Central Cancer Registry Reporting Patient - Definitions - Central Cancer Registry Reporting Content IG v2.0.0-ballot

Central Cancer Registry Reporting Content IG, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-central-cancer-registry-reporting-ig/ and changes regularly. See the Directory of published versions

Resource Profile: CentralCancerRegistryReportingPatient - Detailed Descriptions

Page standards status: Trial-use

Maturity Level: 2

Definitions for the central-cancer-registry-reporting-patient resource profile.

Differential Elements Table
Key Elements Table
Snapshot Elements Table

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

0. Patient
Definition	This profile is based on the Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing a patient for central cancer registry reporting.
Short	Central Cancer Registry Reporting Patient
2. Patient.identifier
Note	This is a business identifier, not a resource identifier (see discussion)
Control	1..*
Must Support	true
Slicing	This element introduces a set of slices on `Patient.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type.coding.system value @ type.coding.code
4. Patient.identifier:MedicareIdentifier
Slice Name	MedicareIdentifier
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1
Must Support	true
6. Patient.identifier:MedicareIdentifier.type
Control	1..1
Type	CodeableConcept
Must Support	true
8. Patient.identifier:MedicareIdentifier.type.coding
Control	1..1
Must Support	true
10. Patient.identifier:MedicareIdentifier.type.coding.system
Control	1..1
Type	uri
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
12. Patient.identifier:MedicareIdentifier.type.coding.code
Control	1..1
Type	code
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`MC`
14. Patient.identifier:MedicaidIdentifier
Slice Name	MedicaidIdentifier
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1
Must Support	true
16. Patient.identifier:MedicaidIdentifier.type
Control	1..1
Type	CodeableConcept
Must Support	true
18. Patient.identifier:MedicaidIdentifier.type.coding
Control	1..1
Must Support	true
20. Patient.identifier:MedicaidIdentifier.type.coding.system
Control	1..1
Type	uri
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
22. Patient.identifier:MedicaidIdentifier.type.coding.code
Control	1..1
Type	code
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`MA`
24. Patient.identifier:MR
Slice Name	MR
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..*
Must Support	true
26. Patient.identifier:MR.type
Control	1..1
Type	CodeableConcept
Must Support	true
28. Patient.identifier:MR.type.coding
Control	1..1
Must Support	true
30. Patient.identifier:MR.type.coding.system
Control	1..1
Type	uri
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
32. Patient.identifier:MR.type.coding.code
Control	1..1
Type	code
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`MR`
34. Patient.identifier:SSNIdentifier
Slice Name	SSNIdentifier
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1
Must Support	true
36. Patient.identifier:SSNIdentifier.type
Control	1..1
Type	CodeableConcept
Must Support	true
38. Patient.identifier:SSNIdentifier.type.coding
Control	1..1
Must Support	true
40. Patient.identifier:SSNIdentifier.type.coding.system
Control	1..1
Type	uri
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
42. Patient.identifier:SSNIdentifier.type.coding.code
Control	1..1
Type	code
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Fixed Value	`SS`
44. Patient.name
Control	1..*
Must Support	true
46. Patient.name.family
Control	1..1
Must Support	true
48. Patient.name.family.extension:data-absent-reason
Slice Name	data-absent-reason
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Must Support	true
50. Patient.name.given
Control	1..*
Must Support	true
52. Patient.name.given.extension:data-absent-reason
Slice Name	data-absent-reason
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Must Support	true
54. Patient.address
Control	1..*
Must Support	true
56. Patient.address.state
Control	1..1
Must Support	true
58. Patient.address.state.extension:data-absent-reason
Slice Name	data-absent-reason
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Must Support	true
60. Patient.maritalStatus
Control	0..1
Must Support	true
62. Patient.generalPractitioner
Control	0..1
Type	Reference(US Core Practitioner Profile)
Must Support	true
64. Patient.managingOrganization
Control	0..1
Type	Reference(Central Cancer Registry Reporting Organization)
Must Support	true

