Advance Directive Observation - Definitions - Consolidated CDA (C-CDA) v4.0.0-ballot

Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

Logical Model: AdvanceDirectiveObservation - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the AdvanceDirectiveObservation logical model.

Guidance on how to interpret the contents of this table can be found here

0. Observation
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`) should-informant: SHOULD contain informant (`informant.exists()`)
2. Observation.templateId
Control	1..?
Slicing	This element introduces a set of slices on `Observation.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root value @ extension
4. Observation.templateId:advance-directive-obs
Slice Name	advance-directive-obs
Control	1..1
6. Observation.templateId:advance-directive-obs.root
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.22.4.48`
8. Observation.templateId:advance-directive-obs.extension
Control	1..?
Pattern Value	`2025-05-01`
10. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC).
Fixed Value	`OBS`
12. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC).
Fixed Value	`EVN`
14. Observation.id
Comments	SHALL contain at least one [1..*] id.
Control	1..?
16. Observation.code
Short	Advance Directive
Invariants	should-translation: SHOULD contain translation (`translation.exists()`)
18. Observation.code.code
Control	1..?
Pattern Value	`75320-2`
20. Observation.code.codeSystem
Short	LOINC
Control	1..?
Pattern Value	`2.16.840.1.113883.6.1`
22. Observation.code.translation
Short	𝗨𝗦𝗖𝗗𝗜: Advance Directive Type
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Advance Directives Categories urn:oid:2.16.840.1.113883.11.20.9.69.4.
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
24. Observation.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Control	1..?
26. Observation.text.reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
28. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Control	1..?
30. Observation.statusCode.code
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Control	1..?
Fixed Value	`completed`
32. Observation.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime.
Control	1..?
34. Observation.effectiveTime.low
Comments	This effectiveTime SHALL contain exactly one [1..1] low.
Control	1..?
36. Observation.effectiveTime.high
Comments	This effectiveTime SHALL contain exactly one [1..1] high.
Control	1..?
Invariants	1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (`value.exists() or nullFlavor = 'NA'`)
38. Observation.value
Comments	MAY contain zero or more [0..*] value.
Control	0..1
40. Observation.author
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119).
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
42. Observation.informant
Short	SHOULD contain informant
44. Observation.participant
Slicing	This element introduces a set of slices on `Observation.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
46. Observation.participant:verifier
Slice Name	verifier
Short	𝗨𝗦𝗖𝗗𝗜: Verifier - The participant "VRF" represents the clinician(s) who verified the patient advance directive.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
Control	0..*
Invariants	should-time: SHOULD contain time (`time.exists()`)
48. Observation.participant:verifier.templateId
Control	1..?
Slicing	This element introduces a set of slices on `Observation.participant.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root
50. Observation.participant:verifier.templateId:primary
Slice Name	primary
Comments	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
Control	1..1
52. Observation.participant:verifier.templateId:primary.root
Comments	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.1.58`
54. Observation.participant:verifier.templateId:primary.extension
Comments	SHALL not contain [0..0] extension
Control	0..0
56. Observation.participant:verifier.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Fixed Value	`VRF`
58. Observation.participant:verifier.time
Comments	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Invariants	value-only: Interval fields SHALL NOT be present (`(low \| high \| width \| center).empty()`)
60. Observation.participant:verifier.time.value
Short	value should be used instead of low/high
62. Observation.participant:verifier.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
Invariants	should-code: SHOULD contain code (`code.exists()`)
64. Observation.participant:verifier.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066`)
66. Observation.participant:verifier.participantRole.addr
Comments	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
68. Observation.participant:verifier.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-28428).
Control	1..?
70. Observation.participant:verifier.participantRole.playingEntity.name
Comments	The playingEntity SHALL contain exactly one [1..1] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
72. Observation.participant:custodian
Slice Name	custodian
Short	This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
Control	0..*
74. Observation.participant:custodian.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Fixed Value	`CST`
76. Observation.participant:custodian.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
Invariants	should-code: SHOULD contain code (`code.exists()`) should-addr: SHOULD contain addr (`addr.exists()`) should-telecom: SHOULD contain telecom (`telecom.exists()`)
78. Observation.participant:custodian.participantRole.classCode
Comments	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Control	1..?
Fixed Value	`AGNT`
80. Observation.participant:custodian.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent or Proxy Choices urn:oid:2.16.840.1.113762.1.4.1046.35 DYNAMIC (CONF:1198-28440).
Binding	The codes SHOULD be taken from Healthcare Agent or Proxy Choices (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35`)
82. Observation.participant:custodian.participantRole.addr
Comments	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
84. Observation.participant:custodian.participantRole.telecom
Comments	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
86. Observation.participant:custodian.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
Control	1..?
Invariants	should-code: SHOULD contain code (`code.exists()`)
88. Observation.participant:custodian.participantRole.playingEntity.code
Comments	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal and Legal Relationship RoleType urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC.
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.12.1`)
90. Observation.participant:custodian.participantRole.playingEntity.name
Short	The name of the healthcare agent.
Comments	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
Control	1..1
92. Observation.reference
Control	1..?
