From 4916f2b90778acece59cf9f0420ceea934736541 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 12 Aug 2026 14:43:15 -0400
Subject: [PATCH 01/62] WIP of improved CQL Decimal

---
 src/datatypes/datatypes.ts             |   1 +
 src/datatypes/decimal.ts               | 216 ++++++++++++++++++++++++
 src/datatypes/interval.ts              |  16 +-
 src/datatypes/quantity.ts              |  41 +++--
 src/datatypes/uncertainty.ts           |   2 +
 src/elm/aggregate.ts                   |  95 ++++++++---
 src/elm/arithmetic.ts                  | 148 +++++++++++++----
 src/elm/interval.ts                    | 218 ++++++++++++++-----------
 src/elm/literal.ts                     |   3 +-
 src/elm/quantity.ts                    |   4 +-
 src/elm/type.ts                        |  38 +++--
 src/runtime/context.ts                 |   8 +-
 src/util/comparison.ts                 |  14 +-
 src/util/math.ts                       | 100 ++++++------
 src/util/units.ts                      |  11 +-
 test/datatypes/decimal-test.ts         |  41 +++++
 test/datatypes/interval-data.ts        |   3 +-
 test/datatypes/interval-test.ts        |  79 ++++-----
 test/elm/aggregate/aggregate-test.ts   |  49 +++---
 test/elm/arithmetic/arithmetic-test.ts | 123 +++++++-------
 test/elm/convert/convert-test.ts       |  35 ++--
 test/elm/datetime/datetime-test.ts     |   7 +-
 test/elm/instance/instance-test.ts     |   6 +-
 test/elm/interval/interval-test.ts     |  25 +--
 test/elm/literal/literal-test.ts       |   7 +-
 test/elm/message/message-test.ts       |   5 +-
 test/elm/parameters/parameters-test.ts |  15 +-
 test/elm/quantity/quantity-test.ts     |   3 +-
 test/elm/query/query-test.ts           |   5 +-
 test/spec-tests/spec-test.ts           |   3 +
 test/util/math-test.ts                 |  21 +--
 test/util/units-test.ts                |  31 ++--
 32 files changed, 926 insertions(+), 447 deletions(-)
 create mode 100644 src/datatypes/decimal.ts
 create mode 100644 test/datatypes/decimal-test.ts

diff --git a/src/datatypes/datatypes.ts b/src/datatypes/datatypes.ts
index ec689cc88..e36a6000c 100644
--- a/src/datatypes/datatypes.ts
+++ b/src/datatypes/datatypes.ts
@@ -1,4 +1,5 @@
 export * from './bigint';
+export * from './decimal';
 export * from './logic';
 export * from './clinical';
 export * from './uncertainty';
diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
new file mode 100644
index 000000000..815b9fb5a
--- /dev/null
+++ b/src/datatypes/decimal.ts
@@ -0,0 +1,216 @@
+
+
+export type DecimalInput = Decimal | string | number | bigint;
+
+export type DecimalRoundingMode = 'down' | 'half-up' | 'half-even' | 'half-ceil' | 'ceil' | 'floor';
+
+const MIN_FLOAT_PRECISION_VALUE = Math.pow(10, -8);
+
+export class Decimal {
+  public readonly value: number;
+
+  private constructor(value: DecimalInput) {
+    const numericValue = toNumber(value);
+    if (!Number.isFinite(numericValue)) {
+      throw new Error('Cannot create a decimal with a non-finite value');
+    }
+    this.value = numericValue;
+  }
+
+  static from(value: DecimalInput) {
+    return value instanceof Decimal ? value : new Decimal(value);
+  }
+
+  get isDecimal() {
+    return true;
+  }
+
+  add(other: DecimalInput) {
+    return new Decimal(this.value + toNumber(other));
+  }
+
+  subtract(other: DecimalInput) {
+    return new Decimal(this.value - toNumber(other));
+  }
+
+  multiplyBy(other: DecimalInput) {
+    return new Decimal(this.value * toNumber(other));
+  }
+
+  divideBy(other: DecimalInput) {
+    const divisor = toNumber(other);
+    if (divisor === 0) {
+      throw new RangeError('Cannot divide a decimal by zero');
+    }
+    return new Decimal(this.value / divisor);
+  }
+
+  modulo(other: DecimalInput) {
+    const divisor = toNumber(other);
+    if (divisor === 0) {
+      throw new RangeError('Cannot calculate decimal modulo by zero');
+    }
+    return new Decimal(this.value % divisor);
+  }
+
+  compareTo(other: DecimalInput) {
+    const otherValue = toNumber(other);
+    return this.value - otherValue;
+  }
+
+  greaterThan(other: DecimalInput) {
+    return this.compareTo(other) > 0;
+  }
+
+  greaterThanOrEquals(other: DecimalInput) {
+    return this.compareTo(other) >= 0;
+  }
+  
+  lessThan(other: DecimalInput) {
+    return this.compareTo(other) < 0;
+  }
+
+  lessThanOrEquals(other: DecimalInput) {
+    return this.compareTo(other) <= 0;
+  }
+
+  equals(other: DecimalInput) {
+    return this.compareTo(other) === 0;
+  }
+
+  successor() {
+    return new Decimal(this.value + MIN_FLOAT_PRECISION_VALUE);
+  }
+
+  predecessor() {
+    return new Decimal(this.value - MIN_FLOAT_PRECISION_VALUE);
+  }
+
+  negate() {
+    return new Decimal(-this.value);
+  }
+
+  abs() {
+    return new Decimal(Math.abs(this.value));
+  }
+
+  truncate() {
+    return Math.trunc(this.value);
+  }
+
+  ceil() {
+    return Math.ceil(this.value);
+  }
+
+  floor() {
+    return Math.floor(this.value);
+  }
+
+  isInteger() {
+    return Number.isInteger(this.value);
+  }
+
+  round(scale = 0) {
+    return this.setScale(scale, 'half-ceil');
+  }
+
+  power(exponent: DecimalInput) {
+    return new Decimal(Math.pow(this.value, toNumber(exponent)));
+  }
+
+  sqrt() {
+    return new Decimal(Math.sqrt(this.value));
+  }
+
+  ln() {
+    return new Decimal(Math.log(this.value));
+  }
+
+  exp() {
+    return new Decimal(Math.exp(this.value));
+  }
+
+  log(base: DecimalInput) {
+    return this.ln().divideBy(Decimal.from(base).ln());
+  }
+
+  /**
+   * Return a value at the requested number of digits after the decimal point.
+   * `down` truncates toward zero, matching the current ToDecimal behavior.
+   */
+  setScale(scale: number, roundingMode: DecimalRoundingMode = 'down') {
+    if (!Number.isInteger(scale) || scale < 0) {
+      throw new RangeError('Decimal scale must be a non-negative integer');
+    }
+
+    const factor = Math.pow(10, scale);
+    return new Decimal(round(this.value * factor, roundingMode) / factor);
+  }
+
+  toInteger() {
+    return this.truncate();
+  }
+
+  toNumber() {
+    return this.value;
+  }
+
+  toLong() {
+    // TODO: this is wrong
+    return BigInt(this.toNumber());
+  }
+
+  toString() {
+    return this.value.toString();
+  }
+
+  toJSON() {
+    return this.toString();
+  }
+}
+
+export const MAX_DECIMAL_STRING = "99999999999999999999.99999999";
+export const MIN_DECIMAL_STRING = "-99999999999999999999.99999999";
+
+export const MAX_DECIMAL_VALUE = Decimal.from(MAX_DECIMAL_STRING);
+export const MIN_DECIMAL_VALUE = Decimal.from(MIN_DECIMAL_STRING);
+
+function toNumber(value: DecimalInput) {
+  if (value instanceof Decimal) {
+    return value.value;
+  }
+  if (typeof value === 'string' && value.trim() === '') {
+    // Number() and Number('') return 0 instead of NaN, so catch that case
+    return NaN;
+  }
+  return Number(value);
+}
+
+function round(value: number, mode: DecimalRoundingMode) {
+  switch (mode) {
+    case 'down':
+      return Math.trunc(value);
+    case 'half-up':
+      return value < 0 ? -Math.round(-value) : Math.round(value);
+    case 'half-even':
+      return roundHalfEven(value);
+    case 'half-ceil':
+      return Math.round(value);
+    case 'ceil':
+      return Math.ceil(value);
+    case 'floor':
+      return Math.floor(value);
+  }
+}
+
+function roundHalfEven(value: number) {
+  const lower = Math.floor(value);
+  const fraction = value - lower;
+  if (fraction < 0.5) {
+    return lower;
+  }
+  if (fraction > 0.5) {
+    return lower + 1;
+  }
+  return lower % 2 === 0 ? lower : lower + 1;
+}
diff --git a/src/datatypes/interval.ts b/src/datatypes/interval.ts
index c4e3fa45f..064e3460f 100644
--- a/src/datatypes/interval.ts
+++ b/src/datatypes/interval.ts
@@ -22,6 +22,7 @@ import {
 } from '../util/elmTypes';
 import { MIN_FLOAT_VALUE } from '../util/limits';
 import { Quantity } from './quantity';
+import { Decimal, MIN_DECIMAL_VALUE } from './decimal';
 
 export class Interval {
   constructor(
@@ -40,9 +41,11 @@ export class Interval {
       }
       if (point != null) {
         if (typeof point === 'number') {
-          this.pointType = Number.isInteger(point) ? ELM_INTEGER_TYPE : ELM_DECIMAL_TYPE;
+          this.pointType = ELM_INTEGER_TYPE;
         } else if (typeof point === 'bigint') {
           this.pointType = ELM_LONG_TYPE;
+        } else if (point.isDecimal) {
+          this.pointType = ELM_DECIMAL_TYPE;
         } else if (point.isTime && point.isTime()) {
           this.pointType = ELM_TIME_TYPE;
         } else if (point.isDate) {
@@ -704,10 +707,11 @@ export class Interval {
     let minValue = minValueForType(this.pointType, getQuantityInstanceForMinMax(this));
 
     // due to floating point issues in JS, we must use 0.0 for Decimal/Quantity instead of min
-    if (minValue === MIN_FLOAT_VALUE) {
-      minValue = 0.0;
+    // TODO: remove this when changing to decimal.js
+    if (minValue === MIN_DECIMAL_VALUE) {
+      minValue = Decimal.from(0.0);
     } else if ((minValue as any)?.isQuantity) {
-      (minValue as Quantity).value = 0.0;
+      minValue = new Quantity(0.0, (minValue as Quantity)?.unit);
     }
 
     if (minValue != null) {
@@ -776,7 +780,9 @@ export class Interval {
   toString() {
     const start = this.lowClosed ? '[' : '(';
     const end = this.highClosed ? ']' : ')';
-    return start + this.low.toString() + ', ' + this.high.toString() + end;
+    const lowString = this.low == null ? "null" : this.low.toString();
+    const highString = this.high == null ? "null" : this.high.toString();
+    return start + lowString + ', ' + highString + end;
   }
 }
 
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index b865d2147..ec98aba2b 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -1,5 +1,6 @@
 import { ELM_DECIMAL_TYPE } from '../util/elmTypes';
 import { decimalAdjust, add, subtract, isValidDecimal, overflowsOrUnderflows } from '../util/math';
+import { Decimal } from './decimal';
 import {
   checkUnit,
   convertUnit,
@@ -9,13 +10,17 @@ import {
 } from '../util/units';
 
 export class Quantity {
+  public readonly value: Decimal;
+
   constructor(
-    public value: any,
+    value: Decimal | string | number | bigint,
     public unit?: any
   ) {
-    if (this.value == null || isNaN(this.value)) {
+    if (value == null || typeof value === 'number' && isNaN(value)) {
       throw new Error('Cannot create a quantity with an undefined value');
-    } else if (!isValidDecimal(this.value)) {
+    }
+    this.value = Decimal.from(value);
+    if (!isValidDecimal(this.value)) {
       throw new Error('Cannot create a quantity with an invalid decimal value');
     }
 
@@ -46,7 +51,7 @@ export class Quantity {
       if (otherVal == null) {
         return null;
       } else {
-        return this.value <= otherVal;
+        return this.value.lessThanOrEquals(otherVal);
       }
     }
   }
@@ -57,7 +62,7 @@ export class Quantity {
       if (otherVal == null) {
         return null;
       } else {
-        return this.value >= otherVal;
+        return this.value.greaterThanOrEquals(otherVal);
       }
     }
   }
@@ -68,7 +73,7 @@ export class Quantity {
       if (otherVal == null) {
         return null;
       } else {
-        return this.value > otherVal;
+        return this.value.greaterThan(otherVal);
       }
     }
   }
@@ -79,7 +84,7 @@ export class Quantity {
       if (otherVal == null) {
         return null;
       } else {
-        return this.value < otherVal;
+        return this.value.lessThan(otherVal);
       }
     }
   }
@@ -95,7 +100,7 @@ export class Quantity {
         if (otherVal == null) {
           return null;
         } else {
-          return decimalAdjust('round', this.value, -8) === otherVal;
+          return this.value.round(8).equals(Decimal.from(otherVal));
         }
       }
     }
@@ -108,7 +113,7 @@ export class Quantity {
   }
 
   dividedBy(other: any) {
-    if (other == null || other === 0 || other.value === 0) {
+    if (other == null || other === 0 || (other.value != null && Decimal.from(other.value).equals(0))) {
       return null;
     } else if (!other.isQuantity) {
       // convert it to a quantity w/ unit 1
@@ -116,19 +121,19 @@ export class Quantity {
     }
 
     const [val1, unit1, val2, unit2] = normalizeUnitsWhenPossible(
-      this.value,
+      this.value.toNumber(),
       this.unit,
-      other.value,
+      Decimal.from(other.value).toNumber(),
       other.unit
     );
-    const resultValue = val1 / val2;
+    const resultValue = Decimal.from(val1 / val2);
     const resultUnit = getQuotientOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
     if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
       return null;
     }
-    return new Quantity(decimalAdjust('round', resultValue, -8), resultUnit);
+    return new Quantity(resultValue.round(8), resultUnit);
   }
 
   multiplyBy(other: any) {
@@ -140,26 +145,26 @@ export class Quantity {
     }
 
     const [val1, unit1, val2, unit2] = normalizeUnitsWhenPossible(
-      this.value,
+      this.value.toNumber(),
       this.unit,
-      other.value,
+      Decimal.from(other.value).toNumber(),
       other.unit
     );
-    const resultValue = val1 * val2;
+    const resultValue = Decimal.from(val1 * val2);
     const resultUnit = getProductOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
     if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
       return null;
     }
-    return new Quantity(decimalAdjust('round', resultValue, -8), resultUnit);
+    return new Quantity(resultValue.round(8), resultUnit);
   }
 }
 
 export function parseQuantity(str: string) {
   const components = /([+|-]?\d+\.?\d*)\s*('(.+)')?/.exec(str);
   if (components != null && components[1] != null) {
-    const value = parseFloat(components[1]);
+    const value = Decimal.from(components[1]);
     if (!isValidDecimal(value)) {
       return null;
     }
diff --git a/src/datatypes/uncertainty.ts b/src/datatypes/uncertainty.ts
index 44de60b3d..e986a581f 100644
--- a/src/datatypes/uncertainty.ts
+++ b/src/datatypes/uncertainty.ts
@@ -143,6 +143,8 @@ export class Uncertainty {
 
       if (typeof a.before === 'function') {
         return a.before(b, precision);
+      } else if (a.isDecimal) { 
+        return a.lessThan(b);
       } else {
         return a < b;
       }
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 72aa736a0..08cd7dbdc 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -1,6 +1,7 @@
 import { Expression } from './expression';
 import { typeIsArray, allTrue, anyTrue, removeNulls, numerical_sort } from '../util/util';
 import { Quantity } from '../datatypes/datatypes';
+import { Decimal } from '../datatypes/decimal';
 import { Context } from '../runtime/context';
 import { Exception } from '../datatypes/exception';
 import { greaterThan, lessThan } from '../util/comparison';
@@ -17,6 +18,32 @@ class AggregateExpression extends Expression {
   }
 }
 
+function hasDecimals(values: any[]) {
+  return values.some(value => value && value.isDecimal);
+}
+
+function isDecimal(value: any): value is Decimal {
+  return value != null && value.isDecimal;
+}
+
+function numberValue(value: any) {
+  return value && value.isDecimal ? value.toNumber() : value;
+}
+
+function sumDecimals(values: Decimal[]) {
+  return values.reduce((sum, value) => sum.add(value)).setScale(8, 'half-up');
+}
+
+function productDecimals(values: Decimal[]) {
+  return values.reduce((product, value) => product.multiplyBy(value)).setScale(8, 'half-up');
+}
+
+function decimalResult(value: number, values: any[], resultTypeName?: string) {
+  return hasDecimals(values) || resultTypeName === ELM_DECIMAL_TYPE
+    ? Decimal.from(value).setScale(8, 'half-up')
+    : value;
+}
+
 export class Count extends AggregateExpression {
   constructor(json: any) {
     super(json);
@@ -53,11 +80,12 @@ export class Sum extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
-      const sum = values.reduce((x, y) => x + y);
+      const sum = sumDecimals(getValuesFromQuantities(items));
       return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : new Quantity(sum, items[0].unit);
     } else {
-      const sum = items.reduce((x: any, y: any) => x + y);
+      const sum = hasDecimals(items)
+        ? sumDecimals(items.map(Decimal.from))
+        : items.reduce((x: any, y: any) => x + y);
       return overflowsOrUnderflows(sum, this.resultTypeName) ? null : sum;
     }
   }
@@ -153,12 +181,14 @@ export class Avg extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
-      const sum = values.reduce((x, y) => x + y);
-      return new Quantity(sum / values.length, items[0].unit);
+      const sum = sumDecimals(getValuesFromQuantities(items));
+      return new Quantity(sum.divideBy(items.length).setScale(8, 'half-up'), items[0].unit);
     } else {
+      if (hasDecimals(items)) {
+        return sumDecimals(items.map(Decimal.from)).divideBy(items.length).setScale(8, 'half-up');
+      }
       const sum = items.reduce((x: number, y: number) => x + y);
-      return sum / items.length;
+      return decimalResult(sum / items.length, items, this.resultTypeName);
     }
   }
 }
@@ -184,11 +214,12 @@ export class Median extends AggregateExpression {
     }
 
     if (!hasOnlyQuantities(items)) {
-      return medianOfNumbers(items);
+      return hasDecimals(items)
+        ? medianOfDecimals(items.map(Decimal.from))
+        : decimalResult(medianOfNumbers(items), items, this.resultTypeName);
     }
 
-    const values = getValuesFromQuantities(items);
-    const median = medianOfNumbers(values);
+    const median = medianOfDecimals(getValuesFromQuantities(items));
     return new Quantity(median, items[0].unit);
   }
 }
@@ -218,9 +249,10 @@ export class Mode extends AggregateExpression {
       const values = getValuesFromQuantities(filtered);
       let mode = this.mode(values);
       if (mode.length === 1) {
-        mode = mode[0];
+        return new Quantity(mode[0], items[0].unit);
+      } else {
+        return mode.map(m => new Quantity(m, items[0].unit));
       }
-      return new Quantity(mode, items[0].unit);
     } else {
       const mode = this.mode(filtered);
       if (mode.length === 1) {
@@ -278,11 +310,14 @@ export class StdDev extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
+      const values = getValuesFromQuantities(items).map(numberValue);
       const stdDev = this.standardDeviation(values);
       return new Quantity(stdDev, items[0].unit);
     } else {
-      return this.standardDeviation(items);
+      const standardDeviation = this.standardDeviation(items.map(numberValue));
+      return standardDeviation == null
+        ? null
+        : decimalResult(standardDeviation, items, this.resultTypeName);
     }
   }
 
@@ -336,15 +371,17 @@ export class Product extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
-      const product = values.reduce((x, y) => x * y);
+      const product = productDecimals(getValuesFromQuantities(items));
       // Units are not multiplied for the geometric product
       return overflowsOrUnderflows(product, ELM_DECIMAL_TYPE)
         ? null
         : new Quantity(product, items[0].unit);
     } else {
-      const product = items.reduce((x: any, y: any) => x * y);
-      return overflowsOrUnderflows(product, this.resultTypeName) ? null : product;
+      const product = hasDecimals(items)
+        ? productDecimals(items.map(Decimal.from))
+        : items.reduce((x: number, y: number) => x * y);
+      const result = isDecimal(product) ? product : decimalResult(product, items, this.resultTypeName);
+      return overflowsOrUnderflows(result, this.resultTypeName) ? null : result;
     }
   }
 }
@@ -371,13 +408,17 @@ export class GeometricMean extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
-      const product = values.reduce((x, y) => x * y);
-      const geoMean = Math.pow(product, 1.0 / items.length);
+      const product = productDecimals(getValuesFromQuantities(items));
+      const geoMean = product.power(1.0 / items.length).setScale(8, 'half-up');
       return new Quantity(geoMean, items[0].unit);
     } else {
+      if (hasDecimals(items)) {
+        return productDecimals(items.map(Decimal.from))
+          .power(1.0 / items.length)
+          .setScale(8, 'half-up');
+      }
       const product = items.reduce((x: number, y: number) => x * y);
-      return Math.pow(product, 1.0 / items.length);
+      return decimalResult(Math.pow(product, 1.0 / items.length), items, this.resultTypeName);
     }
   }
 }
@@ -444,7 +485,7 @@ function processQuantities(values: any[]) {
   }
 }
 
-function getValuesFromQuantities(quantities: Quantity[]): number[] {
+function getValuesFromQuantities(quantities: Quantity[]): Decimal[] {
   return quantities.map(quantity => quantity.value);
 }
 
@@ -471,3 +512,11 @@ function medianOfNumbers(numbers: number[]) {
     return (items[items.length / 2 - 1] + items[items.length / 2]) / 2;
   }
 }
+
+function medianOfDecimals(decimals: Decimal[]) {
+  const items = [...decimals].sort((a, b) => a.compareTo(b));
+  const middle = Math.floor(items.length / 2);
+  return items.length % 2 === 1
+    ? items[middle]
+    : items[middle - 1].add(items[middle]).divideBy(2).setScale(8, 'half-up');
+}
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index d777121e0..c63fa18f0 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -13,6 +13,7 @@ import {
   MIN_DATETIME_VALUE,
   MIN_TIME_VALUE
 } from '../datatypes/datetime';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../datatypes/decimal';
 import {
   ELM_DECIMAL_TYPE,
   ELM_DATETIME_TYPE,
@@ -22,14 +23,47 @@ import {
   ELM_TIME_TYPE
 } from '../util/elmTypes';
 import {
-  MAX_FLOAT_VALUE,
   MAX_INT_VALUE,
   MAX_LONG_VALUE,
-  MIN_FLOAT_VALUE,
   MIN_INT_VALUE,
   MIN_LONG_VALUE
 } from '../util/limits';
 
+function isDecimal(value: any): boolean {
+  return value != null && value.isDecimal;
+}
+
+function decimalResult(value: any, resultTypeName?: string): any {
+  if (isDecimal(value) || (typeof value === 'number' && !Number.isFinite(value))) {
+    return value;
+  }
+  return resultTypeName === ELM_DECIMAL_TYPE || (typeof value === 'number' && !Number.isInteger(value))
+    ? Decimal.from(value).setScale(8, 'half-up')
+    : value;
+}
+
+function add(x: any, y: any) {
+  return isDecimal(x) || isDecimal(y) ? Decimal.from(x).add(y).setScale(8, 'half-up') : x + y;
+}
+
+function subtract(x: any, y: any) {
+  return isDecimal(x) || isDecimal(y)
+    ? Decimal.from(x).subtract(y).setScale(8, 'half-up')
+    : x - y;
+}
+
+function multiply(x: any, y: any) {
+  return isDecimal(x) || isDecimal(y)
+    ? Decimal.from(x).multiplyBy(y).setScale(8, 'half-up')
+    : x * y;
+}
+
+function divide(x: any, y: any) {
+  return isDecimal(x) || isDecimal(y)
+    ? Decimal.from(x).divideBy(y).setScale(8, 'half-up')
+    : x / y;
+}
+
 export class Add extends Expression {
   constructor(json: any) {
     super(json);
@@ -84,10 +118,10 @@ export class Multiply extends Expression {
         if (x.low.isQuantity) {
           return new Uncertainty(doMultiplication(x.low, y.low), doMultiplication(x.high, y.high));
         } else {
-          return new Uncertainty(x.low * y.low, x.high * y.high);
+          return new Uncertainty(multiply(x.low, y.low), multiply(x.high, y.high));
         }
       } else {
-        return x * y;
+        return multiply(x, y);
       }
     });
 
@@ -109,7 +143,9 @@ export class Divide extends Expression {
       return null;
     }
 
-    const quotient = args.reduce((x: any, y: any) => {
+    let quotient;
+    let [x, y] = args;
+    try {
       if (x.isUncertainty && !y.isUncertainty) {
         y = new Uncertainty(y, y);
       } else if (y.isUncertainty && !x.isUncertainty) {
@@ -117,17 +153,20 @@ export class Divide extends Expression {
       }
 
       if (x.isQuantity) {
-        return doDivision(x, y);
+        quotient = doDivision(x, y);
       } else if (x.isUncertainty && y.isUncertainty) {
         if (x.low.isQuantity) {
-          return new Uncertainty(doDivision(x.low, y.high), doDivision(x.high, y.low));
+          quotient = new Uncertainty(doDivision(x.low, y.high), doDivision(x.high, y.low));
         } else {
-          return new Uncertainty(x.low / y.high, x.high / y.low);
+          quotient = new Uncertainty(divide(x.low, y.high), divide(x.high, y.low));
         }
       } else {
-        return x / y;
+        quotient = divide(x, y);
       }
-    });
+    } catch {
+      // Decimal division by zero throws; CQL defines the result as null.
+      return null;
+    }
 
     // Note, anything divided by 0 is Infinity in Javascript, which will be
     // considered as overflow by this check.
@@ -149,7 +188,7 @@ export class TruncatedDivide extends Expression {
       return null;
     }
 