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

0. Patient
Definition	This profile is based on the Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing a patient for central cancer registry reporting. Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Short	Central Cancer Registry Reporting PatientInformation about an individual or animal receiving health care services
Comments	-
Control	0..*
Is Modifier	false
Must Support	false
Summary	false
Alternate Names	SubjectOfCare Client Resident
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) us-core-6: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. (`(name.family.exists() or name.given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`)
2. Patient.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short	A set of rules under which this content was created
Comments	Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control	0..1
Type	uri
Is Modifier	true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	20..*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Patient.extension:race
Slice Name	race
Definition	Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White.
Short	US Core Race Extension
Control	1..1 This element is affected by the following invariants: ele-1
Type	Extension(US Core Race Extension) (Complex Extension)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
8. Patient.extension:race.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	10..*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Patient.extension:race.extension:ombCategory
Slice Name	ombCategory
Definition	The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
Short	American Indian or Alaska Native\|Asian\|Black or African American\|Native Hawaiian or Other Pacific Islander\|WhiteAdditional content defined by implementations
Control	0..5*
Type	Extension
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Patient.extension:race.extension:ombCategory.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`ombCategory`
14. Patient.extension:race.extension:ombCategory.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see OMB Race Categories (required to `http://hl7.org/fhir/us/core/ValueSet/omb-race-category`) The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
Type	Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Patient.extension:race.extension:detailed
Slice Name	detailed
Definition	The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.
Short	Extended race codesAdditional content defined by implementations
Control	0..*
Type	Extension
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Patient.extension:race.extension:detailed.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`detailed`
20. Patient.extension:race.extension:detailed.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see Detailed Race (required to `http://hl7.org/fhir/us/core/ValueSet/detailed-race`)
Type	Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Patient.extension:race.extension:text
Slice Name	text
Definition	Plain text representation of the race concept(s).
Short	Race TextAdditional content defined by implementations
Control	10..1*
Type	Extension
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Patient.extension:race.extension:text.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`text`
26. Patient.extension:race.extension:text.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Type	string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Patient.extension:race.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	For masking purposes, use the data-absent-reason extension and set the required us-core-race extension text to "masked"
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. Patient.extension:race.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Patient.extension:race.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
34. Patient.extension:race.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Patient.extension:race.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/us/core/StructureDefinition/us-core-race`
38. Patient.extension:race.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	0..01
Type	Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Patient.extension:ethnicity
Slice Name	ethnicity
Definition	Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.
Short	US Core ethnicity Extension
Control	1..1 This element is affected by the following invariants: ele-1
Type	Extension(US Core Ethnicity Extension) (Complex Extension)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
42. Patient.extension:ethnicity.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	10..*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
44. Patient.extension:ethnicity.extension:ombCategory
Slice Name	ombCategory
Definition	The 2 ethnicity category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
Short	Hispanic or Latino\|Not Hispanic or LatinoAdditional content defined by implementations
Control	0..1*
Type	Extension
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
46. Patient.extension:ethnicity.extension:ombCategory.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`ombCategory`
48. Patient.extension:ethnicity.extension:ombCategory.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see OMB Ethnicity Categories (required to `http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category`)
Type	Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Patient.extension:ethnicity.extension:detailed
Slice Name	detailed
Definition	The 41 CDC ethnicity codes that are grouped under one of the 2 OMB ethnicity category codes.
Short	Extended ethnicity codesAdditional content defined by implementations
Control	0..*
Type	Extension
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Patient.extension:ethnicity.extension:detailed.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`detailed`
54. Patient.extension:ethnicity.extension:detailed.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see Detailed ethnicity (required to `http://hl7.org/fhir/us/core/ValueSet/detailed-ethnicity`)
Type	Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Patient.extension:ethnicity.extension:text
Slice Name	text
Definition	Plain text representation of the ethnicity concept(s).
Short	ethnicity TextAdditional content defined by implementations
Control	10..1*
Type	Extension
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. Patient.extension:ethnicity.extension:text.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
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.
Summary	false
Fixed Value	`text`
60. Patient.extension:ethnicity.extension:text.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Type	string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Patient.extension:ethnicity.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	For masking purposes, use the data-absent-reason extension and set the required us-core-ethnicity extension text to "masked"
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. Patient.extension:ethnicity.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.extension.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