Slicing	This element introduces a set of slices on `Observation.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
94. Observation.reference:reference1
Slice Name	reference1
Comments	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
Control	1..*
96. Observation.reference:reference1.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Fixed Value	`REFR`
98. Observation.reference:reference1.externalDocument
Short	𝗨𝗦𝗖𝗗𝗜: External Document
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
Control	1..?
100. Observation.reference:reference1.externalDocument.id
Comments	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
Control	1..?
102. Observation.reference:reference1.externalDocument.code
Control	1..?
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
104. Observation.reference:reference1.externalDocument.text
Comments	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
106. Observation.reference:reference1.externalDocument.text.reference
Short	The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
Comments	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Invariants	1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). ()
108. Observation.reference:reference1.externalDocument.sdtcAuthor
Short	𝗨𝗦𝗖𝗗𝗜: Author
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`author`.

Guidance on how to interpret the contents of this table can be found here

0. Observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type. Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Control	10..1*
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`) should-informant: SHOULD contain informant (`informant.exists()`)
2. Observation.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Observation.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
6. Observation.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
8. Observation.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
10. Observation.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
12. Observation.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Observation.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Observation.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
18. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root value @ extension
20. Observation.templateId:advance-directive-obs
Slice Name	advance-directive-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Observation.templateId:advance-directive-obs.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Observation.templateId:advance-directive-obs.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Observation.templateId:advance-directive-obs.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Observation.templateId:advance-directive-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.48`
30. Observation.templateId:advance-directive-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2025-05-01`
32. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC).
Control	1..1
Binding	The codes SHALL be taken from CDAActClassObservation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OBS`
34. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC).
Control	1..1
Binding	The codes SHALL be taken from XActMoodDocumentObservation (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
36. Observation.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
38. Observation.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short	Logical id of this artifact
Comments	SHALL contain at least one [1..*] id. Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
Control	10..*1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IIid
Is Modifier	false
40. Observation.sdtcCategory
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`category`.
42. Observation.code
Definition	Describes what was observed. Sometimes this is called the observation "name".
Short	Advance DirectiveType of observation (code / type)
Comments	All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control	1..1 This element is affected by the following invariants: obs-7
Binding	For example codes, see ObservationTypehttp://hl7.org/fhir/ValueSet/observation-codes (example to `http://terminology.hl7.org/ValueSet/v3-ObservationType`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
Is Modifier	false
XML Format	The type of this property is determined using the `xsi:type`attribute.
Requirements	Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names	Name
Invariants	should-translation: SHOULD contain translation (`translation.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Observation.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
46. Observation.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`75320-2`
48. Observation.code.codeSystem
Definition	Specifies the code system that defines the code.
Short	LOINC
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
50. Observation.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
52. Observation.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
54. Observation.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
56. Observation.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
58. Observation.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
60. Observation.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
62. Observation.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
64. Observation.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Short	𝗨𝗦𝗖𝗗𝗜: Advance Directive Type
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Advance Directives Categories urn:oid:2.16.840.1.113883.11.20.9.69.4.
Control	0..*
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
66. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ST
68. Observation.text
Definition	A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short	SHOULD reference the portion of section narrative text corresponding to this entryText summary of the resource, for human interpretation
Comments	Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control	10..1 This element is affected by the following invariants: dom-6
Type	http://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
Is Modifier	false
XML Format	The type of this property is determined using the `xsi:type`attribute.
Alternate Names	narrative, html, xhtml, display
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Observation.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
72. Observation.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
74. Observation.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
76. Observation.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
78. Observation.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
80. Observation.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
82. Observation.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
84. Observation.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
86. Observation.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
88. Observation.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
90. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
92. Observation.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
94. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Fixed Value	`completed`
96. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
98. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
100. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
102. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
104. Observation.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
106. Observation.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
108. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
110. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
112. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
114. Observation.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
116. Observation.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
118. Observation.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
120. Observation.effectiveTime.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
122. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] low.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
124. Observation.effectiveTime.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
126. Observation.effectiveTime.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
128. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] high.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
Invariants	1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (`value.exists() or nullFlavor = 'NA'`)
130. Observation.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
132. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
134. Observation.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
136. Observation.value
Comments	MAY contain zero or more [0..*] value.
Control	0..1
Type	Choice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
138. Observation.interpretationCode
Control	0..*
Binding	The codes SHALL be taken from CDAObservationInterpretation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
140. Observation.methodCode
Control	0..*
Binding	For example codes, see ObservationMethod (example to `http://terminology.hl7.org/ValueSet/v3-ObservationMethod`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
142. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
144. Observation.subject
Definition	The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
Short	Who and/or what the observation is about
Comments	One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure. This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct)
Is Modifier	false
Requirements	Observations have no value if you don't know who or what they're about.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Observation.specimen
Definition	The specimen that was used when this observation was made.
Short	Specimen used for this observation
Comments	Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
Control	0..*1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SpecimenReference(Specimen, Group)
Is Modifier	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) obs-9: If Observation.specimen is a reference to Group, the group can only have specimens ((reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen))
148. Observation.performer
Definition	Who was responsible for asserting the observed value as "true".