-    let truncatedQuotient: number | bigint;
+    let truncatedQuotient: number | bigint | Decimal;
     if (typeof args[0] === 'bigint') {
       // bigint division always truncates
       try {
@@ -159,8 +198,17 @@ export class TruncatedDivide extends Expression {
         return null;
       }
     } else {
-      const quotient = args.reduce((x: number, y: number) => x / y);
-      truncatedQuotient = quotient >= 0 ? Math.floor(quotient) : Math.ceil(quotient);
+      try {
+        const quotient = args.reduce((x: any, y: any) => divide(x, y));
+        const truncated = isDecimal(quotient)
+          ? quotient.truncate()
+          : quotient >= 0
+            ? Math.floor(quotient)
+            : Math.ceil(quotient);
+        truncatedQuotient = decimalResult(truncated, this.resultTypeName);
+      } catch {
+        return null;
+      }
     }
 
     if (MathUtil.overflowsOrUnderflows(truncatedQuotient, this.resultTypeName)) {
@@ -181,15 +229,17 @@ export class Modulo extends Expression {
       return null;
     }
 
-    let modulo: number | bigint;
+    let modulo: number | bigint | Decimal;
     try {
-      modulo = args.reduce((x: any, y: any) => x % y);
+      modulo = args.reduce((x: any, y: any) =>
+        isDecimal(x) || isDecimal(y) ? Decimal.from(x).modulo(y) : x % y
+      );
     } catch {
       // modulo divide by zero results in null according to specification
       return null;
     }
 
-    return MathUtil.decimalLongOrNull(modulo);
+    return MathUtil.decimalLongOrNull(decimalResult(modulo, this.resultTypeName));
   }
 }
 
@@ -204,7 +254,7 @@ export class Ceiling extends Expression {
       return null;
     }
 
-    return Math.ceil(arg);
+    return isDecimal(arg) ? arg.ceil() : Math.ceil(arg);
   }
 }
 
@@ -219,7 +269,7 @@ export class Floor extends Expression {
       return null;
     }
 
-    return Math.floor(arg);
+    return isDecimal(arg) ? arg.floor() : Math.floor(arg);
   }
 }
 
@@ -234,7 +284,7 @@ export class Truncate extends Expression {
       return null;
     }
 
-    return arg >= 0 ? Math.floor(arg) : Math.ceil(arg);
+    return isDecimal(arg) ? arg.truncate() : arg >= 0 ? Math.floor(arg) : Math.ceil(arg);
   }
 }
 export class Abs extends Expression {
@@ -247,12 +297,17 @@ export class Abs extends Expression {
     if (arg == null) {
       return null;
     } else if (arg.isQuantity) {
-      return new Quantity(Math.abs(arg.value), arg.unit);
+      return new Quantity(arg.value.abs(), arg.unit);
     } else if (typeof arg === 'bigint') {
       const absoluteValue = arg < 0n ? -arg : arg;
       return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
         ? null
         : absoluteValue;
+    } else if (isDecimal(arg)) {
+      const absoluteValue = arg.abs();
+      return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
+        ? null
+        : absoluteValue;
     } else {
       const absoluteValue = Math.abs(arg);
       return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
@@ -272,12 +327,17 @@ export class Negate extends Expression {
     if (arg == null) {
       return null;
     } else if (arg.isQuantity) {
-      return new Quantity(arg.value * -1, arg.unit);
+      return new Quantity(arg.value.negate(), arg.unit);
     } else if (typeof arg === 'bigint') {
       const negatedValue = arg * -1n;
       return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
         ? null
         : negatedValue;
+    } else if (isDecimal(arg)) {
+      const negatedValue = arg.negate();
+      return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
+        ? null
+        : negatedValue;
     } else {
       const negatedValue = arg * -1;
       return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
@@ -302,7 +362,10 @@ export class Round extends Expression {
     }
 
     const dec = this.precision != null ? await this.precision.execute(ctx) : 0;
-    return Math.round(arg * Math.pow(10, dec)) / Math.pow(10, dec);
+    if (isDecimal(arg)) {
+      return arg.round(dec);
+    }
+    return decimalResult(Math.round(arg * Math.pow(10, dec)) / Math.pow(10, dec), this.resultTypeName);
   }
 }
 
@@ -317,9 +380,13 @@ export class Ln extends Expression {
       return null;
     }
 
-    const ln = Math.log(arg);
-
-    return MathUtil.decimalOrNull(ln);
+    try {
+      return isDecimal(arg)
+        ? arg.ln()
+        : MathUtil.decimalOrNull(decimalResult(Math.log(arg), ELM_DECIMAL_TYPE));
+    } catch {
+      return null;
+    }
   }
 }
 
@@ -334,7 +401,14 @@ export class Exp extends Expression {
       return null;
     }
 
-    const power = Math.exp(arg);
+    let power;
+    try {
+      power = isDecimal(arg)
+        ? arg.exp()
+        : decimalResult(Math.exp(arg), ELM_DECIMAL_TYPE);
+    } catch {
+      return null;
+    }
 
     if (MathUtil.overflowsOrUnderflows(power, this.resultTypeName)) {
       return null;
@@ -354,9 +428,16 @@ export class Log extends Expression {
       return null;
     }
 
-    const log = args.reduce((x: number, y: number) => Math.log(x) / Math.log(y));
-
-    return MathUtil.decimalOrNull(log);
+    try {
+      const log = args.reduce((x: any, y: any) =>
+        isDecimal(x) || isDecimal(y)
+          ? Decimal.from(x).log(y)
+          : Math.log(x) / Math.log(y)
+      );
+      return isDecimal(log) ? log : MathUtil.decimalOrNull(decimalResult(log, ELM_DECIMAL_TYPE));
+    } catch {
+      return null;
+    }
   }
 }
 
@@ -371,7 +452,7 @@ export class Power extends Expression {
       return null;
     }
 
-    const power = args.reduce((x: any, y: any) => doPower(x, y));
+    const power = decimalResult(args.reduce((x: any, y: any) => doPower(x, y)), this.resultTypeName);
 
     // Note: The resultTypeName may be wrong if the exponent is a negative number. Math.overflowsOrUnderflows
     // already accounts for this possibility by only considering it an integer if Number.isInteger(value).
@@ -384,6 +465,9 @@ export class Power extends Expression {
 }
 
 function doPower(x: any, y: any) {
+  if (isDecimal(x) || isDecimal(y)) {
+    return Decimal.from(x).power(y);
+  }
   if (typeof x === 'bigint' && typeof y === 'bigint' && y < 0n) {
     // x ** y does not support negative exponents for bigint, so downgrade to number if possible, otherwise return null
     if (
@@ -409,7 +493,7 @@ export class MinValue extends Expression {
   static readonly MIN_VALUES = {
     [ELM_INTEGER_TYPE]: MIN_INT_VALUE,
     [ELM_LONG_TYPE]: MIN_LONG_VALUE,
-    [ELM_DECIMAL_TYPE]: MIN_FLOAT_VALUE,
+    [ELM_DECIMAL_TYPE]: MIN_DECIMAL_VALUE,
     [ELM_DATETIME_TYPE]: MIN_DATETIME_VALUE,
     [ELM_DATE_TYPE]: MIN_DATE_VALUE,
     [ELM_TIME_TYPE]: MIN_TIME_VALUE
@@ -441,7 +525,7 @@ export class MaxValue extends Expression {
   static readonly MAX_VALUES = {
     [ELM_INTEGER_TYPE]: MAX_INT_VALUE,
     [ELM_LONG_TYPE]: MAX_LONG_VALUE,
-    [ELM_DECIMAL_TYPE]: MAX_FLOAT_VALUE,
+    [ELM_DECIMAL_TYPE]: MAX_DECIMAL_VALUE,
     [ELM_DATETIME_TYPE]: MAX_DATETIME_VALUE,
     [ELM_DATE_TYPE]: MAX_DATE_VALUE,
     [ELM_TIME_TYPE]: MAX_TIME_VALUE
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index 236a814b1..5ef38af84 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -1,13 +1,15 @@
 import { Expression } from './expression';
 import { MAX_DATETIME_VALUE, MIN_DATETIME_VALUE } from '../datatypes/datetime';
 import { Quantity } from '../datatypes/quantity';
-import { add, successor, predecessor } from '../util/math';
+import { add, successor, predecessor, subtract } from '../util/math';
+import { greaterThan, lessThan, lessThanOrEquals } from '../util/comparison';
 import { convertUnit, compareUnits, convertToCQLDateUnit } from '../util/units';
 import * as dtivl from '../datatypes/interval';
 import { Context } from '../runtime/context';
 import { build } from './builder';
 import { IntervalTypeSpecifier, NamedTypeSpecifier } from '../types/type-specifiers.interfaces';
 import { ELM_ANY_TYPE, ELM_NAMED_TYPE_SPECIFIER } from '../util/elmTypes';
+import { Decimal } from '../datatypes/decimal';
 
 export class Interval extends Expression {
   lowClosed: boolean;
@@ -409,16 +411,16 @@ function intervalListType(intervals: any) {
       } else {
         return 'mismatch';
       }
-    } else if (Number.isInteger(low) && Number.isInteger(high)) {
+    } else if (typeof low === 'number' && typeof high === 'number') {
       if (type == null) {
         type = 'integer';
-      } else if (type === 'integer' || type === 'decimal') {
+      } else if (type === 'integer') {
         continue;
       } else {
         return 'mismatch';
       }
-    } else if (typeof low === 'number' && typeof high === 'number') {
-      if (type == null || type === 'integer') {
+    } else if (low.isDecimal && high.isDecimal) {
+      if (type == null) {
         type = 'decimal';
       } else if (type === 'decimal') {
         continue;
@@ -445,7 +447,7 @@ export class Expand extends Expression {
     let defaultPer, expandFunction;
     let [intervals, per] = await this.execArgs(ctx);
 
-    if (per?.value === 0) {
+    if (per?.value.equals(0)) {
       // a per of 0 is basically like a divide-by-zero; since spec says divide-by-zero returns null, we'll return null here too
       return null;
     }
@@ -471,11 +473,17 @@ export class Expand extends Expression {
     if (['time', 'date', 'datetime'].includes(type)) {
       expandFunction = this.expandDTishInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.getPrecision());
-    } else if (['quantity'].includes(type)) {
+    } else if (type === 'quantity') {
       expandFunction = this.expandQuantityInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.unit);
-    } else if (['long', 'integer', 'decimal'].includes(type)) {
-      expandFunction = this.expandNumericInterval;
+    } else if (type === 'integer') {
+      expandFunction = this.expandIntegerInterval;
+      defaultPer = (_interval: any) => new Quantity(1, '1');
+    } else if (type === 'long') {
+      expandFunction = this.expandLongInterval;
+      defaultPer = (_interval: any) => new Quantity(1, '1');
+    } else if (type === 'decimal') {
+      expandFunction = this.expandDecimalInterval;
       defaultPer = (_interval: any) => new Quantity(1, '1');
     } else {
       throw new Error('Interval list type not yet supported.');
@@ -587,8 +595,28 @@ export class Expand extends Expression {
     } else {
       result_units = interval.low.unit;
     }
-    const low_value = convertUnit(interval.low.value, interval.low.unit, result_units);
-    const high_value = convertUnit(interval.high.value, interval.high.unit, result_units);
+    let low_value = interval.low.value;
+    let high_value = interval.high.value;
+
+    // Quantity values are always Decimal, but successor is expected to know if the value is an integer
+    // this needs to happen before converting units
+    if (!interval.lowClosed) {
+      if (low_value.isInteger()) {
+        low_value = low_value.add(1);
+      } else {
+        low_value = successor(low_value);
+      }
+    }
+    if (!interval.highClosed) {
+      if (high_value.isInteger()) {
+        high_value = high_value.subtract(1);
+      } else {
+        high_value = predecessor(high_value);
+      }
+    }
+
+    low_value = convertUnit(low_value, interval.low.unit, result_units);
+    high_value = convertUnit(high_value, interval.high.unit, result_units);
     const per_value = convertUnit(per.value, per.unit, result_units);
 
     // return null if unit conversion failed, must have mismatched units
@@ -596,11 +624,9 @@ export class Expand extends Expression {
       return null;
     }
 
-    const results = this.makeNumericIntervalList(
+    const results = this.makeDecimalIntervalList(
       low_value,
       high_value,
-      interval.lowClosed,
-      interval.highClosed,
       per_value
     );
 
@@ -611,103 +637,111 @@ export class Expand extends Expression {
     return results;
   }
 
-  expandNumericInterval(interval: any, per: any) {
+  expandIntegerInterval(interval: any, per: any) { 
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
-    return this.makeNumericIntervalList(
-      interval.low,
-      interval.high,
-      interval.lowClosed,
-      interval.highClosed,
-      per.value
+    const low = interval.lowClosed ? interval.low : successor(interval.low);
+    const high = interval.highClosed ? interval.high : predecessor(interval.high);
+
+    return this.makeDecimalIntervalList(
+      low, high, per.value
     );
   }
 
-  makeNumericIntervalList(
+  expandDecimalInterval(interval: any, per: any) { 
+    if (per.unit !== '1' && per.unit !== '') {
+      return null;
+    }
+    const low = interval.lowClosed ? interval.low : successor(interval.low);
+    const high = interval.highClosed ? interval.high : predecessor(interval.high);
+
+    return this.makeDecimalIntervalList(
+      low, high, per.value
+    );
+  }
+
+  expandLongInterval(interval: any, per: any) { 
+    if (per.unit !== '1' && per.unit !== '') {
+      return null;
+    }
+
+    const low = interval.lowClosed ? interval.low : successor(interval.low);
+    const high = interval.highClosed ? interval.high : predecessor(interval.high);
+
+    return this.makeDecimalIntervalList(
+      low, high, per.value
+    );
+  }
+
+  makeDecimalIntervalList(
     low: any,
     high: any,
-    lowClosed: boolean,
-    highClosed: boolean,
     perValue: any
   ) {
     // If the per value is a Decimal (has a .), 8 decimal places are appropriate
     // Integers should have 0 Decimal places
-    const perIsDecimal = perValue.toString().includes('.');
-    const decimalPrecision = perIsDecimal ? 8 : 0;
-    const hasLongBoundaries = typeof low === 'bigint' || typeof high === 'bigint';
-
-    low = lowClosed ? low : successor(low);
-    high = highClosed ? high : predecessor(high);
-
-    if (hasLongBoundaries && !perIsDecimal) {
-      const longLow = low as bigint;
-      const longHigh = high as bigint;
-
-      if (longLow > longHigh) {
-        return [];
-      }
-      if (longLow == null || longHigh == null) {
-        return [];
-      }
-
-      const perBigInt = BigInt(perValue);
-      if (perBigInt > longHigh - longLow + 1n) {
-        return [];
-      }
-
-      let current_low = longLow;
-      let current_high = current_low + perBigInt - 1n;
-      const results = [];
-      while (current_high <= longHigh) {
-        results.push(new dtivl.Interval(current_low, current_high, true, true));
-        current_low += perBigInt;
-        current_high = current_low + perBigInt - 1n;
-      }
-
-      return results;
-    } else if (hasLongBoundaries) {
-      low = Number(low);
-      high = Number(high);
+    const perIsIntegral = !perValue.toString().includes('.');
+    const decimalPrecision = perIsIntegral ? 0 : 8;    
+
+    // For the purposes of this function, we'll perform all the arithmetic using Decimals,
+    // then convert the results back to the required type if necessary
+    let makeInterval: Function;
+    if (!perIsIntegral) {
+      // If per is not an integer value, then regardless of the original point types, the values will be Decimals
+      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l, h, true, true);
+    } else if (typeof low === 'bigint' || typeof high === 'bigint') {
+      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toLong(), h.toLong(), true, true);
+    } else if (typeof low === 'number' || typeof high === 'number') {
+      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
+    } else {
+      // per is an integer but the original bounds of the interval were Decimal.
+      // TODO: for now just make them integers
+      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
     }
 
+    // treat everything as a Decimal, convert back later if needed
+    low = Decimal.from(low);
+    high = Decimal.from(high);
+
     // If the interval boundaries are more precise than the per quantity, the
     // more precise values will be truncated to the precision specified by the
     // per quantity.
     low = truncateDecimal(low, decimalPrecision);
     high = truncateDecimal(high, decimalPrecision);
 
-    if (low > high) {
+    if (low == null || high == null) {
       return [];
     }
-    if (low == null || high == null) {
+    if (low.greaterThan(high)) {
       return [];
     }
 
-    const perUnitSize = perIsDecimal ? 0.00000001 : 1;
+    const perUnitSize = perIsIntegral ? 1 : 0.00000001;
 
-    if (
-      low === high &&
-      Number.isInteger(low) &&
-      Number.isInteger(high) &&
-      !Number.isInteger(perValue)
-    ) {
-      high = parseFloat((high + 1).toFixed(decimalPrecision));
-    }
+    // TODO: this supports one test case but it's not clear if the test case is correct
+    // if (
+    //   low === high &&
+    //   Number.isInteger(low) &&
+    //   Number.isInteger(high) &&
+    //   !Number.isInteger(perValue)
+    // ) {
+    //   high = parseFloat((high + 1).toFixed(decimalPrecision));
+    // }
 
     let current_low = low;
     const results = [];
 
-    if (perValue > high - low + perUnitSize) {
+    if (perValue.greaterThan(high.subtract(low).add(perUnitSize))) {
       return [];
     }
-    let current_high = parseFloat((current_low + perValue - perUnitSize).toFixed(decimalPrecision));
-    let intervalToAdd = new dtivl.Interval(current_low, current_high, true, true);
-    while (intervalToAdd.high <= high) {
+    let current_high = current_low.add(perValue).subtract(perUnitSize);
+    let intervalToAdd = makeInterval(current_low, current_high);
+    while (current_high.lessThanOrEquals(high)) {
       results.push(intervalToAdd);
-      current_low = parseFloat((current_low + perValue).toFixed(decimalPrecision));
-      current_high = parseFloat((current_low + perValue - perUnitSize).toFixed(decimalPrecision));
-      intervalToAdd = new dtivl.Interval(current_low, current_high, true, true);
+      current_low = current_low.add(perValue);
+      current_high = current_low.add(perValue).subtract(perUnitSize);
+      intervalToAdd = makeInterval(current_low, current_high);
     }
 
     return results;
@@ -762,10 +796,10 @@ function collapseIntervals(intervals: any, perWidth: any) {
           return 1;
         }
       } else if (a.low != null && b.low != null) {
-        if (a.low < b.low) {
+        if (lessThan(a.low, b.low)) {
           return -1;
         }
-        if (a.low > b.low) {
+        if (greaterThan(a.low, b.low)) {
           return 1;
         }
       } else if (a.low != null && b.low == null) {
@@ -782,10 +816,10 @@ function collapseIntervals(intervals: any, perWidth: any) {
           return 1;
         }
       } else if (a.high != null && b.high != null) {
-        if (a.high < b.high) {
+        if (lessThan(a.high, b.high)) {
           return -1;
         }
-        if (a.high > b.high) {
+        if (greaterThan(a.high, b.high)) {
           return 1;
         }
       } else if (a.high != null && b.high == null) {
@@ -828,17 +862,15 @@ function collapseIntervals(intervals: any, perWidth: any) {
           a = b;
         }
       } else {
-        const distance = b.low - a.high;
-        const comparablePerWidth =
-          typeof distance === 'bigint' && Number.isInteger(perWidth.value)
-            ? BigInt(perWidth.value)
-            : perWidth.value;
-        const withinPerWidth =
-          typeof distance === 'bigint' && typeof comparablePerWidth !== 'bigint'
-            ? Number(distance) <= comparablePerWidth
-            : distance <= comparablePerWidth;
+        
+        const distance = subtract(b.low, a.high);
+        // TODO: perWidth.value is a Decimal, but distance could be anything
+        // lessThanOrEquals requires that its args be the same type
+        // so I guess for now, make distance a Decimal
+        const distanceDecimal = Decimal.from(distance);
+        const withinPerWidth = lessThanOrEquals(distanceDecimal, perWidth.value); 
         if (withinPerWidth) {
-          if (b.high > a.high || b.high == null) {
+          if (greaterThan(b.high, a.high) || b.high == null) {
             a.high = b.high;
           }
         } else {
@@ -857,5 +889,5 @@ function truncateDecimal(decimal: any, decimalPlaces: number) {
   // like parseFloat().toFixed() but floor rather than round
   // Needed for when per precision is less than the interval input precision
   const re = new RegExp('^-?\\d+(?:.\\d{0,' + (decimalPlaces || -1) + '})?');
-  return parseFloat(decimal.toString().match(re)[0]);
+  return Decimal.from(decimal.toString().match(re)[0]);
 }
diff --git a/src/elm/literal.ts b/src/elm/literal.ts
index 40d17b393..dea41feb3 100644
--- a/src/elm/literal.ts
+++ b/src/elm/literal.ts
@@ -7,6 +7,7 @@ import {
   ELM_STRING_TYPE
 } from '../util/elmTypes';
 import { Expression } from './expression';
+import { Decimal } from '../datatypes/decimal';
 
 export class Literal extends Expression {
   valueType: string;
@@ -96,7 +97,7 @@ export class LongLiteral extends Literal {
 export class DecimalLiteral extends Literal {
   constructor(json: any) {
     super(json);
-    this.value = parseFloat(this.value);
+    this.value = Decimal.from(this.value);
   }
 
   // Define a simple getter to allow type-checking of this class without instanceof
diff --git a/src/elm/quantity.ts b/src/elm/quantity.ts
index cc9b89335..6bd9ec2c5 100644
--- a/src/elm/quantity.ts
+++ b/src/elm/quantity.ts
@@ -5,12 +5,12 @@ import { Context } from '../runtime/context';
 // Unit conversation is currently implemented on for time duration comparison operations
 // TODO: Implement unit conversation for time duration mathematical operations
 export class Quantity extends Expression {
-  value: number;
+  value: DT.Decimal;
   unit: any;
 
   constructor(json: any) {
     super(json);
-    this.value = parseFloat(json.value);
+    this.value = DT.Decimal.from(json.value);
     this.unit = json.unit;
   }
 
diff --git a/src/elm/type.ts b/src/elm/type.ts
index 6625b7e84..073a12e59 100644
--- a/src/elm/type.ts
+++ b/src/elm/type.ts
@@ -5,6 +5,7 @@ import { DateTime, Date } from '../datatypes/datetime';
 import { Concept } from '../datatypes/clinical';
 import { Interval as dtInterval } from '../datatypes/interval';
 import { Quantity, parseQuantity } from '../datatypes/quantity';
+import { Decimal } from '../datatypes/decimal';
 import { isValidDecimal, isValidInteger, isValidLong, limitDecimalPrecision } from '../util/math';
 import { normalizeMillisecondsField } from '../util/util';
 import { Ratio } from '../datatypes/ratio';
@@ -165,13 +166,17 @@ export class ToDecimal extends Expression {
     const arg = await this.execArgs(ctx);
     if (arg != null) {
       if (arg.isUncertainty) {
-        const low = limitDecimalPrecision(parseFloat(arg.low.toString()));
-        const high = limitDecimalPrecision(parseFloat(arg.high.toString()));
+        const low = Decimal.from(arg.low);
+        const high = Decimal.from(arg.high);
         return new Uncertainty(low, high);
       } else {
-        const decimal = limitDecimalPrecision(parseFloat(arg.toString()));
-        if (isValidDecimal(decimal)) {
-          return decimal;
+        try {
+          const decimal = Decimal.from(arg.toString());
+          if (isValidDecimal(decimal)) {
+            return decimal;
+          }
+        } catch (_e) {
+          return null;
         }
       }
     }
@@ -195,6 +200,11 @@ export class ToInteger extends Expression {
       if (isValidInteger(integer)) {
         return integer;
       }
+    } else if (arg && arg.isDecimal) {
+      const integer = (arg as Decimal).toInteger();
+      if (isValidInteger(integer)) {
+        return integer;
+      }
     } else if (typeof arg === 'string') {
       // check for blank string because Number('') and Number(' ') evaluate to 0.
       if (arg.trim().length === 0) {
@@ -232,6 +242,11 @@ export class ToLong extends Expression {
       } catch {
         return null;
       }
+    } else if (arg && arg.isDecimal) {
+      const long = (arg as Decimal).toLong();
+      if (isValidLong(long)) {
+        return long;
+      }
     } else if (typeof arg === 'string') {
       // check string format because BigInt throws for invalid strings
       if (!/^[+-]?\d+$/.test(arg)) {
@@ -260,14 +275,8 @@ export class ToQuantity extends Expression {
   convertValue(val: any): any {
     if (val == null) {
       return null;
-    } else if (typeof val === 'number') {
+    } else if (typeof val === 'number' || typeof val === 'bigint' || val.isDecimal) {
       return new Quantity(val, '1');
-    } else if (typeof val === 'bigint') {
-      // By definition, Quantity value is a Decimal in CQL, so we need to convert bigint to number.
-      // While this isn't perfect, in practice it is probably OK since the range of safer integers
-      // in JS number is pretty big: -(2^53 - 1) to 2^53 - 1, which is plus/minus 9 quadrillion.
-      // See https://developer.mozilla.org/en-US/docs/Web/JavaScript/Reference/Global_Objects/Number/isSafeInteger#description
-      return new Quantity(Number(val), '1');
     } else if (val.isRatio) {
       // numerator and denominator are guaranteed non-null
       return val.numerator.dividedBy(val.denominator);
@@ -734,10 +743,9 @@ function guessSpecifierType(val: any): any {
     return typeHierarchy[0];
   } else if (typeof val === 'boolean') {
     return { type: ELM_NAMED_TYPE_SPECIFIER, name: ELM_BOOLEAN_TYPE };
-  } else if (typeof val === 'number' && Math.floor(val) === val) {
-    // it could still be a decimal, but we have to just take our best guess!
-    return { type: ELM_NAMED_TYPE_SPECIFIER, name: ELM_INTEGER_TYPE };
   } else if (typeof val === 'number') {
+    return { type: ELM_NAMED_TYPE_SPECIFIER, name: ELM_INTEGER_TYPE };
+  } else if (val.isDecimal) {
     return { type: ELM_NAMED_TYPE_SPECIFIER, name: ELM_DECIMAL_TYPE };
   } else if (typeof val === 'bigint') {
     return { type: ELM_NAMED_TYPE_SPECIFIER, name: ELM_LONG_TYPE };
diff --git a/src/runtime/context.ts b/src/runtime/context.ts
index e28e5ad68..106a53639 100644
--- a/src/runtime/context.ts
+++ b/src/runtime/context.ts
@@ -341,9 +341,9 @@ export class Context {
       case ELM_BOOLEAN_TYPE:
         return typeof val === 'boolean';
       case ELM_DECIMAL_TYPE:
-        return typeof val === 'number';
+        return val && val.isDecimal;
       case ELM_INTEGER_TYPE:
-        return typeof val === 'number' && Math.floor(val) === val;
+        return typeof val === 'number';
       case ELM_LONG_TYPE:
         return typeof val === 'bigint';
       case ELM_STRING_TYPE:
@@ -388,9 +388,9 @@ export class Context {
     if (inst.isBooleanLiteral) {
       return typeof val === 'boolean';
     } else if (inst.isDecimalLiteral) {
-      return typeof val === 'number';
+      return val && val.isDecimal;
     } else if (inst.isIntegerLiteral) {
-      return typeof val === 'number' && Math.floor(val) === val;
+      return typeof val === 'number';
     } else if (inst.isLongLiteral) {
       return typeof val === 'bigint';
     } else if (inst.isStringLiteral) {
diff --git a/src/util/comparison.ts b/src/util/comparison.ts
index 17d45e240..467bb2e82 100644
--- a/src/util/comparison.ts
+++ b/src/util/comparison.ts
@@ -12,6 +12,10 @@ function areStrings(a: any, b: any) {
   return typeof a === 'string' && typeof b === 'string';
 }
 