66. Patient.extension:ethnicity.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
68. Patient.extension:ethnicity.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Patient.extension:ethnicity.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity`
72. Patient.extension:ethnicity.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	0..01
Type	Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Patient.extension:birthsex
Slice Name	birthsex
Definition	A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).
Short	Extension
Comments	The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.
Control	0..1 This element is affected by the following invariants: ele-1
Type	Extension(US Core Birth Sex Extension) (Extension Type: code)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. Patient.extension:genderIdentity
Slice Name	genderIdentity
Definition	An Extension
Short	Extension
Control	0..1 This element is affected by the following invariants: ele-1
Type	Extension(US Core Gender Identity Extension) (Extension Type: CodeableConcept)
Is Modifier	false
Must Support	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
78. Patient.extension:birthPlace
Slice Name	birthPlace
Definition	The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.
Short	Place of Birth for patient
Control	0..1
Type	Extension(Patient Birth Place) (Extension Type: Address)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
80. Patient.extension:individualGenderIdentity
Slice Name	individualGenderIdentity
Definition	An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.
Short	The individual's gender identity
Comments	This represents an individual’s identity, ascertained by asking them what that identity is.
Control	0..*
Type	Extension(Individual Gender Identity) (Complex Extension)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
82. Patient.extension:tribalAffiliation
Slice Name	tribalAffiliation
Definition	Affiliated tribe name and whether or not the patient is an enrolled member
Short	Tribal affiliation and membership of the patient
Control	0..*
Type	Extension(US Public Health Tribal Affiliation Extension) (Complex Extension)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
84. Patient.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short	Extensions that cannot be ignored
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..*
Type	Extension
Is Modifier	true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary	false
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. Patient.identifier
Definition	An identifier for this patient.
Short	An identifier for this patient
Note	This is a business identifier, not a resource identifier (see discussion)
Control	10..*
Type	Identifier
Is Modifier	false
Must Support	true
Summary	true
Requirements	Patients are almost always assigned specific numerical identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing	This element introduces a set of slices on `Patient.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ type.coding.system value @ type.coding.code
88. Patient.identifier.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. Patient.identifier.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.identifier.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
92. Patient.identifier.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
94. Patient.identifier.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Patient.identifier.use
Definition	The purpose of this identifier.
Short	usual \| official \| temp \| secondary \| old (If known)
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control	0..1
Binding	The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1`) Identifies the purpose for this identifier, if known .
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Patient.identifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short	The namespace for the identifier value
Comments	Identifier.system is always case sensitive.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example	General: http://www.acme.com/identifiers/patient
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Patient.identifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short	The value that is unique within the system.
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 123456
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Patient.identifier:MedicareIdentifier
Slice Name	MedicareIdentifier
Definition	An identifier for this patient.
Short	An identifier for this patient
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1*
Type	Identifier
Is Modifier	false
Must Support	true
Summary	true
Requirements	Patients are almost always assigned specific numerical identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Patient.identifier:MedicareIdentifier.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. Patient.identifier:MedicareIdentifier.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.identifier.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
108. Patient.identifier:MedicareIdentifier.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
110. Patient.identifier:MedicareIdentifier.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Patient.identifier:MedicareIdentifier.use
Definition	The purpose of this identifier.
Short	usual \| official \| temp \| secondary \| old (If known)
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control	0..1
Binding	The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1`) Identifies the purpose for this identifier, if known .
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Patient.identifier:MedicareIdentifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short	Description of identifier
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control	10..1
Binding	Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type`) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Patient.identifier:MedicareIdentifier.type.coding
Definition	A reference to a code defined by a terminology system.
Short	Code defined by a terminology system
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control	10..1*
Type	Coding
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Patient.identifier:MedicareIdentifier.type.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Short	Identity of the terminology system
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Patient.identifier:MedicareIdentifier.type.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short	Symbol in syntax defined by the system
Control	10..1
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to refer to a particular code in the system.
Fixed Value	`MC`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Patient.identifier:MedicareIdentifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short	The namespace for the identifier value
Comments	Identifier.system is always case sensitive.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example	General: http://www.acme.com/identifiers/patient
