<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="annotation-reference" />
  <meta>
    <lastUpdated value="2021-11-15T21:30:00.249+02:00" />
  </meta>
  <text>
    <status value="extensions" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top">
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a>
          </th>
          <th style="width: 100px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a>
            <span style="float: right">
              <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
                <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" />
              </a>
            </span>
          </th>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension" title="FHIR resources can be created from unstructured documents using NLP services. For explainability, systems can indicate the start index of the annotated text span in the original document which led to the creation of each resource, as well as its length.">Extension</a>
            <a name="Extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">0</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">*</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Offset and length of annotated text span</td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension">extension</a>
            <a name="Extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">*</span></td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Extension</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:offset" title="Slice offset: The start index in the annotated text span in the original document.">extension:offset</a>
            <a name="Extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Start index.</td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy" />
            <span style="text-decoration:line-through">extension</span>
            <a name="Extension.extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="text-decoration:line-through" />
            <span style="text-decoration:line-through">0</span>
            <span style="text-decoration:line-through">..</span>
            <span style="text-decoration:line-through">0</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:offset.url">url</a>
            <a name="Extension.extension.url"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">1</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">1</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="color: darkgreen">"offset"</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:offset.value[x]">value[x]</a>
            <a name="Extension.extension.value_x_"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/datatypes.html#integer">integer</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Value of extension</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:length" title="Slice length: The length of the annotated text span.">extension:length</a>
            <a name="Extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Span length.</td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy" />
            <span style="text-decoration:line-through">extension</span>
            <a name="Extension.extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="text-decoration:line-through" />
            <span style="text-decoration:line-through">0</span>
            <span style="text-decoration:line-through">..</span>
            <span style="text-decoration:line-through">0</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:length.url">url</a>
            <a name="Extension.extension.url"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">1</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">1</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="color: darkgreen">"length"</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:length.value[x]">value[x]</a>
            <a name="Extension.extension.value_x_"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/datatypes.html#integer">integer</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Value of extension</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:source" title="Slice source: Reference to a source document for this annotation.">extension:source</a>
            <a name="Extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Source reference.</td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy" />
            <span style="text-decoration:line-through">extension</span>
            <a name="Extension.extension.extension"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="text-decoration:line-through" />
            <span style="text-decoration:line-through">0</span>
            <span style="text-decoration:line-through">..</span>
            <span style="text-decoration:line-through">0</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:source.url">url</a>
            <a name="Extension.extension.url"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">1</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">1</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="color: darkgreen">"source"</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.extension:source.value[x]">value[x]</a>
            <a name="Extension.extension.value_x_"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="http://hl7.org/fhir/R4/documentreference.html">DocumentReference</a>)</td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">Value of extension</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy" />
            <a href="StructureDefinition-annotation-reference-definitions.html#Extension.url">url</a>
            <a name="Extension.url"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="opacity: 0.5">1</span>
            <span style="opacity: 0.5">..</span>
            <span style="opacity: 0.5">1</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="color: darkgreen">"http://hl7.org/fhir/StructureDefinition/annotation-reference"</span>
          </td>
        </tr>
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy" />
            <span style="text-decoration:line-through">value[x]</span>
            <a name="Extension.value_x_"></a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <span style="text-decoration:line-through" />
            <span style="text-decoration:line-through">0</span>
            <span style="text-decoration:line-through">..</span>
            <span style="text-decoration:line-through">0</span>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy" />
        </tr>
        <tr>
          <td colspan="5" class="hierarchy">
            <br />
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
              <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" /> Documentation for this format</a>
          </td>
        </tr>
      </table>
    </div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/annotation-reference" />
  <version value="0.1.0" />
  <name value="AnnotationReference" />
  <status value="draft" />
  <date value="2021-11-30T19:21:03+02:00" />
  <publisher value="Microsoft" />
  <contact>
    <name value="Microsoft" />
    <telecom>
      <system value="url" />
      <value value="http://www.microsoft.com" />
    </telecom>
  </contact>
  <contact>
    <name value="Guy Becker" />
    <telecom>
      <system value="email" />
      <value value="guy.becker@microsoft.com" />
      <use value="work" />
    </telecom>
  </contact>
  <description value="FHIR resources can be created from unstructured documents using NLP services. For explainability, systems can indicate the start index of the annotated text span in the original document which led to the creation of each resource, as well as its length." />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="complex-type" />
