DeviceDefinition.regulatoryIdentifier.identifierSystem"
               status="new"/>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceDefinition.deviceName.type">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element old-name="reference" path="DeviceDefinition.hasPart.definition[x]">
         <removed-type name="Reference(DeviceDefinition)"/>
         <added-type name="canonical(DeviceDefinition)"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="DeviceDefinition.deviceVersion" status="new"/>
      <element binding-status="added"
               old-name="languageCode"
               path="DeviceDefinition.outputLanguage">
         <removed-type name="CodeableConcept"/>
         <added-type name="code"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element old-name="relatedDevice" path="DeviceDefinition.link.relatedDevice[x]">
         <removed-type name="CodeableReference"/>
         <added-type name="canonical(DeviceDefinition)"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceDefinition.productionIdentifierInUDI">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceDefinition.correctiveAction.scope">
         <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"/>
      </element>
      <element path="DeviceDefinition.owner" status="deleted"/>
   </type>
   <type name="DeviceMetric" status="changed">
      <element path="DeviceMetric.status" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceMetric.operationalStatus">
         <removed-code code="entered-in-error"/>
         <added-code code="unknown"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceMetric.category">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceMetric.color">
         <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"/>
      </element>
      <element path="DeviceMetric.availability" status="new"/>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="DeviceMetric.calibration.type">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceMetric.calibration.state">
         <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"/>
      </element>
   </type>
   <type name="DeviceRequest" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceRequest.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceRequest.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DeviceRequest.priority">
         <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"/>
      </element>
      <element old-name="code" path="DeviceRequest.product[x]">
         <removed-type name="CodeableReference"/>
         <added-type name="CodeableConcept"/>
         <added-type name="Reference(Device)"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element path="DeviceRequest.requester">
         <removed-type name="Reference(Device | Practitioner | PractitionerRole | Organization)"/>
         <added-type name="Reference(Device | Practitioner | PractitionerRole | Organization | CareTeam | Group | Patient | RelatedPerson)"/>
      </element>
      <element path="DeviceRequest.location" status="new"/>
      <element path="DeviceRequest.instantiatesCanonical" status="deleted"/>
      <element path="DeviceRequest.instantiatesUri" status="deleted"/>
   </type>
   <type name="DiagnosticReport" status="changed">
      <element path="DiagnosticReport.basedOn">
         <removed-type name="Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | MedicationRequest | NutritionOrder | ServiceRequest)"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="DiagnosticReport.status">
         <removed-code code="preliminary"/>
         <removed-code code="modified"/>
         <removed-code code="corrected"/>
         <removed-code code="appended"/>
         <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"/>
      </element>
      <element path="DiagnosticReport.relatesTo" status="new"/>
      <element path="DiagnosticReport.issued">
         <removed-type name="instant"/>
         <added-type name="dateTime"/>
      </element>
      <element path="DiagnosticReport.procedure" status="new"/>
      <element path="DiagnosticReport.performer">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Device | Patient | RelatedPerson)"/>
      </element>
      <element path="DiagnosticReport.resultsInterpreter">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"/>
      </element>
      <element path="DiagnosticReport.study">
         <removed-type name="Reference(GenomicStudy | ImagingStudy)"/>
         <added-type name="Reference(ImagingStudy)"/>
      </element>
      <element path="DiagnosticReport.supportingInfo.reference">
         <removed-type name="Reference(Procedure | Observation | DiagnosticReport | Citation)"/>
         <added-type name="Reference(ImagingStudy | Procedure | Observation | DiagnosticReport | FamilyMemberHistory | AllergyIntolerance | Condition | DocumentReference)"/>
      </element>
      <element path="DiagnosticReport.conclusionCode">
         <removed-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="DiagnosticReport.recomendation" status="new"/>
      <element path="DiagnosticReport.communication" status="new"/>
      <element path="DiagnosticReport.comparison" status="new"/>
   </type>
   <type name="DocumentReference" status="changed">
      <element path="DocumentReference.basedOn">
         <removed-type name="Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)"/>
         <added-type name="Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | VisionPrescription)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="DocumentReference.status">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               modifier="added"
               path="DocumentReference.docStatus">
         <removed-code code="preliminary"/>
         <removed-code code="corrected"/>
         <removed-code code="appended"/>
         <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"/>
      </element>
      <element path="DocumentReference.related" status="new"/>
      <element old-name="bodySite" path="DocumentReference.bodyStructure"/>
      <element path="DocumentReference.date">
         <removed-type name="instant"/>
         <added-type name="dateTime"/>
      </element>
      <element path="DocumentReference.author">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam | Group)"/>
      </element>
      <element path="DocumentReference.attester.party">
         <removed-type name="Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)"/>
         <added-type name="Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization | Group)"/>
      </element>
   </type>
   <type name="DomainResource" status="no-change"/>
   <type name="Encounter" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Encounter.status">
         <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"/>
      </element>
      <element path="Encounter.businessStatus" status="new"/>
      <element path="Encounter.businessStatus.code" status="new"/>
      <element path="Encounter.businessStatus.type" status="new"/>
      <element path="Encounter.businessStatus.effectiveDate" status="new"/>
      <element path="Encounter.basedOn">
         <removed-type name="Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest | RequestOrchestration | NutritionOrder | VisionPrescription)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Encounter.location.status">
         <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"/>
      </element>
   </type>
   <type name="Endpoint" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Endpoint.status">
         <added-code code="limited"/>
         <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"/>
      </element>
      <element path="Endpoint.availability" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Endpoint.payload.mimeType">
         <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"/>
      </element>
      <element path="Endpoint.payload.profileCanonical" status="new"/>
      <element path="Endpoint.payload.profileUri" status="new"/>
   </type>
   <type name="EnrollmentRequest" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EnrollmentRequest.status">
         <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"/>
      </element>
      <element path="EnrollmentRequest.candidate">
         <removed-type name="Reference(Patient)"/>
         <added-type name="Reference(Patient | Group)"/>
      </element>
   </type>
   <type name="EnrollmentResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EnrollmentResponse.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EnrollmentResponse.outcome">
         <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"/>
      </element>
      <element path="EnrollmentResponse.candidate" status="new"/>
   </type>
   <type name="EpisodeOfCare" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EpisodeOfCare.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EpisodeOfCare.statusHistory.status">
         <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"/>
      </element>
      <element new-max="*" old-max="1" path="EpisodeOfCare.reason.use"/>
      <element new-max="*" old-max="1" path="EpisodeOfCare.diagnosis.use"/>
      <element old-name="patient" path="EpisodeOfCare.subject">
         <removed-type name="Reference(Patient)"/>
         <added-type name="Reference(Patient | Group)"/>
      </element>
   </type>
   <type name="EventDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EventDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EventDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
   </type>
   <type name="Evidence" status="changed">
      <element old-name="citeAs[x]" path="Evidence.citeAs">
         <removed-type name="Reference(Citation)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Evidence.status">
         <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"/>
      </element>
      <element path="Evidence.recorder" status="new"/>
      <element path="Evidence.relatesTo" status="new"/>
      <element path="Evidence.relatesTo.type" status="new"/>
      <element path="Evidence.relatesTo.target[x]" status="new"/>
      <element new-min="0" old-min="1" path="Evidence.variableDefinition"/>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="Evidence.variableDefinition.variableRole">
         <removed-type name="CodeableConcept"/>
         <added-type name="code"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/variable-role"
                      strength="extensible"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/variable-role|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Evidence.variableDefinition.roleSubtype" status="new"/>
      <element path="Evidence.variableDefinition.comparatorCategory" status="new"/>
      <element binding-status="removed"
               path="Evidence.variableDefinition.directnessMatch">
         <old-binding reference="http://terminology.hl7.org/ValueSet/directness"
                      strength="extensible"/>
      </element>
      <element binding-status="removed"
               new-max="*"
               old-max="1"
               path="Evidence.synthesisType">
         <old-binding reference="http://terminology.hl7.org/ValueSet/synthesis-type"
                      strength="extensible"/>
      </element>
      <element binding-status="removed" path="Evidence.statistic.statisticType">
         <old-binding reference="http://hl7.org/fhir/ValueSet/statistic-type"
                      strength="extensible"/>
      </element>
      <element path="Evidence.statistic.sampleSize.numberAnalyzed" status="new"/>
      <element binding-status="removed"
               path="Evidence.statistic.attributeEstimate.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/attribute-estimate-type"
                      strength="extensible"/>
      </element>
      <element binding-status="removed"
               path="Evidence.statistic.modelCharacteristic.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/statistic-model-code"
                      strength="extensible"/>
      </element>
      <element old-name="value" path="Evidence.statistic.modelCharacteristic.value[x]">
         <added-type name="Range"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="Evidence.statistic.modelCharacteristic.intended" status="new"/>
      <element path="Evidence.statistic.modelCharacteristic.applied" status="new"/>
      <element binding-status="removed"
               path="Evidence.statistic.modelCharacteristic.variable.handling">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/variable-handling|5.0.0"
                      strength="required"/>
      </element>
      <element old-name="attributeEstimate"
               path="Evidence.statistic.modelCharacteristic.attribute"/>
      <element binding-status="removed" path="Evidence.certainty.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/certainty-type"
                      strength="extensible"/>
      </element>
      <element binding-status="removed" path="Evidence.certainty.rating">
         <old-binding reference="http://hl7.org/fhir/ValueSet/certainty-rating"
                      strength="extensible"/>
      </element>
      <element new-max="*" old-max="1" path="Evidence.certainty.rater"/>
      <element path="Evidence.relatedArtifact" status="deleted"/>
   </type>
   <type name="EvidenceVariable" status="changed">
      <element path="EvidenceVariable.citeAs" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="EvidenceVariable.status">
         <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"/>
      </element>
      <element path="EvidenceVariable.recorder" status="new"/>
      <element path="EvidenceVariable.relatesTo" status="new"/>
      <element path="EvidenceVariable.relatesTo.type" status="new"/>
      <element path="EvidenceVariable.relatesTo.target[x]" status="new"/>
      <element path="EvidenceVariable.definition" status="new"/>
      <element path="EvidenceVariable.definitionModifier" status="new"/>
      <element path="EvidenceVariable.definitionModifier.code" status="new"/>
      <element path="EvidenceVariable.definitionModifier.value[x]" status="new"/>
      <element binding-status="removed" path="EvidenceVariable.handling">
         <removed-type name="code"/>
         <added-type name="CodeableConcept"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/variable-handling|5.0.0"
                      strength="required"/>
      </element>
      <element path="EvidenceVariable.category.value[x]">
         <added-type name="Reference(Group)"/>
      </element>
      <element path="EvidenceVariable.conditional" status="new"/>
      <element path="EvidenceVariable.classifier" status="new"/>
      <element path="EvidenceVariable.dataStorage" status="new"/>
      <element path="EvidenceVariable.dataStorage.datatype" status="new"/>
      <element path="EvidenceVariable.dataStorage.path" status="new"/>
      <element path="EvidenceVariable.dataStorage.delimiter" status="new"/>
      <element path="EvidenceVariable.dataStorage.component" status="new"/>
      <element path="EvidenceVariable.timing" status="new"/>
      <element path="EvidenceVariable.period" status="new"/>
      <element path="EvidenceVariable.constraint" status="new"/>
      <element path="EvidenceVariable.constraint.conditional" status="new"/>
      <element path="EvidenceVariable.constraint.minimumQuantity" status="new"/>
      <element path="EvidenceVariable.constraint.maximumQuantity" status="new"/>
      <element path="EvidenceVariable.constraint.earliestDateTime" status="new"/>
      <element path="EvidenceVariable.constraint.latestDateTime" status="new"/>
      <element path="EvidenceVariable.constraint.minimumStringLength" status="new"/>
      <element path="EvidenceVariable.constraint.maximumStringLength" status="new"/>
      <element path="EvidenceVariable.constraint.code" status="new"/>
      <element path="EvidenceVariable.constraint.expression" status="new"/>
      <element path="EvidenceVariable.constraint.expectedValueSet" status="new"/>
      <element path="EvidenceVariable.constraint.expectedUnitsValueSet" status="new"/>