Short	Who is responsible for the observation
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
Is Modifier	false
Requirements	May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Observation.author
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
152. Observation.informant
Short	SHOULD contain informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
154. Observation.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on `Observation.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
156. Observation.participant:verifier
Slice Name	verifier
Short	𝗨𝗦𝗖𝗗𝗜: Verifier - The participant "VRF" represents the clinician(s) who verified the patient advance directive.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Invariants	should-time: SHOULD contain time (`time.exists()`)
158. Observation.participant:verifier.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
160. Observation.participant:verifier.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
162. Observation.participant:verifier.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
164. Observation.participant:verifier.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
166. Observation.participant:verifier.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
168. Observation.participant:verifier.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
170. Observation.participant:verifier.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
172. Observation.participant:verifier.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
174. Observation.participant:verifier.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.participant.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root
176. Observation.participant:verifier.templateId:primary
Slice Name	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Comments	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
178. Observation.participant:verifier.templateId:primary.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
180. Observation.participant:verifier.templateId:primary.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
182. Observation.participant:verifier.templateId:primary.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
184. Observation.participant:verifier.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Comments	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.1.58`
186. Observation.participant:verifier.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Comments	SHALL not contain [0..0] extension
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
188. Observation.participant:verifier.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`VRF`
190. Observation.participant:verifier.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from CDAContextControl (required to `http://hl7.org/cda/stds/core/ValueSet/CDAContextControl`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OP`
192. Observation.participant:verifier.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`functionCode`.
194. Observation.participant:verifier.time
Comments	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
Invariants	value-only: Interval fields SHALL NOT be present (`(low \| high \| width \| center).empty()`)
196. Observation.participant:verifier.time.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
198. Observation.participant:verifier.time.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Short	value should be used instead of low/high
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
200. Observation.participant:verifier.time.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
202. Observation.participant:verifier.time.low
Definition	This is the low limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
204. Observation.participant:verifier.time.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
206. Observation.participant:verifier.time.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
208. Observation.participant:verifier.time.high
Definition	This is the high limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
210. Observation.participant:verifier.awarenessCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
212. Observation.participant:verifier.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	should-code: SHOULD contain code (`code.exists()`)
214. Observation.participant:verifier.participantRole.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
216. Observation.participant:verifier.participantRole.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
218. Observation.participant:verifier.participantRole.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
220. Observation.participant:verifier.participantRole.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
222. Observation.participant:verifier.participantRole.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
224. Observation.participant:verifier.participantRole.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
226. Observation.participant:verifier.participantRole.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
228. Observation.participant:verifier.participantRole.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
230. Observation.participant:verifier.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
232. Observation.participant:verifier.participantRole.classCode
Control	0..1
Binding	The codes SHALL be taken from CDARoleClassRoot (required to `http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ROL`
234. Observation.participant:verifier.participantRole.id
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
236. Observation.participant:verifier.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`identifiedBy`.
238. Observation.participant:verifier.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
240. Observation.participant:verifier.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Short	Base for all types and resources
Comments	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
Is Modifier	false
Invariants	shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). (`nullFlavor.exists() or item.city.count() = 1`) shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). (`nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)`) should-use: SHOULD contain @use (`nullFlavor.exists() or use.exists()`) should-country: SHOULD contain country (`nullFlavor.exists() or item.country.exists()`) 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296) (`item.xmlText.empty()`) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))`) 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))`) shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country (`(item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)`)
242. Observation.participant:verifier.participantRole.telecom
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
244. Observation.participant:verifier.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Device
246. Observation.participant:verifier.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-28428).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
248. Observation.participant:verifier.participantRole.playingEntity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
250. Observation.participant:verifier.participantRole.playingEntity.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
252. Observation.participant:verifier.participantRole.playingEntity.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
254. Observation.participant:verifier.participantRole.playingEntity.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
256. Observation.participant:verifier.participantRole.playingEntity.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
258. Observation.participant:verifier.participantRole.playingEntity.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
260. Observation.participant:verifier.participantRole.playingEntity.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
262. Observation.participant:verifier.participantRole.playingEntity.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
264. Observation.participant:verifier.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
266. Observation.participant:verifier.participantRole.playingEntity.classCode
Control	0..1
Binding	The codes SHALL be taken from EntityClassRoot (required to `http://terminology.hl7.org/ValueSet/v3-EntityClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ENT`
268. Observation.participant:verifier.participantRole.playingEntity.determinerCode
Control	0..1
Binding	The codes SHALL be taken from EntityDeterminer (required to `http://terminology.hl7.org/ValueSet/v3-EntityDeterminer`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`INSTANCE`
270. Observation.participant:verifier.participantRole.playingEntity.code
Control	0..1
Binding	For example codes, see CDAEntityCode (example to `http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
272. Observation.participant:verifier.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
274. Observation.participant:verifier.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Short	Base for all types and resources
Comments	The playingEntity SHALL contain exactly one [1..1] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifier	false
Invariants	pn-no-ls: No PN name part may have a qualifier of LS. (`(item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).where(qualifier.where($this = 'LS').exists()).empty()`) 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (`conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()`) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (`item.xmlText.exists() implies (item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).empty()`)
276. Observation.participant:verifier.participantRole.playingEntity.sdtcBirthTime
Definition	The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`birthTime`.
