ESMD FHIR Implementation Guide
1.0.0 - esmd

ESMD FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: EsmdListSubmissionSet - Detailed Descriptions

Draft as of 2024-02-25

Definitions for the Esmd-ListSubmissionSet resource profile.

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

0. List
Definition

A list is a curated collection of resources.

ShortA list is a curated collection of resources
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesCollection, WorkingList, Organizer
Invariantsdom-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())
lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
2. List.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta(esMD Meta)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. List.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control10..*
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on List.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 6. List.meta.profile:esmdlistsubmissionset
    Slice Nameesmdlistsubmissionset
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control10..1*
    Typecanonical(StructureDefinition)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-ListSubmissionSet
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. List.meta.security
    Definition

    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

    ShortSecurity Labels applied to this resource
    Comments

    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control10..*
    BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

    Security Labels from the Healthcare Privacy and Security Classification System.

    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-esmd-meta-security-01: esMD supports only V security code (code.exists() implies (code = 'V' or code = 'HTEST'))
    10. List.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.

    ShortA 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.

    Control0..1
    Typeuri
    Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. List.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.

    ShortExtensionAdditional 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.

    Control50..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 14. List.extension:organizationId
      Slice NameorganizationId
      Definition

      Organization ID.

      ShortOrganization ID
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(HIH Organization ID) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-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())
      16. List.extension:organizationId.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.

      ShortExtensionAdditional 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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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())
      SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 18. List.extension:organizationId.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies 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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
        20. List.extension:organizationId.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control10..1
        Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        esmd-oid-format-check: Invalid OrganizationId format. (value.exists() and value.matches('^(urn:oid:)([1-9][0-9]*(.[0-9]+)*)$'))
        22. List.extension:intendedRecipient
        Slice NameintendedRecipient
        Definition

        Intended Recipient ID.

        ShortIntended Recipient ID
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(esMD Intended Recipient OID) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        24. List.extension:linesOfBusinessId
        Slice NamelinesOfBusinessId
        Definition

        esMD support Lines of Business.

        ShortesMD support Lines of Business
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(esMD support Lines of Bunsiness Identification Number) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        26. List.extension:claimId
        Slice NameclaimId
        Definition

        Claim Identifier.

        ShortClaim Identifier
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ESMD Claim ID) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        28. List.extension:caseId
        Slice NamecaseId
        Definition

        Case Identifier.

        ShortCase Identifier
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ESMD Case ID) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        30. List.extension:splitNumber
        Slice NamesplitNumber
        Definition

        Split Number.

        ShortSplit Number
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ESMD Split Number) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        32. List.extension:attachmentControlNumber
        Slice NameattachmentControlNumber
        Definition

        Attachment Control Number.

        ShortAttachment Control Number
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ESMD Attachment Control Number of the SubmissionSet) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        34. List.extension:attachmentControlNumber.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.

        ShortExtensionAdditional 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.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-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())
        SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 36. List.extension:attachmentControlNumber.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies 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.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-AttachmentControlNumber
          38. List.extension:attachmentControlNumber.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          esmd-acn-1: ACN is optional element, if ACN is present, then length should be between 1 and 80 characters. (value.exists() and value.matches('^[A-Za-z0-9-]{1,40}$'))
          40. List.extension:responseTypeCategory
          Slice NameresponseTypeCategory
          Definition

          Response Type Category.

          ShortResponse Type Category
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(ESMD Response Type Category) (Extension Type: string)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-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())
          42. List.extension:responseTypeCategory.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.

          ShortExtensionAdditional 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.

          Control0..0*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-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())
          SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 44. List.extension:responseTypeCategory.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies 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.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ResponseTypeCategory
            46. List.extension:responseTypeCategory.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            esmd-rtc-1: Response Type Category is optional element, if RTC is present, then length should be between 1 and 100 characters. (value.exists() and value.matches('^.{1,100}$'))
            48. List.extension:uniqueId
            Slice NameuniqueId
            Definition

            Transaction Unique ID.