+function areDecimals(a: any, b: any) {
+  return a && a.isDecimal && b && b.isDecimal;
+}
+
 function areDateTimesOrQuantities(a: any, b: any) {
   return (
     (a && a.isDateTime && b && b.isDateTime) ||
@@ -27,6 +31,8 @@ function isUncertainty(x: any) {
 export function lessThan(a: any, b: any, precision?: any) {
   if (areNumbers(a, b) || areBigInts(a, b) || areStrings(a, b)) {
     return a < b;
+  } else if (areDecimals(a, b)) {
+    return a.lessThan(b);
   } else if (areDateTimesOrQuantities(a, b)) {
     return a.before(b, precision);
   } else if (isUncertainty(a)) {
@@ -41,7 +47,9 @@ export function lessThan(a: any, b: any, precision?: any) {
 export function lessThanOrEquals(a: any, b: any, precision?: any) {
   if (areNumbers(a, b) || areBigInts(a, b) || areStrings(a, b)) {
     return a <= b;
-  } else if (areDateTimesOrQuantities(a, b)) {
+  }else if (areDecimals(a, b)) {
+    return a.lessThanOrEquals(b);
+  }  else if (areDateTimesOrQuantities(a, b)) {
     return a.sameOrBefore(b, precision);
   } else if (isUncertainty(a)) {
     return a.lessThanOrEquals(b, precision);
@@ -55,6 +63,8 @@ export function lessThanOrEquals(a: any, b: any, precision?: any) {
 export function greaterThan(a: any, b: any, precision?: any) {
   if (areNumbers(a, b) || areBigInts(a, b) || areStrings(a, b)) {
     return a > b;
+  } else if (areDecimals(a, b)) {
+    return a.greaterThan(b);
   } else if (areDateTimesOrQuantities(a, b)) {
     return a.after(b, precision);
   } else if (isUncertainty(a)) {
@@ -69,6 +79,8 @@ export function greaterThan(a: any, b: any, precision?: any) {
 export function greaterThanOrEquals(a: any, b: any, precision?: any) {
   if (areNumbers(a, b) || areBigInts(a, b) || areStrings(a, b)) {
     return a >= b;
+  } else if (areDecimals(a, b)) {
+    return a.greaterThanOrEquals(b);
   } else if (areDateTimesOrQuantities(a, b)) {
     return a.sameOrAfter(b, precision);
   } else if (isUncertainty(a)) {
diff --git a/src/util/math.ts b/src/util/math.ts
index 1f5f508fd..b0fb84436 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -8,6 +8,13 @@ import {
   MIN_TIME_VALUE,
   MAX_TIME_VALUE
 } from '../datatypes/datetime';
+
+import { 
+  Decimal,
+  MAX_DECIMAL_VALUE,
+  MIN_DECIMAL_VALUE
+} from '../datatypes/decimal';
+
 import { Uncertainty } from '../datatypes/uncertainty';
 import {
   ELM_INTEGER_TYPE,
@@ -19,11 +26,8 @@ import {
   ELM_QUANTITY_TYPE
 } from './elmTypes';
 import {
-  MAX_FLOAT_VALUE,
   MAX_INT_VALUE,
   MAX_LONG_VALUE,
-  MIN_FLOAT_PRECISION_VALUE,
-  MIN_FLOAT_VALUE,
   MIN_INT_VALUE,
   MIN_LONG_VALUE
 } from './limits';
@@ -63,15 +67,11 @@ export function overflowsOrUnderflows(value: any, type?: string): boolean {
       return true;
     }
   } else if (typeof value === 'number') {
-    // Only consider it an integer if it looks like an integer (even if the type says it's an integer).
-    // We need to do this because the CQL-to-ELM Translator's implementation of Power may incorrectly tag
-    // a result as an Integer when it really is a decimal (e.g., when the exponent is a negative number).
-    const isInteger = Number.isInteger(value) && (type === ELM_INTEGER_TYPE || type == null);
-    if (isInteger) {
       if (!isValidInteger(value)) {
         return true;
       }
-    } else if (!isValidDecimal(value)) {
+  } else if (value.isDecimal) { 
+    if (!isValidDecimal(value)) {
       return true;
     }
   } else if (value.isUncertainty) {
@@ -107,16 +107,13 @@ export function isValidLong(long: any) {
 }
 
 export function isValidDecimal(decimal: any) {
-  if (isNaN(decimal)) {
+  if (!decimal.isDecimal) {
     return false;
   }
-  if (typeof decimal !== 'number') {
+  if (decimal.greaterThan(MAX_DECIMAL_VALUE)) {
     return false;
   }
-  if (decimal > MAX_FLOAT_VALUE) {
-    return false;
-  }
-  if (decimal < MIN_FLOAT_VALUE) {
+  if (decimal.lessThan(MIN_DECIMAL_VALUE)) {
     return false;
   }
   return true;
@@ -146,9 +143,11 @@ export function add(a: any, b: any, type?: string): any {
   }
   if (typeof a === 'number' && typeof b === 'number') {
     const sum = a + b;
-    const numberType =
-      type ?? (Number.isInteger(a) && Number.isInteger(b) ? ELM_INTEGER_TYPE : ELM_DECIMAL_TYPE);
-    return overflowsOrUnderflows(sum, numberType) ? null : sum;
+    return overflowsOrUnderflows(sum, ELM_INTEGER_TYPE) ? null : sum;
+  }
+  if (a?.isDecimal && b?.isDecimal) {
+    const sum = a.add(b);
+    return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : sum;
   }
   if (a?.isQuantity && b?.isQuantity) {
     const [aValue, aUnit, bValue, bUnit] = normalizeUnitsWhenPossible(
@@ -160,7 +159,7 @@ export function add(a: any, b: any, type?: string): any {
     if (aUnit !== bUnit) {
       return null;
     }
-    const sum = aValue + bValue;
+    const sum = aValue.add(bValue);
     return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : new Quantity(sum, aUnit);
   }
   if (b?.isQuantity && (a?.isDate || a?.isDateTime || (a?.isTime && a.isTime()))) {
@@ -188,14 +187,18 @@ export function subtract(a: any, b: any, type?: string): any {
   if (typeof b === 'number' || typeof b === 'bigint') {
     return add(a, -b, type);
   }
+  if (a?.isDecimal && b?.isDecimal) {
+    const difference = a.subtract(b);
+    return overflowsOrUnderflows(difference, ELM_DECIMAL_TYPE) ? null : difference;
+  }
   if (b?.isQuantity) {
-    return add(a, { isQuantity: true, value: -b.value, unit: b.unit }, type);
+    return add(a, { isQuantity: true, value: b.value.negate(), unit: b.unit }, type);
   }
 
   throw new Error('Unsupported argument types.');
 }
 
-export function limitDecimalPrecision<T extends number | bigint | Quantity | Uncertainty>(
+export function limitDecimalPrecision<T extends number | bigint | Quantity | Uncertainty | Decimal | undefined>(
   val?: T
 ): T | undefined {
   if (val == null) {
@@ -204,7 +207,7 @@ export function limitDecimalPrecision<T extends number | bigint | Quantity | Unc
     return (Math.round(val * Math.pow(10, 8)) / Math.pow(10, 8)) as T;
   } else if ((val as Quantity).isQuantity) {
     return new Quantity(
-      limitDecimalPrecision((val as Quantity).value),
+      limitDecimalPrecision((val as Quantity).value) as Decimal,
       (val as Quantity).unit
     ) as T;
   } else if ((val as Uncertainty).isUncertainty) {
@@ -220,19 +223,10 @@ export class OverFlowException extends Exception {}
 
 export function successor(val: any, type?: string, precision?: string): any {
   if (typeof val === 'number') {
-    const isInteger = type === ELM_INTEGER_TYPE || (type == null && Number.isInteger(val));
-    if (isInteger) {
-      if (val >= MAX_INT_VALUE) {
-        throw new OverFlowException();
-      } else {
-        return val + 1;
-      }
+    if (val >= MAX_INT_VALUE) {
+      throw new OverFlowException();
     } else {
-      if (val >= MAX_FLOAT_VALUE) {
-        throw new OverFlowException();
-      } else {
-        return val + MIN_FLOAT_PRECISION_VALUE;
-      }
+      return val + 1;
     }
   } else if (typeof val === 'bigint') {
     if (val >= MAX_LONG_VALUE) {
@@ -240,6 +234,12 @@ export function successor(val: any, type?: string, precision?: string): any {
     } else {
       return val + 1n;
     }
+  } else if (val && val.isDecimal) {
+    if (val.greaterThanOrEquals(MAX_DECIMAL_VALUE)) {
+      throw new OverFlowException();
+    } else {
+      return val.successor();
+    }
   } else if (val && val.isTime && val.isTime()) {
     if (val.sameAs(MAX_TIME_VALUE)) {
       throw new OverFlowException();
@@ -279,19 +279,10 @@ export function successor(val: any, type?: string, precision?: string): any {
 
 export function predecessor(val: any, type?: string, precision?: string): any {
   if (typeof val === 'number') {
-    const isInteger = type === ELM_INTEGER_TYPE || (type == null && Number.isInteger(val));
-    if (isInteger) {
-      if (val <= MIN_INT_VALUE) {
-        throw new OverFlowException();
-      } else {
-        return val - 1;
-      }
+    if (val <= MIN_INT_VALUE) {
+      throw new OverFlowException();
     } else {
-      if (val <= MIN_FLOAT_VALUE) {
-        throw new OverFlowException();
-      } else {
-        return val - MIN_FLOAT_PRECISION_VALUE;
-      }
+      return val - 1;
     }
   } else if (typeof val === 'bigint') {
     if (val <= MIN_LONG_VALUE) {
@@ -299,6 +290,12 @@ export function predecessor(val: any, type?: string, precision?: string): any {
     } else {
       return val - 1n;
     }
+  } else if (val && val.isDecimal) {
+    if (val.lessThanOrEquals(MIN_DECIMAL_VALUE)) {
+      throw new OverFlowException();
+    } else {
+      return val.predecessor();
+    }
   } else if (val && val.isTime && val.isTime()) {
     if (val.sameAs(MIN_TIME_VALUE)) {
       throw new OverFlowException();
@@ -343,7 +340,7 @@ export function maxValueForType(type: string, quantityInstance?: Quantity) {
     case ELM_LONG_TYPE:
       return MAX_LONG_VALUE;
     case ELM_DECIMAL_TYPE:
-      return MAX_FLOAT_VALUE;
+      return MAX_DECIMAL_VALUE;
     case ELM_DATETIME_TYPE:
       return MAX_DATETIME_VALUE?.copy();
     case ELM_DATE_TYPE:
@@ -355,7 +352,7 @@ export function maxValueForType(type: string, quantityInstance?: Quantity) {
       // especially if this is being used in the context of an interval or uncertainty since the
       // left and right sides need to be comparable in those cases.
       // See: https://jira.hl7.org/browse/FHIR-57935
-      return new Quantity(MAX_FLOAT_VALUE, quantityInstance?.unit || '1');
+      return new Quantity(MAX_DECIMAL_VALUE, quantityInstance?.unit || '1');
     }
   }
   return null;
@@ -368,7 +365,7 @@ export function minValueForType(type: string, quantityInstance?: Quantity) {
     case ELM_LONG_TYPE:
       return MIN_LONG_VALUE;
     case ELM_DECIMAL_TYPE:
-      return MIN_FLOAT_VALUE;
+      return MIN_DECIMAL_VALUE;
     case ELM_DATETIME_TYPE:
       return MIN_DATETIME_VALUE?.copy();
     case ELM_DATE_TYPE:
@@ -380,7 +377,7 @@ export function minValueForType(type: string, quantityInstance?: Quantity) {
       // especially if this is being used in the context of an interval or uncertainty since the
       // left and right sides need to be comparable in those cases.
       // See: https://jira.hl7.org/browse/FHIR-57935
-      return new Quantity(MIN_FLOAT_VALUE, quantityInstance?.unit || '1');
+      return new Quantity(MIN_DECIMAL_VALUE, quantityInstance?.unit || '1');
     }
   }
   return null;
@@ -414,7 +411,8 @@ export function decimalOrNull(value: any) {
 }
 
 export function decimalLongOrNull(value: any) {
-  return (typeof value === 'number' && isValidDecimal(value)) ||
+  return (typeof value === 'number' && Number.isFinite(value)) ||
+    ((value && value.isDecimal) && isValidDecimal(value)) ||
     (typeof value === 'bigint' && isValidLong(value))
     ? value
     : null;
diff --git a/src/util/units.ts b/src/util/units.ts
index 31f513d6a..553720f42 100644
--- a/src/util/units.ts
+++ b/src/util/units.ts
@@ -1,5 +1,6 @@
 import * as ucum from '@lhncbc/ucum-lhc';
 import { decimalAdjust } from './math';
+import { Decimal } from '../datatypes/decimal';
 const utils = ucum.UcumLhcUtils.getInstance();
 
 // The CQL specification says that dates are based on the Gregorian calendar, so CQL-based year and month
@@ -69,12 +70,16 @@ export function checkUnit(unit: any, allowEmptyUnits = true, allowCQLDateUnits =
 
 export function convertUnit(fromVal: any, fromUnit: any, toUnit: any, adjustPrecision = true) {
   [fromUnit, toUnit] = [fromUnit, toUnit].map(fixUnit);
-  const result = utils.convertUnitTo(fixUnit(fromUnit), fromVal, fixUnit(toUnit));
+  // IMPORTANT: the UCUM library operates on raw JS numbers, not our Decimal
+  const rawFromVal = fromVal.isDecimal ? fromVal.value : fromVal;
+
+  const result = utils.convertUnitTo(fixUnit(fromUnit), rawFromVal, fixUnit(toUnit));
   if (result.status !== 'succeeded') {
     return;
   }
   // note: convert result.toVal to number (by prefixing +) to keep typescript happy
-  return adjustPrecision ? decimalAdjust('round', result.toVal, -8) : +result.toVal;
+  const rawRetVal = adjustPrecision ? decimalAdjust('round', result.toVal, -8) : +result.toVal;
+  return fromVal.isDecimal ? Decimal.from(rawRetVal) : rawRetVal;
 }
 
 export function normalizeUnitsWhenPossible(val1: any, unit1: any, val2: any, unit2: any) {
@@ -121,7 +126,7 @@ export function convertToCQLDateUnit(unit: any) {
 
 export function compareUnits(unit1: any, unit2: any) {
   try {
-    const c = convertUnit(1, unit1, unit2);
+    const c = convertUnit(1, unit1, unit2) as number;
     if (c && c > 1) {
       // unit1 is bigger (less precise)
       return 1;
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
new file mode 100644
index 000000000..780b1ad21
--- /dev/null
+++ b/test/datatypes/decimal-test.ts
@@ -0,0 +1,41 @@
+import { Decimal } from '../../src/datatypes/decimal';
+
+describe('Decimal', () => {
+  it('should retain Decimal runtime identity for a whole-number value', () => {
+    const decimal = Decimal.from('2.0');
+
+    decimal.isDecimal.should.equal(true);
+    (typeof decimal).should.equal('object');
+    decimal.toNumber().should.equal(2);
+  });
+
+  it('should expose arithmetic and comparison operations', () => {
+    const value = Decimal.from('1.5').subtract('0.5');
+
+    value.compareTo('1').should.equal(0);
+    value.add(2).toString().should.equal('3');
+    value.multiplyBy(2).toString().should.equal('2');
+    value.divideBy(2).toString().should.equal('0.5');
+    Decimal.from(3).modulo(2).toString().should.equal('1');
+  });
+
+  it('should provide an explicit scale and JSON representation', () => {
+    Decimal.from('0.444444444').setScale(8).toString().should.equal('0.44444444');
+    JSON.stringify({ value: Decimal.from('1.25') }).should.equal('{"value":"1.25"}');
+  });
+
+  it('should provide CQL arithmetic helpers without exposing a number', () => {
+    Decimal.from('-1.9').truncate().should.equal(-1);
+    Decimal.from('1.1').ceil().should.equal(2);
+    Decimal.from('1.9').floor().should.equal(1);
+    Decimal.from('-0.5').round().should.eql(Decimal.from(0));
+    Decimal.from('2').power(3).should.eql(Decimal.from(8));
+    Decimal.from('9').sqrt().should.eql(Decimal.from(3));
+    Decimal.from('8').log(2).should.eql(Decimal.from(3));
+  });
+
+  it('should reject non-finite and divide-by-zero values', () => {
+    (() => Decimal.from('not a number')).should.throw();
+    (() => Decimal.from(1).divideBy(0)).should.throw();
+  });
+});
diff --git a/test/datatypes/interval-data.ts b/test/datatypes/interval-data.ts
index f551726ca..4ce09e61c 100644
--- a/test/datatypes/interval-data.ts
+++ b/test/datatypes/interval-data.ts
@@ -1,6 +1,7 @@
 import { Interval } from '../../src/datatypes/interval';
 import { DateTime, Date } from '../../src/datatypes/datetime';
 import { Quantity } from '../../src/datatypes/quantity';
+import { Decimal } from '../../src/datatypes/decimal';
 
 class TestDateTime {
   static parse(string: string) {
@@ -296,7 +297,7 @@ export default () => {
       y: new TestInterval(0n, 100n)
     }
   };
-  data['zeroPointFiveToNinePointFive'] = new TestInterval(0.5, 9.5);
+  data['zeroPointFiveToNinePointFive'] = new TestInterval(Decimal.from(0.5), Decimal.from(9.5));
   data['zeroToHundredMg'] = new TestInterval(new Quantity(0, 'mg'), new Quantity(100, 'mg'));
   return data;
 };
diff --git a/test/datatypes/interval-test.ts b/test/datatypes/interval-test.ts
index adef8b2f0..29d4ff072 100644
--- a/test/datatypes/interval-test.ts
+++ b/test/datatypes/interval-test.ts
@@ -11,6 +11,7 @@ import {
 } from '../../src/datatypes/datetime';
 import { Interval } from '../../src/datatypes/interval';
 import { Quantity } from '../../src/datatypes/quantity';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../src/datatypes/decimal';
 import { Uncertainty } from '../../src/datatypes/uncertainty';
 import {
   ELM_DATE_TYPE,
@@ -133,7 +134,7 @@ describe('Interval', () => {
     });
 
     it('should return the point size for Decimal intervals', () => {
-      new Interval(0.5, 9.5).getPointSize().should.equal(0.00000001);
+      new Interval(Decimal.from(0.5), Decimal.from(9.5)).getPointSize().should.eql(Decimal.from(0.00000001));
     });
 
     it('should return the point size for Quantity intervals', () => {
@@ -155,7 +156,7 @@ describe('Interval', () => {
 
     it('should return low for intervals with closed low', () => {
       d.zeroToHundred.closed.start().should.equal(0);
-      d.zeroPointFiveToNinePointFive.closed.start().should.equal(0.5);
+      d.zeroPointFiveToNinePointFive.closed.start().should.eql(Decimal.from(0.5));
       d.zeroToHundredLong.closed.start().should.equal(0n);
       d.zeroToHundredMg.closed.start().should.eql(new Quantity(0, 'mg'));
       d.all2012date.closed.start().should.eql(Date.parse('2012-01-01'));
@@ -165,7 +166,7 @@ describe('Interval', () => {
 
     it('should return successor of low for intervals with open low', () => {
       d.zeroToHundred.openClosed.start().should.equal(1);
-      d.zeroPointFiveToNinePointFive.openClosed.start().should.equal(0.50000001);
+      d.zeroPointFiveToNinePointFive.openClosed.start().should.eql(Decimal.from(0.50000001));
       d.zeroToHundredLong.openClosed.start().should.equal(1n);
       d.zeroToHundredMg.openClosed.start().should.eql(new Quantity(0.00000001, 'mg'));
       d.all2012date.openClosed.start().should.eql(Date.parse('2012-01-02'));
@@ -178,7 +179,7 @@ describe('Interval', () => {
     it('should return type minimum for closed null low endpoints', () => {
       d.zeroToHundred.withNullStart.closed.start().should.equal(MIN_INT_VALUE);
       d.zeroToHundredLong.withNullStart.closed.start().should.equal(MIN_LONG_VALUE);
-      d.zeroPointFiveToNinePointFive.withNullStart.closed.start().should.equal(MIN_FLOAT_VALUE);
+      d.zeroPointFiveToNinePointFive.withNullStart.closed.start().should.eql(Decimal.from(MIN_FLOAT_VALUE));
       d.zeroToHundredMg.withNullStart.closed
         .start()
         .should.eql(new Quantity(MIN_FLOAT_VALUE, 'mg'));
@@ -201,10 +202,10 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_LONG_VALUE, 100n));
       d.zeroPointFiveToNinePointFive.withNullStart.openClosed
         .start()
-        .should.eql(new Uncertainty(MIN_FLOAT_VALUE, 9.5));
+        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, Decimal.from(9.5)));
       d.zeroToHundredMg.withNullStart.openClosed
         .start()
-        .should.eql(new Uncertainty(new Quantity(MIN_FLOAT_VALUE, 'mg'), new Quantity(100, 'mg')));
+        .should.eql(new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(100, 'mg')));
       d.all2012date.withNullStart.openClosed
         .start()
         .should.eql(new Uncertainty(MIN_DATE_VALUE, Date.parse('2012-12-31')));
@@ -225,11 +226,11 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_LONG_VALUE, 99n));
       d.zeroPointFiveToNinePointFive.withNullStart.open
         .start()
-        .should.eql(new Uncertainty(MIN_FLOAT_VALUE, 9.49999999));
+        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, Decimal.from(9.49999999)));
       d.zeroToHundredMg.withNullStart.open
         .start()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_FLOAT_VALUE, 'mg'), new Quantity(99.99999999, 'mg'))
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(99.99999999, 'mg'))
         );
       d.all2012date.withNullStart.open
         .start()
@@ -252,7 +253,7 @@ describe('Interval', () => {
     it('should use default point type when both endpoints are null', () => {
       new Interval(null, null, true, true, ELM_INTEGER_TYPE).start().should.equal(MIN_INT_VALUE);
       new Interval(null, null, true, true, ELM_LONG_TYPE).start().should.equal(MIN_LONG_VALUE);
-      new Interval(null, null, true, true, ELM_DECIMAL_TYPE).start().should.equal(MIN_FLOAT_VALUE);
+      new Interval(null, null, true, true, ELM_DECIMAL_TYPE).start().should.eql(MIN_DECIMAL_VALUE);
       new Interval(null, null, true, true, ELM_QUANTITY_TYPE)
         .start()
         .should.eql(new Quantity(MIN_FLOAT_VALUE, '1'));
@@ -272,11 +273,11 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_LONG_VALUE, MAX_LONG_VALUE));
       new Interval(null, null, false, false, ELM_DECIMAL_TYPE)
         .start()
-        .should.eql(new Uncertainty(MIN_FLOAT_VALUE, MAX_FLOAT_VALUE));
+        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, MAX_DECIMAL_VALUE));
       new Interval(null, null, false, false, ELM_QUANTITY_TYPE)
         .start()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_FLOAT_VALUE, '1'), new Quantity(MAX_FLOAT_VALUE, '1'))
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
         );
       new Interval(null, null, false, false, ELM_DATETIME_TYPE)
         .start()
@@ -295,7 +296,7 @@ describe('Interval', () => {
 
     it('should return high for intervals with closed high', () => {
       d.zeroToHundred.closed.end().should.equal(100);
-      d.zeroPointFiveToNinePointFive.closed.end().should.equal(9.5);
+      d.zeroPointFiveToNinePointFive.closed.end().should.eql(Decimal.from(9.5));
       d.zeroToHundredLong.closed.end().should.equal(100n);
       d.zeroToHundredMg.closed.end().should.eql(new Quantity(100, 'mg'));
       d.all2012date.closed.end().should.eql(Date.parse('2012-12-31'));
@@ -305,7 +306,7 @@ describe('Interval', () => {
 