278. Observation.participant:verifier.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
280. Observation.participant:verifier.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Entity
282. Observation.participant:custodian
Slice Name	custodian
Short	This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
284. Observation.participant:custodian.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
286. Observation.participant:custodian.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
288. Observation.participant:custodian.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
290. Observation.participant:custodian.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
292. Observation.participant:custodian.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
294. Observation.participant:custodian.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
296. Observation.participant:custodian.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
298. Observation.participant:custodian.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
300. Observation.participant:custodian.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
302. Observation.participant:custodian.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`CST`
304. Observation.participant:custodian.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from CDAContextControl (required to `http://hl7.org/cda/stds/core/ValueSet/CDAContextControl`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OP`
306. Observation.participant:custodian.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`functionCode`.
308. Observation.participant:custodian.time
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
310. Observation.participant:custodian.awarenessCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
312. Observation.participant:custodian.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	should-code: SHOULD contain code (`code.exists()`) should-addr: SHOULD contain addr (`addr.exists()`) should-telecom: SHOULD contain telecom (`telecom.exists()`)
314. Observation.participant:custodian.participantRole.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
316. Observation.participant:custodian.participantRole.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
318. Observation.participant:custodian.participantRole.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
320. Observation.participant:custodian.participantRole.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
322. Observation.participant:custodian.participantRole.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
324. Observation.participant:custodian.participantRole.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
326. Observation.participant:custodian.participantRole.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
328. Observation.participant:custodian.participantRole.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
330. Observation.participant:custodian.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
332. Observation.participant:custodian.participantRole.classCode
Comments	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Control	1..1
Binding	The codes SHALL be taken from CDARoleClassRoot (required to `http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ROL`
Fixed Value	`AGNT`
334. Observation.participant:custodian.participantRole.id
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
336. Observation.participant:custodian.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`identifiedBy`.
338. Observation.participant:custodian.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent or Proxy Choices urn:oid:2.16.840.1.113762.1.4.1046.35 DYNAMIC (CONF:1198-28440).
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Agent or Proxy Choices (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
340. Observation.participant:custodian.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Short	Base for all types and resources
Comments	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
Is Modifier	false
Invariants	shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). (`nullFlavor.exists() or item.city.count() = 1`) shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). (`nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)`) should-use: SHOULD contain @use (`nullFlavor.exists() or use.exists()`) should-country: SHOULD contain country (`nullFlavor.exists() or item.country.exists()`) 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296) (`item.xmlText.empty()`) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))`) 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))`) shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country (`(item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)`)
342. Observation.participant:custodian.participantRole.telecom
Comments	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
344. Observation.participant:custodian.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Device
346. Observation.participant:custodian.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
Invariants	should-code: SHOULD contain code (`code.exists()`)
348. Observation.participant:custodian.participantRole.playingEntity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
350. Observation.participant:custodian.participantRole.playingEntity.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
352. Observation.participant:custodian.participantRole.playingEntity.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
354. Observation.participant:custodian.participantRole.playingEntity.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
356. Observation.participant:custodian.participantRole.playingEntity.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
358. Observation.participant:custodian.participantRole.playingEntity.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
360. Observation.participant:custodian.participantRole.playingEntity.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
362. Observation.participant:custodian.participantRole.playingEntity.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
364. Observation.participant:custodian.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
366. Observation.participant:custodian.participantRole.playingEntity.classCode
Control	0..1
Binding	The codes SHALL be taken from EntityClassRoot (required to `http://terminology.hl7.org/ValueSet/v3-EntityClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ENT`
368. Observation.participant:custodian.participantRole.playingEntity.determinerCode
Control	0..1
Binding	The codes SHALL be taken from EntityDeterminer (required to `http://terminology.hl7.org/ValueSet/v3-EntityDeterminer`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`INSTANCE`
370. Observation.participant:custodian.participantRole.playingEntity.code
Comments	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal and Legal Relationship RoleType urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC.
Control	0..1
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.12.1`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
372. Observation.participant:custodian.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
374. Observation.participant:custodian.participantRole.playingEntity.name
Short	The name of the healthcare agent.
Comments	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN
376. Observation.participant:custodian.participantRole.playingEntity.sdtcBirthTime
Definition	The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`birthTime`.