            ShortTransaction Unique ID
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(esMD Unique ID) (Extension Type: string)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-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())
            50. List.extension:uniqueId.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.

            ShortExtensionAdditional 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.

            Control0..0*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-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())
            SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 52. List.extension:uniqueId.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies 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.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-UniqueId
              54. List.extension:uniqueId.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control10..1
              Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              esmd-uid-1: UniqueId must be a required element and its length should be less than or equal to 64 characters. (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
              56. List.extension:npi
              Slice Namenpi
              Definition

              Provider ID.

              ShortProvider ID
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeExtension(esMD Provider NPI) (Extension Type: string)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-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())
              58. List.extension:npi.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.

              ShortExtensionAdditional 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.

              Control0..0*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-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())
              SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 60. List.extension:npi.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies 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.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
                62. List.extension:npi.value[x]
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control10..1
                Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                esmd-npi-1: NPI should be 10 numeric (value.exists() and value.matches('^[0-9]{10}$'))
                64. List.extension:parentUniqueId
                Slice NameparentUniqueId
                Definition

                Transaction Parent Unique ID.

                ShortTransaction Parent Unique ID
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(esMD Parent Unique ID) (Extension Type: string)
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-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())
                66. List.extension:parentUniqueId.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.

                ShortExtensionAdditional 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.

                Control0..0*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-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())
                SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 68. List.extension:parentUniqueId.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies 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.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ParentUniqueId
                  70. List.extension:parentUniqueId.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control10..1
                  This element is affected by the following invariants: esmd-puid-1
                  Typestring, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  esmd-puid-1: ParentUniqueId must be required element and length should be lessthan 64 character (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
                  72. List.modifierExtension
                  Definition

                  An Extension


                  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).

                  ShortExtensionExtensions 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.

                  Control0..0*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  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 Namesextensions, user content
                  Invariantsele-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())
                  74. List.identifier
                  Definition

                  Identifier for the List assigned for business purposes outside the context of FHIR.

                  ShortBusiness identifier
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. List.status
                  Definition

                  Indicates the current state of this list.

                  Shortcurrent | retired | entered-in-error
                  Comments

                  This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                  Control1..1
                  BindingThe codes SHALL be taken from ListStatushttp://hl7.org/fhir/ValueSet/list-status|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/list-status|4.0.1)

                  The current state of the list.

                  Typecode
                  Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Pattern Valuecurrent
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. List.mode
                  Definition

                  How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                  Shortworking | snapshot | changes
                  Comments

                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                  Control1..1
                  BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                  The processing mode that applies to this list.

                  Typecode
                  Is Modifiertrue because If set to "changes", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Lists are used in various ways, and it must be known in what way it is safe to use them.

                  Pattern Valueworking
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  80. List.title
                  Definition

                  A label for the list assigned by the author.

                  ShortDescriptive name for the list
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Allows customization beyond just the code identifying the kind of list.

                  Example<br/><b>General</b>:Dr. Jane's Patients
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. List.code
                  Definition

                  This code defines the purpose of the list - why it was created.

                  ShortWhat the purpose of this list is
                  Comments

                  If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.

                  Control0..1
                  BindingFor example codes, see ExampleUseCodesForListhttp://hl7.org/fhir/ValueSet/list-example-codes
                  (example to http://hl7.org/fhir/ValueSet/list-example-codes)

                  What the purpose of a list is.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. List.subject
                  Definition

                  The common subject (or patient) of the resources that are in the list if there is one.

                  ShortIf all resources have the same subject
                  Comments

                  Some purely arbitrary lists do not have a common subject, so this is optional.

                  Control0..1
                  TypeReference(Patient, Group, Device, Location)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  The primary purpose of listing the subject explicitly is to help with finding the right list.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. List.encounter
                  Definition

                  The encounter that is the context in which this list was created.