  <abstract value="false" />
  <context>
    <type value="element" />
    <expression value="Resource" />
  </context>
  <context>
    <type value="element" />
    <expression value="Element" />
  </context>
  <type value="Extension" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Extension">
      <path value="Extension" />
      <short value="Offset and length of annotated text span" />
      <definition value="FHIR resources can be created from unstructured documents using NLP services. For explainability, systems can indicate the start index of the annotated text span in the original document which led to the creation of each resource, as well as its length." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.id">
      <path value="Extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="1" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:offset">
      <path value="Extension.extension" />
      <sliceName value="offset" />
      <short value="Start index." />
      <definition value="The start index in the annotated text span in the original document." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:offset.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:offset.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:offset.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="offset" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:offset.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:length">
      <path value="Extension.extension" />
      <sliceName value="length" />
      <short value="Span length." />
      <definition value="The length of the annotated text span." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:length.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:length.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:length.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="length" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:length.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:source">
      <path value="Extension.extension" />
      <sliceName value="source" />
      <short value="Source reference." />
      <definition value="Reference to a source document for this annotation." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:source.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:source.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:source.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="source" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:source.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/annotation-reference" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="canonical" />
      </type>
      <type>
        <code value="code" />
      </type>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="id" />
      </type>
      <type>
        <code value="instant" />
      </type>
      <type>
        <code value="integer" />
      </type>
      <type>
        <code value="markdown" />
      </type>
      <type>
        <code value="oid" />
      </type>
      <type>
        <code value="positiveInt" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="unsignedInt" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="url" />
      </type>
      <type>
        <code value="uuid" />
      </type>
      <type>
        <code value="Address" />
      </type>
      <type>
        <code value="Age" />
      </type>
      <type>
        <code value="Annotation" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="ContactPoint" />
      </type>
      <type>
        <code value="Count" />
      </type>
      <type>
        <code value="Distance" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="HumanName" />
      </type>
      <type>
        <code value="Identifier" />
      </type>
      <type>
        <code value="Money" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Reference" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Signature" />
      </type>
      <type>
        <code value="Timing" />
      </type>
      <type>
        <code value="ContactDetail" />
      </type>
      <type>
        <code value="Contributor" />
      </type>
      <type>
        <code value="DataRequirement" />
      </type>
      <type>
        <code value="Expression" />
      </type>
      <type>
        <code value="ParameterDefinition" />
      </type>
      <type>
        <code value="RelatedArtifact" />
      </type>
      <type>
        <code value="TriggerDefinition" />
      </type>
      <type>
        <code value="UsageContext" />
      </type>
      <type>
        <code value="Dosage" />
      </type>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Extension">
      <path value="Extension" />
      <short value="Offset and length of annotated text span" />
      <definition value="FHIR resources can be created from unstructured documents using NLP services. For explainability, systems can indicate the start index of the annotated text span in the original document which led to the creation of each resource, as well as its length." />
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
      <min value="1" />
    </element>
    <element id="Extension.extension:offset">
      <path value="Extension.extension" />
      <sliceName value="offset" />
      <short value="Start index." />
      <definition value="The start index in the annotated text span in the original document." />
      <min value="1" />
      <max value="1" />
    </element>
    <element id="Extension.extension:offset.extension">
      <path value="Extension.extension.extension" />
      <max value="0" />
    </element>
    <element id="Extension.extension:offset.url">
      <path value="Extension.extension.url" />
      <fixedUri value="offset" />
    </element>
    <element id="Extension.extension:offset.value[x]">
      <path value="Extension.extension.value[x]" />
      <min value="1" />
      <type>
        <code value="integer" />
      </type>
    </element>
    <element id="Extension.extension:length">
      <path value="Extension.extension" />
      <sliceName value="length" />
      <short value="Span length." />
      <definition value="The length of the annotated text span." />
      <min value="0" />
      <max value="1" />
    </element>
    <element id="Extension.extension:length.extension">
      <path value="Extension.extension.extension" />
      <max value="0" />
    </element>
    <element id="Extension.extension:length.url">
      <path value="Extension.extension.url" />
      <fixedUri value="length" />
    </element>
    <element id="Extension.extension:length.value[x]">
      <path value="Extension.extension.value[x]" />
      <min value="1" />
      <type>
        <code value="integer" />
      </type>
    </element>
    <element id="Extension.extension:source">
      <path value="Extension.extension" />
      <sliceName value="source" />
      <short value="Source reference." />
      <definition value="Reference to a source document for this annotation." />
      <min value="0" />
      <max value="1" />
    </element>
    <element id="Extension.extension:source.extension">
      <path value="Extension.extension.extension" />
      <max value="0" />
    </element>
    <element id="Extension.extension:source.url">
      <path value="Extension.extension.url" />
      <fixedUri value="source" />
    </element>
    <element id="Extension.extension:source.value[x]">
      <path value="Extension.extension.value[x]" />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
      </type>
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/annotation-reference" />
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <max value="0" />
    </element>
  </differential>
</StructureDefinition>