378. Observation.participant:custodian.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
380. Observation.participant:custodian.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Entity
382. Observation.entryRelationship
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
384. Observation.reference
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
Slicing	This element introduces a set of slices on `Observation.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
386. Observation.reference:reference1
Slice Name	reference1
Comments	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
388. Observation.reference:reference1.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
390. Observation.reference:reference1.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
392. Observation.reference:reference1.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
394. Observation.reference:reference1.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
396. Observation.reference:reference1.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
398. Observation.reference:reference1.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
400. Observation.reference:reference1.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
402. Observation.reference:reference1.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
404. Observation.reference:reference1.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
406. Observation.reference:reference1.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
408. Observation.reference:reference1.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
410. Observation.reference:reference1.externalAct
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
412. Observation.reference:reference1.externalObservation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
414. Observation.reference:reference1.externalProcedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
416. Observation.reference:reference1.externalDocument
Short	𝗨𝗦𝗖𝗗𝗜: External Document
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
418. Observation.reference:reference1.externalDocument.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
420. Observation.reference:reference1.externalDocument.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
422. Observation.reference:reference1.externalDocument.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
424. Observation.reference:reference1.externalDocument.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
426. Observation.reference:reference1.externalDocument.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
428. Observation.reference:reference1.externalDocument.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
430. Observation.reference:reference1.externalDocument.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
432. Observation.reference:reference1.externalDocument.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
434. Observation.reference:reference1.externalDocument.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
436. Observation.reference:reference1.externalDocument.classCode
Control	0..1
Binding	The codes SHALL be taken from ActClassDocument (required to `http://terminology.hl7.org/ValueSet/v3-ActClassDocument`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`DOC`
438. Observation.reference:reference1.externalDocument.moodCode
Control	0..1
Binding	The codes SHALL be taken from CDAActMood (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActMood`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
440. Observation.reference:reference1.externalDocument.id
Comments	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
442. Observation.reference:reference1.externalDocument.code
Control	1..1
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
444. Observation.reference:reference1.externalDocument.text
Comments	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
446. Observation.reference:reference1.externalDocument.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
448. Observation.reference:reference1.externalDocument.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
450. Observation.reference:reference1.externalDocument.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
452. Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
454. Observation.reference:reference1.externalDocument.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
456. Observation.reference:reference1.externalDocument.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
458. Observation.reference:reference1.externalDocument.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
460. Observation.reference:reference1.externalDocument.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
462. Observation.reference:reference1.externalDocument.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Short	The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
Comments	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). ()
464. Observation.reference:reference1.externalDocument.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
466. Observation.reference:reference1.externalDocument.setId
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
468. Observation.reference:reference1.externalDocument.versionNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
470. Observation.reference:reference1.externalDocument.sdtcAuthor
Short	𝗨𝗦𝗖𝗗𝗜: Author
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`author`.
472. Observation.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
474. Observation.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
476. Observation.referenceRange
Definition	Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified. Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.
Short	Provides guide for interpretation
Comments	Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRootBackboneElement
Is Modifier	false
Requirements	Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
478. Observation.referenceRange.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
480. Observation.referenceRange.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
482. Observation.referenceRange.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
484. Observation.referenceRange.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
486. Observation.referenceRange.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
488. Observation.referenceRange.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
490. Observation.referenceRange.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
492. Observation.referenceRange.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
494. Observation.referenceRange.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
496. Observation.referenceRange.typeCode
Control	0..1
Binding	The codes SHALL be taken from CDAActRelationshipType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFV`
498. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
500. Observation.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.

Guidance on how to interpret the contents of this table can be found here

0. Observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`) should-informant: SHOULD contain informant (`informant.exists()`)
2. Observation.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Observation.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
6. Observation.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
8. Observation.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
10. Observation.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
12. Observation.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Observation.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Observation.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
18. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root value @ extension
20. Observation.templateId:advance-directive-obs
Slice Name	advance-directive-obs
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Observation.templateId:advance-directive-obs.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Observation.templateId:advance-directive-obs.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Observation.templateId:advance-directive-obs.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Observation.templateId:advance-directive-obs.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.48`
30. Observation.templateId:advance-directive-obs.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2025-05-01`
32. Observation.classCode
Comments	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC).
Control	1..1
Binding	The codes SHALL be taken from CDAActClassObservation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OBS`
34. Observation.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC).
Control	1..1
Binding	The codes SHALL be taken from XActMoodDocumentObservation (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
36. Observation.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
38. Observation.id
Comments	SHALL contain at least one [1..*] id.
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
40. Observation.sdtcCategory
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`category`.
42. Observation.code
Short	Advance Directive
Control	1..1
Binding	For example codes, see ObservationType (example to `http://terminology.hl7.org/ValueSet/v3-ObservationType`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Invariants	should-translation: SHOULD contain translation (`translation.exists()`)
44. Observation.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
46. Observation.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`75320-2`
48. Observation.code.codeSystem
Definition	Specifies the code system that defines the code.
Short	LOINC
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
50. Observation.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
52. Observation.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
54. Observation.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
56. Observation.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
58. Observation.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
60. Observation.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
62. Observation.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
64. Observation.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Short	𝗨𝗦𝗖𝗗𝗜: Advance Directive Type
Comments	This code SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Advance Directives Categories urn:oid:2.16.840.1.113883.11.20.9.69.4.
Control	0..*
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
66. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ST
68. Observation.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
XML Format	The type of this property is determined using the `xsi:type`attribute.
70. Observation.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
72. Observation.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
74. Observation.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
76. Observation.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
78. Observation.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
80. Observation.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
82. Observation.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
84. Observation.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
86. Observation.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
88. Observation.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
90. Observation.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
92. Observation.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
94. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Comments	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Fixed Value	`completed`
96. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
98. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
100. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
102. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
104. Observation.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
106. Observation.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
108. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
110. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
112. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
114. Observation.effectiveTime
Comments	SHALL contain exactly one [1..1] effectiveTime.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
116. Observation.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
118. Observation.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
120. Observation.effectiveTime.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
122. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] low.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
124. Observation.effectiveTime.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
126. Observation.effectiveTime.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
128. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Comments	This effectiveTime SHALL contain exactly one [1..1] high.