      <element path="EvidenceVariable.constraint.anyValueAllowed" status="new"/>
      <element path="EvidenceVariable.missingDataMeaning" status="new"/>
      <element path="EvidenceVariable.unacceptableDataHandling" status="new"/>
      <element path="EvidenceVariable.relatedArtifact" status="deleted"/>
      <element path="EvidenceVariable.characteristic" status="deleted"/>
   </type>
   <type name="ExampleScenario" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExampleScenario.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExampleScenario.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               new-min="0"
               old-min="1"
               path="ExampleScenario.actor.type">
         <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"/>
      </element>
      <element path="ExampleScenario.actor.definition" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExampleScenario.process.step.operation.type">
         <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"/>
      </element>
   </type>
   <type name="ExplanationOfBenefit" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExplanationOfBenefit.status">
         <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"/>
      </element>
      <element path="ExplanationOfBenefit.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExplanationOfBenefit.use">
         <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"/>
      </element>
      <element old-name="patient" path="ExplanationOfBenefit.subject">
         <removed-type name="Reference(Patient)"/>
         <added-type name="Reference(Patient | Group)"/>
      </element>
      <element path="ExplanationOfBenefit.related.claim">
         <removed-type name="Reference(Claim)"/>
         <added-type name="Reference(Claim | ExplanationOfBenefit)"/>
      </element>
      <element path="ExplanationOfBenefit.prescription">
         <removed-type name="Reference(MedicationRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="ExplanationOfBenefit.originalPrescription">
         <removed-type name="Reference(MedicationRequest)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | ServiceRequest | VisionPrescription)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExplanationOfBenefit.outcome">
         <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"/>
      </element>
      <element path="ExplanationOfBenefit.supportingInfo.timing[x]">
         <removed-type name="date"/>
         <added-type name="dateTime"/>
         <added-type name="Timing"/>
      </element>
      <element path="ExplanationOfBenefit.supportingInfo.value[x]">
         <added-type name="base64Binary"/>
         <added-type name="canonical"/>
         <added-type name="code"/>
         <added-type name="date"/>
         <added-type name="dateTime"/>
         <added-type name="decimal"/>
         <added-type name="id"/>
         <added-type name="instant"/>
         <added-type name="integer"/>
         <added-type name="integer64"/>
         <added-type name="markdown"/>
         <added-type name="oid"/>
         <added-type name="positiveInt"/>
         <added-type name="time"/>
         <added-type name="unsignedInt"/>
         <added-type name="uri"/>
         <added-type name="url"/>
         <added-type name="uuid"/>
         <added-type name="Address"/>
         <added-type name="Age"/>
         <added-type name="Annotation"/>
         <added-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
         <added-type name="Coding"/>
         <added-type name="ContactPoint"/>
         <added-type name="Count"/>
         <added-type name="Distance"/>
         <added-type name="Duration"/>
         <added-type name="HumanName"/>
         <added-type name="Money"/>
         <added-type name="Period"/>
         <added-type name="Range"/>
         <added-type name="Ratio"/>
         <added-type name="RatioRange"/>
         <added-type name="SampledData"/>
         <added-type name="Signature"/>
         <added-type name="Timing"/>
         <added-type name="ContactDetail"/>
         <added-type name="DataRequirement"/>
         <added-type name="Expression"/>
         <added-type name="ParameterDefinition"/>
         <added-type name="RelatedArtifact"/>
         <added-type name="TriggerDefinition"/>
         <added-type name="UsageContext"/>
         <added-type name="Availability"/>
         <added-type name="ExtendedContactDetail"/>
         <added-type name="VirtualServiceDetail"/>
         <added-type name="Dosage"/>
         <added-type name="Meta"/>
      </element>
      <element path="ExplanationOfBenefit.item.subject" status="new"/>
      <element path="ExplanationOfBenefit.item.request">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="ExplanationOfBenefit.item.adjudication.decisionDate" status="new"/>
      <element path="ExplanationOfBenefit.addItem.subject" status="new"/>
      <element path="ExplanationOfBenefit.addItem.informationSequence" status="new"/>
      <element path="ExplanationOfBenefit.addItem.category" status="new"/>
      <element path="ExplanationOfBenefit.addItem.request">
         <removed-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)"/>
         <added-type name="Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | VisionPrescription)"/>
      </element>
      <element path="ExplanationOfBenefit.processNote.class" status="new"/>
      <element path="ExplanationOfBenefit.processNote.text">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ExplanationOfBenefit.processNote.language">
         <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"/>
      </element>
      <element path="ExplanationOfBenefit.careTeam.responsible" status="deleted"/>
   </type>
   <type name="FamilyMemberHistory" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="FamilyMemberHistory.status">
         <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"/>
      </element>
      <element path="FamilyMemberHistory.recorder" status="new"/>
      <element path="FamilyMemberHistory.asserter" status="new"/>
      <element path="FamilyMemberHistory.instantiatesCanonical" status="deleted"/>
      <element path="FamilyMemberHistory.instantiatesUri" status="deleted"/>
      <element path="FamilyMemberHistory.participant" status="deleted"/>
   </type>
   <type name="Flag" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               new-min="0"
               old-min="1"
               path="Flag.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/flag-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/flag-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Flag.supportingInfo" status="new"/>
   </type>
   <type name="Goal" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Goal.lifecycleStatus">
         <removed-code code="active"/>
         <removed-code code="on-hold"/>
         <removed-code code="completed"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/goal-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/goal-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Goal.acceptance" status="new"/>
      <element path="Goal.acceptance.participant" status="new"/>
      <element path="Goal.acceptance.status" status="new"/>
      <element path="Goal.acceptance.priority" status="new"/>
      <element new-max="*" old-max="1" path="Goal.statusReason">
         <removed-type name="string"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="Goal.recorder" status="new"/>
      <element path="Goal.source">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam)"/>
         <added-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam | Group)"/>
      </element>
      <element path="Goal.addresses">
         <removed-type name="Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure)"/>
         <added-type name="Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure | NutritionIntake)"/>
      </element>
      <element path="Goal.outcome" status="deleted"/>
   </type>
   <type name="Group" status="changed">
      <element path="Group.url" status="new"/>
      <element path="Group.version" status="new"/>
      <element path="Group.versionAlgorithm[x]" status="new"/>
      <element path="Group.title" status="new"/>
      <element path="Group.status" status="new"/>
      <element path="Group.experimental" status="new"/>
      <element path="Group.date" status="new"/>
      <element path="Group.publisher" status="new"/>
      <element path="Group.contact" status="new"/>
      <element path="Group.useContext" status="new"/>
      <element path="Group.purpose" status="new"/>
      <element path="Group.copyright" status="new"/>
      <element path="Group.copyrightLabel" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               new-min="0"
               old-min="1"
               path="Group.type">
         <added-code code="medication"/>
         <added-code code="medicinalproductdefinition"/>
         <added-code code="substance"/>
         <added-code code="substancedefinition"/>
         <added-code code="biologicallyDerivedProduct"/>
         <added-code code="nutritionProduct"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/group-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/group-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Group.membership">
         <added-code code="conceptual"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/group-membership-basis|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/group-membership-basis|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="added" path="Group.code">
         <new-binding reference="http://hl7.org/fhir/ValueSet/group-code"
                      strength="extensible"/>
      </element>
      <element path="Group.combinationMethod" status="new"/>
      <element path="Group.combinationThreshold" status="new"/>
      <element path="Group.characteristic.value[x]">
         <added-type name="uri"/>
         <added-type name="Expression"/>
      </element>
      <element path="Group.characteristic.description" status="new"/>
      <element path="Group.characteristic.method" status="new"/>
      <element path="Group.characteristic.formula" status="new"/>
      <element path="Group.characteristic.determiner" status="new"/>
      <element path="Group.characteristic.offset" status="new"/>
      <element path="Group.characteristic.instances[x]" status="new"/>
      <element path="Group.characteristic.duration[x]" status="new"/>
      <element path="Group.characteristic.timing" status="new"/>
      <element path="Group.member.entity">
         <removed-type name="Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen)"/>
         <added-type name="Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Medication | MedicinalProductDefinition | Substance | SubstanceDefinition | BiologicallyDerivedProduct | NutritionProduct)"/>
      </element>
      <element path="Group.member.involvement" status="new"/>
      <element path="Group.active" status="deleted"/>
   </type>
   <type name="GuidanceResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="GuidanceResponse.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/guidance-response-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/guidance-response-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="GuidanceResponse.location" status="new"/>
      <element path="GuidanceResponse.result">
         <removed-type name="Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | Task | VisionPrescription)"/>
         <added-type name="Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | Task | VisionPrescription)"/>
      </element>
   </type>
   <type name="HealthcareService" status="changed">
      <element path="HealthcareService.eligibility.value[x]" status="new"/>
      <element path="HealthcareService.eligibility.period" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="HealthcareService.communication">
         <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"/>
      </element>
      <element path="HealthcareService.referralRequired" status="new"/>
      <element new-max="1" old-max="*" path="HealthcareService.availability"/>
   </type>
   <type name="ImagingSelection" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImagingSelection.status">
         <added-code code="inactive"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/imagingselection-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/imagingselection-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ImagingSelection.modality" status="new"/>
      <element path="ImagingSelection.subject">
         <removed-type name="Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | Specimen)"/>
         <added-type name="Reference(Patient | Group | Device | Procedure | Practitioner | Medication | Substance | Specimen)"/>
      </element>
      <element new-min="1" old-min="0" path="ImagingSelection.performer.actor"/>
      <element path="ImagingSelection.basedOn">
         <removed-type name="Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)"/>
         <added-type name="Reference(CarePlan | ServiceRequest | Appointment | Task)"/>
      </element>
      <element new-max="1" old-max="*" path="ImagingSelection.derivedFrom"/>
      <element new-max="*" old-max="1" path="ImagingSelection.bodySite"/>
      <element binding-status="removed" path="ImagingSelection.instance.sopClass">
         <removed-type name="Coding"/>
         <added-type name="oid"/>
         <old-binding reference="http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1"
                      strength="extensible"/>
      </element>
      <element path="ImagingSelection.instance.frameNumber" status="new"/>
      <element path="ImagingSelection.instance.referencedContentItemIdentifier"
               status="new"/>
      <element path="ImagingSelection.instance.segmentNumber" status="new"/>
      <element path="ImagingSelection.instance.regionOfInterest" status="new"/>
      <element path="ImagingSelection.instance.waveFormChannel" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImagingSelection.instance.imageRegion2D.regionType">
         <removed-code code="interpolated"/>
         <added-code code="multipoint"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/imagingselection-2dgraphictype|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/imagingselection-2dgraphictype|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ImagingSelection.imageRegion3D" status="new"/>
      <element path="ImagingSelection.imageRegion3D.regionType" status="new"/>
      <element path="ImagingSelection.imageRegion3D.coordinate" status="new"/>
      <element path="ImagingSelection.instance.subset" status="deleted"/>
      <element path="ImagingSelection.instance.imageRegion3D" status="deleted"/>
   </type>
   <type name="ImagingStudy" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImagingStudy.status">
         <added-code code="inactive"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/imagingstudy-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/imagingstudy-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ImagingStudy.basedOn">
         <removed-type name="Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)"/>
         <added-type name="Reference(CarePlan | ServiceRequest | Appointment | Task)"/>
      </element>
      <element path="ImagingStudy.procedure">
         <removed-type name="CodeableReference"/>
         <added-type name="Reference(Procedure)"/>
      </element>
      <element binding-status="removed" path="ImagingStudy.series.instance.sopClass">
         <removed-type name="Coding"/>
         <added-type name="oid"/>
         <old-binding reference="http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1"
                      strength="extensible"/>
      </element>
      <element path="ImagingStudy.series.instance.numberOfFrames" status="new"/>
      <element path="ImagingStudy.partOf" status="deleted"/>
      <element path="ImagingStudy.series.laterality" status="deleted"/>
   </type>