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Patient.identifier:MedicareIdentifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short	The value that is unique within the system.
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 123456
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Patient.identifier:MedicaidIdentifier
Slice Name	MedicaidIdentifier
Definition	An identifier for this patient.
Short	An identifier for this patient
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1*
Type	Identifier
Is Modifier	false
Must Support	true
Summary	true
Requirements	Patients are almost always assigned specific numerical identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. Patient.identifier:MedicaidIdentifier.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
130. Patient.identifier:MedicaidIdentifier.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.identifier.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
132. Patient.identifier:MedicaidIdentifier.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
134. Patient.identifier:MedicaidIdentifier.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Patient.identifier:MedicaidIdentifier.use
Definition	The purpose of this identifier.
Short	usual \| official \| temp \| secondary \| old (If known)
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control	0..1
Binding	The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1`) Identifies the purpose for this identifier, if known .
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Patient.identifier:MedicaidIdentifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short	Description of identifier
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control	10..1
Binding	Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type`) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Patient.identifier:MedicaidIdentifier.type.coding
Definition	A reference to a code defined by a terminology system.
Short	Code defined by a terminology system
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control	10..1*
Type	Coding
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Patient.identifier:MedicaidIdentifier.type.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Short	Identity of the terminology system
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Patient.identifier:MedicaidIdentifier.type.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short	Symbol in syntax defined by the system
Control	10..1
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to refer to a particular code in the system.
Fixed Value	`MA`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Patient.identifier:MedicaidIdentifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short	The namespace for the identifier value
Comments	Identifier.system is always case sensitive.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example	General: http://www.acme.com/identifiers/patient
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Patient.identifier:MedicaidIdentifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short	The value that is unique within the system.
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 123456
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Patient.identifier:MR
Slice Name	MR
Definition	An identifier for this patient.
Short	An identifier for this patient
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..*
Type	Identifier
Is Modifier	false
Must Support	true
Summary	true
Requirements	Patients are almost always assigned specific numerical identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. Patient.identifier:MR.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
154. Patient.identifier:MR.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.identifier.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
156. Patient.identifier:MR.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
158. Patient.identifier:MR.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Patient.identifier:MR.use
Definition	The purpose of this identifier.
Short	usual \| official \| temp \| secondary \| old (If known)
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control	0..1
Binding	The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1`) Identifies the purpose for this identifier, if known .
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Patient.identifier:MR.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short	Description of identifier
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control	10..1
Binding	Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type`) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Patient.identifier:MR.type.coding
Definition	A reference to a code defined by a terminology system.
Short	Code defined by a terminology system
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control	10..1*
Type	Coding
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Patient.identifier:MR.type.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Short	Identity of the terminology system
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Patient.identifier:MR.type.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short	Symbol in syntax defined by the system
Control	10..1
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to refer to a particular code in the system.
Fixed Value	`MR`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Patient.identifier:MR.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short	The namespace for the identifier value
Comments	Identifier.system is always case sensitive.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example	General: http://www.acme.com/identifiers/patient
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Patient.identifier:MR.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short	The value that is unique within the system.
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 123456
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Patient.identifier:SSNIdentifier
Slice Name	SSNIdentifier
Definition	An identifier for this patient.
Short	An identifier for this patient
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1*
Type	Identifier
Is Modifier	false
Must Support	true
Summary	true
Requirements	Patients are almost always assigned specific numerical identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
176. Patient.identifier:SSNIdentifier.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
178. Patient.identifier:SSNIdentifier.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.identifier.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
180. Patient.identifier:SSNIdentifier.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
182. Patient.identifier:SSNIdentifier.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Patient.identifier:SSNIdentifier.use
Definition	The purpose of this identifier.
Short	usual \| official \| temp \| secondary \| old (If known)
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control	0..1
Binding	The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1`) Identifies the purpose for this identifier, if known .