     it('should return predecessor of high for intervals with open high', () => {
       d.zeroToHundred.closedOpen.end().should.equal(99);
-      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equal(9.49999999);
+      d.zeroPointFiveToNinePointFive.closedOpen.end().should.eql(Decimal.from(9.49999999));
       d.zeroToHundredLong.closedOpen.end().should.equal(99n);
       d.zeroToHundredMg.closedOpen.end().should.eql(new Quantity(99.99999999, 'mg'));
       d.all2012date.closedOpen.end().should.eql(Date.parse('2012-12-30'));
@@ -316,8 +317,8 @@ describe('Interval', () => {
     it('should return type maximum for closed null high endpoints', () => {
       d.zeroToHundred.withNullEnd.closed.end().should.equal(MAX_INT_VALUE);
       d.zeroToHundredLong.withNullEnd.closed.end().should.equal(MAX_LONG_VALUE);
-      d.zeroPointFiveToNinePointFive.withNullEnd.closed.end().should.equal(MAX_FLOAT_VALUE);
-      d.zeroToHundredMg.withNullEnd.closed.end().should.eql(new Quantity(MAX_FLOAT_VALUE, 'mg'));
+      d.zeroPointFiveToNinePointFive.withNullEnd.closed.end().should.eql(MAX_DECIMAL_VALUE);
+      d.zeroToHundredMg.withNullEnd.closed.end().should.eql(new Quantity(MAX_DECIMAL_VALUE, 'mg'));
       d.all2012date.withNullEnd.closed.end().should.eql(MAX_DATE_VALUE);
       d.all2012.withNullEnd.closed.end().should.eql(MAX_DATETIME_VALUE);
       d.alldaytime.withNullEnd.closed.end().should.eql(MAX_TIME_VALUE);
@@ -335,10 +336,10 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(0n, MAX_LONG_VALUE));
       d.zeroPointFiveToNinePointFive.withNullEnd.closedOpen
         .end()
-        .should.eql(new Uncertainty(0.5, MAX_FLOAT_VALUE));
+        .should.eql(new Uncertainty(Decimal.from(0.5), MAX_DECIMAL_VALUE));
       d.zeroToHundredMg.withNullEnd.closedOpen
         .end()
-        .should.eql(new Uncertainty(new Quantity(0, 'mg'), new Quantity(MAX_FLOAT_VALUE, 'mg')));
+        .should.eql(new Uncertainty(new Quantity(0, 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg')));
       d.all2012date.withNullEnd.closedOpen
         .end()
         .should.eql(new Uncertainty(Date.parse('2012-01-01'), MAX_DATE_VALUE));
@@ -357,11 +358,11 @@ describe('Interval', () => {
       d.zeroToHundredLong.withNullEnd.open.end().should.eql(new Uncertainty(1n, MAX_LONG_VALUE));
       d.zeroPointFiveToNinePointFive.withNullEnd.open
         .end()
-        .should.eql(new Uncertainty(0.50000001, MAX_FLOAT_VALUE));
+        .should.eql(new Uncertainty(Decimal.from(0.50000001), MAX_DECIMAL_VALUE));
       d.zeroToHundredMg.withNullEnd.open
         .end()
         .should.eql(
-          new Uncertainty(new Quantity(0.00000001, 'mg'), new Quantity(MAX_FLOAT_VALUE, 'mg'))
+          new Uncertainty(new Quantity(0.00000001, 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg'))
         );
       d.all2012date.withNullEnd.open
         .end()
@@ -384,7 +385,7 @@ describe('Interval', () => {
     it('should use default point type when both endpoints are null', () => {
       new Interval(null, null, true, true, ELM_INTEGER_TYPE).end().should.equal(MAX_INT_VALUE);
       new Interval(null, null, true, true, ELM_LONG_TYPE).end().should.equal(MAX_LONG_VALUE);
-      new Interval(null, null, true, true, ELM_DECIMAL_TYPE).end().should.equal(MAX_FLOAT_VALUE);
+      new Interval(null, null, true, true, ELM_DECIMAL_TYPE).end().should.eql(MAX_DECIMAL_VALUE);
       new Interval(null, null, true, true, ELM_QUANTITY_TYPE)
         .end()
         .should.eql(new Quantity(MAX_FLOAT_VALUE, '1'));
@@ -402,11 +403,11 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_LONG_VALUE, MAX_LONG_VALUE));
       new Interval(null, null, false, false, ELM_DECIMAL_TYPE)
         .end()
-        .should.eql(new Uncertainty(MIN_FLOAT_VALUE, MAX_FLOAT_VALUE));
+        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, MAX_DECIMAL_VALUE));
       new Interval(null, null, false, false, ELM_QUANTITY_TYPE)
         .end()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_FLOAT_VALUE, '1'), new Quantity(MAX_FLOAT_VALUE, '1'))
+          new Uncertainty(new Quantity(MIN_FLOAT_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
         );
       new Interval(null, null, false, false, ELM_DATETIME_TYPE)
         .end()
@@ -7003,37 +7004,37 @@ describe('DecimalInterval', () => {
   });
 
   it('should calculate width and size outside the Integer range', () => {
-    const interval = new Interval(0.0, 3000000000.0, true, true, ELM_DECIMAL_TYPE);
+    const interval = new Interval(Decimal.from(0.0), Decimal.from(3000000000.0), true, true, ELM_DECIMAL_TYPE);
 
-    interval.width().should.equal(3000000000.0);
-    interval.size().should.equal(3000000000.0);
+    interval.width().should.eql(Decimal.from(3000000000.0));
+    interval.size().should.eql(Decimal.from(3000000000.0));
   });
 
   it('should close open decimal uncertainty endpoints using decimal point size', () => {
     const closed = new Interval(
-      new Uncertainty(1, 2),
-      new Uncertainty(3, 4),
+      new Uncertainty(Decimal.from(1), Decimal.from(2)),
+      new Uncertainty(Decimal.from(3), Decimal.from(4)),
       false,
       false,
       ELM_DECIMAL_TYPE
     ).toClosed();
 
-    closed.low.should.eql(new Uncertainty(1.00000001, 2.00000001));
-    closed.high.should.eql(new Uncertainty(2.99999999, 3.99999999));
+    closed.low.should.eql(new Uncertainty(Decimal.from(1.00000001), Decimal.from(2.00000001)));
+    closed.high.should.eql(new Uncertainty(Decimal.from(2.99999999), Decimal.from(3.99999999)));
     closed.lowClosed.should.be.true();
     closed.highClosed.should.be.true();
   });
 
   it('should use decimal point size for meetsBefore decimal uncertainty bounds', () => {
-    const earlier = new Interval(1, 1.99999999);
-    const later = new Interval(new Uncertainty(2, 2), null, true, false, ELM_DECIMAL_TYPE);
+    const earlier = new Interval(Decimal.from(1), Decimal.from(1.99999999));
+    const later = new Interval(new Uncertainty(Decimal.from(2), Decimal.from(2)), null, true, false, ELM_DECIMAL_TYPE);
 
     earlier.meetsBefore(later).should.be.true();
   });
 
   it('should use decimal point size for meetsAfter decimal uncertainty bounds', () => {
-    const earlier = new Interval(null, new Uncertainty(1, 1), false, true, ELM_DECIMAL_TYPE);
-    const later = new Interval(1.00000001, 2);
+    const earlier = new Interval(null, new Uncertainty(Decimal.from(1), Decimal.from(1)), false, true, ELM_DECIMAL_TYPE);
+    const later = new Interval(Decimal.from(1.00000001), Decimal.from(2));
 
     later.meetsAfter(earlier).should.be.true();
   });
@@ -7099,12 +7100,12 @@ describe('DecimalInterval', () => {
   });
 
   it('should properly handle null endpoints', () => {
-    const decimal = 1.5;
-    const early = -1.5;
-    const late = 3.5;
-    const decimalInterval = new Interval(0.5, 1.5);
-    const earlyInterval = new Interval(early, -0.5);
-    const lateInterval = new Interval(3.5, late);
+    const decimal = Decimal.from(1.5);
+    const early = Decimal.from(-1.5);
+    const late = Decimal.from(3.5);
+    const decimalInterval = new Interval(Decimal.from(0.5), Decimal.from(1.5));
+    const earlyInterval = new Interval(early, Decimal.from(-0.5));
+    const lateInterval = new Interval(Decimal.from(3.5), late);
     const startsAtDecimal = new Interval(decimal, late);
     const endsAtDecimal = new Interval(early, decimal);
 
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 9fa028950..d4da6e1bd 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -1,9 +1,10 @@
 import should from 'should';
 import setup from '../../setup';
+import { Decimal } from '../../../src/datatypes/decimal';
 const data = require('./data');
 const validateQuantity = function (object: any, expectedValue: any, expectedUnit: any) {
   object.isQuantity.should.be.true();
-  object.value.should.equal(expectedValue);
+  object.value.should.eql(Decimal.from(expectedValue));
   object.unit.should.equal(expectedUnit);
 };
 
@@ -72,11 +73,11 @@ describe('Sum', () => {
   });
 
   it('should be able to sum lists with decimals', async function () {
-    (await this.decimals.exec(this.ctx)).should.equal(16.5);
+    (await this.decimals.exec(this.ctx)).should.eql(Decimal.from(16.5));
   });
 
   it('should be able to sum decimals up to max decimal value', async function () {
-    (await this.decimals_at_max_value.exec(this.ctx)).should.equal(99999999999999999999.99999999);
+    (await this.decimals_at_max_value.exec(this.ctx)).should.eql(Decimal.from(99999999999999999999.99999999));
   });
 
   it('should return null when overflowing the max decimal value', async function () {
@@ -84,7 +85,7 @@ describe('Sum', () => {
   });
 
   it('should be able to sum decimals down to min decimal value', async function () {
-    (await this.decimals_at_min_value.exec(this.ctx)).should.equal(-99999999999999999999.99999999);
+    (await this.decimals_at_min_value.exec(this.ctx)).should.eql(Decimal.from(-99999999999999999999.99999999));
   });
 
   it('should return null when underflowing the min decimal value', async function () {
@@ -183,7 +184,7 @@ describe('Min', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMin.exec(this.ctx)).should.equal(-5);
+    (await this.decimalMin.exec(this.ctx)).should.eql(Decimal.from(-5));
   });
 
   it('list of DateTimes', async function () {
@@ -260,7 +261,7 @@ describe('Max', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMax.exec(this.ctx)).should.equal(5.1);
+    (await this.decimalMax.exec(this.ctx)).should.eql(Decimal.from(5.1));
   });
 
   it('list of DateTimes', async function () {
@@ -309,11 +310,11 @@ describe('Avg', () => {
   });
 
   it('should be able to find average for lists without nulls', async function () {
-    (await this.not_null.exec(this.ctx)).should.equal(3);
+    (await this.not_null.exec(this.ctx)).should.eql(Decimal.from(3));
   });
 
   it('should be able to find average for lists with nulls', async function () {
-    (await this.has_null.exec(this.ctx)).should.equal(1.5);
+    (await this.has_null.exec(this.ctx)).should.eql(Decimal.from(1.5));
   });
 
   it('should return null for empty list', async function () {
@@ -350,19 +351,19 @@ describe('Median', () => {
   });
 
   it('should be able to find median of odd numbered list', async function () {
-    (await this.odd.exec(this.ctx)).should.equal(3);
+    (await this.odd.exec(this.ctx)).should.eql(Decimal.from(3));
   });
 
   it('should be able to find median of even numbered list', async function () {
-    (await this.even.exec(this.ctx)).should.equal(3.5);
+    (await this.even.exec(this.ctx)).should.eql(Decimal.from(3.5));
   });
 
   it('should be able to find median of odd numbered list that contains duplicates', async function () {
-    (await this.dup_vals_odd.exec(this.ctx)).should.equal(3);
+    (await this.dup_vals_odd.exec(this.ctx)).should.eql(Decimal.from(3));
   });
 
   it('should be able to find median of even numbered list that contians duplicates', async function () {
-    (await this.dup_vals_even.exec(this.ctx)).should.equal(2.5);
+    (await this.dup_vals_even.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
 
   it('should return null for empty list', async function () {
@@ -437,7 +438,7 @@ describe('PopulationVariance', () => {
     setup(this, data);
   });
   it('should be able to find PopulationVariance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.equal(2);
+    (await this.v.exec(this.ctx)).should.eql(Decimal.from(2));
   });
   it('should be able to find PopulationVariance of a list of like quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2, 'ml');
@@ -458,7 +459,7 @@ describe('Variance', () => {
     setup(this, data);
   });
   it('should be able to find Variance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.equal(2.5);
+    (await this.v.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
   it('should be able to find Variance of a list of matched quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2.5, 'ml');
@@ -479,7 +480,7 @@ describe('StdDev', () => {
     setup(this, data);
   });
   it('should be able to find Standard Dev of a list ', async function () {
-    (await this.std.exec(this.ctx)).should.equal(1.5811388300841898);
+    (await this.std.exec(this.ctx)).should.eql(Decimal.from(1.58113883));
   });
   it('should be able to find Standard Dev of a list of like quantities', async function () {
     validateQuantity(await this.std_q.exec(this.ctx), 1.5811388300841898, 'ml');
@@ -500,7 +501,7 @@ describe('PopulationStdDev', () => {
     setup(this, data);
   });
   it('should be able to find Population Standard Dev of a list ', async function () {
-    (await this.dev.exec(this.ctx)).should.equal(1.4142135623730951);
+    (await this.dev.exec(this.ctx)).should.eql(Decimal.from(1.41421356));
   });
   it('should be able to find Population Standard Dev of a list of quantities', async function () {
     validateQuantity(await this.dev_q.exec(this.ctx), 1.4142135623730951, 'ml');
@@ -562,12 +563,12 @@ describe('Product', () => {
   });
 
   it('should return a decimal product', async function () {
-    (await this.decimal_product.exec(this.ctx)).should.equal(24.0);
+    (await this.decimal_product.exec(this.ctx)).should.eql(Decimal.from(24.0));
   });
 
   it('should return decimal product up to max decimal value', async function () {
-    (await this.decimals_at_max_value_product.exec(this.ctx)).should.equal(
-      99999999999999999999.99999999
+    (await this.decimals_at_max_value_product.exec(this.ctx)).should.eql(
+      Decimal.from(99999999999999999999.99999999)
     );
   });
 
@@ -576,8 +577,8 @@ describe('Product', () => {
   });
 
   it('should return decimal product down to min decimal value', async function () {
-    (await this.decimals_at_min_value_product.exec(this.ctx)).should.equal(
-      -99999999999999999999.99999999
+    (await this.decimals_at_min_value_product.exec(this.ctx)).should.eql(
+      Decimal.from(-99999999999999999999.99999999)
     );
   });
 
@@ -653,15 +654,15 @@ describe('GeometricMean', () => {
   });
 
   it('should return decimal geometric mean', async function () {
-    (await this.decimal_geometric_mean.exec(this.ctx)).should.equal(4.0);
+    (await this.decimal_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(4.0));
   });
 
   it('should retun 0 as a geometric mean', async function () {
-    (await this.zero_geometric_mean.exec(this.ctx)).should.equal(0);
+    (await this.zero_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(0));
   });
 
   it('should return value when pass in list that contains nulls', async function () {
-    (await this.null_geometric_mean.exec(this.ctx)).should.equal(1.4142135623730951);
+    (await this.null_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(1.41421356));
   });
 
   it('should return null when list is all null', async function () {
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index b9e866575..618265736 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -9,10 +9,8 @@ import {
 } from '../../../src/datatypes/quantity';
 import setup from '../../setup';
 import {
-  MAX_FLOAT_VALUE,
   MAX_INT_VALUE,
   MAX_LONG_VALUE,
-  MIN_FLOAT_VALUE,
   MIN_INT_VALUE,
   MIN_LONG_VALUE
 } from '../../../src/util/limits';
@@ -24,10 +22,11 @@ import {
   MIN_DATETIME_VALUE,
   MIN_TIME_VALUE
 } from '../../../src/datatypes/datetime';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
 
 const data = require('./data');
 
-const validateQuantity = function (object: any, expectedValue: number, expectedUnit: string) {
+const validateQuantity = function (object: any, expectedValue: number | Decimal, expectedUnit: string) {
   object.isQuantity.should.be.true();
   const q = new Quantity(expectedValue, expectedUnit);
   q.equals(object).should.be.true('Expected ' + object + ' to equal ' + q);
@@ -212,64 +211,64 @@ describe('Divide', () => {
   });
 
   it('should divide two numbers', async function () {
-    (await this.tenDividedByTwo.exec(this.ctx)).should.equal(5);
+    (await this.tenDividedByTwo.exec(this.ctx)).should.eql(Decimal.from(5));
   });
 
   it("should divide two numbers that don't evenly divide", async function () {
-    (await this.tenDividedByFour.exec(this.ctx)).should.equal(2.5);
+    (await this.tenDividedByFour.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
 
   it('should divide multiple numbers', async function () {
-    (await this.divideMultiple.exec(this.ctx)).should.equal(5);
+    (await this.divideMultiple.exec(this.ctx)).should.eql(Decimal.from(5));
   });
 
   it('should divide variables', async function () {
-    (await this.divideVariables.exec(this.ctx)).should.equal(25);
+    (await this.divideVariables.exec(this.ctx)).should.eql(Decimal.from(25));
   });
 
   it('should divide two longs', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoLong.exec(this.ctx)).should.equal(5);
+    (await this.tenDividedByTwoLong.exec(this.ctx)).should.eql(Decimal.from(5));
   });
 
   it('should divide integer by long', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.equal(5);
+    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.eql(Decimal.from(5));
   });
 
   it('should divide long by integer', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.equal(5);
+    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.eql(Decimal.from(5));
   });
 
   it('should divide two longs with decimal result', async function () {
-    (await this.tenDividedByFourLong.exec(this.ctx)).should.equal(2.5);
+    (await this.tenDividedByFourLong.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
 
   it('should divide integer by long with decimal result', async function () {
-    (await this.tenDividedByFourMixed.exec(this.ctx)).should.equal(2.5);
+    (await this.tenDividedByFourMixed.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
 
   it('should divide long by integer with decimal result', async function () {
-    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.equal(2.5);
+    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.eql(Decimal.from(2.5));
   });
 
   it('should divide uncertainty by uncertainty', async function () {
     const result = await this.divideUncertainties.exec(this.ctx);
-    result.low.should.equal(6 / 14);
-    result.high.should.equal(9);
+    result.low.should.eql(Decimal.from(0.42857143)); // 6/14
+    result.high.should.eql(Decimal.from(9));
   });
 
   it('should divide uncertainty by number', async function () {
     const result = await this.divideUncertaintyByNumber.exec(this.ctx);
-    result.low.should.equal(3);
-    result.high.should.equal(9);
+    result.low.should.eql(Decimal.from(3));
+    result.high.should.eql(Decimal.from(9));
   });
 
   it('should divide number by uncertainty', async function () {
     const result = await this.divideNumberByUncertainty.exec(this.ctx);
-    result.low.should.equal(2);
-    result.high.should.equal(6);
+    result.low.should.eql(Decimal.from(2));
+    result.high.should.eql(Decimal.from(6));
   });
 });
 
@@ -301,11 +300,11 @@ describe('MathPrecedence', () => {
   });
 
   it('should follow order of operations', async function () {
-    (await this.mixed.exec(this.ctx)).should.equal(46);
+    (await this.mixed.exec(this.ctx)).should.eql(Decimal.from(46));
   });
 
   it('should allow parentheses to override order of operations', async function () {
-    (await this.parenthetical.exec(this.ctx)).should.equal(-10);
+    (await this.parenthetical.exec(this.ctx)).should.eql(Decimal.from(-10));
   });
 });
 
@@ -315,11 +314,11 @@ describe('Power', () => {
   });
 
   it('should be able to calculate the power of a number', async function () {
-    (await this.pow.exec(this.ctx)).should.equal(81);
+    (await this.pow.exec(this.ctx)).should.eql(81);
   });
 
   it('should be able to calculate the negative power of a number', async function () {
-    (await this.negPow.exec(this.ctx)).should.equal(0.1);
+    (await this.negPow.exec(this.ctx)).should.eql(Decimal.from(0.1));
   });
 
   it('should be able to calculate the power of a long', async function () {
@@ -335,7 +334,7 @@ describe('Power', () => {
   });
 
   it('should be able to calculate the negative power of a long', async function () {
-    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.equal(0.1);
+    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.eql(Decimal.from(0.1));
   });
 
   it('should return null when a long power exponent is too large (beyond max Long value)', async function () {
@@ -552,11 +551,11 @@ describe('Ln', () => {
   });
 
   it('should be able to return the natural log of a number', async function () {
-    (await this.ln.exec(this.ctx)).should.equal(Math.log(4));
+    (await this.ln.exec(this.ctx)).should.eql(Decimal.from(Math.log(4)));
   });
 
   it('should be able to return the natural log of a long', async function () {
-    (await this.lnFourLong.exec(this.ctx)).should.equal(Math.log(4));
+    (await this.lnFourLong.exec(this.ctx)).should.eql(Decimal.from(Math.log(4)));
   });
 });
 
@@ -566,11 +565,11 @@ describe('Log', () => {
   });
 
   it('should be able to return the log of a number based on an arbitrary base value', async function () {
-    (await this.log.exec(this.ctx)).should.equal(0.25);
+    (await this.log.exec(this.ctx)).should.eql(Decimal.from(0.25));
   });
 
   it('should be able to return the log of a long based on an arbitrary base value', async function () {
-    (await this.logLong.exec(this.ctx)).should.equal(0.25);
+    (await this.logLong.exec(this.ctx)).should.eql(Decimal.from(0.25));
   });
 });
 
@@ -639,12 +638,12 @@ describe('Round', () => {
   });
 
   it('should be able to round a number up or down to the closest integer value', async function () {
-    (await this.up.exec(this.ctx)).should.equal(5);
-    (await this.down.exec(this.ctx)).should.equal(4);
+    (await this.up.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.down.exec(this.ctx)).should.eql(Decimal.from(4));
   });
   it('should be able to round a number up or down to the closest decimal place ', async function () {
-    (await this.up_percent.exec(this.ctx)).should.equal(4.6);
-    (await this.down_percent.exec(this.ctx)).should.equal(4.4);
+    (await this.up_percent.exec(this.ctx)).should.eql(Decimal.from(4.6));
+    (await this.down_percent.exec(this.ctx)).should.eql(Decimal.from(4.4));
   });
 });
 
@@ -662,7 +661,7 @@ describe('Successor', () => {
   });
 
   it('should be able to get Real Successor', async function () {
-    (await this.rs.exec(this.ctx)).should.equal(2.2 + Math.pow(10, -8));
+    (await this.rs.exec(this.ctx)).should.eql(Decimal.from(2.2 + Math.pow(10, -8)));
   });
 
   it('should return null for Successor greater than Integer Max value', async function () {
@@ -765,7 +764,7 @@ describe('Predecessor', () => {
   });
 
   it('should be able to get Real Predecessor', async function () {
-    (await this.rs.exec(this.ctx)).should.equal(2.2 - Math.pow(10, -8));
+    (await this.rs.exec(this.ctx)).should.eql(Decimal.from(2.2 - Math.pow(10, -8)));
   });
 
   it('should return null for Predecessor greater than Integer Max value', async function () {
@@ -892,13 +891,13 @@ describe('Quantity', () => {
 
   it('should be able to perform Quantity Absolution', async function () {
     const q = await this.abs.exec(this.ctx);
-    q.value.should.equal(10);
+    q.value.should.eql(Decimal.from(10));
     q.unit.should.equal('days');
   });
 
   it('should be able to perform Quantity Negation', async function () {
     const q = await this.neg.exec(this.ctx);
-    q.value.should.equal(-10);
+    q.value.should.eql(Decimal.from(-10));
     q.unit.should.equal('days');
   });
 
@@ -1024,12 +1023,12 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but more than max integer and near JavaScript max safe number
-      should(await this.integerDivideNearOverflow.exec(this.ctx)).equal(8589934588000000);
+      should(await this.integerDivideNearOverflow.exec(this.ctx)).eql(Decimal.from(8589934588000000));
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but less than min integer and near JavaScript min safe number
-      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equal(-8589934592000000);
+      should(await this.integerDivideNearUnderflow.exec(this.ctx)).eql(Decimal.from(-8589934592000000));
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1128,12 +1127,12 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but near JavaScript max safe number
-      should(await this.longDivideNearOverflow.exec(this.ctx)).equal(9007199254740992);
+      should(await this.longDivideNearOverflow.exec(this.ctx)).eql(Decimal.from(9007199254740992n));
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but near JavaScript min safe number
-      should(await this.longDivideNearUnderflow.exec(this.ctx)).equal(-9007199254740992);
+      should(await this.longDivideNearUnderflow.exec(this.ctx)).eql(Decimal.from(-9007199254740992n));
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1183,11 +1182,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Add near overflow', async function () {
-      should(await this.decimalAddNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalAddNearOverflow.exec(this.ctx)).eql(MAX_DECIMAL_VALUE);
     });
 
     it('should return value for Add near underflow', async function () {
-      should(await this.decimalAddNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalAddNearUnderflow.exec(this.ctx)).eql(MIN_DECIMAL_VALUE);
     });
 
     it('should return null for Subtract overflow', async function () {
@@ -1199,11 +1198,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Subtract near overflow', async function () {
-      should(await this.decimalSubtractNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalSubtractNearOverflow.exec(this.ctx)).eql(MAX_DECIMAL_VALUE);
     });
 
     it('should return value for Subtract near underflow', async function () {
-      should(await this.decimalSubtractNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalSubtractNearUnderflow.exec(this.ctx)).eql(MIN_DECIMAL_VALUE);
     });
 
     it('should return null for Multiply overflow', async function () {
@@ -1215,11 +1214,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Multiply near overflow', async function () {
-      should(await this.decimalMultiplyNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalMultiplyNearOverflow.exec(this.ctx)).eql(MAX_DECIMAL_VALUE);
     });
 
     it('should return value for Multiply near underflow', async function () {
-      should(await this.decimalMultiplyNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalMultiplyNearUnderflow.exec(this.ctx)).eql(MIN_DECIMAL_VALUE);
     });
 
     it('should return null for Divide overflow', async function () {
@@ -1231,11 +1230,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Divide near overflow', async function () {
-      should(await this.decimalDivideNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalDivideNearOverflow.exec(this.ctx)).eql(MAX_DECIMAL_VALUE);
     });
 
     it('should return value for Divide near underflow', async function () {
-      should(await this.decimalDivideNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalDivideNearUnderflow.exec(this.ctx)).eql(MIN_DECIMAL_VALUE);
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1251,11 +1250,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Power near overflow', async function () {
-      should(await this.decimalPowerNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalPowerNearOverflow.exec(this.ctx)).eql(MAX_DECIMAL_VALUE);
     });
 
     it('should return value for Power near underflow', async function () {
-      should(await this.decimalPowerNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalPowerNearUnderflow.exec(this.ctx)).eql(MIN_DECIMAL_VALUE);
     });
 
     it('should return null for successor overflow', async function () {
@@ -1268,11 +1267,11 @@ describe('OutOfBounds', () => {
 