                  ShortContext in which list created
                  Control0..01
                  TypeReference(Encounter)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. List.date
                  Definition

                  The date that the list was prepared.

                  ShortWhen the list was prepared
                  Comments

                  The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

                  Control10..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Identifies how current the list is which affects relevance.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. List.source
                  Definition

                  The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

                  ShortWho and/or what defined the list contents (aka Author)
                  Comments

                  The primary source is the entity that made the decisions what items are in the list. This may be software or user.

                  Control0..1
                  TypeReference(Practitioner, PractitionerRole, Patient, Device)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows follow-up as well as context.

                  Alternate NamesAuthor
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. List.orderedBy
                  Definition

                  What order applies to the items in the list.

                  ShortWhat order the list has
                  Comments

                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                  Control0..01
                  BindingThe codes SHOULD be taken from ListOrderCodeshttp://hl7.org/fhir/ValueSet/list-order
                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                  What order applies to the items in a list.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. List.note
                  Definition

                  Comments that apply to the overall list.

                  ShortComments about the list
                  Control0..1*
                  TypeAnnotation
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. List.entry
                  Definition

                  Entries in this list.

                  ShortEntries in the list
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control10..*
                  This element is affected by the following invariants: lst-1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. List.entry.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).

                  ShortExtensions 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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  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 Namesextensions, user content, modifiers
                  Invariantsele-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())
                  100. List.entry.flag
                  Definition

                  The flag allows the system constructing the list to indicate the role and significance of the item in the list.

                  ShortStatus/Workflow information about this item
                  Comments

                  The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

                  Control0..01
                  BindingFor example codes, see PatientMedicineChangeTypeshttp://hl7.org/fhir/ValueSet/list-item-flag
                  (example to http://hl7.org/fhir/ValueSet/list-item-flag)

                  Codes that provide further information about the reason and meaning of the item in the list.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. List.entry.deleted
                  Definition

                  True if this item is marked as deleted in the list.

                  ShortIf this item is actually marked as deleted
                  Comments

                  If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

                  Control0..01
                  This element is affected by the following invariants: lst-2
                  Typeboolean
                  Is Modifiertrue because If deleted is true, then the item included in the list isn't actually part of the list anymore
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

                  Meaning if MissingList items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. List.entry.date
                  Definition

                  When this item was added to the list.

                  ShortWhen item added to list
                  Control0..01
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  The date may be significant for understanding the meaning of items in a working list.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. List.entry.item
                  Definition

                  A reference to the actual resource from which data was derived.

                  ShortActual entry
                  Control1..1
                  TypeReference(Esmd Document Reference Profile, Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. List.emptyReason
                  Definition

                  If the list is empty, why the list is empty.

                  ShortWhy list is empty
                  Comments

                  The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                  Control0..01
                  This element is affected by the following invariants: lst-1
                  BindingThe codes SHOULD be taken from ListEmptyReasonshttp://hl7.org/fhir/ValueSet/list-empty-reason
                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                  If a list is empty, why it is empty.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                  Invariantsele-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 found here

                  0. List
                  2. List.meta
                  TypeMeta(esMD Meta)
                  Must Supporttrue
                  4. List.meta.profile
                  6. List.meta.profile:esmdlistsubmissionset
                  Slice Nameesmdlistsubmissionset
                  Control1..1
                  Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-ListSubmissionSet
                  8. List.meta.security
                  Control1..?
                  Must Supporttrue
                  10. List.extension
                  Control5..?
                  SlicingThis element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 12. List.extension:organizationId
                    Slice NameorganizationId
                    Definition

                    Organization ID.

                    ShortOrganization ID
                    Control1..1
                    TypeExtension(HIH Organization ID) (Extension Type: string)
                    Must Supporttrue
                    14. List.extension:organizationId.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-oid-format-check: Invalid OrganizationId format. (value.exists() and value.matches('^(urn:oid:)([1-9][0-9]*(.[0-9]+)*)$'))
                    16. List.extension:intendedRecipient
                    Slice NameintendedRecipient
                    Definition

                    Intended Recipient ID.