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Patient.identifier:SSNIdentifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short	Description of identifier
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control	10..1
Binding	Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type`) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Patient.identifier:SSNIdentifier.type.coding
Definition	A reference to a code defined by a terminology system.
Short	Code defined by a terminology system
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control	10..1*
Type	Coding
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. Patient.identifier:SSNIdentifier.type.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Short	Identity of the terminology system
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Fixed Value	`http://terminology.hl7.org/CodeSystem/v2-0203`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. Patient.identifier:SSNIdentifier.type.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short	Symbol in syntax defined by the system
Control	10..1
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to refer to a particular code in the system.
Fixed Value	`SS`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Patient.identifier:SSNIdentifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short	The namespace for the identifier value
Comments	Identifier.system is always case sensitive.
Control	10..1
Type	uri
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example	General: http://www.acme.com/identifiers/patient
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Patient.identifier:SSNIdentifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short	The value that is unique within the system.
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 123456
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Patient.active
Definition	Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Short	Whether this patient's record is in active use
Comments	If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Control	0..1
Type	boolean
Is Modifier	true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Need to be able to mark a patient record as not to be used because it was created in error.
Meaning if Missing	This resource is generally assumed to be active if no value is provided for the active element
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
200. Patient.name
Definition	A name associated with the individual.
Short	A name associated with the patient
Comments	A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
Control	10..*
Type	HumanName
Is Modifier	false
Must Support	true
Summary	true
Requirements	Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Patient.name.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
204. Patient.name.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.name.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
206. Patient.name.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
208. Patient.name.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
210. Patient.name.use
Definition	Identifies the purpose for this name.
Short	usual \| official \| temp \| nickname \| anonymous \| old \| maiden
Comments	Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/name-use\|4.0.1`) The use of a human name.
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate name for a particular context of use to be selected from among a set of names.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
212. Patient.name.family
Definition	The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Short	Family name (often called 'Surname')
Comments	Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Control	10..1 This element is affected by the following invariants: us-core-6
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	surname
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
214. Patient.name.family.extension:data-absent-reason
Slice Name	data-absent-reason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
216. Patient.name.given
Definition	Given name.
Short	Given names (not always 'first'). Includes middle names
Comments	If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
Control	10..* This element is affected by the following invariants: us-core-6
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	first name, middle name
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Patient.name.given.extension:data-absent-reason
Slice Name	data-absent-reason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
220. Patient.telecom
Definition	A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short	A contact detail for the individual
Comments	A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Control	10..*
Type	ContactPoint
Is Modifier	false
Must Support	true
Summary	true
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing	This element introduces a set of slices on `Patient.telecom`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ system
222. Patient.telecom.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
224. Patient.telecom.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.telecom.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
226. Patient.telecom.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
228. Patient.telecom.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
230. Patient.telecom.system
Definition	Telecommunications form for contact point - what communications system is required to make use of the contact.
Short	phone \| fax \| email \| pager \| url \| sms \| other
Control	10..1 This element is affected by the following invariants: cpt-2
Binding	The codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-system`) Telecommunications form for contact point.
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Patient.telecom.value
Definition	The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Short	The actual contact point details
Comments	Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to support legacy numbers that are not in a tightly controlled format.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Patient.telecom.use
Definition	Identifies the purpose for the contact point.
Short	home \| work \| temp \| old \| mobile - purpose of this contact point
Comments	Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-use`)
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
236. Patient.telecom:phone
Slice Name	phone
Definition	A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short	A contact detail for the individual
Comments	A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Control	0..*
Type	ContactPoint
Is Modifier	false
Must Support	true
Summary	true
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
238. Patient.telecom:phone.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
240. Patient.telecom:phone.system
Definition	Telecommunications form for contact point - what communications system is required to make use of the contact.
Short	phone \| fax \| email \| pager \| url \| sms \| other
Control	10..1 This element is affected by the following invariants: cpt-2