     // NOTE: skipping successor/predecessor tests near overflow due to JS Number imprecision
     it.skip('should return value for successor near overflow', async function () {
-      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equal(MAX_FLOAT_VALUE);
+      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equal(MAX_DECIMAL_VALUE);
     });
 
     it.skip('should return value for predecessor near underflow', async function () {
-      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equal(MIN_FLOAT_VALUE);
+      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equal(MIN_DECIMAL_VALUE);
     });
   });
 
@@ -1288,13 +1287,13 @@ describe('OutOfBounds', () => {
     it('should return value for Add near overflow', async function () {
       const result = await this.quantityAddNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MAX_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MAX_DECIMAL_VALUE, 'mm');
     });
 
     it('should return value for Add near underflow', async function () {
       const result = await this.quantityAddNearUnderflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MIN_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MIN_DECIMAL_VALUE, 'mm');
     });
 
     it('should return null for Subtract overflow', async function () {
@@ -1308,13 +1307,13 @@ describe('OutOfBounds', () => {
     it('should return value for Subtract near overflow', async function () {
       const result = await this.quantitySubtractNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MAX_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MAX_DECIMAL_VALUE, 'mm');
     });
 
     it('should return value for Subtract near underflow', async function () {
       const result = await this.quantitySubtractNearUnderflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MIN_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MIN_DECIMAL_VALUE, 'mm');
     });
 
     it('should return null for Multiply overflow', async function () {
@@ -1328,13 +1327,13 @@ describe('OutOfBounds', () => {
     it('should return value for Multiply near overflow', async function () {
       const result = await this.quantityMultiplyNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MAX_FLOAT_VALUE, 'mm2');
+      validateQuantity(result, MAX_DECIMAL_VALUE, 'mm2');
     });
 
     it('should return value for Multiply near underflow', async function () {
       const result = await this.quantityMultiplyNearUnderflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MIN_FLOAT_VALUE, 'mm2');
+      validateQuantity(result, MIN_DECIMAL_VALUE, 'mm2');
     });
 
     it('should return null for Divide overflow', async function () {
@@ -1348,13 +1347,13 @@ describe('OutOfBounds', () => {
     it('should return value for Divide near overflow', async function () {
       const result = await this.quantityDivideNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MAX_FLOAT_VALUE, '1');
+      validateQuantity(result, MAX_DECIMAL_VALUE, '1');
     });
 
     it('should return value for Divide near underflow', async function () {
       const result = await this.quantityDivideNearUnderflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MIN_FLOAT_VALUE, '1');
+      validateQuantity(result, MIN_DECIMAL_VALUE, '1');
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1373,13 +1372,13 @@ describe('OutOfBounds', () => {
     it.skip('should return value for successor near overflow', async function () {
       const result = await this.quantitySuccessorNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MAX_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MAX_DECIMAL_VALUE, 'mm');
     });
 
     it.skip('should return value for predecessor near underflow', async function () {
       const result = await this.quantitPpredecessorNearOverflow.exec(this.ctx);
       should(result).not.be.null();
-      validateQuantity(result, MIN_FLOAT_VALUE, 'mm');
+      validateQuantity(result, MIN_DECIMAL_VALUE, 'mm');
     });
   });
 
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index 6548f3e60..72f6c059a 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -5,6 +5,7 @@ import { isNull } from '../../../src/util/util';
 import { DateTime } from '../../../src/datatypes/datetime';
 import { Quantity } from '../../../src/datatypes/quantity';
 import { Uncertainty } from '../../../src/datatypes/uncertainty';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('FromString', () => {
   beforeEach(function () {
@@ -28,7 +29,7 @@ describe('FromString', () => {
   });
 
   it("should convert '10.2' to Decimal", async function () {
-    (await this.decimalValid.exec(this.ctx)).should.equal(10.2);
+    (await this.decimalValid.exec(this.ctx)).should.eql(Decimal.from(10.2));
   });
 
   it("should be null trying to convert 'abc' to Decimal", async function () {
@@ -61,25 +62,25 @@ describe('FromString', () => {
 
   it('should convert "10 \'A\'" to Quantity', async function () {
     const quantity = await this.quantityStr.exec(this.ctx);
-    quantity.value.should.equal(10);
+    quantity.value.should.eql(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "+10 \'A\'" to Quantity', async function () {
     const quantity = await this.posQuantityStr.exec(this.ctx);
-    quantity.value.should.equal(10);
+    quantity.value.should.eql(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "-10 \'A\'" to Quantity', async function () {
     const quantity = await this.negQuantityStr.exec(this.ctx);
-    quantity.value.should.equal(-10);
+    quantity.value.should.eql(Decimal.from(-10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "10.0\'mA\'" to Quantity', async function () {
     const quantity = await this.quantityStrDecimal.exec(this.ctx);
-    quantity.value.should.equal(10.0);
+    quantity.value.should.eql(Decimal.from(10.0));
     quantity.unit.should.equal('mA');
   });
 
@@ -128,7 +129,7 @@ describe('FromInteger', () => {
   });
 
   it('should convert 10 to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.equal(10.0);
+    (await this.decimal10.exec(this.ctx)).should.eql(Decimal.from(10.0));
   });
 
   it('should convert null to null', async function () {
@@ -154,7 +155,7 @@ describe('FromLong', () => {
   });
 
   it('should convert 10L to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.equal(10.0);
+    (await this.decimal10.exec(this.ctx)).should.eql(Decimal.from(10.0));
   });
 
   it('should convert null to null', async function () {
@@ -185,7 +186,7 @@ describe('FromQuantity', () => {
 
   it('should convert "10 \'A\'" to "10 \'A\'"', async function () {
     const quantity = await this.quantityQuantity.exec(this.ctx);
-    quantity.value.should.equal(10);
+    quantity.value.should.eql(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 });
@@ -242,7 +243,7 @@ describe('FromDateTime', () => {
     dateTime.minute.should.equal(1);
     dateTime.second.should.equal(2);
     dateTime.millisecond.should.equal(321);
-    dateTime.timezoneOffset.should.equal(-6);
+    dateTime.timezoneOffset.should.eql(Decimal.from(-6));
   });
 });
 
@@ -344,19 +345,19 @@ describe('ToDecimal', () => {
   });
 
   it("should convert '0.0' to 0.0", async function () {
-    (await this.noSign.exec(this.ctx)).should.equal(0.0);
+    (await this.noSign.exec(this.ctx)).should.eql(Decimal.from(0.0));
   });
 
   it("should convert '+1.1' to 1.1", async function () {
-    (await this.positiveSign.exec(this.ctx)).should.equal(1.1);
+    (await this.positiveSign.exec(this.ctx)).should.eql(Decimal.from(1.1));
   });
 
   it("should convert '-1.1' to -1.1", async function () {
-    (await this.negativeSign.exec(this.ctx)).should.equal(-1.1);
+    (await this.negativeSign.exec(this.ctx)).should.eql(Decimal.from(-1.1));
   });
 
   it('should truncate decimal to 8 digits after decimal point', async function () {
-    (await this.tooPrecise.exec(this.ctx)).should.equal(0.44444444);
+    (await this.tooPrecise.exec(this.ctx)).should.eql(Decimal.from(0.44444444));
   });
 
   it('should be null for decimal that is above max decimal value', async function () {
@@ -560,17 +561,17 @@ describe('ToRatio', () => {
 
   it('should be valid given quantities with custom UCUM units', async function () {
     const ratio = await this.isValidWithCustomUCUM.exec(this.ctx);
-    ratio.numerator.value.should.eql(1.0);
+    ratio.numerator.value.should.eql(Decimal.from(1.0));
     ratio.numerator.unit.should.eql('{foo:bar}');
-    ratio.denominator.value.should.eql(2.0);
+    ratio.denominator.value.should.eql(Decimal.from(2.0));
     ratio.denominator.unit.should.eql('mg');
   });
 
   it('should create valid ratio', async function () {
     const ratio = await this.isValid.exec(this.ctx);
-    ratio.numerator.value.should.eql(1.0);
+    ratio.numerator.value.should.eql(Decimal.from(1.0));
     ratio.numerator.unit.should.eql('mg');
-    ratio.denominator.value.should.eql(2.0);
+    ratio.denominator.value.should.eql(Decimal.from(2.0));
     ratio.denominator.unit.should.eql('mg');
   });
 });
diff --git a/test/elm/datetime/datetime-test.ts b/test/elm/datetime/datetime-test.ts
index b02346725..0c87541a8 100644
--- a/test/elm/datetime/datetime-test.ts
+++ b/test/elm/datetime/datetime-test.ts
@@ -4,6 +4,7 @@ const data = require('./data');
 import * as DT from '../../../src/datatypes/datatypes';
 import { PatientContext } from '../../../src/cql';
 import { Uncertainty } from '../../../src/datatypes/uncertainty';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('DateTime', () => {
   beforeEach(function () {
@@ -99,7 +100,7 @@ describe('DateTime', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.equal(-8);
+    d.timezoneOffset.should.eql(Decimal.from(-8));
   });
 });
 
@@ -408,8 +409,8 @@ describe('TimezoneOffsetFrom', () => {
   });
 
   it('should return the timezoneoffset from a fully defined DateTime', async function () {
-    (await this.centralEuropean.exec(this.ctx)).should.equal(1);
-    (await this.easternStandard.exec(this.ctx)).should.equal(-5);
+    (await this.centralEuropean.exec(this.ctx)).should.eql(Decimal.from(1));
+    (await this.easternStandard.exec(this.ctx)).should.eql(Decimal.from(-5));
   });
 
   it('should return the default timezone when not specified', async function () {
diff --git a/test/elm/instance/instance-test.ts b/test/elm/instance/instance-test.ts
index 70fc00e57..722e7ca05 100644
--- a/test/elm/instance/instance-test.ts
+++ b/test/elm/instance/instance-test.ts
@@ -3,6 +3,7 @@ import setup from '../../setup';
 const data = require('./data');
 import { Code, Concept } from '../../../src/datatypes/clinical';
 import { Quantity } from '../../../src/datatypes/quantity';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('Instance', () => {
   beforeEach(function () {
@@ -13,9 +14,10 @@ describe('Instance', () => {
     const q = await this.quantityA.exec(this.ctx);
     should(q).be.instanceof(Quantity);
     q.unit.should.eql('a');
-    q.value.should.eql(12);
+    const decimal12 = Decimal.from(12);
+    q.value.should.eql(decimal12);
     q.toString().should.equal("12 'a'");
-    (await this.val.exec(this.ctx)).should.eql(12);
+    (await this.val.exec(this.ctx)).should.eql(decimal12);
   });
 
   it('should be able to construct a Code', async function () {
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 710afb3c3..45d5b94b3 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -4,14 +4,13 @@ const data = require('./data');
 import { Interval } from '../../../src/datatypes/interval';
 import { DateTime, MIN_DATETIME_VALUE, MAX_DATETIME_VALUE } from '../../../src/datatypes/datetime';
 import { Uncertainty } from '../../../src/datatypes/uncertainty';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
 import {
   MIN_INT_VALUE,
   MAX_INT_VALUE,
   MIN_LONG_VALUE,
   MAX_LONG_VALUE,
-  MIN_FLOAT_VALUE,
-  MIN_FLOAT_PRECISION_VALUE,
-  MAX_FLOAT_VALUE
+  MIN_FLOAT_PRECISION_VALUE
 } from '../../../src/util/limits';
 
 describe('Interval', () => {
@@ -1620,9 +1619,9 @@ describe('Width', () => {
 
   it('should calculate the width of real intervals', async function () {
     // define RealWidth: width of Interval[1.23, 4.56]
-    (await this.realWidth.exec(this.ctx)).should.equal(3.33);
+    (await this.realWidth.exec(this.ctx)).should.eql(Decimal.from(3.33));
     // define RealOpenWidth: width of Interval(1.23, 4.56)
-    (await this.realOpenWidth.exec(this.ctx)).should.equal(3.32999998);
+    (await this.realOpenWidth.exec(this.ctx)).should.eql(Decimal.from(3.32999998));
   });
 
   it('should calculate the width of infinite intervals', async function () {
@@ -1646,7 +1645,7 @@ describe('Width', () => {
   it('should calculate the width of interval of quantities', async function () {
     // define WidthOfQuantityInterval: width of Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}]
     const width = await this.widthOfQuantityInterval.exec(this.ctx);
-    width.value.should.equal(9);
+    width.value.should.eql(Decimal.from(9));
     width.unit.should.equal('mm');
   });
 
@@ -1687,9 +1686,9 @@ describe('Size', () => {
 
   it('should calculate the size of real intervals', async function () {
     // define RealSize: Size(Interval[1.23, 4.56])
-    (await this.realSize.exec(this.ctx)).should.equal(3.33 + MIN_FLOAT_PRECISION_VALUE);
+    (await this.realSize.exec(this.ctx)).should.eql(Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE));
     // define RealOpenSize: Size(Interval(1.23, 4.56))
-    (await this.realOpenSize.exec(this.ctx)).should.equal(3.32999998 + MIN_FLOAT_PRECISION_VALUE);
+    (await this.realOpenSize.exec(this.ctx)).should.eql(Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE));
   });
 
   it('should calculate the size of infinite intervals', async function () {
@@ -1723,7 +1722,7 @@ describe('Size', () => {
   it('should calculate size of interval of quantities', async function () {
     // define SizeOfQuantityInterval: Size(Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}])
     const size = await this.sizeOfQuantityInterval.exec(this.ctx);
-    size.value.should.equal(9.00000001);
+    size.value.should.eql(Decimal.from(9.00000001));
     size.unit.should.equal('mm');
   });
 
@@ -1771,7 +1770,7 @@ describe('Start', () => {
   });
 
   it('should return the minimum possible Decimal', async function () {
-    (await this.closedNullDecimal.exec(this.ctx)).should.eql(MIN_FLOAT_VALUE);
+    (await this.closedNullDecimal.exec(this.ctx)).should.eql(MIN_DECIMAL_VALUE);
   });
 
   it('should return null when the interval is null', async function () {
@@ -1821,7 +1820,7 @@ describe('End', () => {
   });
 
   it('should return the maximum possible Decimal', async function () {
-    (await this.closedNullDecimal.exec(this.ctx)).should.eql(MAX_FLOAT_VALUE);
+    (await this.closedNullDecimal.exec(this.ctx)).should.eql(MAX_DECIMAL_VALUE);
   });
 
   it('should return null when the interval is null', async function () {
@@ -3491,6 +3490,9 @@ describe('QuantityIntervalExpand', () => {
   });
 
   it('returns null when per zero, not applicable, or mismatch interval', async function () {
+
+    console.log('debuggger')
+    
     // define perZero: expand { Interval[2 'g', 4 'g'] } per 0 'g'
     let a = await this.perZero.exec(this.ctx);
     should.not.exist(a);
@@ -3619,6 +3621,7 @@ describe('LongIntervalExpand', () => {
   it('expands lists of multiple intervals', async function () {
     let a = await this.longNullInList.exec(this.ctx);
     prettyList(a).should.equal('{ [2, 2], [3, 3], [4, 4] }');
+    // define LongOverlapping: expand { Interval[2L, 4L], Interval[3L, 5L] } per 1 '1'
     a = await this.longOverlapping.exec(this.ctx);
     prettyList(a).should.equal('{ [2, 2], [3, 3], [4, 4], [5, 5] }');
     a = await this.longNonOverlapping.exec(this.ctx);
diff --git a/test/elm/literal/literal-test.ts b/test/elm/literal/literal-test.ts
index e46dc7228..87f1d508c 100644
--- a/test/elm/literal/literal-test.ts
+++ b/test/elm/literal/literal-test.ts
@@ -1,5 +1,6 @@
 import should from 'should';
 import setup from '../../setup';
+import { Decimal } from '../../../src/datatypes/decimal';
 const data = require('./data');
 
 describe('Literal', () => {
@@ -40,11 +41,11 @@ describe('Literal', () => {
   });
 
   it('should convert .1 to decimal .1', function () {
-    this.decimalTenth.value.should.equal(0.1);
+    this.decimalTenth.value.should.eql(Decimal.from(0.1));
   });
 
   it('should execute .1 as .1', async function () {
-    (await this.decimalTenth.exec(this.ctx)).should.equal(0.1);
+    (await this.decimalTenth.exec(this.ctx)).should.eql(Decimal.from(0.1));
   });
 
   it("should convert 'true' to string 'true'", function () {
@@ -65,7 +66,7 @@ describe('Literal', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.equal(0);
+    d.timezoneOffset.should.eql(Decimal.from(0));
   });
 
   it("should execute '' as correct Time", async function () {
diff --git a/test/elm/message/message-test.ts b/test/elm/message/message-test.ts
index 6335beca6..c1f2d29db 100644
--- a/test/elm/message/message-test.ts
+++ b/test/elm/message/message-test.ts
@@ -2,6 +2,7 @@ import should from 'should';
 import setup from '../../setup';
 const data = require('./data');
 import { Repository } from '../../../src/cql';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('Message', () => {
   let messageCollector: any;
@@ -13,7 +14,7 @@ describe('Message', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.equal(0.5);
+    (await this.oneOverTwo.exec(this.ctx)).should.eql(Decimal.from(0.5));
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
@@ -39,7 +40,7 @@ describe('Retrieve', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.equal(0.5);
+    (await this.oneOverTwo.exec(this.ctx)).should.eql(Decimal.from(0.5));
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
diff --git a/test/elm/parameters/parameters-test.ts b/test/elm/parameters/parameters-test.ts
index cd9210e8a..3a7c80ff4 100644
--- a/test/elm/parameters/parameters-test.ts
+++ b/test/elm/parameters/parameters-test.ts
@@ -3,6 +3,7 @@ import { Code, Concept } from '../../../src/datatypes/clinical';
 import { Date, DateTime } from '../../../src/datatypes/datetime';
 import { Interval } from '../../../src/datatypes/interval';
 import { Quantity } from '../../../src/datatypes/quantity';
+import { Decimal } from '../../../src/datatypes/decimal';
 import setup from '../../setup';
 const data = require('./data');
 
@@ -99,7 +100,7 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to provided valid value', async function () {
-    (await this.foo.exec(this.ctx.withParameters({ FooP: 3.0 }))).should.equal(3.0);
+    (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.eql(Decimal.from(3.0));
   });
 
   it('should throw when provided value is wrong type', function () {
@@ -107,11 +108,11 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to default value', async function () {
-    (await this.foo2.exec(this.ctx)).should.equal(1.5);
+    (await this.foo2.exec(this.ctx)).should.eql(Decimal.from(1.5));
   });
 
   it('should execute to overriding valid value', async function () {
-    (await this.foo2.exec(this.ctx.withParameters({ FooDP: 3.0 }))).should.equal(3.0);
+    (await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))).should.eql(Decimal.from(3.0));
   });
 
   it('should throw when overriding value is wrong type', function () {
@@ -129,7 +130,7 @@ describe('IntegerParameterTypes', () => {
   });
 
   it('should throw when provided value is wrong type', function () {
-    should(() => this.foo.exec(this.ctx.withParameters({ FooP: 3.5 }))).throw(/.*wrong type.*/);
+    should(() => this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.5) }))).throw(/.*wrong type.*/);
   });
 
   it('should execute to default value', async function () {
@@ -141,7 +142,7 @@ describe('IntegerParameterTypes', () => {
   });
 
   it('should throw when overriding value is wrong type', function () {
-    should(() => this.foo2.exec(this.ctx.withParameters({ FooDP: 3.5 }))).throw(/.*wrong type.*/);
+    should(() => this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.5) }))).throw(/.*wrong type.*/);
   });
 });
 
@@ -423,7 +424,7 @@ describe('IntervalParameterTypes', () => {
   });
 
   it('should throw when interval contains a wrong point type', async function () {
-    should(() => this.foo.exec(this.ctx.withParameters({ FooP: new Interval(1.5, 5.5) }))).throw(
+    should(() => this.foo.exec(this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) }))).throw(
       /.*wrong type.*/
     );
   });
@@ -443,7 +444,7 @@ describe('IntervalParameterTypes', () => {
   });
 
   it('should throw when overriding interval contains a wrong point type', async function () {
-    should(() => this.foo2.exec(this.ctx.withParameters({ FooP: new Interval(1.5, 5.5) }))).throw(
+    should(() => this.foo2.exec(this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) }))).throw(
       /.*wrong type.*/
     );
   });
diff --git a/test/elm/quantity/quantity-test.ts b/test/elm/quantity/quantity-test.ts
index 290c15c8d..602f5239e 100644
--- a/test/elm/quantity/quantity-test.ts
+++ b/test/elm/quantity/quantity-test.ts
@@ -6,6 +6,7 @@ import {
   doSubtraction,
   Quantity
 } from '../../../src/datatypes/quantity';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('Quantity', () => {
   it('should allow creation of Quantity with valid ucum units', () =>
@@ -62,7 +63,7 @@ describe('Quantity', () => {
     const denominator = new Quantity(2.0, 'mg');
     const result = numerator.dividedBy(denominator);
     result.unit.should.equal('1');
-    result.value.should.equal(-2.75);
+    result.value.should.eql(Decimal.from(-2.75));
   });
 
   it('should allow for singular time units', () => {
diff --git a/test/elm/query/query-test.ts b/test/elm/query/query-test.ts
index 95f8490f0..2ee9e3cb4 100644
--- a/test/elm/query/query-test.ts
+++ b/test/elm/query/query-test.ts
@@ -7,6 +7,7 @@ import { Interval } from '../../../src/datatypes/interval';
 import { DateTime } from '../../../src/datatypes/datetime';
 import { Quantity } from '../../../src/datatypes/quantity';
 import { getLocalIdByPath } from '../../testHelpers';
+import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('DateRangeOptimizedQuery', () => {
   beforeEach(function () {
@@ -196,12 +197,12 @@ describe('Sorting', () => {
   it('should correctly sort quantities asc', async function () {
     const e = await this.quantityListAsc.exec(this.ctx);
     e.should.have.length(2);
-    e[0]['value'].should.equal(2);
+    e[0]['value'].should.eql(Decimal.from(2));
   });
 
   it('should correctly sort quantities', async function () {
     const e = await this.quantityListSort.exec(this.ctx);
-    e[0]['N']['value'].should.equal(2);
+    e[0]['N']['value'].should.eql(Decimal.from(2));
   });
 
   it('should be able to sort by a tuple field asc', async function () {
diff --git a/test/spec-tests/spec-test.ts b/test/spec-tests/spec-test.ts
index cf70ead67..e1bcbf3f1 100644
--- a/test/spec-tests/spec-test.ts
+++ b/test/spec-tests/spec-test.ts
@@ -44,6 +44,9 @@ describe('CQL Spec Tests (from XML)', () => {
           }
           suite.expression.element.forEach((t: any) => {
             it(`should properly evaluate ${t.name}`, async function () {
+              if (t.name === 'beans') {
+                debugger;
+              }
               const testCaseMap = convertTupleToMap(t.value);
               if (testCaseMap.has('skipped')) {
                 this.skip();
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index fa9388dad..16cb165b8 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -1,5 +1,6 @@
 import { Uncertainty } from '../../src/datatypes/uncertainty';
 import { MAX_FLOAT_VALUE, MIN_FLOAT_VALUE } from '../../src/util/limits';
+import { Decimal } from '../../src/datatypes/decimal';
 import { predecessor, successor } from '../../src/util/math';
 import { ELM_DECIMAL_TYPE, ELM_INTEGER_TYPE } from '../../src/util/elmTypes';
 
@@ -11,14 +12,14 @@ describe('successor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0), ELM_DECIMAL_TYPE);
-    result.low.should.equal(1.00000001);
-    result.high.should.equal(2.00000001);
+    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
+    result.low.should.eql(Decimal.from(1.00000001));
+    result.high.should.eql(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
-    const result = successor(new Uncertainty(1, MAX_FLOAT_VALUE), ELM_DECIMAL_TYPE);
-    result.should.eql(new Uncertainty(1.00000001, MAX_FLOAT_VALUE));
+    const result = successor(new Uncertainty(Decimal.from(1), MAX_FLOAT_VALUE), ELM_DECIMAL_TYPE);
+    result.should.eql(new Uncertainty(Decimal.from(1.00000001), MAX_FLOAT_VALUE));
   });
 });
 