   <type name="Immunization" status="changed">
      <element path="Immunization.basedOn">
         <removed-type name="Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)"/>
         <added-type name="Reference(CarePlan | MedicationRequest | ServiceRequest)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Immunization.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/immunization-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/immunization-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Immunization.performer.function">
         <old-binding reference="http://hl7.org/fhir/ValueSet/immunization-function"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/immunization-function"
                      strength="extensible"/>
      </element>
      <element new-min="0"
               old-min="1"
               path="Immunization.protocolApplied.doseNumber">
         <removed-type name="string"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="Immunization.protocolApplied.seriesDoses">
         <removed-type name="string"/>
         <added-type name="CodeableConcept"/>
      </element>
   </type>
   <type name="ImplementationGuide" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.license">
         <old-binding reference="http://hl7.org/fhir/ValueSet/spdx-license|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/spdx-license|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.fhirVersion">
         <removed-code code="0.0.80"/>
         <removed-code code="0.0.81"/>
         <removed-code code="0.0.82"/>
         <removed-code code="0.4.0"/>
         <removed-code code="0.5.0"/>
         <removed-code code="1.0.0"/>
         <removed-code code="1.0.1"/>
         <removed-code code="1.0.2"/>
         <removed-code code="1.1.0"/>
         <removed-code code="1.4.0"/>
         <removed-code code="1.6.0"/>
         <removed-code code="1.8.0"/>
         <removed-code code="3.0.0"/>
         <removed-code code="3.0.1"/>
         <removed-code code="3.0.2"/>
         <removed-code code="3.3.0"/>
         <removed-code code="3.5.0"/>
         <removed-code code="4.0.0"/>
         <removed-code code="4.0.1"/>
         <removed-code code="4.1.0"/>
         <removed-code code="4.2.0"/>
         <removed-code code="4.3.0"/>
         <removed-code code="4.3.0-cibuild"/>
         <removed-code code="4.3.0-snapshot1"/>
         <removed-code code="4.4.0"/>
         <removed-code code="4.5.0"/>
         <removed-code code="4.6.0"/>
         <removed-code code="5.0.0"/>
         <removed-code code="5.0.0-cibuild"/>
         <removed-code code="5.0.0-snapshot1"/>
         <removed-code code="5.0.0-snapshot2"/>
         <removed-code code="5.0.0-ballot"/>
         <removed-code code="5.0.0-snapshot3"/>
         <removed-code code="5.0.0-draft-final"/>
         <added-code code="6.0"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.global.type">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.definition.resource.fhirVersion">
         <removed-code code="0.0.80"/>
         <removed-code code="0.0.81"/>
         <removed-code code="0.0.82"/>
         <removed-code code="0.4.0"/>
         <removed-code code="0.5.0"/>
         <removed-code code="1.0.0"/>
         <removed-code code="1.0.1"/>
         <removed-code code="1.0.2"/>
         <removed-code code="1.1.0"/>
         <removed-code code="1.4.0"/>
         <removed-code code="1.6.0"/>
         <removed-code code="1.8.0"/>
         <removed-code code="3.0.0"/>
         <removed-code code="3.0.1"/>
         <removed-code code="3.0.2"/>
         <removed-code code="3.3.0"/>
         <removed-code code="3.5.0"/>
         <removed-code code="4.0.0"/>
         <removed-code code="4.0.1"/>
         <removed-code code="4.1.0"/>
         <removed-code code="4.2.0"/>
         <removed-code code="4.3.0"/>
         <removed-code code="4.3.0-cibuild"/>
         <removed-code code="4.3.0-snapshot1"/>
         <removed-code code="4.4.0"/>
         <removed-code code="4.5.0"/>
         <removed-code code="4.6.0"/>
         <removed-code code="5.0.0"/>
         <removed-code code="5.0.0-cibuild"/>
         <removed-code code="5.0.0-snapshot1"/>
         <removed-code code="5.0.0-snapshot2"/>
         <removed-code code="5.0.0-ballot"/>
         <removed-code code="5.0.0-snapshot3"/>
         <removed-code code="5.0.0-draft-final"/>
         <added-code code="6.0"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ImplementationGuide.definition.page.generation">
         <old-binding reference="http://hl7.org/fhir/ValueSet/guide-page-generation|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/guide-page-generation|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Ingredient" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Ingredient.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Ingredient.manufacturer.role">
         <old-binding reference="http://hl7.org/fhir/ValueSet/ingredient-manufacturer-role|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/ingredient-manufacturer-role|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="InsurancePlan" status="changed">
      <element path="InsurancePlan.product" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="InsurancePlan.specificCost.benefit.cost.applicability">
         <old-binding reference="http://hl7.org/fhir/ValueSet/insuranceplan-applicability|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/insuranceplan-applicability|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="InsurancePlan.specificCost.benefit.cost.qualifier" status="new"/>
      <element path="InsurancePlan.identifier" status="deleted"/>
      <element path="InsurancePlan.status" status="deleted"/>
      <element path="InsurancePlan.type" status="deleted"/>
      <element path="InsurancePlan.name" status="deleted"/>
      <element path="InsurancePlan.alias" status="deleted"/>
      <element path="InsurancePlan.period" status="deleted"/>
      <element path="InsurancePlan.ownedBy" status="deleted"/>
      <element path="InsurancePlan.administeredBy" status="deleted"/>
      <element path="InsurancePlan.coverageArea" status="deleted"/>
      <element path="InsurancePlan.contact" status="deleted"/>
      <element path="InsurancePlan.endpoint" status="deleted"/>
      <element path="InsurancePlan.network" status="deleted"/>
      <element path="InsurancePlan.coverage" status="deleted"/>
      <element path="InsurancePlan.plan" status="deleted"/>
   </type>
   <type name="InsuranceProduct" status="new"/>
   <type name="Invoice" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Invoice.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/invoice-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/invoice-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element old-name="date" path="Invoice.period[x]">
         <removed-type name="dateTime"/>
         <added-type name="date"/>
         <added-type name="Period"/>
      </element>
      <element path="Invoice.issuer">
         <removed-type name="Reference(Organization)"/>
         <added-type name="Reference(Organization | Practitioner | PractitionerRole)"/>
      </element>
      <element path="Invoice.period[x]" status="deleted"/>
   </type>
   <type name="Library" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Library.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Library.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/library-type"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/library-type"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Library.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
   </type>
   <type name="List" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="List.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/list-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/list-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="List.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/list-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/list-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="List.source">
         <removed-type name="Reference(Practitioner | PractitionerRole | Patient | Device | Organization | RelatedPerson | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Patient | Device | Organization | RelatedPerson | CareTeam | Group)"/>
      </element>
   </type>
   <type name="Location" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Location.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/location-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/location-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Location.code" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Location.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/location-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/location-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="removed" path="Location.type">
         <old-binding reference="http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType"
                      strength="extensible"/>
      </element>
      <element new-max="1" old-max="*" path="Location.hoursOfOperation"/>
   </type>
   <type name="ManufacturedItemDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ManufacturedItemDefinition.status">
         <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"/>
      </element>
      <element path="ManufacturedItemDefinition.property.value[x]">
         <added-type name="Range"/>
      </element>
   </type>
   <type name="Measure" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Measure.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
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                      strength="extensible"/>
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               binding-valueset-changed="true"
               path="Measure.group.type">
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               binding-status="changed"
               binding-valueset-changed="true"
               path="Measure.group.basis">
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         <removed-code code="Annotation"/>
         <removed-code code="Attachment"/>
         <removed-code code="Availability"/>
         <removed-code code="BackboneType"/>
         <removed-code code="Dosage"/>
         <removed-code code="ElementDefinition"/>
         <removed-code code="MarketingStatus"/>
         <removed-code code="ProductShelfLife"/>
         <removed-code code="Timing"/>
         <removed-code code="CodeableConcept"/>
         <removed-code code="CodeableReference"/>
         <removed-code code="Coding"/>
         <removed-code code="ContactDetail"/>
         <removed-code code="ContactPoint"/>
         <removed-code code="Contributor"/>
         <removed-code code="DataRequirement"/>
         <removed-code code="Expression"/>
         <removed-code code="ExtendedContactDetail"/>
         <removed-code code="Extension"/>
         <removed-code code="HumanName"/>
         <removed-code code="Identifier"/>
         <removed-code code="Meta"/>
         <removed-code code="MonetaryComponent"/>
         <removed-code code="Money"/>
         <removed-code code="Narrative"/>
         <removed-code code="ParameterDefinition"/>
         <removed-code code="Period"/>
         <removed-code code="PrimitiveType"/>
         <removed-code code="base64Binary"/>
         <removed-code code="boolean"/>
         <removed-code code="date"/>
         <removed-code code="dateTime"/>
         <removed-code code="decimal"/>
         <removed-code code="instant"/>
         <removed-code code="integer"/>
         <removed-code code="positiveInt"/>
         <removed-code code="unsignedInt"/>
         <removed-code code="integer64"/>
         <removed-code code="string"/>
         <removed-code code="code"/>
         <removed-code code="id"/>
         <removed-code code="markdown"/>
         <removed-code code="time"/>
         <removed-code code="uri"/>
         <removed-code code="canonical"/>
         <removed-code code="oid"/>
         <removed-code code="url"/>
         <removed-code code="uuid"/>
         <removed-code code="Quantity"/>
         <removed-code code="Age"/>
         <removed-code code="Count"/>
         <removed-code code="Distance"/>
         <removed-code code="Duration"/>
         <removed-code code="Range"/>
         <removed-code code="Ratio"/>
         <removed-code code="RatioRange"/>
         <removed-code code="Reference"/>
         <removed-code code="RelatedArtifact"/>
         <removed-code code="SampledData"/>
         <removed-code code="Signature"/>
         <removed-code code="TriggerDefinition"/>
         <removed-code code="UsageContext"/>
         <removed-code code="VirtualServiceDetail"/>
         <removed-code code="xhtml"/>
         <removed-code code="Resource"/>
         <removed-code code="Binary"/>
         <removed-code code="Bundle"/>
         <removed-code code="DomainResource"/>
         <removed-code code="Account"/>
         <removed-code code="ActivityDefinition"/>
         <removed-code code="ActorDefinition"/>
         <removed-code code="AdministrableProductDefinition"/>
         <removed-code code="AdverseEvent"/>
         <removed-code code="AllergyIntolerance"/>
         <removed-code code="Appointment"/>
         <removed-code code="AppointmentResponse"/>
         <removed-code code="ArtifactAssessment"/>
         <removed-code code="AuditEvent"/>
         <removed-code code="Basic"/>
         <removed-code code="BiologicallyDerivedProduct"/>
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="BodyStructure"/>
         <removed-code code="CanonicalResource"/>
         <removed-code code="CapabilityStatement"/>
         <removed-code code="CarePlan"/>
         <removed-code code="CareTeam"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="Claim"/>
         <removed-code code="ClaimResponse"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ClinicalUseDefinition"/>
         <removed-code code="CodeSystem"/>
         <removed-code code="Communication"/>
         <removed-code code="CommunicationRequest"/>
         <removed-code code="CompartmentDefinition"/>
         <removed-code code="Composition"/>
         <removed-code code="ConceptMap"/>
         <removed-code code="Condition"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="Consent"/>
         <removed-code code="Contract"/>
         <removed-code code="Coverage"/>
         <removed-code code="CoverageEligibilityRequest"/>
         <removed-code code="CoverageEligibilityResponse"/>
         <removed-code code="DetectedIssue"/>
         <removed-code code="Device"/>
         <removed-code code="DeviceAssociation"/>
         <removed-code code="DeviceDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceMetric"/>
         <removed-code code="DeviceRequest"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="DiagnosticReport"/>
         <removed-code code="DocumentReference"/>
         <removed-code code="Encounter"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="Endpoint"/>
         <removed-code code="EnrollmentRequest"/>
         <removed-code code="EnrollmentResponse"/>
         <removed-code code="EpisodeOfCare"/>
         <removed-code code="EventDefinition"/>
         <removed-code code="Evidence"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="EvidenceVariable"/>
         <removed-code code="ExampleScenario"/>
         <removed-code code="ExplanationOfBenefit"/>
         <removed-code code="FamilyMemberHistory"/>
         <removed-code code="Flag"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="Goal"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="Group"/>
         <removed-code code="GuidanceResponse"/>
         <removed-code code="HealthcareService"/>
         <removed-code code="ImagingSelection"/>
         <removed-code code="ImagingStudy"/>
         <removed-code code="Immunization"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="ImplementationGuide"/>
         <removed-code code="Ingredient"/>
         <removed-code code="InsurancePlan"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Invoice"/>