Binding	The codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-system`) Telecommunications form for contact point.
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Fixed Value	`phone`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Patient.telecom:phone.value
Definition	The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Short	The actual contact point details
Comments	Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to support legacy numbers that are not in a tightly controlled format.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Patient.telecom:phone.use
Definition	Identifies the purpose for the contact point.
Short	home \| work \| temp \| old \| mobile - purpose of this contact point
Comments	Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-use`)
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
246. Patient.telecom:email
Slice Name	email
Definition	A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short	A contact detail for the individual
Comments	A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Control	0..*
Type	ContactPoint
Is Modifier	false
Must Support	true
Summary	true
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Patient.telecom:email.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
250. Patient.telecom:email.system
Definition	Telecommunications form for contact point - what communications system is required to make use of the contact.
Short	phone \| fax \| email \| pager \| url \| sms \| other
Control	10..1 This element is affected by the following invariants: cpt-2
Binding	The codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-system`) Telecommunications form for contact point.
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Fixed Value	`email`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
252. Patient.telecom:email.value
Definition	The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Short	The actual contact point details
Comments	Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Control	10..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to support legacy numbers that are not in a tightly controlled format.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. Patient.telecom:email.use
Definition	Identifies the purpose for the contact point.
Short	home \| work \| temp \| old \| mobile - purpose of this contact point
Comments	Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-use`)
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
256. Patient.gender
Definition	Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Short	male \| female \| other \| unknown
Comments	The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.
Control	10..1
Binding	The codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/administrative-gender`)
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Needed for identification of the individual, in combination with (at least) name and birth date.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
258. Patient.gender.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1 This element is affected by the following invariants: ele-1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
260. Patient.gender.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.gender.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
262. Patient.gender.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
264. Patient.gender.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
266. Patient.birthDate
Definition	The date of birth for the individual.
Short	The date of birth for the individual
Comments	At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
Control	10..1
Type	date
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Requirements	Age of the individual drives many clinical processes.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
LOINC Code	21112-8
268. Patient.birthDate.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1 This element is affected by the following invariants: ele-1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
270. Patient.birthDate.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.birthDate.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
272. Patient.birthDate.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
274. Patient.birthDate.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
276. Patient.deceased[x]
Definition	Indicates if the individual is deceased or not.
Short	If patient is deceased, use type dateTime and set to deceased date.Indicates if the individual is deceased or not
Comments	If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control	10..1
Type	Choice of: boolean, dateTime
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Must Support Types	No must-support rules about the choice of types/profiles
Summary	true
Requirements	The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
278. Patient.address
Definition	If the patient is homeless, complete as much address information as possible (city, zip, county, etc.) and use the Characteristics of Home Environment profile in the Social History Section of the eICR Composition to indicate that the patient is homeless. An address for the individual.
Short	An address for the individual
Comments	Patient may have multiple addresses with different uses or applicable periods.
Control	10..*
Type	Address
Is Modifier	false
Must Support	true
Summary	true
Requirements	May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
280. Patient.address.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
282. Patient.address.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.address.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
284. Patient.address.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
286. Patient.address.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
288. Patient.address.use
Definition	The purpose of this address.
Short	home \| work \| temp \| old \| billing - purpose of this address
Comments	Applications can assume that an address is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/address-use\|4.0.1`) The use of an address.
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows an appropriate address to be chosen from a list of many.
Example	General: home
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
290. Patient.address.line
Definition	This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.
Short	Street name, number, direction & P.O. Box etc.
Control	0..*
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Example	General: 137 Nowhere Street
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
292. Patient.address.city
Definition	The name of the city, town, suburb, village or other community or delivery center.
Short	Name of city, town etc.
Control	0..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	Municpality
Example	General: Erewhon
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
294. Patient.address.district
Definition	The name of the administrative area (county).
Short	CountyDistrict name (aka county)
Comments	District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