@@ -30,13 +31,13 @@ describe('predecessor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0), ELM_DECIMAL_TYPE);
-    result.low.should.equal(1.00000001);
-    result.high.should.equal(2.00000001);
+    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
+    result.low.should.eql(Decimal.from(1.00000001));
+    result.high.should.eql(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
-    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, 2), ELM_DECIMAL_TYPE);
-    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, 1.99999999));
+    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(2)), ELM_DECIMAL_TYPE);
+    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(1.99999999)));
   });
 });
diff --git a/test/util/units-test.ts b/test/util/units-test.ts
index f98dbb546..b3c046065 100644
--- a/test/util/units-test.ts
+++ b/test/util/units-test.ts
@@ -1,4 +1,5 @@
 import should from 'should';
+import { Decimal } from '../../src/datatypes/decimal';
 import {
   checkUnit,
   compareUnits,
@@ -108,41 +109,41 @@ describe('checkUnit', () => {
 
 describe('convertUnit', () => {
   it('should convert compatible units', () => {
-    convertUnit(18, '[in_i]', '[ft_i]').should.eql(1.5);
+    convertUnit(Decimal.from(18), '[in_i]', '[ft_i]').should.eql(Decimal.from(1.5));
   });
 
   it('should return same value for same units', () => {
-    convertUnit(18, '[in_i]', '[in_i]').should.eql(18);
+    convertUnit(Decimal.from(18), '[in_i]', '[in_i]').should.eql(Decimal.from(18));
   });
 
   it('should consider empty as 1 during conversion', () => {
-    convertUnit(18, '', '').should.eql(18);
-    convertUnit(18, null, null).should.eql(18);
-    convertUnit(18, '', null).should.eql(18);
-    convertUnit(18, null, '').should.eql(18);
+    convertUnit(Decimal.from(18), '', '').should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(18), null, null).should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(18), '', null).should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(18), null, '').should.eql(Decimal.from(18));
   });
 
   it('should support CQL date units during conversion', () => {
-    convertUnit(18, 'months', 'years').should.eql(1.5);
-    convertUnit(1.5, 'years', 'months').should.eql(18);
-    convertUnit(2, 'seconds', 'milliseconds').should.eql(2000);
-    convertUnit(2000, 'milliseconds', 'seconds').should.eql(2);
+    convertUnit(Decimal.from(18), 'months', 'years').should.eql(Decimal.from(1.5));
+    convertUnit(Decimal.from(1.5), 'years', 'months').should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(2), 'seconds', 'milliseconds').should.eql(Decimal.from(2000));
+    convertUnit(Decimal.from(2000), 'milliseconds', 'seconds').should.eql(Decimal.from(2));
   });
 
   it('should truncate precision to 8 decimals by default', () => {
-    const result = convertUnit(1, '[ft_i]', '[mi_i]');
-    result.should.equal(0.00018939);
+    const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]');
+    result.should.eql(Decimal.from("0.00018939"));
   });
 
   it('should note truncate precision to 8 decimals when adjustPrecision is false', () => {
-    const result = convertUnit(1, '[ft_i]', '[mi_i]', false);
-    result.should.not.equal(0.00018939);
+    const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]', false);
+    result.should.not.eql(Decimal.from("0.00018939"));
     result.toString().length.should.be.greaterThan(10);
     result.toString().should.startWith('0.000189393939393');
   });
 
   it('should return undefined for incompatible units', () => {
-    should(convertUnit(18, '[in_i]', '[in_i]2')).be.undefined();
+    should(convertUnit(Decimal.from(18), '[in_i]', '[in_i]2')).be.undefined();
   });
 });
 

From c943426640f4cf187bd12e9ffe8e15df742a7a93 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 19 Aug 2026 15:33:32 -0400
Subject: [PATCH 02/62] WIP of better CQL Decimal support, checkpoint 2

---
 package-lock.json                             |    7 +
 package.json                                  |    1 +
 src/datatypes/datetime.ts                     |   36 +-
 src/datatypes/decimal.ts                      |  167 +--
 src/datatypes/quantity.ts                     |   27 +-
 src/elm/aggregate.ts                          |   64 +-
 src/elm/arithmetic.ts                         |  201 ++-
 src/elm/clinical.ts                           |    2 +-
 src/elm/interval.ts                           |   18 +-
 src/elm/type.ts                               |    6 +-
 src/runtime/context.ts                        |    2 +-
 src/util/immutableUtil.ts                     |   16 +-
 src/util/math.ts                              |   66 +-
 src/util/units.ts                             |   31 +-
 test/datatypes/date-test.ts                   |    7 +-
 test/datatypes/datetime-test.ts               |    5 +-
 test/datatypes/decimal-test.ts                |    8 +-
 test/datatypes/interval-test.ts               |   26 +-
 test/elm/aggregate/aggregate-test.ts          |   68 +-
 test/elm/aggregate/data.cql                   |   24 +-
 test/elm/aggregate/data.js                    | 1267 ++++++++++-------
 test/elm/arithmetic/arithmetic-test.ts        |  122 +-
 test/elm/arithmetic/data.cql                  |    2 +-
 test/elm/arithmetic/data.js                   |    6 +-
 test/elm/clinical/clinical-test.ts            |    4 +-
 test/elm/convert/convert-test.ts              |   42 +-
 test/elm/datetime/datetime-test.ts            |   34 +-
 test/elm/interval/interval-test.ts            |   16 +-
 test/elm/literal/literal-test.ts              |    6 +-
 test/elm/message/message-test.ts              |    4 +-
 test/elm/parameters/parameters-test.ts        |    6 +-
 test/elm/quantity/quantity-test.ts            |    2 +-
 test/elm/query/query-test.ts                  |    4 +-
 test/should-extensions.ts                     |   11 +
 .../cql/CqlArithmeticFunctionsTest.cql        |    6 +-
 .../cql/CqlArithmeticFunctionsTest.json       |    6 +-
 .../cql/ValueLiteralsAndSelectors.cql         |    4 +-
 .../cql/ValueLiteralsAndSelectors.json        |    4 +-
 test/spec-tests/skip-list.txt                 |   10 +-
 test/spec-tests/spec-test.ts                  |   15 +-
 test/util/math-test.ts                        |    8 +-
 test/util/units-test.ts                       |   53 +-
 42 files changed, 1333 insertions(+), 1081 deletions(-)

diff --git a/package-lock.json b/package-lock.json
index 3e3cd80d1..e3c125fad 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -10,6 +10,7 @@
       "license": "Apache-2.0",
       "dependencies": {
         "@lhncbc/ucum-lhc": "^7.1.9",
+        "decimal.js": "^10.6.0",
         "immutable": "^5.1.6",
         "luxon": "^3.7.2"
       },
@@ -2035,6 +2036,12 @@
         "node": ">=0.10.0"
       }
     },
+    "node_modules/decimal.js": {
+      "version": "10.6.0",
+      "resolved": "https://artifacts.mitre.org:443/artifactory/api/npm/node-npm/decimal.js/-/decimal.js-10.6.0.tgz",
+      "integrity": "sha512-YpgQiITW3JXGntzdUmyUR1V812Hn8T1YVXhCu+wO3OpS4eU9l4YdD3qjyiKdV6mvV29zapkMeD390UVEf2lkUg==",
+      "license": "MIT"
+    },
     "node_modules/default-require-extensions": {
       "version": "3.0.1",
       "resolved": "https://registry.npmjs.org/default-require-extensions/-/default-require-extensions-3.0.1.tgz",
diff --git a/package.json b/package.json
index d7e5bd2ed..c06af919c 100644
--- a/package.json
+++ b/package.json
@@ -87,6 +87,7 @@
   },
   "dependencies": {
     "@lhncbc/ucum-lhc": "^7.1.9",
+    "decimal.js": "^10.6.0",
     "immutable": "^5.1.6",
     "luxon": "^3.7.2"
   },
diff --git a/src/datatypes/datetime.ts b/src/datatypes/datetime.ts
index 23fcb4ed2..b8f288895 100644
--- a/src/datatypes/datetime.ts
+++ b/src/datatypes/datetime.ts
@@ -19,6 +19,7 @@ import {
   MIN_DATETIME_VALUE_STRING,
   MIN_TIME_VALUE_STRING
 } from '../util/limits';
+import { Decimal } from './decimal';
 
 // It's easiest and most performant to organize formats by length of the supported strings.
 // This way we can test strings only against the formats that have a chance of working.
@@ -529,7 +530,7 @@ export class DateTime extends AbstractDate {
   minute: number | null;
   second: number | null;
   millisecond: number | null;
-  timezoneOffset: number | null;
+  timezoneOffset: Decimal | null;
 
   static readonly Unit = {
     YEAR: 'year',
@@ -599,13 +600,19 @@ export class DateTime extends AbstractDate {
   }
 
   // TODO: Note: using the jsDate type causes issues, fix later
-  static fromJSDate(date: any, timezoneOffset?: any) {
+  static fromJSDate(date: any, timezoneOffset?: number | string | Decimal) {
     //This is from a JS Date, not a CQL Date
     if (date instanceof DateTime) {
       return date;
     }
     if (timezoneOffset != null) {
-      date = new jsDate(date.getTime() + timezoneOffset * 60 * 60 * 1000);
+      let tzOffset: number;
+      if (timezoneOffset instanceof Decimal) {
+        tzOffset = timezoneOffset.toNumber();
+      } else {
+        tzOffset = +timezoneOffset;
+      }
+      date = new jsDate(date.getTime() + tzOffset * 60 * 60 * 1000);
       return new DateTime(
         date.getUTCFullYear(),
         date.getUTCMonth() + 1,
@@ -614,7 +621,7 @@ export class DateTime extends AbstractDate {
         date.getUTCMinutes(),
         date.getUTCSeconds(),
         date.getUTCMilliseconds(),
-        timezoneOffset
+        tzOffset
       );
     } else {
       return new DateTime(
@@ -641,7 +648,7 @@ export class DateTime extends AbstractDate {
       luxonDT.minute,
       luxonDT.second,
       luxonDT.millisecond,
-      luxonDT.offset / 60
+      Decimal.from(luxonDT.offset / 60)
     );
   }
 
@@ -653,7 +660,7 @@ export class DateTime extends AbstractDate {
     minute: number | null = null,
     second: number | null = null,
     millisecond: number | null = null,
-    timezoneOffset?: number | null
+    timezoneOffset?: Decimal | number | null
   ) {
     // from the spec: If no timezone is specified, the timezone of the evaluation request timestamp is used.
     // NOTE: timezoneOffset will be explicitly null for the Time overload, whereas
@@ -664,9 +671,11 @@ export class DateTime extends AbstractDate {
     this.second = second;
     this.millisecond = millisecond;
     if (timezoneOffset === undefined) {
-      this.timezoneOffset = (new jsDate().getTimezoneOffset() / 60) * -1;
+      this.timezoneOffset = Decimal.from((new jsDate().getTimezoneOffset() / 60) * -1);
+    } else if (timezoneOffset === null) {
+      this.timezoneOffset = null;
     } else {
-      this.timezoneOffset = timezoneOffset;
+      this.timezoneOffset = Decimal.from(timezoneOffset);
     }
   }
 
@@ -869,7 +878,7 @@ export class DateTime extends AbstractDate {
   toLuxonDateTime() {
     const offsetMins =
       this.timezoneOffset != null
-        ? this.timezoneOffset * 60
+        ? this.timezoneOffset.toNumber() * 60
         : new jsDate().getTimezoneOffset() * -1;
     return LuxonDateTime.fromObject(
       {
@@ -958,10 +967,11 @@ export class DateTime extends AbstractDate {
     }
 
     if (str.indexOf('T') !== -1 && this.timezoneOffset != null) {
-      str += this.timezoneOffset < 0 ? '-' : '+';
-      const offsetHours = Math.floor(Math.abs(this.timezoneOffset));
+      const tzOffset = this.timezoneOffset.toNumber();
+      str += tzOffset < 0 ? '-' : '+';
+      const offsetHours = Math.floor(Math.abs(tzOffset));
       str += String(offsetHours).padStart(2, '0');
-      const offsetMin = (Math.abs(this.timezoneOffset) - offsetHours) * 60;
+      const offsetMin = (Math.abs(tzOffset) - offsetHours) * 60;
       str += ':' + String(offsetMin).padStart(2, '0');
     }
 
@@ -1202,7 +1212,7 @@ export class Date extends AbstractDate {
     return str;
   }
 
-  getDateTime(timeZoneOffset?: number | null) {
+  getDateTime(timeZoneOffset?: Decimal | null) {
     // from the spec: the result will be a DateTime with the time components unspecified,
     // except for the timezone offset, which will be set to the timezone offset of the evaluation
     // request timestamp. (this last part is achieved by passing in the timeZoneOffset from the context)
diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 815b9fb5a..55b60c82a 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -1,48 +1,75 @@
 
+import { Decimal as DecimalJS } from 'decimal.js';
+
+// Default precision is set to 30 significant figures. (Not decimal places)
+// MAX_DECIMAL_VALUE = 99999999999999999999.99999999 is 28 significant figures,
+// 30 is just a cleaner number.
+DecimalJS.set({ precision: 30 });
 
 export type DecimalInput = Decimal | string | number | bigint;
 
-export type DecimalRoundingMode = 'down' | 'half-up' | 'half-even' | 'half-ceil' | 'ceil' | 'floor';
+export type DecimalRoundingMode = DecimalJS.Rounding;
+
+const MIN_FLOAT_PRECISION_VALUE = DecimalJS.pow(10, -8);
 
-const MIN_FLOAT_PRECISION_VALUE = Math.pow(10, -8);
+const CQL_IMPLICIT_SCALE = 8;
+const CQL_IMPLICIT_ROUNDING = DecimalJS.ROUND_HALF_UP;
 
 export class Decimal {
-  public readonly value: number;
+  private value: DecimalJS;
 
-  private constructor(value: DecimalInput) {
-    const numericValue = toNumber(value);
-    if (!Number.isFinite(numericValue)) {
+  private constructor(value: string | number | bigint | DecimalJS) {
+    this.value = new DecimalJS(value);
+    if (!this.value.isFinite()) {
       throw new Error('Cannot create a decimal with a non-finite value');
     }
-    this.value = numericValue;
   }
 
   static from(value: DecimalInput) {
-    return value instanceof Decimal ? value : new Decimal(value);
+    if (value instanceof Decimal) {
+      return value;
+    }
+
+    return new Decimal(value);
   }
 
   get isDecimal() {
     return true;
   }
 
-  add(other: DecimalInput) {
-    return new Decimal(this.value + toNumber(other));
+  normalized() {
+    if (this.value.decimalPlaces() <= CQL_IMPLICIT_SCALE) {
+      return this;
+    }
+    return this.setScale(CQL_IMPLICIT_SCALE, CQL_IMPLICIT_ROUNDING);
   }
 
-  subtract(other: DecimalInput) {
-    return new Decimal(this.value - toNumber(other));
+  private applyWrapper(
+    operation: (value: any) => DecimalJS,
+    other: DecimalInput
+  ): Decimal {
+    const operand = other instanceof Decimal ? other.value : other;
+
+    return new Decimal(operation.call(this.value, operand));
   }
 
-  multiplyBy(other: DecimalInput) {
-    return new Decimal(this.value * toNumber(other));
+  add(other: DecimalInput) : Decimal {
+    return this.applyWrapper(this.value.add, other);
   }
 
-  divideBy(other: DecimalInput) {
-    const divisor = toNumber(other);
-    if (divisor === 0) {
+  subtract(other: DecimalInput) : Decimal {
+    return this.applyWrapper(this.value.minus, other);
+  }
+
+  multiplyBy(other: DecimalInput) : Decimal {
+    return this.applyWrapper(this.value.times, other);
+  }
+
+  divideBy(other: DecimalInput) : Decimal {
+    if (toNumber(other) === 0) {
       throw new RangeError('Cannot divide a decimal by zero');
     }
-    return new Decimal(this.value / divisor);
+    return this.applyWrapper(this.value.dividedBy, other);
   }
 
   modulo(other: DecimalInput) {
@@ -50,12 +77,14 @@ export class Decimal {
     if (divisor === 0) {
       throw new RangeError('Cannot calculate decimal modulo by zero');
     }
-    return new Decimal(this.value % divisor);
+    return this.applyWrapper(this.value.mod, other);
   }
 
   compareTo(other: DecimalInput) {
-    const otherValue = toNumber(other);
-    return this.value - otherValue;
+    if (other instanceof Decimal) {
+      return this.value.comparedTo(other.value)
+    }
+    return this.value.comparedTo(other);
   }
 
   greaterThan(other: DecimalInput) {
@@ -79,72 +108,77 @@ export class Decimal {
   }
 
   successor() {
-    return new Decimal(this.value + MIN_FLOAT_PRECISION_VALUE);
+    return new Decimal(this.value.add(MIN_FLOAT_PRECISION_VALUE));
   }
 
   predecessor() {
-    return new Decimal(this.value - MIN_FLOAT_PRECISION_VALUE);
+    return new Decimal(this.value.minus(MIN_FLOAT_PRECISION_VALUE));
   }
 
   negate() {
-    return new Decimal(-this.value);
+    return new Decimal(this.value.neg());
   }
 
   abs() {
-    return new Decimal(Math.abs(this.value));
+    return new Decimal(this.value.abs());
   }
 
-  truncate() {
-    return Math.trunc(this.value);
+  truncate() : number {
+    return this.value.truncated().toNumber();
   }
 
-  ceil() {
-    return Math.ceil(this.value);
+  truncated() : Decimal {
+    return new Decimal(this.value.truncated());
   }
 
-  floor() {
-    return Math.floor(this.value);
+  ceil() : number {
+    return this.value.ceil().toNumber();
   }
 
-  isInteger() {
-    return Number.isInteger(this.value);
+  floor() : number {
+    return this.value.floor().toNumber();
   }
 
-  round(scale = 0) {
-    return this.setScale(scale, 'half-ceil');
+  isInteger() {
+    return this.value.isInteger();
   }
 
   power(exponent: DecimalInput) {
-    return new Decimal(Math.pow(this.value, toNumber(exponent)));
+    return this.applyWrapper(this.value.toPower, exponent);
   }
 
   sqrt() {
-    return new Decimal(Math.sqrt(this.value));
+    return new Decimal(this.value.sqrt());
   }
 
   ln() {
-    return new Decimal(Math.log(this.value));
+    return new Decimal(this.value.ln());
   }
 
   exp() {
-    return new Decimal(Math.exp(this.value));
+    return new Decimal(this.value.exp());
   }
 
   log(base: DecimalInput) {
-    return this.ln().divideBy(Decimal.from(base).ln());
+    return this.applyWrapper(this.value.log, base);
+  }
+
+  round(scale: number) {
+    // notes on rounding modes
+    // ROUND_HALF_UP "Rounds towards nearest neighbour. If equidistant, rounds away from zero"
+    // rounds 0.5 -> 1.0, -0.5 -> -1.0
+    // ROUND_HALF_CEIL "Rounds towards nearest neighbour. If equidistant, rounds towards Infinity"
+    // rounds 0.5 -> 1.0, -0.5 -> 0.0
+    // https://mikemcl.github.io/decimal.js/#modes
+    return this.setScale(scale, DecimalJS.ROUND_HALF_CEIL);
   }
 
-  /**
-   * Return a value at the requested number of digits after the decimal point.
-   * `down` truncates toward zero, matching the current ToDecimal behavior.
-   */
-  setScale(scale: number, roundingMode: DecimalRoundingMode = 'down') {
+  setScale(scale: number, roundingMode: DecimalRoundingMode = DecimalJS.ROUND_DOWN) {
     if (!Number.isInteger(scale) || scale < 0) {
       throw new RangeError('Decimal scale must be a non-negative integer');
     }
-
-    const factor = Math.pow(10, scale);
-    return new Decimal(round(this.value * factor, roundingMode) / factor);
+    
+    return new Decimal(this.value.toDecimalPlaces(scale, roundingMode));
   }
 
   toInteger() {
@@ -152,12 +186,12 @@ export class Decimal {
   }
 
   toNumber() {
-    return this.value;
+    return this.value.toNumber();
   }
 
   toLong() {
-    // TODO: this is wrong
-    return BigInt(this.toNumber());
+    // TODO
+    return BigInt(this.toString());
   }
 
   toString() {
@@ -177,7 +211,7 @@ export const MIN_DECIMAL_VALUE = Decimal.from(MIN_DECIMAL_STRING);
 
 function toNumber(value: DecimalInput) {
   if (value instanceof Decimal) {
-    return value.value;
+    return value.toNumber();
   }
   if (typeof value === 'string' && value.trim() === '') {
     // Number() and Number('') return 0 instead of NaN, so catch that case
@@ -185,32 +219,3 @@ function toNumber(value: DecimalInput) {
   }
   return Number(value);
 }
-
-function round(value: number, mode: DecimalRoundingMode) {
-  switch (mode) {
-    case 'down':
-      return Math.trunc(value);
-    case 'half-up':
-      return value < 0 ? -Math.round(-value) : Math.round(value);
-    case 'half-even':
-      return roundHalfEven(value);
-    case 'half-ceil':
-      return Math.round(value);
-    case 'ceil':
-      return Math.ceil(value);
-    case 'floor':
-      return Math.floor(value);
-  }
-}
-
-function roundHalfEven(value: number) {
-  const lower = Math.floor(value);
-  const fraction = value - lower;
-  if (fraction < 0.5) {
-    return lower;
-  }
-  if (fraction > 0.5) {
-    return lower + 1;
-  }
-  return lower % 2 === 0 ? lower : lower + 1;
-}
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index ec98aba2b..62c56b7ec 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -13,13 +13,13 @@ export class Quantity {
   public readonly value: Decimal;
 
   constructor(
-    value: Decimal | string | number | bigint,
+    value?: Decimal | string | number | bigint,
     public unit?: any
   ) {
     if (value == null || typeof value === 'number' && isNaN(value)) {
       throw new Error('Cannot create a quantity with an undefined value');
     }
-    this.value = Decimal.from(value);
+    this.value = Decimal.from(value).normalized();
     if (!isValidDecimal(this.value)) {
       throw new Error('Cannot create a quantity with an invalid decimal value');
     }
@@ -93,14 +93,15 @@ export class Quantity {
     if (other != null && other.isQuantity) {
       if ((!this.unit && other.unit) || (this.unit && !other.unit)) {
         return false;
-      } else if (!this.unit && !other.unit) {
-        return this.value === other.value;
+      } else if (this.unit === other.unit) {
+        // same unit, or both are null
+        return this.value.equals(other.value);
       } else {
         const otherVal = convertUnit(other.value, other.unit, this.unit);
         if (otherVal == null) {
           return null;
         } else {
-          return this.value.round(8).equals(Decimal.from(otherVal));
+          return this.value.equals(otherVal);
         }
       }
     }
@@ -121,19 +122,19 @@ export class Quantity {
     }
 
     const [val1, unit1, val2, unit2] = normalizeUnitsWhenPossible(
-      this.value.toNumber(),
+      this.value,
       this.unit,
-      Decimal.from(other.value).toNumber(),
+      other.value,
       other.unit
     );
-    const resultValue = Decimal.from(val1 / val2);
+    const resultValue = val1.divideBy(val2);
     const resultUnit = getQuotientOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
     if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
       return null;
     }
-    return new Quantity(resultValue.round(8), resultUnit);
+    return new Quantity(resultValue, resultUnit);
   }
 
   multiplyBy(other: any) {
@@ -145,19 +146,19 @@ export class Quantity {
     }
 
     const [val1, unit1, val2, unit2] = normalizeUnitsWhenPossible(
-      this.value.toNumber(),
+      this.value,
       this.unit,
-      Decimal.from(other.value).toNumber(),
+      other.value,
       other.unit
     );
-    const resultValue = Decimal.from(val1 * val2);
+    const resultValue = val1.multiplyBy(val2);
     const resultUnit = getProductOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
     if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
       return null;
     }
-    return new Quantity(resultValue.round(8), resultUnit);
+    return new Quantity(resultValue, resultUnit);
   }
 }
 
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 08cd7dbdc..e94784810 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -26,21 +26,17 @@ function isDecimal(value: any): value is Decimal {
   return value != null && value.isDecimal;
 }
 
-function numberValue(value: any) {
-  return value && value.isDecimal ? value.toNumber() : value;
-}
-
 function sumDecimals(values: Decimal[]) {
-  return values.reduce((sum, value) => sum.add(value)).setScale(8, 'half-up');
+  return values.reduce((sum, value) => sum.add(value));
 }
 
 function productDecimals(values: Decimal[]) {
-  return values.reduce((product, value) => product.multiplyBy(value)).setScale(8, 'half-up');
+  return values.reduce((product, value) => product.multiplyBy(value));
 }
 
 function decimalResult(value: number, values: any[], resultTypeName?: string) {
   return hasDecimals(values) || resultTypeName === ELM_DECIMAL_TYPE
-    ? Decimal.from(value).setScale(8, 'half-up')
+    ? Decimal.from(value).normalized()
     : value;
 }
 
@@ -182,13 +178,10 @@ export class Avg extends AggregateExpression {
 
     if (hasOnlyQuantities(items)) {
       const sum = sumDecimals(getValuesFromQuantities(items));
-      return new Quantity(sum.divideBy(items.length).setScale(8, 'half-up'), items[0].unit);
+      return new Quantity(sum.divideBy(items.length), items[0].unit);
     } else {
-      if (hasDecimals(items)) {
-        return sumDecimals(items.map(Decimal.from)).divideBy(items.length).setScale(8, 'half-up');
-      }
-      const sum = items.reduce((x: number, y: number) => x + y);
-      return decimalResult(sum / items.length, items, this.resultTypeName);
+      // return type is always Decimal, so just map everything to Decimals
+      return sumDecimals(items.map(Decimal.from)).divideBy(items.length).normalized();
     }
   }
 }
@@ -310,37 +303,35 @@ export class StdDev extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items).map(numberValue);
+      const values = getValuesFromQuantities(items);
       const stdDev = this.standardDeviation(values);
       return new Quantity(stdDev, items[0].unit);
     } else {
-      const standardDeviation = this.standardDeviation(items.map(numberValue));
-      return standardDeviation == null
-        ? null
-        : decimalResult(standardDeviation, items, this.resultTypeName);
+      const standardDeviation = this.standardDeviation(items.map(Decimal.from));
+      return standardDeviation?.normalized(); // TODO: review function signatures. always return Decimal makes sense but is it correct?
     }
   }
 
-  standardDeviation(list: any[]) {
+  standardDeviation(list: Decimal[]) {
     const val = this.stats(list);
     if (val) {
       return val[this.type];
     }
   }
 
-  stats(list: any[]) {
-    const sum = list.reduce((x, y) => x + y);
-    const mean = sum / list.length;
-    let sumOfSquares = 0;
+  stats(list: Decimal[]) {
+    const sum = list.reduce((x, y) => x.add(y), Decimal.from(0));
+    const mean = sum.divideBy(list.length);
 