                    ShortIntended Recipient ID
                    Control1..1
                    TypeExtension(esMD Intended Recipient OID) (Extension Type: code)
                    Must Supporttrue
                    18. List.extension:linesOfBusinessId
                    Slice NamelinesOfBusinessId
                    Definition

                    esMD support Lines of Business.

                    ShortesMD support Lines of Business
                    Control1..1
                    TypeExtension(esMD support Lines of Bunsiness Identification Number) (Extension Type: code)
                    Must Supporttrue
                    20. List.extension:claimId
                    Slice NameclaimId
                    Definition

                    Claim Identifier.

                    ShortClaim Identifier
                    Control0..1
                    TypeExtension(ESMD Claim ID) (Extension Type: string)
                    Must Supporttrue
                    22. List.extension:caseId
                    Slice NamecaseId
                    Definition

                    Case Identifier.

                    ShortCase Identifier
                    Control0..1
                    TypeExtension(ESMD Case ID) (Extension Type: string)
                    Must Supporttrue
                    24. List.extension:splitNumber
                    Slice NamesplitNumber
                    Definition

                    Split Number.

                    ShortSplit Number
                    Control0..1
                    TypeExtension(ESMD Split Number) (Extension Type: string)
                    Must Supporttrue
                    26. List.extension:attachmentControlNumber
                    Slice NameattachmentControlNumber
                    Definition

                    Attachment Control Number.

                    ShortAttachment Control Number
                    Control0..1
                    TypeExtension(ESMD Attachment Control Number of the SubmissionSet) (Extension Type: string)
                    Must Supporttrue
                    28. List.extension:attachmentControlNumber.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-acn-1: ACN is optional element, if ACN is present, then length should be between 1 and 80 characters. (value.exists() and value.matches('^[A-Za-z0-9-]{1,40}$'))
                    30. List.extension:responseTypeCategory
                    Slice NameresponseTypeCategory
                    Definition

                    Response Type Category.

                    ShortResponse Type Category
                    Control0..1
                    TypeExtension(ESMD Response Type Category) (Extension Type: string)
                    Must Supporttrue
                    32. List.extension:responseTypeCategory.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-rtc-1: Response Type Category is optional element, if RTC is present, then length should be between 1 and 100 characters. (value.exists() and value.matches('^.{1,100}$'))
                    34. List.extension:uniqueId
                    Slice NameuniqueId
                    Definition

                    Transaction Unique ID.

                    ShortTransaction Unique ID
                    Control1..1
                    TypeExtension(esMD Unique ID) (Extension Type: string)
                    Must Supporttrue
                    36. List.extension:uniqueId.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-uid-1: UniqueId must be a required element and its length should be less than or equal to 64 characters. (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
                    38. List.extension:npi
                    Slice Namenpi
                    Definition

                    Provider ID.

                    ShortProvider ID
                    Control1..1
                    TypeExtension(esMD Provider NPI) (Extension Type: string)
                    Must Supporttrue
                    40. List.extension:npi.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-npi-1: NPI should be 10 numeric (value.exists() and value.matches('^[0-9]{10}$'))
                    42. List.extension:parentUniqueId
                    Slice NameparentUniqueId
                    Definition

                    Transaction Parent Unique ID.