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
Invariants	1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (`value.exists() or nullFlavor = 'NA'`)
130. Observation.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
132. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
134. Observation.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
136. Observation.value
Comments	MAY contain zero or more [0..*] value.
Control	0..1
Type	Choice of: http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/SC, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ
XML Format	The type of this property is determined using the `xsi:type`attribute.
138. Observation.interpretationCode
Control	0..*
Binding	The codes SHALL be taken from CDAObservationInterpretation (required to `http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
140. Observation.methodCode
Control	0..*
Binding	For example codes, see ObservationMethod (example to `http://terminology.hl7.org/ValueSet/v3-ObservationMethod`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
142. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
144. Observation.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
146. Observation.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
148. Observation.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
150. Observation.author
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
152. Observation.informant
Short	SHOULD contain informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
154. Observation.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on `Observation.participant`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
156. Observation.participant:verifier
Slice Name	verifier
Short	𝗨𝗦𝗖𝗗𝗜: Verifier - The participant "VRF" represents the clinician(s) who verified the patient advance directive.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
Invariants	should-time: SHOULD contain time (`time.exists()`)
158. Observation.participant:verifier.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
160. Observation.participant:verifier.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
162. Observation.participant:verifier.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
164. Observation.participant:verifier.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
166. Observation.participant:verifier.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
168. Observation.participant:verifier.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
170. Observation.participant:verifier.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
172. Observation.participant:verifier.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
174. Observation.participant:verifier.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This element introduces a set of slices on `Observation.participant.templateId`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ root
176. Observation.participant:verifier.templateId:primary
Slice Name	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Comments	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
178. Observation.participant:verifier.templateId:primary.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
180. Observation.participant:verifier.templateId:primary.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
182. Observation.participant:verifier.templateId:primary.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
184. Observation.participant:verifier.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Comments	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.1.58`
186. Observation.participant:verifier.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Comments	SHALL not contain [0..0] extension
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
188. Observation.participant:verifier.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`VRF`
190. Observation.participant:verifier.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from CDAContextControl (required to `http://hl7.org/cda/stds/core/ValueSet/CDAContextControl`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OP`
192. Observation.participant:verifier.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`functionCode`.
194. Observation.participant:verifier.time
Comments	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
Invariants	value-only: Interval fields SHALL NOT be present (`(low \| high \| width \| center).empty()`)
196. Observation.participant:verifier.time.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
198. Observation.participant:verifier.time.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Short	value should be used instead of low/high
Control	0..1
Type	dateTime(ts: Point in Time)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Date Format	YYYYMMDDHHMMSS.UUUU[+\|-ZZzz]
XML Format	In the XML format, this property is represented as an attribute.
200. Observation.participant:verifier.time.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Binding	The codes SHALL be taken from CDASetOperator (required to `http://hl7.org/cda/stds/core/ValueSet/CDASetOperator`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`I`
202. Observation.participant:verifier.time.low
Definition	This is the low limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	Low Boundary
204. Observation.participant:verifier.time.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
Label	Central Value
206. Observation.participant:verifier.time.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
Label	Width
208. Observation.participant:verifier.time.high
Definition	This is the high limit of the interval.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
Label	High Boundary
210. Observation.participant:verifier.awarenessCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
212. Observation.participant:verifier.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	should-code: SHOULD contain code (`code.exists()`)
214. Observation.participant:verifier.participantRole.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
216. Observation.participant:verifier.participantRole.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
218. Observation.participant:verifier.participantRole.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
220. Observation.participant:verifier.participantRole.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
222. Observation.participant:verifier.participantRole.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
224. Observation.participant:verifier.participantRole.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
226. Observation.participant:verifier.participantRole.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
228. Observation.participant:verifier.participantRole.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
230. Observation.participant:verifier.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
232. Observation.participant:verifier.participantRole.classCode
Control	0..1
Binding	The codes SHALL be taken from CDARoleClassRoot (required to `http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ROL`