-    for (const sq of list) {
-      sumOfSquares += Math.pow(sq - mean, 2);
-    }
+    const sumOfSquares = list.reduce((total, value) => {
+      const difference = value.subtract(mean);
+      return total.add(difference.power(2));
+    }, Decimal.from(0));
 
-    const std_var = (1 / (list.length - 1)) * sumOfSquares;
-    const pop_var = (1 / list.length) * sumOfSquares;
-    const std_dev = Math.sqrt(std_var);
-    const pop_dev = Math.sqrt(pop_var);
+    const std_var = sumOfSquares.divideBy(list.length - 1);
+    const pop_var = sumOfSquares.divideBy(list.length);
+    const std_dev = std_var.sqrt();
+    const pop_dev = pop_var.sqrt();
     return {
       standard_variance: std_var,
       population_variance: pop_var,
@@ -409,16 +400,11 @@ export class GeometricMean extends AggregateExpression {
 
     if (hasOnlyQuantities(items)) {
       const product = productDecimals(getValuesFromQuantities(items));
-      const geoMean = product.power(1.0 / items.length).setScale(8, 'half-up');
+      const geoMean = product.power(1.0 / items.length);
       return new Quantity(geoMean, items[0].unit);
     } else {
-      if (hasDecimals(items)) {
-        return productDecimals(items.map(Decimal.from))
-          .power(1.0 / items.length)
-          .setScale(8, 'half-up');
-      }
-      const product = items.reduce((x: number, y: number) => x * y);
-      return decimalResult(Math.pow(product, 1.0 / items.length), items, this.resultTypeName);
+      return productDecimals(items.map(Decimal.from))
+          .power(1.0 / items.length).normalized();
     }
   }
 }
@@ -518,5 +504,5 @@ function medianOfDecimals(decimals: Decimal[]) {
   const middle = Math.floor(items.length / 2);
   return items.length % 2 === 1
     ? items[middle]
-    : items[middle - 1].add(items[middle]).divideBy(2).setScale(8, 'half-up');
+    : items[middle - 1].add(items[middle]).divideBy(2);
 }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index c63fa18f0..c14a01eca 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -29,39 +29,22 @@ import {
   MIN_LONG_VALUE
 } from '../util/limits';
 
-function isDecimal(value: any): boolean {
-  return value != null && value.isDecimal;
-}
-
-function decimalResult(value: any, resultTypeName?: string): any {
-  if (isDecimal(value) || (typeof value === 'number' && !Number.isFinite(value))) {
-    return value;
-  }
-  return resultTypeName === ELM_DECIMAL_TYPE || (typeof value === 'number' && !Number.isInteger(value))
-    ? Decimal.from(value).setScale(8, 'half-up')
-    : value;
-}
-
-function add(x: any, y: any) {
-  return isDecimal(x) || isDecimal(y) ? Decimal.from(x).add(y).setScale(8, 'half-up') : x + y;
-}
-
-function subtract(x: any, y: any) {
-  return isDecimal(x) || isDecimal(y)
-    ? Decimal.from(x).subtract(y).setScale(8, 'half-up')
-    : x - y;
-}
-
-function multiply(x: any, y: any) {
-  return isDecimal(x) || isDecimal(y)
-    ? Decimal.from(x).multiplyBy(y).setScale(8, 'half-up')
-    : x * y;
-}
+function finalizeNumericResult(result: any, type?: string) {
+
+    if (result instanceof Decimal) {
+      return result.normalized();
+    } else if (result instanceof Quantity) {
+      return new Quantity(result.value.normalized(), result.unit);
+    } else if (result instanceof Uncertainty) {
+      if (result.low instanceof Quantity || result.low instanceof Decimal) {
+        result.low = finalizeNumericResult(result.low);
+      }
+      if (result.high instanceof Quantity || result.high instanceof Decimal) {
+        result.high = finalizeNumericResult(result.high);
+      }
+    }
 
-function divide(x: any, y: any) {
-  return isDecimal(x) || isDecimal(y)
-    ? Decimal.from(x).divideBy(y).setScale(8, 'half-up')
-    : x / y;
+    return result;
 }
 
 export class Add extends Expression {
@@ -75,7 +58,8 @@ export class Add extends Expression {
       return null;
     }
 
-    return MathUtil.add(args[0], args[1], this.resultTypeName);
+    const sum = MathUtil.add(args[0], args[1], this.resultTypeName);
+    return finalizeNumericResult(sum, this.resultTypeName);
   }
 }
 
@@ -90,7 +74,8 @@ export class Subtract extends Expression {
       return null;
     }
 
-    return MathUtil.subtract(args[0], args[1], this.resultTypeName);
+    const difference = MathUtil.subtract(args[0], args[1], this.resultTypeName);
+    return finalizeNumericResult(difference, this.resultTypeName);
   }
 }
 
@@ -105,30 +90,32 @@ export class Multiply extends Expression {
       return null;
     }
 
-    const product = args.reduce((x: any, y: any) => {
-      if (x.isUncertainty && !y.isUncertainty) {
-        y = new Uncertainty(y, y);
-      } else if (y.isUncertainty && !x.isUncertainty) {
-        x = new Uncertainty(x, x);
-      }
-
-      if (x.isQuantity || y.isQuantity) {
-        return doMultiplication(x, y);
-      } else if (x.isUncertainty && y.isUncertainty) {
-        if (x.low.isQuantity) {
-          return new Uncertainty(doMultiplication(x.low, y.low), doMultiplication(x.high, y.high));
-        } else {
-          return new Uncertainty(multiply(x.low, y.low), multiply(x.high, y.high));
-        }
+    let [x, y] = args;
+    
+    if (x.isUncertainty && !y.isUncertainty) {
+      y = new Uncertainty(y, y);
+    } else if (y.isUncertainty && !x.isUncertainty) {
+      x = new Uncertainty(x, x);
+    }
+
+    let product;
+    if (x.isQuantity || y.isQuantity) {
+      product = doMultiplication(x, y);
+    } else if (x.isUncertainty && y.isUncertainty) {
+      if (x.low.isQuantity) {
+        product = new Uncertainty(doMultiplication(x.low, y.low), doMultiplication(x.high, y.high));
       } else {
-        return multiply(x, y);
+        product = new Uncertainty(MathUtil.multiply(x.low, y.low), MathUtil.multiply(x.high, y.high));
       }
-    });
+    } else {
+      product = MathUtil.multiply(x, y);
+    }
 
     if (MathUtil.overflowsOrUnderflows(product, this.resultTypeName)) {
       return null;
     }
-    return product;
+    
+    return finalizeNumericResult(product, this.resultTypeName);
   }
 }
 
@@ -155,25 +142,28 @@ export class Divide extends Expression {
       if (x.isQuantity) {
         quotient = doDivision(x, y);
       } else if (x.isUncertainty && y.isUncertainty) {
+        let low, high;
+        // TODO change this section back
         if (x.low.isQuantity) {
-          quotient = new Uncertainty(doDivision(x.low, y.high), doDivision(x.high, y.low));
+          low = doDivision(x.low, y.high);
+          high = doDivision(x.high, y.low);
         } else {
-          quotient = new Uncertainty(divide(x.low, y.high), divide(x.high, y.low));
+          low = MathUtil.divide(x.low, y.high);
+          high = MathUtil.divide(x.high, y.low);
         }
+        quotient = new Uncertainty(low, high);
       } else {
-        quotient = divide(x, y);
+        quotient = MathUtil.divide(x, y);
       }
     } catch {
       // Decimal division by zero throws; CQL defines the result as null.
       return null;
     }
 
-    // Note, anything divided by 0 is Infinity in Javascript, which will be
-    // considered as overflow by this check.
     if (MathUtil.overflowsOrUnderflows(quotient, this.resultTypeName)) {
       return null;
     }
-    return quotient;
+    return finalizeNumericResult(quotient, this.resultTypeName);
   }
 }
 
@@ -187,34 +177,27 @@ export class TruncatedDivide extends Expression {
     if (args == null || args.some((x: any) => x == null)) {
       return null;
     }
-
-    let truncatedQuotient: number | bigint | Decimal;
-    if (typeof args[0] === 'bigint') {
-      // bigint division always truncates
-      try {
-        truncatedQuotient = args.reduce((x: bigint, y: bigint) => x / y);
-      } catch {
-        // bigint divide by 0 throws an error
-        return null;
+    
+    let [x, y] = args;
+    let quotient;
+    if (x.isQuantity) {
+      quotient = doDivision(x, y);
+      if (quotient instanceof Quantity) {
+        quotient = new Quantity(quotient.value.truncated(), quotient.unit);
       }
     } else {
-      try {
-        const quotient = args.reduce((x: any, y: any) => divide(x, y));
-        const truncated = isDecimal(quotient)
-          ? quotient.truncate()
-          : quotient >= 0
-            ? Math.floor(quotient)
-            : Math.ceil(quotient);
-        truncatedQuotient = decimalResult(truncated, this.resultTypeName);
-      } catch {
-        return null;
+      quotient = MathUtil.divide(x, y);
+
+      // MathUtil.divide performs truncated division for Integers and Longs implicitly
+      if (quotient != null && (x.isDecimal || y.isDecimal || this.resultTypeName === ELM_DECIMAL_TYPE)) {
+        quotient = (quotient as Decimal).truncated();
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(truncatedQuotient, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(quotient, this.resultTypeName)) {
       return null;
     }
-    return truncatedQuotient;
+    return quotient;
   }
 }
 
@@ -230,16 +213,16 @@ export class Modulo extends Expression {
     }
 
     let modulo: number | bigint | Decimal;
+    const [x, y] = args;
     try {
-      modulo = args.reduce((x: any, y: any) =>
-        isDecimal(x) || isDecimal(y) ? Decimal.from(x).modulo(y) : x % y
-      );
+      modulo = 
+        x.isDecimal || y.isDecimal ? Decimal.from(x).modulo(y) : x % y;
     } catch {
       // modulo divide by zero results in null according to specification
       return null;
     }
 
-    return MathUtil.decimalLongOrNull(decimalResult(modulo, this.resultTypeName));
+    return MathUtil.decimalLongOrNull(finalizeNumericResult(modulo, this.resultTypeName))
   }
 }
 
@@ -254,7 +237,7 @@ export class Ceiling extends Expression {
       return null;
     }
 
-    return isDecimal(arg) ? arg.ceil() : Math.ceil(arg);
+    return arg.isDecimal ? arg.ceil() : Math.ceil(arg);
   }
 }
 
@@ -269,7 +252,7 @@ export class Floor extends Expression {
       return null;
     }
 
-    return isDecimal(arg) ? arg.floor() : Math.floor(arg);
+    return arg.isDecimal ? arg.floor() : Math.floor(arg);
   }
 }
 
@@ -284,7 +267,7 @@ export class Truncate extends Expression {
       return null;
     }
 
-    return isDecimal(arg) ? arg.truncate() : arg >= 0 ? Math.floor(arg) : Math.ceil(arg);
+    return arg.isDecimal ? arg.truncate() : arg >= 0 ? Math.floor(arg) : Math.ceil(arg);
   }
 }
 export class Abs extends Expression {
@@ -303,7 +286,7 @@ export class Abs extends Expression {
       return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
         ? null
         : absoluteValue;
-    } else if (isDecimal(arg)) {
+    } else if (arg.isDecimal) {
       const absoluteValue = arg.abs();
       return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
         ? null
@@ -333,7 +316,7 @@ export class Negate extends Expression {
       return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
         ? null
         : negatedValue;
-    } else if (isDecimal(arg)) {
+    } else if (arg.isDecimal) {
       const negatedValue = arg.negate();
       return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
         ? null
@@ -362,10 +345,7 @@ export class Round extends Expression {
     }
 
     const dec = this.precision != null ? await this.precision.execute(ctx) : 0;
-    if (isDecimal(arg)) {
-      return arg.round(dec);
-    }
-    return decimalResult(Math.round(arg * Math.pow(10, dec)) / Math.pow(10, dec), this.resultTypeName);
+    return Decimal.from(arg).round(dec);
   }
 }
 
@@ -381,9 +361,8 @@ export class Ln extends Expression {
     }
 
     try {
-      return isDecimal(arg)
-        ? arg.ln()
-        : MathUtil.decimalOrNull(decimalResult(Math.log(arg), ELM_DECIMAL_TYPE));
+      const ln = Decimal.from(arg).ln().normalized();
+      return MathUtil.decimalOrNull(ln);
     } catch {
       return null;
     }
@@ -403,9 +382,7 @@ export class Exp extends Expression {
 
     let power;
     try {
-      power = isDecimal(arg)
-        ? arg.exp()
-        : decimalResult(Math.exp(arg), ELM_DECIMAL_TYPE);
+      power = Decimal.from(arg).exp().normalized();
     } catch {
       return null;
     }
@@ -429,12 +406,8 @@ export class Log extends Expression {
     }
 
     try {
-      const log = args.reduce((x: any, y: any) =>
-        isDecimal(x) || isDecimal(y)
-          ? Decimal.from(x).log(y)
-          : Math.log(x) / Math.log(y)
-      );
-      return isDecimal(log) ? log : MathUtil.decimalOrNull(decimalResult(log, ELM_DECIMAL_TYPE));
+      const log = Decimal.from(args[0]).log(args[1]);
+      return MathUtil.decimalOrNull(log);
     } catch {
       return null;
     }
@@ -451,8 +424,9 @@ export class Power extends Expression {
     if (args == null || args.some((x: any) => x == null)) {
       return null;
     }
-
-    const power = decimalResult(args.reduce((x: any, y: any) => doPower(x, y)), this.resultTypeName);
+    // TODO: cql spec shows the return type is always Decimal, but that's not true
+    const [x, y] = args;
+    const power = doPower(x, y);
 
     // Note: The resultTypeName may be wrong if the exponent is a negative number. Math.overflowsOrUnderflows
     // already accounts for this possibility by only considering it an integer if Number.isInteger(value).
@@ -465,21 +439,10 @@ export class Power extends Expression {
 }
 
 function doPower(x: any, y: any) {
-  if (isDecimal(x) || isDecimal(y)) {
+  if (x.isDecimal || y.isDecimal || (typeof y == 'number' && y < 0) || (typeof y === 'bigint' && y < 0n)) {
+    // Decimal values or negative powers always produce Decimal result
     return Decimal.from(x).power(y);
   }
-  if (typeof x === 'bigint' && typeof y === 'bigint' && y < 0n) {
-    // x ** y does not support negative exponents for bigint, so downgrade to number if possible, otherwise return null
-    if (
-      x < BigInt(Number.MIN_SAFE_INTEGER) ||
-      x > BigInt(Number.MAX_SAFE_INTEGER) ||
-      y < BigInt(Number.MIN_SAFE_INTEGER)
-    ) {
-      // can't safely convert to number so just return null
-      return null;
-    }
-    return Number(x) ** Number(y);
-  }
 
   try {
     return x ** y;
diff --git a/src/elm/clinical.ts b/src/elm/clinical.ts
index 26a9c0019..5d0acd4f5 100644
--- a/src/elm/clinical.ts
+++ b/src/elm/clinical.ts
@@ -344,7 +344,7 @@ function calculateAge(
   precision: string,
   birthDate?: dt.Date | dt.DateTime,
   asOf?: dt.Date | dt.DateTime,
-  timeZoneOffset?: number | null
+  timeZoneOffset?: dt.Decimal | null
 ) {
   if (birthDate != null && asOf != null) {
     // Ensure we use like types (Date or DateTime) based on asOf type
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index 5ef38af84..14a109f44 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -516,12 +516,11 @@ export class Expand extends Expression {
     return results;
   }
 
-  expandDTishInterval(interval: any, per: any) {
+  expandDTishInterval(interval: any, per: Quantity) {
     per.unit = convertToCQLDateUnit(per.unit);
 
     if (per.unit === 'week') {
-      per.value *= 7;
-      per.unit = 'day';
+      per = new Quantity(per.value.multiplyBy(7), 'day');
     }
 
     // Precision Checks
@@ -679,9 +678,9 @@ export class Expand extends Expression {
     high: any,
     perValue: any
   ) {
-    // If the per value is a Decimal (has a .), 8 decimal places are appropriate
+    // If the per value is a decimal, 8 decimal places are appropriate
     // Integers should have 0 Decimal places
-    const perIsIntegral = !perValue.toString().includes('.');
+    const perIsIntegral = perValue.isInteger();
     const decimalPrecision = perIsIntegral ? 0 : 8;    
 
     // For the purposes of this function, we'll perform all the arithmetic using Decimals,
@@ -707,8 +706,8 @@ export class Expand extends Expression {
     // If the interval boundaries are more precise than the per quantity, the
     // more precise values will be truncated to the precision specified by the
     // per quantity.
-    low = truncateDecimal(low, decimalPrecision);
-    high = truncateDecimal(high, decimalPrecision);
+    low = low.setScale(decimalPrecision);
+    high = high.setScale(decimalPrecision);
 
     if (low == null || high == null) {
       return [];
@@ -783,7 +782,7 @@ function collapseIntervals(intervals: any, perWidth: any) {
     // width equal to the result of the successor function for the point type).
     if (perWidth == null) {
       const pointSize = intervalsClone[0].getPointSize();
-      perWidth = pointSize.isQuantity ? pointSize : new Quantity(Number(pointSize), '1');
+      perWidth = pointSize.isQuantity ? pointSize : new Quantity(pointSize, '1');
     }
 
     // sort intervalsClone by start
@@ -844,8 +843,7 @@ function collapseIntervals(intervals: any, perWidth: any) {
             a.high = b.high;
           }
         } else if (
-          (a.high != null ? a.high.durationBetween(b.low, perWidth.unit).high : undefined) <=
-          perWidth.value
+          perWidth.value.greaterThanOrEquals(a.high != null ? a.high.durationBetween(b.low, perWidth.unit).high : undefined)
         ) {
           a.high = b.high;
         } else {
diff --git a/src/elm/type.ts b/src/elm/type.ts
index 073a12e59..2215be8b4 100644
--- a/src/elm/type.ts
+++ b/src/elm/type.ts
@@ -166,14 +166,14 @@ export class ToDecimal extends Expression {
     const arg = await this.execArgs(ctx);
     if (arg != null) {
       if (arg.isUncertainty) {
-        const low = Decimal.from(arg.low);
-        const high = Decimal.from(arg.high);
+        const low = Decimal.from(arg.low).normalized()
+        const high = Decimal.from(arg.high).normalized();
         return new Uncertainty(low, high);
       } else {
         try {
           const decimal = Decimal.from(arg.toString());
           if (isValidDecimal(decimal)) {
-            return decimal;
+            return decimal.normalized();
           }
         } catch (_e) {
           return null;
diff --git a/src/runtime/context.ts b/src/runtime/context.ts
index 106a53639..84ec265a0 100644
--- a/src/runtime/context.ts
+++ b/src/runtime/context.ts
@@ -126,7 +126,7 @@ export class Context {
     }
   }
 
-  getTimezoneOffset(): number | null {
+  getTimezoneOffset(): dt.Decimal | null {
     if (this.executionDateTime != null) {
       return this.executionDateTime.timezoneOffset;
     } else if (this.parent && this.parent.getTimezoneOffset != null) {
diff --git a/src/util/immutableUtil.ts b/src/util/immutableUtil.ts
index 8f77acfda..d57e80772 100644
--- a/src/util/immutableUtil.ts
+++ b/src/util/immutableUtil.ts
@@ -1,6 +1,6 @@
 import * as ucum from '@lhncbc/ucum-lhc';
 import { type Collection, Map as ImmutableMap, Seq as ImmutableSeq } from 'immutable';
-import { Code, DateTime, Interval, Quantity, Ratio, Uncertainty } from '../datatypes/datatypes';
+import { Code, DateTime, Decimal, Interval, Quantity, Ratio, Uncertainty } from '../datatypes/datatypes';
 import { decimalAdjust } from './math';
 import { convertUnit } from './units';
 
@@ -56,7 +56,7 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
       });
 
     case DateTime:
-      if (typeof js.timezoneOffset === 'number' && js.timezoneOffset !== 0) {
+      if (js.timezoneOffset?.isDecimal && !js.timezoneOffset.equals(0)) {
         return ImmutableSeq(js.convertToTimezoneOffset(0))
           .map((x: any) => toNormalizedKey(x))
           .toMap()
@@ -68,6 +68,12 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
           .set('__instance', js.constructor);
       }
 
+    case Decimal:
+      return ImmutableMap({
+        value: js.toString(),
+        __instance: js.constructor
+      });
+
     case Interval:
       return ImmutableSeq(js.toClosed())
         .map((x: any) => toNormalizedKey(x))
@@ -77,7 +83,7 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
     case Quantity:
       if (!js.unit) {
         return ImmutableMap({
-          value: js.value ?? null,
+          value: js.value ? toNormalizedKey(js.value) : null,
           unit: null,
           __instance: js.constructor
         });
@@ -89,7 +95,7 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
       if (!baseUnitKey) {
         // No units found - normalization not possible and use provided values
         return ImmutableMap({
-          value: js.value ?? null,
+          value:  js.value ? toNormalizedKey(js.value) : null,
           unit: js.unit ?? null,
           __instance: js.constructor
         });
@@ -99,7 +105,7 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
         const conversionValue = convertUnit(js.value, js.unit, baseUnitKeyCode);
         const finalValue = conversionValue ? decimalAdjust('round', conversionValue, -8) : null;
         return ImmutableMap({
-          value: finalValue ?? null,
+          value: finalValue ? toNormalizedKey(finalValue) : null,
           unit: baseUnitKeyCode ?? null,
           __instance: js.constructor
         });
diff --git a/src/util/math.ts b/src/util/math.ts
index b0fb84436..d70db1bc3 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -133,22 +133,18 @@ export function add(a: any, b: any, type?: string): any {
     return low == null || high == null ? null : new Uncertainty(low, high);
   }
 
-  if (typeof a === 'bigint') {
-    const sum = a + (typeof b === 'bigint' ? b : BigInt(b));
-    return overflowsOrUnderflows(sum, ELM_LONG_TYPE) ? null : sum;
+  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+    const sum = Decimal.from(a).add(Decimal.from(b));
+    return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : sum;
   }
-  if (typeof b === 'bigint') {
-    const sum = BigInt(a) + b;
+  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+    const sum = BigInt(a) + BigInt(b);
     return overflowsOrUnderflows(sum, ELM_LONG_TYPE) ? null : sum;
   }
   if (typeof a === 'number' && typeof b === 'number') {
     const sum = a + b;
     return overflowsOrUnderflows(sum, ELM_INTEGER_TYPE) ? null : sum;
   }
-  if (a?.isDecimal && b?.isDecimal) {
-    const sum = a.add(b);
-    return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : sum;
-  }
   if (a?.isQuantity && b?.isQuantity) {
     const [aValue, aUnit, bValue, bUnit] = normalizeUnitsWhenPossible(
       a.value,
@@ -187,17 +183,63 @@ export function subtract(a: any, b: any, type?: string): any {
   if (typeof b === 'number' || typeof b === 'bigint') {
     return add(a, -b, type);
   }
-  if (a?.isDecimal && b?.isDecimal) {
-    const difference = a.subtract(b);
-    return overflowsOrUnderflows(difference, ELM_DECIMAL_TYPE) ? null : difference;
+  if (b?.isDecimal) {
+    return add(a, (b as Decimal).negate(), type);
   }
   if (b?.isQuantity) {
+    // Note - this path uses a fake Quantity object to defer validation of the unit
     return add(a, { isQuantity: true, value: b.value.negate(), unit: b.unit }, type);
   }
 
   throw new Error('Unsupported argument types.');
 }
 
+export function multiply(a: any, b: any, type?: string) {
+  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+    const product = Decimal.from(a).multiplyBy(b);
+    return overflowsOrUnderflows(product, ELM_DECIMAL_TYPE) ? null : product;
+  }
+  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+    const product = BigInt(a) * BigInt(b);
+    return overflowsOrUnderflows(product, ELM_LONG_TYPE) ? null : product;
+  }
+  if (typeof a === 'number' && typeof b === 'number') {
+    const product = a * b;
+    return overflowsOrUnderflows(product, ELM_INTEGER_TYPE) ? null : product;
+  }
+
+  throw new Error('Unsupported argument types.');
+}
+
+export function divide(a: any, b: any, type?: string) {
+  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+    b = Decimal.from(b);
+    if (b.equals(0)) {
+      return null;
+    }
+    const quotient = Decimal.from(a).divideBy(b);
+    return overflowsOrUnderflows(quotient, ELM_DECIMAL_TYPE) ? null : quotient;
+  }
+  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+    if (b === 0 || b === 0n) {
+      return null;
+    }
+    // BigInt division is inherently truncated, eg 10n / 3n = 3n
+    const quotient = BigInt(a) / BigInt(b);
+    return overflowsOrUnderflows(quotient, ELM_LONG_TYPE) ? null : quotient;
+  }
+  if (typeof a === 'number' && typeof b === 'number') {
+    if (b === 0) {
+      return null;
+    }
+    // here we need to truncate manually to ensure the value is an integer
+    const quotient = Math.trunc(a / b);
+    return overflowsOrUnderflows(quotient, ELM_INTEGER_TYPE) ? null : quotient;
+  }
+  
+  throw new Error('Unsupported argument types.');
+}
+
 export function limitDecimalPrecision<T extends number | bigint | Quantity | Uncertainty | Decimal | undefined>(
   val?: T
 ): T | undefined {
diff --git a/src/util/units.ts b/src/util/units.ts
index 553720f42..688ef2f6f 100644
--- a/src/util/units.ts
+++ b/src/util/units.ts
@@ -68,21 +68,24 @@ export function checkUnit(unit: any, allowEmptyUnits = true, allowCQLDateUnits =
   return unitValidityCache.get(unit);
 }
 