                    ShortTransaction Parent Unique ID
                    Control0..1
                    TypeExtension(esMD Parent Unique ID) (Extension Type: string)
                    Must Supporttrue
                    44. List.extension:parentUniqueId.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Invariantsesmd-puid-1: ParentUniqueId must be required element and length should be lessthan 64 character (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
                    46. List.modifierExtension
                    Control0..0
                    48. List.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    50. List.status
                    Must Supporttrue
                    Pattern Valuecurrent
                    52. List.mode
                    Pattern Valueworking
                    54. List.title
                    56. List.code
                    58. List.subject
                    60. List.encounter
                    Control0..0
                    62. List.date
                    Control1..?
                    Must Supporttrue
                    64. List.source
                    66. List.orderedBy
                    Control0..0
                    68. List.note
                    Control0..1
                    70. List.entry
                    Control1..?
                    72. List.entry.flag
                    Control0..0
                    74. List.entry.deleted
                    Control0..0
                    76. List.entry.date
                    Control0..0
                    78. List.entry.item
                    TypeReference(Esmd Document Reference Profile)
                    80. List.emptyReason
                    Control0..0

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

                    0. List
                    Definition

                    A list is a curated collection of resources.

                    ShortA list is a curated collection of resources
                    Control0..*
                    Is Modifierfalse
                    Summaryfalse
                    Alternate NamesCollection, WorkingList, Organizer
                    Invariantsdom-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())
                    lst-1: A list can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    lst-2: The deleted flag can only be used if the mode of the list is "changes" (mode = 'changes' or entry.deleted.empty())
                    lst-3: An entry date can only be used if the mode of the list is "working" (mode = 'working' or entry.date.empty())
                    2. List.id
                    Definition

                    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                    ShortLogical 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.

                    Control0..1
                    Typeid
                    Is Modifierfalse
                    Summarytrue
                    4. List.meta
                    Definition

                    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                    ShortMetadata about the resource
                    Control0..1
                    TypeMeta(esMD Meta)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    6. List.meta.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    8. List.meta.extension
                    Definition

                    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.

                    ShortAdditional 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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-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())
                    SlicingThis element introduces a set of slices on List.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 10. List.meta.versionId
                      Definition

                      The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                      ShortVersion specific identifier
                      Comments

                      The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                      Control0..1
                      Typeid
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. List.meta.lastUpdated
                      Definition

                      When the resource last changed - e.g. when the version changed.

                      ShortWhen the resource version last changed
                      Comments

                      This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                      Control0..1
                      Typeinstant
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      14. List.meta.source
                      Definition

                      A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                      ShortIdentifies where the resource comes from
                      Comments

                      In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                      This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                      Control0..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      16. List.meta.profile
                      Definition

                      A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                      ShortProfiles this resource claims to conform to
                      Comments

                      It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                      Control1..*
                      Typecanonical(StructureDefinition)
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on List.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ $this
                      • 18. List.meta.profile:esmdlistsubmissionset
                        Slice Nameesmdlistsubmissionset
                        Definition

                        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                        ShortProfiles this resource claims to conform to
                        Comments

                        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                        Control1..1
                        Typecanonical(StructureDefinition)
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-ListSubmissionSet
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        20. List.meta.security
                        Definition

                        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                        ShortSecurity Labels applied to this resource
                        Comments

                        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                        Control1..*
                        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                        Security Labels from the Healthcare Privacy and Security Classification System.

                        TypeCoding
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        inv-esmd-meta-security-01: esMD supports only V security code (code.exists() implies (code = 'V' or code = 'HTEST'))
                        22. List.meta.tag
                        Definition

                        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                        ShortTags applied to this resource
                        Comments

                        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                        Control0..*
                        BindingFor example codes, see CommonTags
                        (example to http://hl7.org/fhir/ValueSet/common-tags)

                        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                        TypeCoding
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        24. List.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.

                        ShortA 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.

                        Control0..1
                        Typeuri
                        Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        26. List.language
                        Definition

                        The base language in which the resource is written.

                        ShortLanguage of the resource content
                        Comments

                        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                        Control0..1
                        BindingThe codes SHOULD be taken from CommonLanguages
                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                        A human language.