234. Observation.participant:verifier.participantRole.id
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
236. Observation.participant:verifier.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`identifiedBy`.
238. Observation.participant:verifier.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
240. Observation.participant:verifier.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Short	Base for all types and resources
Comments	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
Is Modifier	false
Invariants	shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). (`nullFlavor.exists() or item.city.count() = 1`) shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). (`nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)`) should-use: SHOULD contain @use (`nullFlavor.exists() or use.exists()`) should-country: SHOULD contain country (`nullFlavor.exists() or item.country.exists()`) 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296) (`item.xmlText.empty()`) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))`) 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))`) shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country (`(item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)`)
242. Observation.participant:verifier.participantRole.telecom
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
244. Observation.participant:verifier.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Device
246. Observation.participant:verifier.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-28428).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
248. Observation.participant:verifier.participantRole.playingEntity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
250. Observation.participant:verifier.participantRole.playingEntity.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
252. Observation.participant:verifier.participantRole.playingEntity.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
254. Observation.participant:verifier.participantRole.playingEntity.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
256. Observation.participant:verifier.participantRole.playingEntity.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
258. Observation.participant:verifier.participantRole.playingEntity.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
260. Observation.participant:verifier.participantRole.playingEntity.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
262. Observation.participant:verifier.participantRole.playingEntity.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
264. Observation.participant:verifier.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
266. Observation.participant:verifier.participantRole.playingEntity.classCode
Control	0..1
Binding	The codes SHALL be taken from EntityClassRoot (required to `http://terminology.hl7.org/ValueSet/v3-EntityClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ENT`
268. Observation.participant:verifier.participantRole.playingEntity.determinerCode
Control	0..1
Binding	The codes SHALL be taken from EntityDeterminer (required to `http://terminology.hl7.org/ValueSet/v3-EntityDeterminer`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`INSTANCE`
270. Observation.participant:verifier.participantRole.playingEntity.code
Control	0..1
Binding	For example codes, see CDAEntityCode (example to `http://hl7.org/cda/stds/core/ValueSet/CDAEntityCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
272. Observation.participant:verifier.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
274. Observation.participant:verifier.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Short	Base for all types and resources
Comments	The playingEntity SHALL contain exactly one [1..1] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
Is Modifier	false
Invariants	pn-no-ls: No PN name part may have a qualifier of LS. (`(item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).where(qualifier.where($this = 'LS').exists()).empty()`) 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (`conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists()`) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (`item.xmlText.exists() implies (item.delimiter \| item.family \| item.given \| item.prefix \| item.suffix).empty()`)
276. Observation.participant:verifier.participantRole.playingEntity.sdtcBirthTime
Definition	The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`birthTime`.
278. Observation.participant:verifier.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
280. Observation.participant:verifier.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Entity
282. Observation.participant:custodian
Slice Name	custodian
Short	This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter.
Comments	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
284. Observation.participant:custodian.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
286. Observation.participant:custodian.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
288. Observation.participant:custodian.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
290. Observation.participant:custodian.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
292. Observation.participant:custodian.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
294. Observation.participant:custodian.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
296. Observation.participant:custodian.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
298. Observation.participant:custodian.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
300. Observation.participant:custodian.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
302. Observation.participant:custodian.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Control	1..1
Binding	The codes SHALL be taken from CDAParticipationType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`CST`
304. Observation.participant:custodian.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from CDAContextControl (required to `http://hl7.org/cda/stds/core/ValueSet/CDAContextControl`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`OP`
306. Observation.participant:custodian.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`functionCode`.
308. Observation.participant:custodian.time
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
310. Observation.participant:custodian.awarenessCode
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
312. Observation.participant:custodian.participantRole
Comments	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ParticipantRole
Invariants	should-code: SHOULD contain code (`code.exists()`) should-addr: SHOULD contain addr (`addr.exists()`) should-telecom: SHOULD contain telecom (`telecom.exists()`)
314. Observation.participant:custodian.participantRole.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
316. Observation.participant:custodian.participantRole.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
318. Observation.participant:custodian.participantRole.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
320. Observation.participant:custodian.participantRole.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
322. Observation.participant:custodian.participantRole.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
324. Observation.participant:custodian.participantRole.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
326. Observation.participant:custodian.participantRole.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
328. Observation.participant:custodian.participantRole.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
330. Observation.participant:custodian.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
332. Observation.participant:custodian.participantRole.classCode
Comments	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Control	1..1
Binding	The codes SHALL be taken from CDARoleClassRoot (required to `http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ROL`
Fixed Value	`AGNT`
334. Observation.participant:custodian.participantRole.id
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
336. Observation.participant:custodian.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/IdentifiedBy
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`identifiedBy`.
338. Observation.participant:custodian.participantRole.code
Comments	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent or Proxy Choices urn:oid:2.16.840.1.113762.1.4.1046.35 DYNAMIC (CONF:1198-28440).