         <removed-code code="Library"/>
         <removed-code code="Linkage"/>
         <removed-code code="List"/>
         <removed-code code="Location"/>
         <removed-code code="ManufacturedItemDefinition"/>
         <removed-code code="Measure"/>
         <removed-code code="MeasureReport"/>
         <removed-code code="Medication"/>
         <removed-code code="MedicationAdministration"/>
         <removed-code code="MedicationDispense"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MedicationRequest"/>
         <removed-code code="MedicationStatement"/>
         <removed-code code="MedicinalProductDefinition"/>
         <removed-code code="MessageDefinition"/>
         <removed-code code="MessageHeader"/>
         <removed-code code="MetadataResource"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="NamingSystem"/>
         <removed-code code="NutritionIntake"/>
         <removed-code code="NutritionOrder"/>
         <removed-code code="NutritionProduct"/>
         <removed-code code="Observation"/>
         <removed-code code="ObservationDefinition"/>
         <removed-code code="OperationDefinition"/>
         <removed-code code="OperationOutcome"/>
         <removed-code code="Organization"/>
         <removed-code code="OrganizationAffiliation"/>
         <removed-code code="PackagedProductDefinition"/>
         <removed-code code="Patient"/>
         <removed-code code="PaymentNotice"/>
         <removed-code code="PaymentReconciliation"/>
         <removed-code code="Permission"/>
         <removed-code code="Person"/>
         <removed-code code="PlanDefinition"/>
         <removed-code code="Practitioner"/>
         <removed-code code="PractitionerRole"/>
         <removed-code code="Procedure"/>
         <removed-code code="Provenance"/>
         <removed-code code="Questionnaire"/>
         <removed-code code="QuestionnaireResponse"/>
         <removed-code code="RegulatedAuthorization"/>
         <removed-code code="RelatedPerson"/>
         <removed-code code="RequestOrchestration"/>
         <removed-code code="Requirements"/>
         <removed-code code="ResearchStudy"/>
         <removed-code code="ResearchSubject"/>
         <removed-code code="RiskAssessment"/>
         <removed-code code="Schedule"/>
         <removed-code code="SearchParameter"/>
         <removed-code code="ServiceRequest"/>
         <removed-code code="Slot"/>
         <removed-code code="Specimen"/>
         <removed-code code="SpecimenDefinition"/>
         <removed-code code="StructureDefinition"/>
         <removed-code code="StructureMap"/>
         <removed-code code="Subscription"/>
         <removed-code code="SubscriptionStatus"/>
         <removed-code code="SubscriptionTopic"/>
         <removed-code code="Substance"/>
         <removed-code code="SubstanceDefinition"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="Task"/>
         <removed-code code="TerminologyCapabilities"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="ValueSet"/>
         <removed-code code="VerificationResult"/>
         <removed-code code="VisionPrescription"/>
         <removed-code code="Parameters"/>
         <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"
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      </element>
      <element path="Measure.group.basisRequirement" status="new"/>
      <element path="Measure.group.scoringPrecision" status="new"/>
      <element path="Measure.group.compositeScoring" status="new"/>
      <element path="Measure.group.component" status="new"/>
      <element path="Measure.group.component.measure" status="new"/>
      <element path="Measure.group.component.groupId" status="new"/>
      <element path="Measure.group.component.weight" status="new"/>
      <element binding-status="changed"
               binding-strength-changed="true"
               binding-valueset-changed="true"
               path="Measure.group.improvementNotation">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-improvement-notation|5.0.0"
                      strength="required"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-improvement-notation"
                      strength="extensible"/>
      </element>
      <element path="Measure.group.improvementNotationGuidance" status="new"/>
      <element path="Measure.group.population.title" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Measure.group.population.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-population"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-population"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Measure.group.population.aggregateMethod">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-aggregate-method"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-aggregate-method"
                      strength="extensible"/>
      </element>
      <element path="Measure.group.stratifier.title" status="new"/>
      <element path="Measure.group.stratifier.component.valueSet" status="new"/>
      <element path="Measure.group.stratifier.component.unit" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Measure.supplementalData.usage">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-data-usage"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-data-usage"
                      strength="extensible"/>
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      <element path="Measure.supplementalData.valueSet" status="new"/>
      <element path="Measure.supplementalData.unit" status="new"/>
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      <element path="Measure.scoring" status="deleted"/>
      <element path="Measure.scoringUnit" status="deleted"/>
      <element path="Measure.compositeScoring" status="deleted"/>
      <element path="Measure.type" status="deleted"/>
      <element path="Measure.improvementNotation" status="deleted"/>
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      <element path="MeasureReport.category" status="new"/>
      <element path="MeasureReport.messages" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MeasureReport.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-report-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/measure-report-status|6.0.0-ballot4"
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      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MeasureReport.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-report-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/measure-report-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MeasureReport.dataUpdateType">
         <old-binding reference="http://hl7.org/fhir/ValueSet/submit-data-update-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/submit-data-update-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="MeasureReport.reporter">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Group)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization)"/>
      </element>
      <element new-max="*" old-max="1" path="MeasureReport.location"/>
      <element path="MeasureReport.group.title" status="new"/>
      <element path="MeasureReport.group.calculatedDate" status="new"/>
      <element path="MeasureReport.group.description" status="new"/>
      <element path="MeasureReport.group.type" status="new"/>
      <element path="MeasureReport.group.scoring" status="new"/>
      <element path="MeasureReport.group.improvementNotation" status="new"/>
      <element path="MeasureReport.group.improvementNotationGuidance" status="new"/>
      <element path="MeasureReport.group.population.title" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MeasureReport.group.population.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-population"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-population"
                      strength="extensible"/>
      </element>
      <element path="MeasureReport.group.population.description" status="new"/>
      <element path="MeasureReport.group.population.countQuantity" status="new"/>
      <element path="MeasureReport.group.measureScore[x]">
         <added-type name="boolean"/>
         <added-type name="Ratio"/>
      </element>
      <element path="MeasureReport.group.stratifier.title" status="new"/>
      <element path="MeasureReport.group.stratifier.description" status="new"/>
      <element path="MeasureReport.group.stratifier.stratum.component.description"
               status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MeasureReport.group.stratifier.stratum.population.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/measure-population"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/measure-population"
                      strength="extensible"/>
      </element>
      <element path="MeasureReport.group.stratifier.stratum.population.countQuantity"
               status="new"/>
      <element path="MeasureReport.group.stratifier.stratum.measureScore[x]">
         <added-type name="boolean"/>
         <added-type name="Ratio"/>
      </element>
      <element path="MeasureReport.scoring" status="deleted"/>
      <element path="MeasureReport.improvementNotation" status="deleted"/>
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   <type name="Medication" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Medication.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/medication-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medication-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Medication.packageSize" status="new"/>
      <element path="Medication.packageSize.numberOfItems" status="new"/>
      <element path="Medication.packageSize.amountPerItem" status="new"/>
      <element path="Medication.ingredient.role" status="new"/>
      <element old-name="batch" path="Medication.instance"/>
      <element path="Medication.instance.identifier" status="new"/>
      <element path="Medication.definition">
         <removed-type name="Reference(MedicationKnowledge)"/>
         <added-type name="Reference(MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition)"/>
      </element>
      <element path="Medication.totalVolume" status="deleted"/>
   </type>
   <type name="MedicationAdministration" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationAdministration.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/medication-admin-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medication-admin-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element old-name="occurence[x]" path="MedicationAdministration.occurrence[x]"/>
   </type>
   <type name="MedicationDispense" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationDispense.status">
         <removed-code code="stopped"/>
         <added-code code="unfulfilled"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/medicationdispense-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medicationdispense-status|6.0.0-ballot4"
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      </element>
      <element path="MedicationDispense.performer.actor">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam | Group)"/>
      </element>
      <element path="MedicationDispense.fillNumber" status="new"/>
      <element path="MedicationDispense.receiver">
         <removed-type name="Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole)"/>
         <added-type name="Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole | Organization | Group)"/>
      </element>
      <element new-max="1" old-max="*" path="MedicationDispense.dosageInstruction">
         <removed-type name="Dosage"/>
         <added-type name="DosageDetails"/>
      </element>
      <element path="MedicationDispense.doseAdministrationAid" status="new"/>
      <element path="MedicationDispense.renderedDosageInstruction" status="deleted"/>
   </type>
   <type name="MedicationRequest" status="changed">
      <element path="MedicationRequest.basedOn">
         <removed-type name="Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)"/>
         <added-type name="Reference(CarePlan | MedicationRequest | ServiceRequest | RequestOrchestration)"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationRequest.status">
         <removed-code code="stopped"/>
         <removed-code code="completed"/>
         <removed-code code="cancelled"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/medicationrequest-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medicationrequest-status|6.0.0-ballot4"
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      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationRequest.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/medicationrequest-intent|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medicationrequest-intent|6.0.0-ballot4"
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      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationRequest.priority">
         <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"
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      </element>
      <element path="MedicationRequest.informationSource">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)"/>
         <added-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization | Group)"/>
      </element>
      <element old-name="reported" path="MedicationRequest.isRecordOfRequest"/>
      <element path="MedicationRequest.performer">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | DeviceDefinition | RelatedPerson | CareTeam | HealthcareService | Group)"/>
      </element>
      <element old-name="effectiveDosePeriod"
               path="MedicationRequest.effectiveTiming[x]">
         <added-type name="Duration"/>
         <added-type name="Range"/>
      </element>
      <element new-max="1" old-max="*" path="MedicationRequest.dosageInstruction">
         <removed-type name="Dosage"/>
         <added-type name="DosageDetails"/>
      </element>
      <element path="MedicationRequest.dispenseRequest.dispenserInstruction">
         <removed-type name="Annotation"/>
         <added-type name="CodeableConcept"/>
      </element>
      <element path="MedicationRequest.dispenseRequest.destination" status="new"/>
      <element path="MedicationRequest.renderedDosageInstruction" status="deleted"/>
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   <type name="MedicationStatement" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MedicationStatement.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/medication-statement-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/medication-statement-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="MedicationStatement.author" status="new"/>
      <element path="MedicationStatement.informationSource">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)"/>
         <added-type name="Reference(Device | Patient | Practitioner | PractitionerRole | RelatedPerson | Organization | Group)"/>
      </element>
      <element new-max="1" old-max="*" path="MedicationStatement.dosage">
         <removed-type name="Dosage"/>
         <added-type name="DosageDetails"/>
      </element>
      <element path="MedicationStatement.renderedDosageInstruction" status="deleted"/>
   </type>
   <type name="MedicinalProductDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MedicinalProductDefinition.name.usage.language">
         <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"/>
      </element>
      <element path="MedicinalProductDefinition.characteristic.value[x]">
         <added-type name="Range"/>
      </element>
   </type>
   <type name="MessageDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MessageDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MessageDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MessageDefinition.category">
         <old-binding reference="http://hl7.org/fhir/ValueSet/message-significance-category|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/message-significance-category|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="MessageDefinition.focus.code">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MessageDefinition.responseRequired">