Control	0..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	County
Example	General: Madison
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
296. Patient.address.state
Definition	Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).
Short	Sub-unit of country (abbreviations ok)
Control	10..1
Binding	Unless not suitable, these codes SHALL be taken from For codes, see USPS Two Letter Alphabetic Codes (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`) Two Letter USPS alphabetic codes.
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	Province, Territory
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
298. Patient.address.state.extension:data-absent-reason
Slice Name	data-absent-reason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
300. Patient.address.postalCode
Definition	A postal code designating a region defined by the postal service.
Short	US Zip CodesPostal code for area
Control	0..1
Type	string
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	true
Alternate Names	Zip, Zip Code
Example	General: 9132
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
302. Patient.address.period
Definition	Time period when address was/is in use.
Short	Time period when address was/is in use
Control	0..1
Type	Period
Is Modifier	false
Must Support	true
Summary	true
Requirements	Allows addresses to be placed in historical context.
Example	General: { "start" : "2010-03-23", "end" : "2010-07-01" }
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
304. Patient.maritalStatus
Definition	This field contains a patient's most recent marital (civil) status.
Short	Marital (civil) status of a patient
Control	0..1
Binding	Unless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status (extensible to `http://hl7.org/fhir/ValueSet/marital-status`) The domestic partnership status of a person.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	false
Requirements	Most, if not all systems capture it.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
306. Patient.contact
Definition	A contact party (e.g. guardian, partner, friend) for the patient.
Short	A contact party (e.g. guardian, partner, friend) for the patient
Comments	Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Control	0..*
Type	BackboneElement
Is Modifier	false
Must Support	true
Summary	false
Requirements	Need to track people you can contact about the patient.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) pat-1: SHALL at least contain a contact's details or a reference to an organization (`name.exists() or telecom.exists() or address.exists() or organization.exists()`) pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
308. Patient.contact.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short	Extensions that cannot be ignored even if unrecognized
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..*
Type	Extension
Is Modifier	true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary	true
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names	extensions, user content, modifiers
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
310. Patient.contact.relationship
Definition	The nature of the relationship between the patient and the contact person.
Short	The kind of relationship
Control	10..1*
Binding	Unless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship (extensible to `http://hl7.org/fhir/ValueSet/patient-contactrelationship`) The nature of the relationship between a patient and a contact person for that patient.
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	false
Requirements	Used to determine which contact person is the most relevant to approach, depending on circumstances.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
312. Patient.contact.name
Definition	A name associated with the contact person.
Short	A name associated with the contact person
Control	10..1
Type	HumanName
Is Modifier	false
Must Support	true
Summary	false
Requirements	Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
314. Patient.contact.name.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
316. Patient.contact.name.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.contact.name.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
318. Patient.contact.name.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
320. Patient.contact.name.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
322. Patient.contact.name.use
Definition	Identifies the purpose for this name.
Short	usual \| official \| temp \| nickname \| anonymous \| old \| maiden
Comments	Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/name-use\|4.0.1`) The use of a human name.
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows the appropriate name for a particular context of use to be selected from among a set of names.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
324. Patient.contact.telecom
Definition	A contact detail for the person, e.g. a telephone number or an email address.
Short	A contact detail for the person
Comments	Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
Control	10..*
Type	ContactPoint
Is Modifier	false
Must Support	true
Summary	false
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
326. Patient.contact.telecom.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
328. Patient.contact.telecom.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.contact.telecom.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
330. Patient.contact.telecom.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
332. Patient.contact.telecom.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
334. Patient.contact.telecom.use
Definition	Identifies the purpose for the contact point.
Short	home \| work \| temp \| old \| mobile - purpose of this contact point
Comments	Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1`) Use of contact point.
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
336. Patient.contact.address
Definition	Address for the contact person.
Short	Address for the contact person
Control	10..1
Type	Address
Is Modifier	false
Must Support	true
Summary	false
Requirements	Need to keep track where the contact person can be contacted per postal mail or visited.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
338. Patient.contact.address.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
340. Patient.contact.address.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.contact.address.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
342. Patient.contact.address.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
344. Patient.contact.address.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
346. Patient.contact.address.use
Definition	The purpose of this address.
Short	home \| work \| temp \| old \| billing - purpose of this address
Comments	Applications can assume that an address is current unless it explicitly says that it is temporary or old.
Control	0..1
Binding	The codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/address-use\|4.0.1`) The use of an address.
Type	code