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Agent or Proxy Choices (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
340. Observation.participant:custodian.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Short	Base for all types and resources
Comments	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
Is Modifier	false
Invariants	shall-city: SHALL contain exactly one [1..1] city (CONF:81-7292). (`nullFlavor.exists() or item.city.count() = 1`) shall-streetAddressLine: SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). (`nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4)`) should-use: SHOULD contain @use (`nullFlavor.exists() or use.exists()`) should-country: SHOULD contain country (`nullFlavor.exists() or item.country.exists()`) 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296) (`item.xmlText.empty()`) 81-10024: If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'))`) 81-10025: If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). (`nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?'))`) shall-max-ad-parts: SHALL have at most one of each: state, city, postalCode, and country (`(item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1)`)
342. Observation.participant:custodian.participantRole.telecom
Comments	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
344. Observation.participant:custodian.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Device
346. Observation.participant:custodian.participantRole.playingEntity
Comments	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PlayingEntity
Invariants	should-code: SHOULD contain code (`code.exists()`)
348. Observation.participant:custodian.participantRole.playingEntity.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
350. Observation.participant:custodian.participantRole.playingEntity.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
352. Observation.participant:custodian.participantRole.playingEntity.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
354. Observation.participant:custodian.participantRole.playingEntity.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
356. Observation.participant:custodian.participantRole.playingEntity.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
358. Observation.participant:custodian.participantRole.playingEntity.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
360. Observation.participant:custodian.participantRole.playingEntity.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
362. Observation.participant:custodian.participantRole.playingEntity.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
364. Observation.participant:custodian.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
366. Observation.participant:custodian.participantRole.playingEntity.classCode
Control	0..1
Binding	The codes SHALL be taken from EntityClassRoot (required to `http://terminology.hl7.org/ValueSet/v3-EntityClassRoot`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`ENT`
368. Observation.participant:custodian.participantRole.playingEntity.determinerCode
Control	0..1
Binding	The codes SHALL be taken from EntityDeterminer (required to `http://terminology.hl7.org/ValueSet/v3-EntityDeterminer`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`INSTANCE`
370. Observation.participant:custodian.participantRole.playingEntity.code
Comments	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal and Legal Relationship RoleType urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC.
Control	0..1
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.12.1`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
372. Observation.participant:custodian.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/PQ
374. Observation.participant:custodian.participantRole.playingEntity.name
Short	The name of the healthcare agent.
Comments	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/PN
376. Observation.participant:custodian.participantRole.playingEntity.sdtcBirthTime
Definition	The purpose of this extension is to allow the recording of the subscriber or member of a health plan in cases where the health plan eligibility system has different information on file than the provider does for the patient.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TS
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`birthTime`.
378. Observation.participant:custodian.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
380. Observation.participant:custodian.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Entity
382. Observation.entryRelationship
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
384. Observation.reference
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
Slicing	This element introduces a set of slices on `Observation.reference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ typeCode
386. Observation.reference:reference1
Slice Name	reference1
Comments	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
388. Observation.reference:reference1.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
390. Observation.reference:reference1.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
392. Observation.reference:reference1.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
394. Observation.reference:reference1.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
396. Observation.reference:reference1.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
398. Observation.reference:reference1.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
400. Observation.reference:reference1.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
402. Observation.reference:reference1.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
404. Observation.reference:reference1.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
406. Observation.reference:reference1.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
408. Observation.reference:reference1.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
410. Observation.reference:reference1.externalAct
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
412. Observation.reference:reference1.externalObservation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
414. Observation.reference:reference1.externalProcedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
416. Observation.reference:reference1.externalDocument
Short	𝗨𝗦𝗖𝗗𝗜: External Document
Comments	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument
418. Observation.reference:reference1.externalDocument.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
420. Observation.reference:reference1.externalDocument.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
422. Observation.reference:reference1.externalDocument.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
424. Observation.reference:reference1.externalDocument.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
426. Observation.reference:reference1.externalDocument.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
428. Observation.reference:reference1.externalDocument.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
430. Observation.reference:reference1.externalDocument.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
432. Observation.reference:reference1.externalDocument.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
434. Observation.reference:reference1.externalDocument.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
436. Observation.reference:reference1.externalDocument.classCode
Control	0..1
Binding	The codes SHALL be taken from ActClassDocument (required to `http://terminology.hl7.org/ValueSet/v3-ActClassDocument`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`DOC`
438. Observation.reference:reference1.externalDocument.moodCode
Control	0..1
Binding	The codes SHALL be taken from CDAActMood (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActMood`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
440. Observation.reference:reference1.externalDocument.id
Comments	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
442. Observation.reference:reference1.externalDocument.code
Control	1..1
Binding	The codes SHOULD be taken from Advance Directives Categories (preferred to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
444. Observation.reference:reference1.externalDocument.text
Comments	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
446. Observation.reference:reference1.externalDocument.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
448. Observation.reference:reference1.externalDocument.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
450. Observation.reference:reference1.externalDocument.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
452. Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
454. Observation.reference:reference1.externalDocument.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
456. Observation.reference:reference1.externalDocument.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
458. Observation.reference:reference1.externalDocument.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
460. Observation.reference:reference1.externalDocument.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
462. Observation.reference:reference1.externalDocument.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Short	The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
Comments	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). ()
464. Observation.reference:reference1.externalDocument.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
466. Observation.reference:reference1.externalDocument.setId
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
468. Observation.reference:reference1.externalDocument.versionNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
470. Observation.reference:reference1.externalDocument.sdtcAuthor
Short	𝗨𝗦𝗖𝗗𝗜: Author
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`author`.
472. Observation.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
474. Observation.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
476. Observation.referenceRange
Definition	Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
478. Observation.referenceRange.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
480. Observation.referenceRange.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
482. Observation.referenceRange.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
484. Observation.referenceRange.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
486. Observation.referenceRange.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
488. Observation.referenceRange.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
490. Observation.referenceRange.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
492. Observation.referenceRange.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
494. Observation.referenceRange.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
496. Observation.referenceRange.typeCode
Control	0..1
Binding	The codes SHALL be taken from CDAActRelationshipType (required to `http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFV`
498. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
500. Observation.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.