# hl7.fhir.us.davinci-pdex 2.0.0 → 2.1.0 — version-difference evidence pack

The quietest element-level pair at this scale — 63 requirement changes across 25 shared profiles — while still adding 12 profiles outright.

This pack is the downloadable form of the public report at `/ig-gap/davinci-pdex-2-0-0-to-2-1-0`. It is per-pair and carries public content only; the cross-pair rollup and arbitrary-pair export remain a separate, gated capability (IG-115 / Suite B).

## Inputs

| Side | Package | sha256 |
|---|---|---|
| Baseline | `hl7.fhir.us.davinci-pdex#2.0.0` | `d4b7a63134e0ccccfbdd22e5dafb958349a0f3393a186bce605f2d55135646ce` |
| Target | `hl7.fhir.us.davinci-pdex#2.1.0` | `da9e8b3a1e702e911a4473545e22e753d3219d2374ddd7889994ae0e38929571` |

Engines: comparison 1.1.0 · normalization 1.6.0 · schema v3 · generator 1.3.0 · inputs hash `f6e36045a4a74fc49bd6e327dab8a115`

These two archives, identified by SHA-256, are the complete input. Anyone can fetch them and confirm they are looking at the same bytes this analysis read. The analysis itself is ImOnFHIR's.

There is deliberately no generation timestamp: the report is a pure function of the two archives, so the digests date it better than a clock would.

## The shape of the change

63 element-level requirement changes, each graded to exactly one tier — every count in this pack is complete, computed over the full change set.

| Tier | Count |
|---|---|
| Critical | 1 |
| Warning | 42 |
| Unspecified | 0 |
| Informational | 20 |
| **Total** | **63** |

### Read the element counts as a floor

12 profiles exist only in 2.1.0, and 1 only in 2.0.0. Those have no counterpart to compare against, so they contribute no element-level rows — the element comparison covers the 25 profiles present in both versions. Neither number is a total on its own.

The 100 mandatory or must-support elements attributed to added profiles are counted from each profile’s effective element list; where a profile ships no snapshot that list is reconstructed by merging its differential onto its base, so treat the figure as indicative rather than audited.

## Where the change concentrates

Most breaking changes (absolute critical count):

- `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense` — 1 critical of 16 changes

Most sharply changed (critical share; profiles with at least 5 changes — the floor keeps one-change profiles from scoring 100%):

- `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense` — 6% of 16 changes critical

## The other planes

| Plane | Changes | Highest severity present |
|---|---|---|
| Operations | 1 | informational |
| Value sets | 27 | warning |
| Capability statements | 16 | warning |

## Profile coverage

Compared in both versions: 25 · added in target: 12 · removed from baseline: 1

- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provider-group`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-out`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provider-consent`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-when-adjudicated`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-members-opted-out`
- PROFILE_REMOVED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-endpoint-connection-type-version`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-last-typefilter`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-member-no-match-group`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-last-transmission`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-member-match-group`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-last-types`

## Changes by effect

| Effect | Count |
|---|---|
| binding added | 1 |
| binding strength changed | 1 |
| cardinality expanded | 3 |
| invariant added | 5 |
| invariant removed | 1 |
| new support expectation | 13 |
| profile inheritance changed | 1 |
| slice added | 15 |
| slice cardinality changed | 3 |
| support expectation removed | 2 |
| target profile narrowed | 1 |
| type expanded | 1 |
| valueset reference changed | 16 |

## Sampled evidence rows

Every count above is complete. The rows below are a bounded, deterministic sample of 40 (23 further changes are counted above but not sampled here), chosen so every kind of change and the most-affected profiles are each represented. Each row carries its stable change id — cite the id, not the prose; the id survives regeneration, the prose may not.

- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.context||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.context` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Encounter","http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"] → ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter","http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"]
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-identifier-status|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-identifier-status`
  - element: `Extension.value[x]` · valueset reference changed · warning
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/IdentifierStatusVS"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/IdentifierStatusVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-bundle|Bundle.type||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-bundle`
  - element: `Bundle.type` · valueset reference changed · warning
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/BundleTypeVS"} → {"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/bundle-type"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-endpoint|Endpoint.payloadMimeType||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-endpoint`
  - element: `Endpoint.payloadMimeType` · valueset reference changed · warning
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/EndpointFhirMimeTypeVS"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/EndpointFhirMimeTypeVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|CLIA|INVARIANT|us-core-18|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: CLIA) · invariant added · warning
  - — → {"key":"us-core-18","severity":"error","human":"CLIA number must be 10 digits with a letter \"D\" in third position","expression":"value.matches('^[0-9]{2}D[0-9]{7}$')","xpath":"f:value/f:matches(value,/^[0-9]{2}D[0-9]{7}$/)","source":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|CLIA|MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: CLIA) · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|NAIC|SLICING|NAIC|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: NAIC) · slice added · warning
  - — → {"sliceName":"NAIC","min":0,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|NPI|INVARIANT|us-core-16|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: NPI) · invariant added · warning
  - — → {"key":"us-core-16","severity":"error","human":"NPI must be 10 digits","expression":"value.matches('^[0-9]{10}$')","xpath":"f:value/f:matches(value,/^[0-9]{10}$/)"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|NPI|INVARIANT|us-core-17|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: NPI) · invariant added · warning
  - — → {"key":"us-core-17","severity":"error","human":"NPI check digit must be valid (Luhn algorithm check)","expression":"(((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.telecom.value||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.telecom.value` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.authorizingPrescription||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.authorizingPrescription` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.context||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.context` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.dosageInstruction||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.dosageInstruction` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.medication[x]|medicationCodeableConcept|MUST_SUPPORT||medicationCodeableConcept:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.medication[x]` (slice: medicationCodeableConcept) · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.medication[x]||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.medication[x]` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.performer.actor||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.performer.actor` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.performer||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.performer` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.quantity||BINDING||:BINDING_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.quantity` · binding added · warning
  - — → {"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet","valueCanonical":"http://hl7.org/fhir/ValueSet/ucum-units"}],"strength":"preferred","valueSet":"http://hl7.org/fhir/ValueSet/ucum-common"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.quantity||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.quantity` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.type||BINDING_STRENGTH||:BINDING_STRENGTH_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.type` · binding strength changed · warning
  - {"strength":"example","valueSet":"http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"} → {"strength":"required","valueSet":"http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.type||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.type` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense.whenHandedOver||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense.whenHandedOver` · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense||INVARIANT|us-core-20|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense` · invariant added · warning
  - — → {"key":"us-core-20","severity":"error","human":"whenHandedOver SHALL be present if the status is \"completed\"","expression":"status='completed' implies whenHandedOver.exists()","source":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense|MedicationDispense||PROFILE_INHERITANCE||:PROFILE_INHERITANCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense`
  - element: `MedicationDispense` · profile inheritance changed · warning
  - http://hl7.org/fhir/StructureDefinition/MedicationDispense → http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.adjudication.category|adjudicationamounttype|MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.adjudication.category` (slice: adjudicationamounttype) · new support expectation · warning
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.adjudication.extension|adjudicationActionDate|SLICING|adjudicationActionDate|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.adjudication.extension` (slice: adjudicationActionDate) · slice added · warning
  - — → {"sliceName":"adjudicationActionDate","min":0,"max":"1"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.adjudication.extension|adjudicationamounttype/adjudicationActionDate|SLICING|adjudicationActionDate|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.adjudication.extension` (slices: adjudicationamounttype › adjudicationActionDate) · slice added · warning
  - — → {"sliceName":"adjudicationActionDate","min":0,"max":"1"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance|Provenance.agent||INVARIANT|provenance-1|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance`
  - element: `Provenance.agent` · invariant added · warning
  - — → {"key":"provenance-1","severity":"error","human":"onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device","expression":"who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()","source":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|CLIA|MAX_CARDINALITY||:CARDINALITY_EXPANDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: CLIA) · cardinality expanded · informational
  - 1 → *
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization|Organization.identifier|CLIA|SLICE_CARDINALITY|CLIA|:SLICE_CARDINALITY_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/mtls-organization`
  - element: `Organization.identifier` (slice: CLIA) · slice cardinality changed · informational
  - {"min":0,"max":"1"} → {"min":0,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.adjudication|denialreason|TYPE||:TYPE_EXPANDED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.adjudication` (slice: denialreason) · type expanded · informational
  - [] → ["BackboneElement"]
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.item.adjudication.value|consumedunits|MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.item.adjudication.value` (slice: consumedunits) · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization|ExplanationOfBenefit.item.adjudication|consumedunits|MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-priorauthorization`
  - element: `ExplanationOfBenefit.item.adjudication` (slice: consumedunits) · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-associatedServers|Extension.extension.value[x]|associatedServersType|VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-associatedServers`
  - element: `Extension.extension.value[x]` (slice: associatedServersType) · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/NdhAssociatedServersTypeVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/NdhAssociatedServersTypeVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-dynamicRegistration|Extension.extension.value[x]|trustProfile|VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-dynamicRegistration`
  - element: `Extension.extension.value[x]` (slice: trustProfile) · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/TrustProfileVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/TrustProfileVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-endpoint-usecase|Extension.extension.value[x]|endpointUsecasetype|VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-endpoint-usecase`
  - element: `Extension.extension.value[x]` (slice: endpointUsecasetype) · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/NdhFhirEndpointUseCaseVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/NdhFhirEndpointUseCaseVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-endpointAccessControlMechanism|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-endpointAccessControlMechanism`
  - element: `Extension.value[x]` · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/EndpointAccessControlMechanismVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/EndpointAccessControlMechanismVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-secureExchangeArtifacts|Extension.extension.value[x]|secureExchangeArtifactsType|VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-secureExchangeArtifacts`
  - element: `Extension.extension.value[x]` (slice: secureExchangeArtifactsType) · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/NdhSecureExchangeArtifactsVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/NdhSecureExchangeArtifactsVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-verification-status|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-verification-status`
  - element: `Extension.value[x]` · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/NdhVerificationStatusVS"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/ndh/ValueSet/NdhVerificationStatusVS"}
- `req:http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-mtls-signedobject-extension|Extension.extension.value[x]|ObjectType|VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-mtls-signedobject-extension`
  - element: `Extension.extension.value[x]` (slice: ObjectType) · valueset reference changed · informational
  - {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/MtlsObjectType"} → {"strength":"extensible","valueSet":"http://hl7.org/fhir/us/davinci-pdex/ValueSet/MtlsObjectTypeVS"}

## Where rules we track mention this guide

Context only, quoted from our mandate register. None of it changes the comparison above, which depends on the two packages and nothing else.

- CMS-0057-F (by 2027-01-01) — register records a recommended version of `2.1.0` — compliance 2027-01-01 — https://www.cms.gov/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f

## Who maintains this guide, per our register

Where standards work on this guide happens — the room a ballot comment or a question should go to. Quoted from our workgroup register; sourced from the guide's own published footer attribution.

- HL7 International / Financial Management (owner) — https://www.hl7.org/Special/committees/fm · https://hl7.org/fhir/us/davinci-pas/en/index.html — reviewed 2026-07-26

## What this pack is not

Not a compliance assessment. The comparison carries no deadline and renders no verdict about any organization or implementation. Observed validator differences are not automatic proof of official IG requirement changes.