Is Modifier	true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Requirements	Allows an appropriate address to be chosen from a list of many.
Example	General: home
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
348. Patient.communication
Definition	A language which may be used to communicate with the patient about his or her health.
Short	A language which may be used to communicate with the patient about his or her health
Comments	If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
Control	10..*
Type	BackboneElement
Is Modifier	false
Must Support	true
Summary	false
Requirements	If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
350. Patient.communication.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short	Extensions that cannot be ignored even if unrecognized
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..*
Type	Extension
Is Modifier	true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary	true
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names	extensions, user content, modifiers
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
352. Patient.communication.language
Definition	The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Short	The language which can be used to communicate with the patient about his or her health
Comments	The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Control	1..1
Binding	Unless not suitable, these codes SHALL be taken from The codes SHOULD be taken from Language codes with language and optionally a region modifierhttp://hl7.org/fhir/ValueSet/languages (extensible to `http://hl7.org/fhir/us/core/ValueSet/simple-language`)
Type	CodeableConcept
Is Modifier	false
Must Support	true
Summary	false
Requirements	Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
354. Patient.communication.language.extension:dataAbsentReason
Slice Name	dataAbsentReason
Definition	Provides a reason why the expected value or elements in the element that is extended are missing.
Short	unknown \| asked \| temp \| notasked \| masked \| unsupported \| astext \| error
Control	0..1
Type	Extension(Data Absent Reason) (Extension Type: code)
Is Modifier	false
Must Support	true
Summary	false
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
356. Patient.communication.language.extension:dataAbsentReason.extension
Definition	An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short	ExtensionAdditional content defined by implementations
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..0*
Type	Extension
Is Modifier	false
Summary	false
Alternate Names	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing	This element introduces a set of slices on `Patient.communication.language.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
358. Patient.communication.language.extension:dataAbsentReason.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Short	identifies the meaning of the extension
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control	1..1
Type	uri
Is Modifier	false
XML Format	In the XML format, this property is represented as an attribute.
Summary	false
Fixed Value	`http://hl7.org/fhir/StructureDefinition/data-absent-reason`
360. Patient.communication.language.extension:dataAbsentReason.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short	Value of extension
Control	10..1
Binding	The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason\|4.0.1`) Used to specify why the normally expected content of the data element is missing.
Type	code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note	SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Must Support	true
Summary	false
Fixed Value	`masked`
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
362. Patient.generalPractitioner
Definition	Patient's nominated care provider.
Short	Patient's nominated primary care provider
Comments	This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Control	0..1*
Type	Reference(US Core Practitioner Profile, Organization, Practitioner, PractitionerRole)
Is Modifier	false
Must Support	true
Summary	false
Alternate Names	careProvider
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
364. Patient.managingOrganization
Definition	Organization that is the custodian of the patient record.
Short	Organization that is the custodian of the patient record
Comments	There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
Control	0..1
Type	Reference(Central Cancer Registry Reporting Organization, Organization)
Is Modifier	false
Must Support	true
Summary	true
Requirements	Need to know who recognizes this patient record, manages and updates it.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
366. Patient.link
Definition	Link to another patient resource that concerns the same actual patient.
Short	Link to another patient resource that concerns the same actual person
Comments	There is no assumption that linked patient records have mutual links.
Control	0..*
Type	BackboneElement
Is Modifier	true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
Summary	true
Requirements	There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers.
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
368. Patient.link.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short	Extensions that cannot be ignored even if unrecognized
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control	0..*
Type	Extension
Is Modifier	true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary	true
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names	extensions, user content, modifiers
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
370. Patient.link.other
Definition	The other patient resource that the link refers to.
Short	The other patient or related person resource that the link refers to
Comments	Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Control	1..1
Type	Reference(Patient, RelatedPerson)
Is Modifier	false
Summary	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
372. Patient.link.type
Definition	The type of link between this patient resource and another patient resource.
Short	replaced-by \| replaces \| refer \| seealso
Control	1..1
Binding	The codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type\|4.0.1 (required to `http://hl7.org/fhir/ValueSet/link-type\|4.0.1`) The type of link between this patient resource and another patient resource.
Type	code
Is Modifier	false
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
Summary	true
Invariants	ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Patient

Definition

This profile is based on the Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing a patient for central cancer registry reporting.

Short Central Cancer Registry Reporting Patient

Comments

Control 0..*

Is Modifier false

Must Support false

Summary false

Alternate Names SubjectOfCare Client Resident

Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
us-core-6: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. ((name.family.exists() or name.given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())

2. Patient.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

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 0..1