                        Additional BindingsPurpose
                        AllLanguagesMax Binding
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        28. List.text
                        Definition

                        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                        ShortText summary of the resource, for human interpretation
                        Comments

                        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                        Control0..1
                        TypeNarrative
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesnarrative, html, xhtml, display
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. List.contained
                        Definition

                        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                        ShortContained, inline Resources
                        Comments

                        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                        Control0..*
                        TypeResource
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesinline resources, anonymous resources, contained resources
                        32. List.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control5..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-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())
                        SlicingThis element introduces a set of slices on List.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 34. List.extension:organizationId
                          Slice NameorganizationId
                          Definition

                          Organization ID.

                          ShortOrganization ID
                          Control1..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(HIH Organization ID) (Extension Type: string)
                          Is Modifierfalse
                          Must Supporttrue
                          Invariantsele-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())
                          36. List.extension:organizationId.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          38. List.extension:organizationId.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..0
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-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())
                          SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 40. List.extension:organizationId.url
                            Definition

                            Source of the definition for the extension code - a logical name or a URL.

                            Shortidentifies 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.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
                            42. List.extension:organizationId.value[x]
                            Definition

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            ShortValue of extension
                            Control1..1
                            Typestring
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            esmd-oid-format-check: Invalid OrganizationId format. (value.exists() and value.matches('^(urn:oid:)([1-9][0-9]*(.[0-9]+)*)$'))
                            44. List.extension:intendedRecipient
                            Slice NameintendedRecipient
                            Definition

                            Intended Recipient ID.

                            ShortIntended Recipient ID
                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(esMD Intended Recipient OID) (Extension Type: code)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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. List.extension:linesOfBusinessId
                            Slice NamelinesOfBusinessId
                            Definition

                            esMD support Lines of Business.

                            ShortesMD support Lines of Business
                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(esMD support Lines of Bunsiness Identification Number) (Extension Type: code)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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())
                            48. List.extension:claimId
                            Slice NameclaimId
                            Definition

                            Claim Identifier.

                            ShortClaim Identifier
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ESMD Claim ID) (Extension Type: string)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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())
                            50. List.extension:caseId
                            Slice NamecaseId
                            Definition

                            Case Identifier.

                            ShortCase Identifier
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ESMD Case ID) (Extension Type: string)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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. List.extension:splitNumber
                            Slice NamesplitNumber
                            Definition

                            Split Number.

                            ShortSplit Number
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ESMD Split Number) (Extension Type: string)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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())
                            54. List.extension:attachmentControlNumber
                            Slice NameattachmentControlNumber
                            Definition

                            Attachment Control Number.

                            ShortAttachment Control Number
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ESMD Attachment Control Number of the SubmissionSet) (Extension Type: string)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-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())
                            56. List.extension:attachmentControlNumber.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            58. List.extension:attachmentControlNumber.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..0
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-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())
                            SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 60. List.extension:attachmentControlNumber.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies 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.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-AttachmentControlNumber
                              62. List.extension:attachmentControlNumber.value[x]
                              Definition

                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                              ShortValue of extension
                              Control1..1
                              Typestring
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              esmd-acn-1: ACN is optional element, if ACN is present, then length should be between 1 and 80 characters. (value.exists() and value.matches('^[A-Za-z0-9-]{1,40}$'))
                              64. List.extension:responseTypeCategory
                              Slice NameresponseTypeCategory
                              Definition

                              Response Type Category.

                              ShortResponse Type Category
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(ESMD Response Type Category) (Extension Type: string)
                              Is Modifierfalse
                              Must Supporttrue
                              Invariantsele-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())
                              66. List.extension:responseTypeCategory.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              68. List.extension:responseTypeCategory.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..0
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-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())
                              SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 70. List.extension:responseTypeCategory.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies 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.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ResponseTypeCategory
                                72. List.extension:responseTypeCategory.value[x]
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control1..1
                                Typestring
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                esmd-rtc-1: Response Type Category is optional element, if RTC is present, then length should be between 1 and 100 characters. (value.exists() and value.matches('^.{1,100}$'))
                                74. List.extension:uniqueId
                                Slice NameuniqueId
                                Definition

                                Transaction Unique ID.