         <old-binding reference="http://hl7.org/fhir/ValueSet/messageheader-response-request|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/messageheader-response-request|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="MessageDefinition.graph" status="deleted"/>
   </type>
   <type name="MessageHeader" status="changed">
      <element path="MessageHeader.event[x]">
         <added-type name="uri"/>
      </element>
      <element path="MessageHeader.destination.receiver">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization)"/>
         <added-type name="Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
      </element>
      <element path="MessageHeader.source.sender">
         <removed-type name="Reference(Practitioner | PractitionerRole | Device | Organization)"/>
         <added-type name="Reference(Device | Organization | Patient | Practitioner | PractitionerRole)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="MessageHeader.response.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/response-code|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/response-code|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="MessageHeader.destination.target" status="deleted"/>
      <element path="MessageHeader.author" status="deleted"/>
      <element path="MessageHeader.responsible" status="deleted"/>
   </type>
   <type name="MetadataResource" status="changed">
      <element path="MetadataResource.usage" status="new"/>
   </type>
   <type name="NamingSystem" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NamingSystem.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NamingSystem.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/namingsystem-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/namingsystem-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NamingSystem.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NamingSystem.uniqueId.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/namingsystem-identifier-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/namingsystem-identifier-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="NutritionIntake" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NutritionIntake.status">
         <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"/>
      </element>
      <element path="NutritionIntake.nutritionItem" status="new"/>
      <element path="NutritionIntake.nutritionItem.type" status="new"/>
      <element path="NutritionIntake.nutritionItem.nutritionProduct" status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem" status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.schedule" status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.amount" status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.rate[x]" status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.totalIntake"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.totalIntake.nutrient"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.totalIntake.amount"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.consumedItem.totalIntake.energy"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.notConsumedItem" status="new"/>
      <element path="NutritionIntake.nutritionItem.notConsumedItem.reason"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.notConsumedItem.schedule"
               status="new"/>
      <element path="NutritionIntake.nutritionItem.notConsumedItem.amount"
               status="new"/>
      <element path="NutritionIntake.performer.actor">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | Group)"/>
      </element>
      <element path="NutritionIntake.instantiatesCanonical" status="deleted"/>
      <element path="NutritionIntake.instantiatesUri" status="deleted"/>
      <element path="NutritionIntake.consumedItem" status="deleted"/>
      <element path="NutritionIntake.ingredientLabel" status="deleted"/>
   </type>
   <type name="NutritionOrder" status="changed">
      <element path="NutritionOrder.basedOn">
         <removed-type name="Reference(CarePlan | NutritionOrder | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration)"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="NutritionOrder.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="NutritionOrder.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NutritionOrder.priority">
         <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"
                      strength="required"/>
      </element>
      <element old-name="orderer" path="NutritionOrder.requester"/>
      <element path="NutritionOrder.oralDiet.nutrient.amount">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element old-name="foodType" path="NutritionOrder.oralDiet.texture.type"/>
      <element path="NutritionOrder.oralDiet.caloricDensity" status="new"/>
      <element path="NutritionOrder.supplement.quantity">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element path="NutritionOrder.supplement.caloricDensity" status="new"/>
      <element old-name="baseFormulaType" path="NutritionOrder.enteralFormula.type"/>
      <element old-name="baseFormulaProductName"
               path="NutritionOrder.enteralFormula.productName"/>
      <element new-max="1"
               old-max="*"
               old-name="deliveryDevice"
               path="NutritionOrder.enteralFormula.deliveryDevice[x]">
         <removed-type name="CodeableReference"/>
         <added-type name="CodeableConcept"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element path="NutritionOrder.enteralFormula.caloricDensity">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element new-max="*"
               old-max="1"
               path="NutritionOrder.enteralFormula.routeOfAdministration"/>
      <element path="NutritionOrder.enteralFormula.administration.quantity">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element path="NutritionOrder.enteralFormula.administration.rate[x]">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
      </element>
      <element old-name="maxVolumeToDeliver"
               path="NutritionOrder.enteralFormula.maxVolumeToAdminister">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element path="NutritionOrder.additive" status="new"/>
      <element path="NutritionOrder.additive.modularType" status="new"/>
      <element path="NutritionOrder.additive.productName" status="new"/>
      <element path="NutritionOrder.additive.quantity" status="new"/>
      <element path="NutritionOrder.additive.routeOfAdministration" status="new"/>
      <element path="NutritionOrder.instantiatesCanonical" status="deleted"/>
      <element path="NutritionOrder.instantiatesUri" status="deleted"/>
      <element path="NutritionOrder.instantiates" status="deleted"/>
      <element path="NutritionOrder.oralDiet.fluidConsistencyType" status="deleted"/>
      <element path="NutritionOrder.enteralFormula.additive" status="deleted"/>
   </type>
   <type name="NutritionProduct" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="NutritionProduct.status">
         <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"/>
      </element>
      <element path="NutritionProduct.manufacturer">
         <removed-type name="Reference(Organization)"/>
         <added-type name="Reference(Organization | RelatedPerson)"/>
      </element>
      <element new-min="1" old-min="0" path="NutritionProduct.nutrient.item"/>
      <element new-max="1"
               old-max="*"
               old-name="amount"
               path="NutritionProduct.nutrient.amount[x]">
         <added-type name="Quantity"/>
      </element>
      <element path="NutritionProduct.ingredientSummary" status="new"/>
      <element new-max="1"
               old-max="*"
               old-name="amount"
               path="NutritionProduct.ingredient.amount[x]">
         <added-type name="Quantity"/>
      </element>
      <element path="NutritionProduct.ingredient.allergen" status="new"/>
      <element path="NutritionProduct.energy" status="new"/>
      <element path="NutritionProduct.knownAllergen" status="deleted"/>
   </type>
   <type name="Observation" status="changed">
      <element path="Observation.basedOn">
         <removed-type name="Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Observation.triggeredBy.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/observation-triggeredbytype|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/observation-triggeredbytype|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Observation.partOf">
         <removed-type name="Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy)"/>
         <added-type name="Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Observation.status">
         <removed-code code="corrected"/>
         <added-code code="specimen-in-process"/>
         <added-code code="cannot-be-obtained"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/observation-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/observation-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element modifier="added" path="Observation.focus"/>
      <element path="Observation.organizer" status="new"/>
      <element path="Observation.performer">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService | Group)"/>
      </element>
      <element path="Observation.value[x]">
         <removed-type name="Reference(MolecularSequence)"/>
      </element>
      <element path="Observation.interpretationContext" status="new"/>
      <element path="Observation.bodyStructure">
         <removed-type name="Reference(BodyStructure)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="Observation.referenceRange.low">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element path="Observation.referenceRange.high">
         <removed-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="Quantity"/>
      </element>
      <element binding-status="removed" path="Observation.referenceRange.normalValue">
         <old-binding reference="http://hl7.org/fhir/ValueSet/observation-referencerange-normalvalue"
                      strength="extensible"/>
      </element>
      <element path="Observation.hasMember">
         <removed-type name="Reference(Observation | QuestionnaireResponse | MolecularSequence)"/>
         <added-type name="Reference(Observation | QuestionnaireResponse)"/>
      </element>
      <element path="Observation.derivedFrom">
         <removed-type name="Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy)"/>
         <added-type name="Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation)"/>
      </element>
      <element path="Observation.component.value[x]">
         <removed-type name="Reference(MolecularSequence)"/>
      </element>
      <element path="Observation.instantiates[x]" status="deleted"/>
   </type>
   <type name="ObservationDefinition" status="changed">
      <element new-max="*" old-max="1" path="ObservationDefinition.identifier"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ObservationDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ObservationDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ObservationDefinition.permittedDataType">
         <old-binding reference="http://hl7.org/fhir/ValueSet/permitted-data-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/permitted-data-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element old-name="bodySite" path="ObservationDefinition.bodyStructure">
         <removed-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
      </element>
      <element new-max="1"
               old-max="*"
               old-name="device"
               path="ObservationDefinition.device[x]">
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               old-name="gender"
               path="ObservationDefinition.qualifiedValue.sexParameterForClinicalUse">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ObservationDefinition.qualifiedValue.rangeCategory">
         <old-binding reference="http://hl7.org/fhir/ValueSet/observation-range-category|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/observation-range-category|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ObservationDefinition.qualifiedValue.interpretation" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ObservationDefinition.component.permittedDataType">
         <old-binding reference="http://hl7.org/fhir/ValueSet/permitted-data-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/permitted-data-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="OperationDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/operation-kind|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/operation-kind|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element path="OperationDefinition.synchronicity" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.resource">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.parameter.use">
         <old-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-use|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-use|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.parameter.scope">
         <old-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-scope|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/operation-parameter-scope|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="OperationDefinition.parameter.min">
         <removed-type name="integer"/>
         <added-type name="unsignedInt"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="OperationDefinition.parameter.type">
         <removed-code code="Element"/>
         <removed-code code="BackboneElement"/>
         <removed-code code="DataType"/>
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               path="OperationDefinition.parameter.searchType">
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               binding-valueset-changed="true"
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         <removed-code code="code-invalid"/>
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         <removed-code code="business-rule"/>
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      <element path="Patient.contact.additionalAddress" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Patient.contact.gender">
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               binding-valueset-changed="true"
               path="Patient.communication.language">
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               binding-valueset-changed="true"
               path="Patient.link.type">
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               binding-valueset-changed="true"
               path="PaymentNotice.status">
         <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"/>
      </element>
      <element path="PaymentNotice.statusReason" status="new"/>
   </type>
   <type name="PaymentReconciliation" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PaymentReconciliation.status">
         <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"/>
      </element>
      <element path="PaymentReconciliation.statusReason" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PaymentReconciliation.outcome">
         <old-binding reference="http://hl7.org/fhir/ValueSet/payment-outcome|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/payment-outcome|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element new-min="0" old-min="1" path="PaymentReconciliation.amount"/>
      <element path="PaymentReconciliation.allocation.target">
         <removed-type name="Reference(Claim | Account | Invoice | ChargeItem | Encounter | Contract)"/>
         <added-type name="Reference(Claim | Account | Invoice | Encounter | Contract)"/>
      </element>
      <element path="PaymentReconciliation.allocation.noteNumber" status="new"/>
      <element path="PaymentReconciliation.processNote.class" status="new"/>