                                ShortTransaction Unique ID
                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(esMD Unique ID) (Extension Type: string)
                                Is Modifierfalse
                                Must Supporttrue
                                Invariantsele-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())
                                76. List.extension:uniqueId.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                78. List.extension:uniqueId.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..0
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-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())
                                SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 80. List.extension:uniqueId.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies 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.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-UniqueId
                                  82. List.extension:uniqueId.value[x]
                                  Definition

                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                  ShortValue of extension
                                  Control1..1
                                  Typestring
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  esmd-uid-1: UniqueId must be a required element and its length should be less than or equal to 64 characters. (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
                                  84. List.extension:npi
                                  Slice Namenpi
                                  Definition

                                  Provider ID.

                                  ShortProvider ID
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(esMD Provider NPI) (Extension Type: string)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Invariantsele-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. List.extension:npi.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  88. List.extension:npi.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..0
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-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())
                                  SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 90. List.extension:npi.url
                                    Definition

                                    Source of the definition for the extension code - a logical name or a URL.

                                    Shortidentifies 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.

                                    Control1..1
                                    Typeuri
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
                                    92. List.extension:npi.value[x]
                                    Definition

                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                    ShortValue of extension
                                    Control1..1
                                    Typestring
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    esmd-npi-1: NPI should be 10 numeric (value.exists() and value.matches('^[0-9]{10}$'))
                                    94. List.extension:parentUniqueId
                                    Slice NameparentUniqueId
                                    Definition

                                    Transaction Parent Unique ID.

                                    ShortTransaction Parent Unique ID
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(esMD Parent Unique ID) (Extension Type: string)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-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())
                                    96. List.extension:parentUniqueId.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    98. List.extension:parentUniqueId.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control0..0
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-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())
                                    SlicingThis element introduces a set of slices on List.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 100. List.extension:parentUniqueId.url
                                      Definition

                                      Source of the definition for the extension code - a logical name or a URL.

                                      Shortidentifies 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.

                                      Control1..1
                                      Typeuri
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      Fixed Valuehttps://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ParentUniqueId
                                      102. List.extension:parentUniqueId.value[x]
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control1..1
                                      This element is affected by the following invariants: esmd-puid-1
                                      Typestring
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      esmd-puid-1: ParentUniqueId must be required element and length should be lessthan 64 character (value.exists() and value.matches('^[A-Za-z0-9_-]{1,64}$'))
                                      104. List.modifierExtension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..0
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                      Summaryfalse
                                      Invariantsele-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. List.identifier
                                      Definition

                                      Identifier for the List assigned for business purposes outside the context of FHIR.

                                      ShortBusiness identifier
                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      108. List.status
                                      Definition

                                      Indicates the current state of this list.

                                      Shortcurrent | retired | entered-in-error
                                      Comments

                                      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                      Control1..1
                                      BindingThe codes SHALL be taken from ListStatus
                                      (required to http://hl7.org/fhir/ValueSet/list-status|4.0.1)

                                      The current state of the list.

                                      Typecode
                                      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Pattern Valuecurrent
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      110. List.mode
                                      Definition

                                      How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                      Shortworking | snapshot | changes
                                      Comments

                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                      Control1..1
                                      BindingThe codes SHALL be taken from ListMode
                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                      The processing mode that applies to this list.

                                      Typecode
                                      Is Modifiertrue because If set to "changes", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Lists are used in various ways, and it must be known in what way it is safe to use them.

                                      Pattern Valueworking
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      112. List.title
                                      Definition

                                      A label for the list assigned by the author.

                                      ShortDescriptive name for the list
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Allows customization beyond just the code identifying the kind of list.

                                      Example<br/><b>General</b>:Dr. Jane's Patients
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      114. List.code
                                      Definition

                                      This code defines the purpose of the list - why it was created.