      <element path="PaymentReconciliation.processNote.number" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PaymentReconciliation.processNote.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/note-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/note-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="PaymentReconciliation.processNote.text">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
   </type>
   <type name="Person" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Person.gender">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Person.communication.language">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Person.link.assurance">
         <old-binding reference="http://hl7.org/fhir/ValueSet/identity-assuranceLevel|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/identity-assuranceLevel|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="PlanDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/plan-definition-type"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/plan-definition-type"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.actor.option.type">
         <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"/>
      </element>
      <element path="PlanDefinition.actor.option.typeCanonical">
         <removed-type name="canonical(CapabilityStatement)"/>
         <added-type name="canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"/>
      </element>
      <element path="PlanDefinition.actor.option.typeReference">
         <removed-type name="Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
         <added-type name="Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.priority">
         <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"/>
      </element>
      <element path="PlanDefinition.action.goalId">
         <removed-type name="id"/>
         <added-type name="string"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.condition.kind">
         <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"/>
      </element>
      <element path="PlanDefinition.action.input.relatedData">
         <removed-type name="id"/>
         <added-type name="string"/>
      </element>
      <element path="PlanDefinition.action.relatedAction.targetId">
         <removed-type name="id"/>
         <added-type name="string"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.relatedAction.relationship">
         <removed-code code="before-start"/>
         <removed-code code="before-end"/>
         <removed-code code="concurrent-with-start"/>
         <removed-code code="concurrent-with-end"/>
         <removed-code code="after-start"/>
         <removed-code code="after-end"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.relatedAction.endRelationship">
         <removed-code code="before-start"/>
         <removed-code code="before-end"/>
         <removed-code code="concurrent-with-start"/>
         <removed-code code="concurrent-with-end"/>
         <removed-code code="after-start"/>
         <removed-code code="after-end"/>
         <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"/>
      </element>
      <element path="PlanDefinition.action.timing[x]">
         <added-type name="RelativeTime"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.participant.type">
         <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"/>
      </element>
      <element path="PlanDefinition.action.participant.typeCanonical">
         <removed-type name="canonical(CapabilityStatement)"/>
         <added-type name="canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"/>
      </element>
      <element path="PlanDefinition.action.participant.typeReference">
         <removed-type name="Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
         <added-type name="Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/action-type"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/action-type"
                      strength="extensible"/>
      </element>
      <element path="PlanDefinition.action.applicabilityBehavior" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.groupingBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.selectionBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.requiredBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.precheckBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PlanDefinition.action.cardinalityBehavior">
         <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"/>
      </element>
   </type>
   <type name="Practitioner" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Practitioner.gender">
         <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"/>
      </element>
      <element modifier="added" path="Practitioner.deceased[x]"/>
      <element path="Practitioner.qualification.status" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Practitioner.communication.language">
         <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"/>
      </element>
   </type>
   <type name="PractitionerRole" status="changed">
      <element path="PractitionerRole.network" status="new"/>
      <element path="PractitionerRole.display" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="PractitionerRole.communication">
         <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"/>
      </element>
      <element new-max="1" old-max="*" path="PractitionerRole.availability"/>
   </type>
   <type name="Procedure" status="changed">
      <element path="Procedure.basedOn">
         <removed-type name="Reference(CarePlan | ServiceRequest)"/>
         <added-type name="Reference(CarePlan | ServiceRequest | MedicationRequest)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Procedure.status">
         <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"/>
      </element>
      <element modifier="added" path="Procedure.focus"/>
      <element path="Procedure.bodyStructure" status="new"/>
      <element new-max="*" old-max="1" path="Procedure.outcome">
         <removed-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="Procedure.report">
         <removed-type name="Reference(DiagnosticReport | DocumentReference | Composition)"/>
         <added-type name="Reference(DiagnosticReport | DocumentReference | Composition | Bundle)"/>
      </element>
      <element path="Procedure.followUp">
         <removed-type name="CodeableConcept"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="Procedure.instantiatesCanonical" status="deleted"/>
      <element path="Procedure.instantiatesUri" status="deleted"/>
   </type>
   <type name="Provenance" status="changed">
      <element path="Provenance.why" status="new"/>
      <element path="Provenance.basedOn">
         <removed-type name="Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task)"/>
         <added-type name="Reference(Resource)"/>
      </element>
      <element path="Provenance.agent.who">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson | Group | HealthcareService)"/>
      </element>
      <element path="Provenance.agent.onBehalfOf">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Group | HealthcareService)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Provenance.entity.role">
         <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"/>
      </element>
   </type>
   <type name="Questionnaire" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.status">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.subjectType">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element new-max="*" old-max="1" path="Questionnaire.item.definition"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.item.type">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.item.enableWhen.operator">
         <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"/>
      </element>
      <element path="Questionnaire.item.enableWhen.answer[x]">
         <added-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
         <added-type name="uri"/>
         <added-type name="Attachment"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.item.enableBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.item.disabledDisplay">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Questionnaire.item.answerConstraint">
         <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"/>
      </element>
      <element path="Questionnaire.item.answerOption.value[x]">
         <added-type name="decimal"/>
         <added-type name="dateTime"/>
         <added-type name="uri"/>
         <added-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
      </element>
      <element path="Questionnaire.item.initial.value[x]">
         <added-type name="Quantity(http://hl7.org/fhir/StructureDefinition/SimpleQuantity)"/>
      </element>
   </type>
   <type name="QuestionnaireResponse" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="QuestionnaireResponse.status">
         <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"/>
      </element>
      <element path="QuestionnaireResponse.author">
         <removed-type name="Reference(Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)"/>
         <added-type name="Reference(Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization | Group)"/>
      </element>
      <element new-max="*"
               old-max="1"
               path="QuestionnaireResponse.item.definition"/>
   </type>
   <type name="RegulatedAuthorization" status="changed">
      <element modifier="added" path="RegulatedAuthorization.status"/>
   </type>
   <type name="RelatedPerson" status="changed">
      <element path="RelatedPerson.role" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RelatedPerson.gender">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RelatedPerson.communication.language">
         <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"/>
      </element>
   </type>
   <type name="RequestOrchestration" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.priority">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.priority">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.condition.kind">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.relatedAction.relationship">
         <removed-code code="before-start"/>
         <removed-code code="before-end"/>
         <removed-code code="concurrent-with-start"/>
         <removed-code code="concurrent-with-end"/>
         <removed-code code="after-start"/>
         <removed-code code="after-end"/>
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.relatedAction.endRelationship">
         <removed-code code="before-start"/>
         <removed-code code="before-end"/>
         <removed-code code="concurrent-with-start"/>
         <removed-code code="concurrent-with-end"/>
         <removed-code code="after-start"/>
         <removed-code code="after-end"/>
         <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"/>
      </element>
      <element path="RequestOrchestration.action.timing[x]">
         <added-type name="RelativeTime"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.participant.type">
         <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"/>
      </element>
      <element path="RequestOrchestration.action.participant.typeCanonical">
         <removed-type name="canonical(CapabilityStatement)"/>
         <added-type name="canonical(ActorDefinition | CapabilityStatement | DeviceDefinition | Group | SpecimenDefinition | StructureDefinition)"/>
      </element>
      <element path="RequestOrchestration.action.participant.typeReference">
         <removed-type name="Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
         <added-type name="Reference(BiologicallyDerivedProduct | CareTeam | Device | Endpoint | HealthcareService | Location | Medication | MedicinalProductDefinition | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Specimen | Substance | SubstanceDefinition)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/action-type"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/action-type"
                      strength="extensible"/>
      </element>
      <element path="RequestOrchestration.action.applicabilityBehavior" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.groupingBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.selectionBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.requiredBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.precheckBehavior">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="RequestOrchestration.action.cardinalityBehavior">
         <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"/>
      </element>
   </type>
   <type name="Requirements" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Requirements.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Requirements.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element path="Requirements.imports" status="new"/>
      <element path="Requirements.imports.reference" status="new"/>
      <element path="Requirements.imports.key" status="new"/>
      <element path="Requirements.actor">
         <removed-type name="canonical(ActorDefinition)"/>
         <added-type name="BackboneElement"/>
      </element>
      <element path="Requirements.actor.reference" status="new"/>
      <element path="Requirements.actor.key" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="Requirements.statement.conformance">
         <added-code code="SHALL-NOT"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/conformance-expectation|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/conformance-expectation|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Requirements.statement.category" status="new"/>
      <element path="Requirements.statement.derivedFrom">
         <removed-type name="string"/>
         <added-type name="BackboneElement"/>
      </element>
      <element path="Requirements.statement.derivedFrom.reference" status="new"/>
      <element path="Requirements.statement.derivedFrom.key" status="new"/>
      <element path="Requirements.statement.partOf" status="new"/>
      <element path="Requirements.statement.partOf.reference" status="new"/>
      <element path="Requirements.statement.partOf.key" status="new"/>
      <element path="Requirements.statement.actor" status="new"/>
      <element path="Requirements.statement.parent" status="deleted"/>
   </type>
   <type name="ResearchStudy" status="changed">
      <element binding-status="removed" path="ResearchStudy.label.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/title-type"
                      strength="extensible"/>
      </element>
      <element path="ResearchStudy.label.language" status="new"/>
      <element path="ResearchStudy.citeAs" status="new"/>
      <element path="ResearchStudy.relatesTo" status="new"/>
      <element path="ResearchStudy.relatesTo.type" status="new"/>
      <element path="ResearchStudy.relatesTo.target[x]" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ResearchStudy.status">
         <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"/>
      </element>
      <element binding-status="removed" path="ResearchStudy.region">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="removed" path="ResearchStudy.associatedParty.role">
         <old-binding reference="http://hl7.org/fhir/ValueSet/research-study-party-role"
                      strength="extensible"/>
      </element>
      <element binding-status="removed" path="ResearchStudy.progressStatus.state">
         <old-binding reference="http://hl7.org/fhir/ValueSet/research-study-status"
                      strength="extensible"/>
      </element>
      <element path="ResearchStudy.recruitment.eligibility">
         <removed-type name="Reference(Group | EvidenceVariable)"/>
         <added-type name="Reference(Group)"/>
      </element>
      <element path="ResearchStudy.recruitment.description" status="new"/>
      <element path="ResearchStudy.comparisonGroup.targetNumber" status="new"/>
      <element path="ResearchStudy.comparisonGroup.actualNumber" status="new"/>
      <element path="ResearchStudy.comparisonGroup.eligibility" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.name" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.type" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.description" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.endpoint" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.population" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.intervention" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.comparator" status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.summaryMeasure"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.endpointAnalysisPlan"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.eventHandling"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.eventHandling.event"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.eventHandling.group"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.eventHandling.handling"
               status="new"/>
      <element path="ResearchStudy.objective.outcomeMeasure.eventHandling.description"
               status="new"/>
      <element path="ResearchStudy.result">
         <removed-type name="Reference(EvidenceReport | Citation | DiagnosticReport)"/>
         <added-type name="Reference(Composition | DiagnosticReport | Evidence)"/>
      </element>
      <element path="ResearchStudy.relatedArtifact" status="deleted"/>
      <element path="ResearchStudy.comparisonGroup.linkId" status="deleted"/>
      <element path="ResearchStudy.comparisonGroup.name" status="deleted"/>
      <element path="ResearchStudy.comparisonGroup.type" status="deleted"/>
      <element path="ResearchStudy.comparisonGroup.intendedExposure" status="deleted"/>
      <element path="ResearchStudy.outcomeMeasure" status="deleted"/>
   </type>
   <type name="ResearchSubject" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ResearchSubject.status">
         <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"/>
      </element>
      <element path="ResearchSubject.subject">
         <removed-type name="Reference(Patient | Group | Specimen | Device | Medication | Substance | BiologicallyDerivedProduct)"/>
         <added-type name="Reference(Patient | Group | Specimen | Device | Medication | Substance | SubstanceDefinition | BiologicallyDerivedProduct)"/>
      </element>
      <element old-name="progress" path="ResearchSubject.subjectState"/>
      <element binding-status="removed"
               new-min="1"
               old-min="0"
               old-name="subjectState"
               path="ResearchSubject.subjectState.code">
         <old-binding reference="http://hl7.org/fhir/ValueSet/research-subject-state|5.0.0"
                      strength="required"/>
      </element>
      <element new-min="1"
               old-min="0"
               path="ResearchSubject.subjectState.startDate"/>
      <element path="ResearchSubject.subjectMilestone" status="new"/>
      <element new-min="1"
               old-min="0"
               path="ResearchSubject.subjectMilestone.milestone"/>
      <element path="ResearchSubject.subjectMilestone.date" status="new"/>
      <element path="ResearchSubject.subjectMilestone.reason" status="new"/>
      <element path="ResearchSubject.comparisonGroup" status="new"/>
      <element path="ResearchSubject.progress.type" status="deleted"/>
      <element path="ResearchSubject.assignedComparisonGroup" status="deleted"/>
      <element path="ResearchSubject.actualComparisonGroup" status="deleted"/>
   </type>
   <type name="Resource" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Resource.language">
         <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"/>
      </element>
   </type>
   <type name="RiskAssessment" status="changed">
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="RiskAssessment.status">
         <removed-code code="corrected"/>
         <added-code code="specimen-in-process"/>
         <added-code code="cannot-be-obtained"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/observation-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/observation-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="RiskAssessment.prediction.probability[x]">
         <added-type name="Quantity"/>
      </element>
   </type>
   <type name="Schedule" status="no-change"/>
   <type name="SearchParameter" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element path="SearchParameter.aliasCode" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.base">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.type">
         <added-code code="resource"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-param-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-param-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.processingMode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-processingmode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-processingmode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.target">
         <removed-code code="BiologicallyDerivedProductDispense"/>
         <removed-code code="ChargeItem"/>
         <removed-code code="ChargeItemDefinition"/>
         <removed-code code="Citation"/>
         <removed-code code="ClinicalImpression"/>
         <removed-code code="ConditionDefinition"/>
         <removed-code code="DeviceDispense"/>
         <removed-code code="DeviceUsage"/>
         <removed-code code="EncounterHistory"/>
         <removed-code code="EvidenceReport"/>
         <removed-code code="FormularyItem"/>
         <removed-code code="GenomicStudy"/>
         <removed-code code="GraphDefinition"/>
         <removed-code code="ImmunizationEvaluation"/>
         <removed-code code="ImmunizationRecommendation"/>
         <removed-code code="InventoryItem"/>
         <removed-code code="InventoryReport"/>
         <removed-code code="Linkage"/>
         <removed-code code="MedicationKnowledge"/>
         <removed-code code="MolecularSequence"/>
         <removed-code code="Permission"/>
         <removed-code code="SubstanceNucleicAcid"/>
         <removed-code code="SubstancePolymer"/>
         <removed-code code="SubstanceProtein"/>
         <removed-code code="SubstanceReferenceInformation"/>
         <removed-code code="SubstanceSourceMaterial"/>
         <removed-code code="SupplyDelivery"/>
         <removed-code code="SupplyRequest"/>
         <removed-code code="TestPlan"/>
         <removed-code code="TestReport"/>
         <removed-code code="TestScript"/>
         <removed-code code="Transport"/>
         <removed-code code="VerificationResult"/>
         <added-code code="DeviceAlert"/>
         <added-code code="InsuranceProduct"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/version-independent-all-resource-types|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.comparator">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SearchParameter.modifier">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-code|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-all-codes|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="ServiceRequest" status="changed">
      <element path="ServiceRequest.basedOn">
         <removed-type name="Reference(CarePlan | ServiceRequest | MedicationRequest)"/>
         <added-type name="Reference(CarePlan | DocumentReference | ServiceRequest | MedicationRequest | RequestOrchestration | NutritionOrder | DocumentReference)"/>
      </element>
      <element path="ServiceRequest.replaces">
         <removed-type name="Reference(ServiceRequest)"/>
         <added-type name="Reference(ServiceRequest | MedicationRequest | RequestOrchestration | CarePlan | DeviceRequest | CommunicationRequest | NutritionOrder | VisionPrescription)"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ServiceRequest.status">
         <removed-code code="revoked"/>
         <removed-code code="completed"/>
         <added-code code="ended"/>
         <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"/>
      </element>
      <element path="ServiceRequest.statusReason" status="new"/>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="ServiceRequest.intent">
         <removed-code code="original-order"/>
         <removed-code code="reflex-order"/>
         <removed-code code="filler-order"/>
         <removed-code code="instance-order"/>
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ServiceRequest.priority">
         <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"/>
      </element>
      <element old-name="parameterFocus"
               path="ServiceRequest.orderDetail.parameterFocus[x]">
         <removed-type name="CodeableReference"/>
         <added-type name="CodeableConcept"/>
         <added-type name="Reference(Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition)"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element old-name="asNeeded[x]" path="ServiceRequest.asNeeded">
         <removed-type name="CodeableConcept"/>
      </element>
      <element path="ServiceRequest.asNeededFor" status="new"/>
      <element path="ServiceRequest.requester">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group)"/>
      </element>
      <element path="ServiceRequest.performer">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | Group)"/>
      </element>
      <element path="ServiceRequest.bodyStructure">
         <removed-type name="Reference(BodyStructure)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="ServiceRequest.instantiatesCanonical" status="deleted"/>
      <element path="ServiceRequest.instantiatesUri" status="deleted"/>
      <element path="ServiceRequest.specimen" status="deleted"/>
      <element path="ServiceRequest.bodySite" status="deleted"/>
   </type>
   <type name="Slot" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Slot.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/slotstatus|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/slotstatus|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Specimen" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Specimen.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/specimen-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/specimen-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Specimen.subject">
         <removed-type name="Reference(Patient | Group | Device | BiologicallyDerivedProduct | Substance | Location)"/>
         <added-type name="Reference(Patient | Group | Device | BiologicallyDerivedProduct | Substance | Location | NutritionProduct)"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Specimen.combined">
         <old-binding reference="http://hl7.org/fhir/ValueSet/specimen-combined|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/specimen-combined|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Specimen.collection.collector">
         <removed-type name="Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)"/>
         <added-type name="Reference(Organization | Practitioner | PractitionerRole | Patient | RelatedPerson)"/>
      </element>
      <element old-name="device" path="Specimen.collection.device[x]">
         <removed-type name="CodeableReference"/>
         <added-type name="CodeableConcept"/>
         <added-type name="Reference(Device)"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element path="Specimen.processing.performer" status="new"/>
      <element path="Specimen.processing.device[x]" status="new"/>
      <element path="Specimen.processing.additive">
         <removed-type name="Reference(Substance)"/>
         <added-type name="CodeableReference"/>
      </element>
      <element path="Specimen.processing.time[x]">
         <added-type name="Duration"/>
      </element>
      <element old-name="device" path="Specimen.container.device[x]">
         <added-type name="CodeableConcept"/>
         <added-type name="canonical(DeviceDefinition)"/>
      </element>
      <element binding-status="removed" path="Specimen.condition">
         <old-binding reference="http://terminology.hl7.org/ValueSet/v2-0493"
                      strength="extensible"/>
      </element>
      <element path="Specimen.accessionIdentifier" status="deleted"/>
      <element path="Specimen.container.location" status="deleted"/>
   </type>
   <type name="SpecimenDefinition" status="changed">
      <element new-max="*" old-max="1" path="SpecimenDefinition.identifier"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SpecimenDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SpecimenDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SpecimenDefinition.typeTested.preference">
         <old-binding reference="http://hl7.org/fhir/ValueSet/specimen-contained-preference|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/specimen-contained-preference|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="StructureDefinition" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.fhirVersion">
         <removed-code code="0.0.80"/>
         <removed-code code="0.0.81"/>
         <removed-code code="0.0.82"/>
         <removed-code code="0.4.0"/>
         <removed-code code="0.5.0"/>
         <removed-code code="1.0.0"/>
         <removed-code code="1.0.1"/>
         <removed-code code="1.0.2"/>
         <removed-code code="1.1.0"/>
         <removed-code code="1.4.0"/>
         <removed-code code="1.6.0"/>
         <removed-code code="1.8.0"/>
         <removed-code code="3.0.0"/>
         <removed-code code="3.0.1"/>
         <removed-code code="3.0.2"/>
         <removed-code code="3.3.0"/>
         <removed-code code="3.5.0"/>
         <removed-code code="4.0.0"/>
         <removed-code code="4.0.1"/>
         <removed-code code="4.1.0"/>
         <removed-code code="4.2.0"/>
         <removed-code code="4.3.0"/>
         <removed-code code="4.3.0-cibuild"/>
         <removed-code code="4.3.0-snapshot1"/>
         <removed-code code="4.4.0"/>
         <removed-code code="4.5.0"/>
         <removed-code code="4.6.0"/>
         <removed-code code="5.0.0"/>
         <removed-code code="5.0.0-cibuild"/>
         <removed-code code="5.0.0-snapshot1"/>
         <removed-code code="5.0.0-snapshot2"/>
         <removed-code code="5.0.0-ballot"/>
         <removed-code code="5.0.0-snapshot3"/>
         <removed-code code="5.0.0-draft-final"/>
         <added-code code="6.0"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/FHIR-version|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/structure-definition-kind|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/structure-definition-kind|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.context.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/extension-context-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/extension-context-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureDefinition.derivation">
         <old-binding reference="http://hl7.org/fhir/ValueSet/type-derivation-rule|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/type-derivation-rule|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="StructureMap" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.structure.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-model-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-model-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.group.typeMode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-group-type-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-group-type-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.group.input.mode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-input-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-input-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="StructureMap.group.rule.source.min">
         <removed-type name="integer"/>
         <added-type name="unsignedInt"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.group.rule.source.listMode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-source-list-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-source-list-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.group.rule.target.listMode">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-target-list-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-target-list-mode|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="StructureMap.group.rule.target.transform">