                                      ShortWhat the purpose of this list is
                                      Comments

                                      If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.

                                      Control0..1
                                      BindingFor example codes, see ExampleUseCodesForList
                                      (example to http://hl7.org/fhir/ValueSet/list-example-codes)

                                      What the purpose of a list is.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      116. List.subject
                                      Definition

                                      The common subject (or patient) of the resources that are in the list if there is one.

                                      ShortIf all resources have the same subject
                                      Comments

                                      Some purely arbitrary lists do not have a common subject, so this is optional.

                                      Control0..1
                                      TypeReference(Patient, Group, Device, Location)
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      The primary purpose of listing the subject explicitly is to help with finding the right list.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      118. List.encounter
                                      Definition

                                      The encounter that is the context in which this list was created.

                                      ShortContext in which list created
                                      Control0..0
                                      TypeReference(Encounter)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      120. List.date
                                      Definition

                                      The date that the list was prepared.

                                      ShortWhen the list was prepared
                                      Comments

                                      The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.

                                      Control1..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Identifies how current the list is which affects relevance.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      122. List.source
                                      Definition

                                      The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

                                      ShortWho and/or what defined the list contents (aka Author)
                                      Comments

                                      The primary source is the entity that made the decisions what items are in the list. This may be software or user.

                                      Control0..1
                                      TypeReference(Practitioner, PractitionerRole, Patient, Device)
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Allows follow-up as well as context.

                                      Alternate NamesAuthor
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      124. List.orderedBy
                                      Definition

                                      What order applies to the items in the list.

                                      ShortWhat order the list has
                                      Comments

                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                      Control0..0
                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                      What order applies to the items in a list.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      126. List.note
                                      Definition

                                      Comments that apply to the overall list.

                                      ShortComments about the list
                                      Control0..1
                                      TypeAnnotation
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      128. List.entry
                                      Definition

                                      Entries in this list.

                                      ShortEntries in the list
                                      Comments

                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                      Control1..*
                                      This element is affected by the following invariants: lst-1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      130. List.entry.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      132. List.entry.extension
                                      Definition

                                      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.

                                      ShortAdditional 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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-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())
                                      134. List.entry.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).

                                      ShortExtensions 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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      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 Namesextensions, user content, modifiers
                                      Invariantsele-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())
                                      136. List.entry.flag
                                      Definition

                                      The flag allows the system constructing the list to indicate the role and significance of the item in the list.

                                      ShortStatus/Workflow information about this item
                                      Comments

                                      The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

                                      Control0..0
                                      BindingFor example codes, see PatientMedicineChangeTypes
                                      (example to http://hl7.org/fhir/ValueSet/list-item-flag)

                                      Codes that provide further information about the reason and meaning of the item in the list.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      138. List.entry.deleted
                                      Definition

                                      True if this item is marked as deleted in the list.

                                      ShortIf this item is actually marked as deleted
                                      Comments

                                      If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

                                      Control0..0
                                      This element is affected by the following invariants: lst-2
                                      Typeboolean
                                      Is Modifiertrue because If deleted is true, then the item included in the list isn't actually part of the list anymore
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

                                      The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

                                      Meaning if MissingList items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      140. List.entry.date
                                      Definition

                                      When this item was added to the list.

                                      ShortWhen item added to list
                                      Control0..0
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

                                      The date may be significant for understanding the meaning of items in a working list.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      142. List.entry.item
                                      Definition

                                      A reference to the actual resource from which data was derived.

                                      ShortActual entry
                                      Control1..1
                                      TypeReference(Esmd Document Reference Profile)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      144. List.emptyReason
                                      Definition

                                      If the list is empty, why the list is empty.

                                      ShortWhy list is empty
                                      Comments

                                      The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                      Control0..0
                                      This element is affected by the following invariants: lst-1
                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                      If a list is empty, why it is empty.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))