         <old-binding reference="http://hl7.org/fhir/ValueSet/map-transform|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/map-transform|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="Subscription" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Subscription.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscription-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscription-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Subscription.managingEntity">
         <removed-type name="Reference(CareTeam | HealthcareService | Organization | RelatedPerson | Patient | Practitioner | PractitionerRole)"/>
         <added-type name="Reference(CareTeam | Device | Group | HealthcareService | Organization | RelatedPerson | Patient | Practitioner | PractitionerRole)"/>
      </element>
      <element old-name="resourceType" path="Subscription.filterBy.resource"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Subscription.filterBy.comparator">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Subscription.filterBy.modifier">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-code|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-code|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Subscription.filterBy.event" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Subscription.contentType">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Subscription.content">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscription-payload-content|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscription-payload-content|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="SubscriptionStatus" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionStatus.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscription-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscription-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionStatus.type">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscription-notification-type|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscription-notification-type|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="SubscriptionStatus.notificationEvent.triggerEvent" status="new"/>
      <element path="SubscriptionStatus.notificationEvent.relatedQuery" status="new"/>
      <element path="SubscriptionStatus.notificationEvent.relatedQuery.queryType"
               status="new"/>
      <element path="SubscriptionStatus.notificationEvent.relatedQuery.query"
               status="new"/>
      <element path="SubscriptionStatus.notificationEvent.authorizationHint"
               status="new"/>
      <element path="SubscriptionStatus.notificationEvent.authorizationHint.authorizationType"
               status="new"/>
      <element path="SubscriptionStatus.notificationEvent.authorizationHint.value"
               status="new"/>
   </type>
   <type name="SubscriptionTopic" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element old-name="resourceTrigger" path="SubscriptionTopic.trigger"/>
      <element path="SubscriptionTopic.trigger.description" status="new"/>
      <element path="SubscriptionTopic.trigger.resource" status="new"/>
      <element path="SubscriptionTopic.trigger.supportedInteraction" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.trigger.queryCriteria.resultForCreate">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.trigger.queryCriteria.resultForDelete">
         <old-binding reference="http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/subscriptiontopic-cr-behavior|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="SubscriptionTopic.trigger.event" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.trigger.canFilterBy.comparator">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-comparator|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubscriptionTopic.trigger.canFilterBy.modifier">
         <old-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-code|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/search-modifier-code|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="SubscriptionTopic.trigger.notificationShape.include" status="new"/>
      <element path="SubscriptionTopic.trigger.notificationShape.relatedQuery"
               status="new"/>
      <element path="SubscriptionTopic.trigger.notificationShape.relatedQuery.queryType"
               status="new"/>
      <element path="SubscriptionTopic.trigger.notificationShape.relatedQuery.query"
               status="new"/>
      <element path="SubscriptionTopic.resourceTrigger.description" status="deleted"/>
      <element path="SubscriptionTopic.resourceTrigger.resource" status="deleted"/>
      <element path="SubscriptionTopic.resourceTrigger.supportedInteraction"
               status="deleted"/>
      <element path="SubscriptionTopic.eventTrigger" status="deleted"/>
      <element path="SubscriptionTopic.notificationShape.include" status="deleted"/>
   </type>
   <type name="Substance" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Substance.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/substance-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/substance-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="Substance.instance" status="deleted"/>
      <element path="Substance.ingredient" status="deleted"/>
   </type>
   <type name="SubstanceDefinition" status="changed">
      <element modifier="added" path="SubstanceDefinition.status"/>
      <element path="SubstanceDefinition.property.value[x]">
         <added-type name="Range"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="SubstanceDefinition.name.language">
         <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"/>
      </element>
      <element binding-codes-changed="true"
               binding-status="changed"
               binding-valueset-changed="true"
               path="SubstanceDefinition.sourceMaterial.countryOfOrigin">
         <added-code code="AA"/>
         <added-code code="QM"/>
         <added-code code="QN"/>
         <added-code code="QO"/>
         <added-code code="QP"/>
         <added-code code="QQ"/>
         <added-code code="QR"/>
         <added-code code="QS"/>
         <added-code code="QT"/>
         <added-code code="QU"/>
         <added-code code="QV"/>
         <added-code code="QW"/>
         <added-code code="QX"/>
         <added-code code="QY"/>
         <added-code code="QZ"/>
         <added-code code="XA"/>
         <added-code code="XB"/>
         <added-code code="XC"/>
         <added-code code="XD"/>
         <added-code code="XE"/>
         <added-code code="XF"/>
         <added-code code="XG"/>
         <added-code code="XH"/>
         <added-code code="XI"/>
         <added-code code="XJ"/>
         <added-code code="XK"/>
         <added-code code="XL"/>
         <added-code code="XM"/>
         <added-code code="XN"/>
         <added-code code="XO"/>
         <added-code code="XP"/>
         <added-code code="XQ"/>
         <added-code code="XR"/>
         <added-code code="XS"/>
         <added-code code="XT"/>
         <added-code code="XU"/>
         <added-code code="XV"/>
         <added-code code="XW"/>
         <added-code code="XX"/>
         <added-code code="XY"/>
         <added-code code="XZ"/>
         <added-code code="ZZ"/>
         <old-binding reference="http://hl7.org/fhir/ValueSet/country|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/country|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="SubstanceDefinition.informationSource" status="deleted"/>
      <element path="SubstanceDefinition.referenceInformation" status="deleted"/>
      <element path="SubstanceDefinition.nucleicAcid" status="deleted"/>
      <element path="SubstanceDefinition.polymer" status="deleted"/>
      <element path="SubstanceDefinition.protein" status="deleted"/>
   </type>
   <type name="Task" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Task.status">
         <old-binding reference="http://hl7.org/fhir/ValueSet/task-status|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/task-status|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element new-max="*" old-max="1" path="Task.statusReason"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Task.intent">
         <old-binding reference="http://hl7.org/fhir/ValueSet/task-intent|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/task-intent|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="Task.priority">
         <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"/>
      </element>
      <element binding-status="added" path="Task.code">
         <new-binding reference="http://hl7.org/fhir/ValueSet/task-code"
                      strength="extensible"/>
      </element>
      <element path="Task.description">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element new-max="*" old-max="1" path="Task.focus">
         <removed-type name="Reference(Resource)"/>
         <added-type name="BackboneElement"/>
      </element>
      <element path="Task.focus.value[x]" status="new"/>
      <element path="Task.requester">
         <removed-type name="Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
         <added-type name="Reference(Device | Group | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)"/>
      </element>
      <element path="Task.owner">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | Group)"/>
      </element>
      <element path="Task.performer.actor">
         <removed-type name="Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)"/>
         <added-type name="Reference(Practitioner | Device | Organization | PractitionerRole | CareTeam | Patient | RelatedPerson | Group)"/>
      </element>
      <element path="Task.restriction.recipient">
         <removed-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Group | Organization)"/>
         <added-type name="Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Group | Organization | Device)"/>
      </element>
      <element path="Task.input.value[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element path="Task.output.value[x]">
         <added-type name="VirtualServiceDetail"/>
      </element>
      <element path="Task.instantiatesCanonical" status="deleted"/>
      <element path="Task.instantiatesUri" status="deleted"/>
   </type>
   <type name="TerminologyCapabilities" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.kind">
         <old-binding reference="http://hl7.org/fhir/ValueSet/capability-statement-kind|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/capability-statement-kind|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="TerminologyCapabilities.implementation.description">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element path="TerminologyCapabilities.codeSystem.supplement" status="new"/>
      <element path="TerminologyCapabilities.codeSystem.version.supplement"
               status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.codeSystem.version.language">
         <old-binding reference="http://hl7.org/fhir/ValueSet/languages|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.codeSystem.content">
         <old-binding reference="http://hl7.org/fhir/ValueSet/codesystem-content-mode|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/codesystem-content-mode|6.0.0"
                      strength="required"/>
      </element>
      <element path="TerminologyCapabilities.supplements" status="new"/>
      <element path="TerminologyCapabilities.supplements.globals" status="new"/>
      <element path="TerminologyCapabilities.expansion.parameter.documentation">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="TerminologyCapabilities.codeSearch">
         <old-binding reference="http://hl7.org/fhir/ValueSet/code-search-support|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/code-search-support|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="TerminologyCapabilities.closure" status="deleted"/>
   </type>
   <type name="ValueSet" status="changed">
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ValueSet.status">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ValueSet.jurisdiction">
         <old-binding reference="http://hl7.org/fhir/ValueSet/jurisdiction"
                      strength="extensible"/>
         <new-binding reference="http://terminology.hl7.org/ValueSet/jurisdiction"
                      strength="extensible"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ValueSet.compose.include.concept.designation.language">
         <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"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="ValueSet.compose.include.filter.op">
         <old-binding reference="http://hl7.org/fhir/ValueSet/filter-operator|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/filter-operator|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element path="ValueSet.compose.include.copyright">
         <removed-type name="string"/>
         <added-type name="markdown"/>
      </element>
      <element path="ValueSet.scope" status="deleted"/>
   </type>
   <type name="VisionPrescription" status="changed">
      <element path="VisionPrescription.basedOn" status="new"/>
      <element path="VisionPrescription.groupIdentifier" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="VisionPrescription.status">
         <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"/>
      </element>
      <element path="VisionPrescription.priority" status="new"/>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="VisionPrescription.lensSpecification.eye">
         <old-binding reference="http://hl7.org/fhir/ValueSet/vision-eye-codes|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/vision-eye-codes|6.0.0-ballot4"
                      strength="required"/>
      </element>
      <element binding-status="changed"
               binding-valueset-changed="true"
               path="VisionPrescription.lensSpecification.prism.base">
         <old-binding reference="http://hl7.org/fhir/ValueSet/vision-base-codes|5.0.0"
                      strength="required"/>
         <new-binding reference="http://hl7.org/fhir/ValueSet/vision-base-codes|6.0.0-ballot4"
                      strength="required"/>
      </element>
   </type>
   <type name="BiologicallyDerivedProductDispense" status="deleted"/>
   <type name="ChargeItem" status="deleted"/>
   <type name="ChargeItemDefinition" status="deleted"/>
   <type name="Citation" status="deleted"/>
   <type name="ClinicalImpression" status="deleted"/>
   <type name="ConditionDefinition" status="deleted"/>
   <type name="DeviceDispense" status="deleted"/>
   <type name="DeviceUsage" status="deleted"/>
   <type name="EncounterHistory" status="deleted"/>
   <type name="EvidenceReport" status="deleted"/>
   <type name="FormularyItem" status="deleted"/>
   <type name="GenomicStudy" status="deleted"/>
   <type name="GraphDefinition" status="deleted"/>
   <type name="ImmunizationEvaluation" status="deleted"/>
   <type name="ImmunizationRecommendation" status="deleted"/>
   <type name="InventoryItem" status="deleted"/>
   <type name="InventoryReport" status="deleted"/>
   <type name="Linkage" status="deleted"/>
   <type name="MedicationKnowledge" status="deleted"/>
   <type name="MolecularSequence" status="deleted"/>
   <type name="Permission" status="deleted"/>
   <type name="SubstanceNucleicAcid" status="deleted"/>
   <type name="SubstancePolymer" status="deleted"/>
   <type name="SubstanceProtein" status="deleted"/>
   <type name="SubstanceReferenceInformation" status="deleted"/>
   <type name="SubstanceSourceMaterial" status="deleted"/>
   <type name="SupplyDelivery" status="deleted"/>
   <type name="SupplyRequest" status="deleted"/>
   <type name="TestPlan" status="deleted"/>
   <type name="TestReport" status="deleted"/>
   <type name="TestScript" status="deleted"/>
   <type name="Transport" status="deleted"/>
   <type name="VerificationResult" status="deleted"/>
</difference>