-export function convertUnit(fromVal: any, fromUnit: any, toUnit: any, adjustPrecision = true) {
+export function convertUnit(fromVal: Decimal, fromUnit: any, toUnit: any) {
   [fromUnit, toUnit] = [fromUnit, toUnit].map(fixUnit);
+  if (fromUnit === toUnit) {
+    return fromVal;
+  }
   // IMPORTANT: the UCUM library operates on raw JS numbers, not our Decimal
-  const rawFromVal = fromVal.isDecimal ? fromVal.value : fromVal;
-
-  const result = utils.convertUnitTo(fixUnit(fromUnit), rawFromVal, fixUnit(toUnit));
+  // this means that extremely large or extremely small numbers would lose precision via this function.
+  // To prevent this, instead of converting fromVal directly, convert 1 unit to get the conversion factor,
+  // and manually multiply the fromVal by it.
+  const result = utils.convertUnitTo(fromUnit, 1, toUnit);
   if (result.status !== 'succeeded') {
     return;
   }
-  // note: convert result.toVal to number (by prefixing +) to keep typescript happy
-  const rawRetVal = adjustPrecision ? decimalAdjust('round', result.toVal, -8) : +result.toVal;
-  return fromVal.isDecimal ? Decimal.from(rawRetVal) : rawRetVal;
+  const conversionFactor = result.toVal;
+  return fromVal.multiplyBy(conversionFactor).normalized();
 }
 
-export function normalizeUnitsWhenPossible(val1: any, unit1: any, val2: any, unit2: any) {
+export function normalizeUnitsWhenPossible(val1: Decimal, unit1: any, val2: Decimal, unit2: any) {
   // If both units are CQL date units, return CQL date units
   const useCQLDateUnits = unit1 in CQL_TO_UCUM_DATE_UNITS && unit2 in CQL_TO_UCUM_DATE_UNITS;
   const resultConverter = (unit: any) => {
@@ -100,8 +103,8 @@ export function normalizeUnitsWhenPossible(val1: any, unit1: any, val2: any, uni
     // it was not convertible, so just return the quantities as-is
     return [val1, resultConverter(unit1), val2, resultConverter(unit2)];
   }
-  // If the new val2 > old val2, return since we prefer conversion to smaller units
-  if (newVal2 >= val2) {
+  // If the new val2 >= old val2, return since we prefer conversion to smaller units
+  if (newVal2.greaterThanOrEquals(val2)) {
     return [val1, resultConverter(unit1), newVal2, resultConverter(newUnit2)];
   }
   // else it was a conversion to a larger unit, so go the other way around
@@ -126,11 +129,11 @@ export function convertToCQLDateUnit(unit: any) {
 
 export function compareUnits(unit1: any, unit2: any) {
   try {
-    const c = convertUnit(1, unit1, unit2) as number;
-    if (c && c > 1) {
+    const c = convertUnit(Decimal.from(1), unit1, unit2);
+    if (c && c.greaterThan(1)) {
       // unit1 is bigger (less precise)
       return 1;
-    } else if (c && c < 1) {
+    } else if (c && c.lessThan(1)) {
       // unit1 is smaller
       return -1;
     }
@@ -245,7 +248,7 @@ export function getQuotientOfUnits(unit1: any, unit2: any) {
 
 // UNEXPORTED FUNCTIONS
 
-function convertToBaseUnit(fromVal: any, fromUnit: any, toBaseUnit: any) {
+function convertToBaseUnit(fromVal: Decimal, fromUnit: any, toBaseUnit: any) {
   const fromPower = getBaseUnitAndPower(fromUnit)[1];
   const toUnit = fromPower === 1 ? toBaseUnit : `${toBaseUnit}${fromPower}`;
   const newVal = convertUnit(fromVal, fromUnit, toUnit);
diff --git a/test/datatypes/date-test.ts b/test/datatypes/date-test.ts
index 4fb294092..90080282f 100644
--- a/test/datatypes/date-test.ts
+++ b/test/datatypes/date-test.ts
@@ -3,6 +3,7 @@ import should from 'should';
 import { Date, DateTime, MAX_DATE_VALUE, MIN_DATE_VALUE } from '../../src/datatypes/datetime';
 import { Uncertainty } from '../../src/datatypes/uncertainty';
 import { jsDate } from '../../src/util/util';
+import { Decimal } from '../../src/datatypes/decimal';
 
 describe('Date', () => {
   it('should properly set all properties when constructed', () => {
@@ -884,11 +885,11 @@ describe('Date.getPrecisionValue', () => {
 describe('Date.getDateTime', () => {
   it('should return a DateTime that has the passed in timeZoneOffset', () => {
     const d = new Date(2000, 12, 1);
-    const dateTime = d.getDateTime(2);
+    const dateTime = d.getDateTime(Decimal.from(2));
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);
-    dateTime.timezoneOffset.should.equal(2);
+    dateTime.timezoneOffset.should.equalDecimal(Decimal.from(2));
   });
 
   it('should return a DateTime with a timeZoneOffset when one is not passed in', () => {
@@ -897,7 +898,7 @@ describe('Date.getDateTime', () => {
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);
-    dateTime.timezoneOffset.should.equal((new jsDate().getTimezoneOffset() / 60) * -1);
+    dateTime.timezoneOffset.should.equalDecimal(Decimal.from((new jsDate().getTimezoneOffset() / 60) * -1));
   });
 
   it('should return a DateTime without a timeZoneOffset when a null timeZoneOffset is passed in', () => {
diff --git a/test/datatypes/datetime-test.ts b/test/datatypes/datetime-test.ts
index cd4e71f24..e771a8aca 100644
--- a/test/datatypes/datetime-test.ts
+++ b/test/datatypes/datetime-test.ts
@@ -2,6 +2,7 @@ import * as luxon from 'luxon';
 import should from 'should';
 import { DateTime, MAX_DATETIME_VALUE, MIN_DATETIME_VALUE } from '../../src/datatypes/datetime';
 import { Uncertainty } from '../../src/datatypes/uncertainty';
+import { Decimal } from '../../src/datatypes/decimal';
 
 const tzDate = function (
   y: number,
@@ -59,13 +60,13 @@ describe('DateTime', () => {
     d.minute.should.equal(25);
     d.second.should.equal(59);
     d.millisecond.should.equal(246);
-    d.timezoneOffset.should.equal(5.5);
+    d.timezoneOffset.should.equalDecimal(Decimal.from(5.5));
   });
 
   it('should leave unset properties as undefined', () => {
     const d = new DateTime(2000);
     d.year.should.equal(2000);
-    d.timezoneOffset.should.equal((new Date().getTimezoneOffset() / 60) * -1);
+    d.timezoneOffset.should.equalDecimal(Decimal.from((new Date().getTimezoneOffset() / 60) * -1));
     should.not.exist(d.month);
     should.not.exist(d.day);
     should.not.exist(d.hour);
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 780b1ad21..54e693207 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -28,10 +28,10 @@ describe('Decimal', () => {
     Decimal.from('-1.9').truncate().should.equal(-1);
     Decimal.from('1.1').ceil().should.equal(2);
     Decimal.from('1.9').floor().should.equal(1);
-    Decimal.from('-0.5').round().should.eql(Decimal.from(0));
-    Decimal.from('2').power(3).should.eql(Decimal.from(8));
-    Decimal.from('9').sqrt().should.eql(Decimal.from(3));
-    Decimal.from('8').log(2).should.eql(Decimal.from(3));
+    Decimal.from('-0.5').setScale(0).should.equalDecimal(Decimal.from(0));
+    Decimal.from('2').power(3).should.equalDecimal(Decimal.from(8));
+    Decimal.from('9').sqrt().should.equalDecimal(Decimal.from(3));
+    Decimal.from('8').log(2).should.equalDecimal(Decimal.from(3));
   });
 
   it('should reject non-finite and divide-by-zero values', () => {
diff --git a/test/datatypes/interval-test.ts b/test/datatypes/interval-test.ts
index 29d4ff072..57f1e15de 100644
--- a/test/datatypes/interval-test.ts
+++ b/test/datatypes/interval-test.ts
@@ -23,10 +23,8 @@ import {
   ELM_TIME_TYPE
 } from '../../src/util/elmTypes';
 import {
-  MAX_FLOAT_VALUE,
   MAX_INT_VALUE,
   MAX_LONG_VALUE,
-  MIN_FLOAT_VALUE,
   MIN_INT_VALUE,
   MIN_LONG_VALUE
 } from '../../src/util/limits';
@@ -134,7 +132,7 @@ describe('Interval', () => {
     });
 
     it('should return the point size for Decimal intervals', () => {
-      new Interval(Decimal.from(0.5), Decimal.from(9.5)).getPointSize().should.eql(Decimal.from(0.00000001));
+      new Interval(Decimal.from(0.5), Decimal.from(9.5)).getPointSize().should.equalDecimal(Decimal.from(0.00000001));
     });
 
     it('should return the point size for Quantity intervals', () => {
@@ -156,7 +154,7 @@ describe('Interval', () => {
 
     it('should return low for intervals with closed low', () => {
       d.zeroToHundred.closed.start().should.equal(0);
-      d.zeroPointFiveToNinePointFive.closed.start().should.eql(Decimal.from(0.5));
+      d.zeroPointFiveToNinePointFive.closed.start().should.equalDecimal(Decimal.from(0.5));
       d.zeroToHundredLong.closed.start().should.equal(0n);
       d.zeroToHundredMg.closed.start().should.eql(new Quantity(0, 'mg'));
       d.all2012date.closed.start().should.eql(Date.parse('2012-01-01'));
@@ -166,7 +164,7 @@ describe('Interval', () => {
 
     it('should return successor of low for intervals with open low', () => {
       d.zeroToHundred.openClosed.start().should.equal(1);
-      d.zeroPointFiveToNinePointFive.openClosed.start().should.eql(Decimal.from(0.50000001));
+      d.zeroPointFiveToNinePointFive.openClosed.start().should.equalDecimal(Decimal.from("0.50000001"));
       d.zeroToHundredLong.openClosed.start().should.equal(1n);
       d.zeroToHundredMg.openClosed.start().should.eql(new Quantity(0.00000001, 'mg'));
       d.all2012date.openClosed.start().should.eql(Date.parse('2012-01-02'));
@@ -179,10 +177,10 @@ describe('Interval', () => {
     it('should return type minimum for closed null low endpoints', () => {
       d.zeroToHundred.withNullStart.closed.start().should.equal(MIN_INT_VALUE);
       d.zeroToHundredLong.withNullStart.closed.start().should.equal(MIN_LONG_VALUE);
-      d.zeroPointFiveToNinePointFive.withNullStart.closed.start().should.eql(Decimal.from(MIN_FLOAT_VALUE));
+      d.zeroPointFiveToNinePointFive.withNullStart.closed.start().should.equalDecimal(MIN_DECIMAL_VALUE);
       d.zeroToHundredMg.withNullStart.closed
         .start()
-        .should.eql(new Quantity(MIN_FLOAT_VALUE, 'mg'));
+        .should.eql(new Quantity(MIN_DECIMAL_VALUE, 'mg'));
       d.all2012date.withNullStart.closed.start().should.eql(MIN_DATE_VALUE);
       d.all2012.withNullStart.closed.start().should.eql(MIN_DATETIME_VALUE);
       d.alldaytime.withNullStart.closed.start().should.eql(MIN_TIME_VALUE);
@@ -256,7 +254,7 @@ describe('Interval', () => {
       new Interval(null, null, true, true, ELM_DECIMAL_TYPE).start().should.eql(MIN_DECIMAL_VALUE);
       new Interval(null, null, true, true, ELM_QUANTITY_TYPE)
         .start()
-        .should.eql(new Quantity(MIN_FLOAT_VALUE, '1'));
+        .should.eql(new Quantity(MIN_DECIMAL_VALUE, '1'));
       new Interval(null, null, true, true, ELM_DATETIME_TYPE)
         .start()
         .should.eql(MIN_DATETIME_VALUE);
@@ -296,7 +294,7 @@ describe('Interval', () => {
 
     it('should return high for intervals with closed high', () => {
       d.zeroToHundred.closed.end().should.equal(100);
-      d.zeroPointFiveToNinePointFive.closed.end().should.eql(Decimal.from(9.5));
+      d.zeroPointFiveToNinePointFive.closed.end().should.equalDecimal(Decimal.from(9.5));
       d.zeroToHundredLong.closed.end().should.equal(100n);
       d.zeroToHundredMg.closed.end().should.eql(new Quantity(100, 'mg'));
       d.all2012date.closed.end().should.eql(Date.parse('2012-12-31'));
@@ -306,7 +304,7 @@ describe('Interval', () => {
 
     it('should return predecessor of high for intervals with open high', () => {
       d.zeroToHundred.closedOpen.end().should.equal(99);
-      d.zeroPointFiveToNinePointFive.closedOpen.end().should.eql(Decimal.from(9.49999999));
+      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equalDecimal(Decimal.from(9.49999999));
       d.zeroToHundredLong.closedOpen.end().should.equal(99n);
       d.zeroToHundredMg.closedOpen.end().should.eql(new Quantity(99.99999999, 'mg'));
       d.all2012date.closedOpen.end().should.eql(Date.parse('2012-12-30'));
@@ -388,7 +386,7 @@ describe('Interval', () => {
       new Interval(null, null, true, true, ELM_DECIMAL_TYPE).end().should.eql(MAX_DECIMAL_VALUE);
       new Interval(null, null, true, true, ELM_QUANTITY_TYPE)
         .end()
-        .should.eql(new Quantity(MAX_FLOAT_VALUE, '1'));
+        .should.eql(new Quantity(MAX_DECIMAL_VALUE, '1'));
       new Interval(null, null, true, true, ELM_DATETIME_TYPE).end().should.eql(MAX_DATETIME_VALUE);
       new Interval(null, null, true, true, ELM_DATE_TYPE).end().should.eql(MAX_DATE_VALUE);
       new Interval(null, null, true, true, ELM_TIME_TYPE).end().should.eql(MAX_TIME_VALUE);
@@ -407,7 +405,7 @@ describe('Interval', () => {
       new Interval(null, null, false, false, ELM_QUANTITY_TYPE)
         .end()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_FLOAT_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
         );
       new Interval(null, null, false, false, ELM_DATETIME_TYPE)
         .end()
@@ -7006,8 +7004,8 @@ describe('DecimalInterval', () => {
   it('should calculate width and size outside the Integer range', () => {
     const interval = new Interval(Decimal.from(0.0), Decimal.from(3000000000.0), true, true, ELM_DECIMAL_TYPE);
 
-    interval.width().should.eql(Decimal.from(3000000000.0));
-    interval.size().should.eql(Decimal.from(3000000000.0));
+    interval.width().should.equalDecimal(Decimal.from("3000000000.0"));
+    interval.size().should.equalDecimal(Decimal.from("3000000000.00000001"));
   });
 
   it('should close open decimal uncertainty endpoints using decimal point size', () => {
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index d4da6e1bd..6adc191e6 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -1,10 +1,10 @@
 import should from 'should';
 import setup from '../../setup';
-import { Decimal } from '../../../src/datatypes/decimal';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
 const data = require('./data');
 const validateQuantity = function (object: any, expectedValue: any, expectedUnit: any) {
   object.isQuantity.should.be.true();
-  object.value.should.eql(Decimal.from(expectedValue));
+  object.value.should.equalDecimal(expectedValue);
   object.unit.should.equal(expectedUnit);
 };
 
@@ -73,11 +73,11 @@ describe('Sum', () => {
   });
 
   it('should be able to sum lists with decimals', async function () {
-    (await this.decimals.exec(this.ctx)).should.eql(Decimal.from(16.5));
+    (await this.decimals.exec(this.ctx)).should.equalDecimal(Decimal.from(16.5));
   });
 
   it('should be able to sum decimals up to max decimal value', async function () {
-    (await this.decimals_at_max_value.exec(this.ctx)).should.eql(Decimal.from(99999999999999999999.99999999));
+    (await this.decimals_at_max_value.exec(this.ctx)).should.equalDecimal(MAX_DECIMAL_VALUE);
   });
 
   it('should return null when overflowing the max decimal value', async function () {
@@ -85,7 +85,7 @@ describe('Sum', () => {
   });
 
   it('should be able to sum decimals down to min decimal value', async function () {
-    (await this.decimals_at_min_value.exec(this.ctx)).should.eql(Decimal.from(-99999999999999999999.99999999));
+    (await this.decimals_at_min_value.exec(this.ctx)).should.equalDecimal(MIN_DECIMAL_VALUE);
   });
 
   it('should return null when underflowing the min decimal value', async function () {
@@ -100,7 +100,7 @@ describe('Sum', () => {
   it('should be able to sum quantities up to max decimal value', async function () {
     validateQuantity(
       await this.quantities_at_max_value.exec(this.ctx),
-      99999999999999999999.99999999,
+      MAX_DECIMAL_VALUE,
       'ml'
     );
   });
@@ -112,7 +112,7 @@ describe('Sum', () => {
   it('should be able to sum quantities down to min decimal value', async function () {
     validateQuantity(
       await this.quantities_at_min_value.exec(this.ctx),
-      -99999999999999999999.99999999,
+      MIN_DECIMAL_VALUE,
       'ml'
     );
   });
@@ -184,7 +184,7 @@ describe('Min', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMin.exec(this.ctx)).should.eql(Decimal.from(-5));
+    (await this.decimalMin.exec(this.ctx)).should.equalDecimal(Decimal.from(-5));
   });
 
   it('list of DateTimes', async function () {
@@ -261,7 +261,7 @@ describe('Max', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMax.exec(this.ctx)).should.eql(Decimal.from(5.1));
+    (await this.decimalMax.exec(this.ctx)).should.equalDecimal(Decimal.from(5.1));
   });
 
   it('list of DateTimes', async function () {
@@ -310,28 +310,28 @@ describe('Avg', () => {
   });
 
   it('should be able to find average for lists without nulls', async function () {
-    (await this.not_null.exec(this.ctx)).should.eql(Decimal.from(3));
+    (await this.not_null.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
   });
 
   it('should be able to find average for lists with nulls', async function () {
-    (await this.has_null.exec(this.ctx)).should.eql(Decimal.from(1.5));
+    (await this.has_null.exec(this.ctx)).should.equalDecimal(Decimal.from(1.5));
   });
 
   it('should return null for empty list', async function () {
     should(await this.empty.exec(this.ctx)).be.null();
   });
 
-  it('should be able to find average for lists of quantiies without nulls', async function () {
+  it('should be able to find average for lists of quantities without nulls', async function () {
     const q = await this.not_null_q.exec(this.ctx);
     validateQuantity(q, 3, 'ml');
   });
 
-  it('should be able to find average for lists of quantiies with nulls', async function () {
+  it('should be able to find average for lists of quantities with nulls', async function () {
     const q = await this.has_null_q.exec(this.ctx);
     validateQuantity(q, 1.5, 'ml');
   });
 
-  it('should be able to find average for lists of quantiies with related units', async function () {
+  it('should be able to find average for lists of quantities with related units', async function () {
     const q = await this.q_diff_units.exec(this.ctx);
     validateQuantity(q, 3, 'ml');
   });
@@ -351,19 +351,19 @@ describe('Median', () => {
   });
 
   it('should be able to find median of odd numbered list', async function () {
-    (await this.odd.exec(this.ctx)).should.eql(Decimal.from(3));
+    (await this.odd.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
   });
 
   it('should be able to find median of even numbered list', async function () {
-    (await this.even.exec(this.ctx)).should.eql(Decimal.from(3.5));
+    (await this.even.exec(this.ctx)).should.equalDecimal(Decimal.from(3.5));
   });
 
   it('should be able to find median of odd numbered list that contains duplicates', async function () {
-    (await this.dup_vals_odd.exec(this.ctx)).should.eql(Decimal.from(3));
+    (await this.dup_vals_odd.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
   });
 
   it('should be able to find median of even numbered list that contians duplicates', async function () {
-    (await this.dup_vals_even.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.dup_vals_even.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
 
   it('should return null for empty list', async function () {
@@ -438,7 +438,7 @@ describe('PopulationVariance', () => {
     setup(this, data);
   });
   it('should be able to find PopulationVariance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.eql(Decimal.from(2));
+    (await this.v.exec(this.ctx)).should.equalDecimal(Decimal.from(2));
   });
   it('should be able to find PopulationVariance of a list of like quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2, 'ml');
@@ -459,7 +459,7 @@ describe('Variance', () => {
     setup(this, data);
   });
   it('should be able to find Variance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.v.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
   it('should be able to find Variance of a list of matched quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2.5, 'ml');
@@ -480,13 +480,13 @@ describe('StdDev', () => {
     setup(this, data);
   });
   it('should be able to find Standard Dev of a list ', async function () {
-    (await this.std.exec(this.ctx)).should.eql(Decimal.from(1.58113883));
+    (await this.std.exec(this.ctx)).should.equalDecimal(Decimal.from("1.58113883"));
   });
   it('should be able to find Standard Dev of a list of like quantities', async function () {
-    validateQuantity(await this.std_q.exec(this.ctx), 1.5811388300841898, 'ml');
+    validateQuantity(await this.std_q.exec(this.ctx), "1.58113883", 'ml');
   });
   it('should be able to find Standard Dev of a list of related quantities', async function () {
-    validateQuantity(await this.q_diff_units.exec(this.ctx), 1.5811388300841898, 'ml');
+    validateQuantity(await this.q_diff_units.exec(this.ctx), "1.58113883", 'ml');
   });
   it('should be null if some are numbers and some are quantities', async function () {
     should(await this.numbersAndQuantities.exec(this.ctx)).be.null();
@@ -501,13 +501,13 @@ describe('PopulationStdDev', () => {
     setup(this, data);
   });
   it('should be able to find Population Standard Dev of a list ', async function () {
-    (await this.dev.exec(this.ctx)).should.eql(Decimal.from(1.41421356));
+    (await this.dev.exec(this.ctx)).should.equalDecimal(Decimal.from("1.41421356"));
   });
   it('should be able to find Population Standard Dev of a list of quantities', async function () {
-    validateQuantity(await this.dev_q.exec(this.ctx), 1.4142135623730951, 'ml');
+    validateQuantity(await this.dev_q.exec(this.ctx), "1.41421356", 'ml');
   });
   it('should be able to find Population Standard Dev of a list of related quantities', async function () {
-    validateQuantity(await this.q_diff_units.exec(this.ctx), 1.4142135623730951, 'ml');
+    validateQuantity(await this.q_diff_units.exec(this.ctx), "1.41421356", 'ml');
   });
   it('should be null if some are numbers and some are quantities', async function () {
     should(await this.numbersAndQuantities.exec(this.ctx)).be.null();
@@ -563,12 +563,12 @@ describe('Product', () => {
   });
 
   it('should return a decimal product', async function () {
-    (await this.decimal_product.exec(this.ctx)).should.eql(Decimal.from(24.0));
+    (await this.decimal_product.exec(this.ctx)).should.equalDecimal(Decimal.from(24.0));
   });
 
   it('should return decimal product up to max decimal value', async function () {
     (await this.decimals_at_max_value_product.exec(this.ctx)).should.eql(
-      Decimal.from(99999999999999999999.99999999)
+      MAX_DECIMAL_VALUE
     );
   });
 
@@ -578,7 +578,7 @@ describe('Product', () => {
 
   it('should return decimal product down to min decimal value', async function () {
     (await this.decimals_at_min_value_product.exec(this.ctx)).should.eql(
-      Decimal.from(-99999999999999999999.99999999)
+      MIN_DECIMAL_VALUE
     );
   });
 
@@ -597,7 +597,7 @@ describe('Product', () => {
   it('should return quantity product up to max decimal value', async function () {
     validateQuantity(
       await this.quantities_at_max_value_product.exec(this.ctx),
-      99999999999999999999.99999999,
+      MAX_DECIMAL_VALUE,
       'g'
     );
   });
@@ -609,7 +609,7 @@ describe('Product', () => {
   it('should return quantity product down to min decimal value', async function () {
     validateQuantity(
       await this.quantities_at_min_value_product.exec(this.ctx),
-      -99999999999999999999.99999999,
+      MIN_DECIMAL_VALUE,
       'g'
     );
   });
@@ -654,15 +654,15 @@ describe('GeometricMean', () => {
   });
 
   it('should return decimal geometric mean', async function () {
-    (await this.decimal_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(4.0));
+    (await this.decimal_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from(4.0));
   });
 
   it('should retun 0 as a geometric mean', async function () {
-    (await this.zero_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(0));
+    (await this.zero_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
   });
 
   it('should return value when pass in list that contains nulls', async function () {
-    (await this.null_geometric_mean.exec(this.ctx)).should.eql(Decimal.from(1.41421356));
+    (await this.null_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from("1.41421356"));
   });
 
   it('should return null when list is all null', async function () {
diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index 40968e0b3..c82e2527e 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -21,10 +21,14 @@ define decimals_above_max_value: Sum({99999999999999999999.99999999, 99999999999
 define decimals_at_min_value: Sum({-99999999999999999999.99999999})
 define decimals_below_min_value: Sum({-99999999999999999999.99999999, -99999999999999999999.99999999})
 define quantities: Sum({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
-define quantities_at_max_value: Sum({99999999999999999999.99999999 'ml'})
-define quantities_above_max_value: Sum({99999999999999999999.99999999 'ml', 99999999999999999999.99999999 'ml'})
-define quantities_at_min_value: Sum({-99999999999999999999.99999999 'ml'})
-define quantities_below_min_value: Sum({-99999999999999999999.99999999 'ml', -99999999999999999999.99999999 'ml'})
+// Max/Min-valued quantities are described using the "maximum" and "minimum" operators
+// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+define MaxValueMLQuantity: Quantity { value: maximum Decimal, unit: 'ml' }
+define MinValueMLQuantity: Quantity { value: minimum Decimal, unit: 'ml' }
+define quantities_at_max_value: Sum({MaxValueMLQuantity})
+define quantities_above_max_value: Sum({MaxValueMLQuantity, MaxValueMLQuantity})
+define quantities_at_min_value: Sum({MinValueMLQuantity})
+define quantities_below_min_value: Sum({MinValueMLQuantity, MinValueMLQuantity})
 define has_null: Sum({1,null,null,null,2})
 define has_null_q: Sum({1 'ml',null,null,null,2 'ml'})
 define unmatched_units_q: Min({1 'ml',2 'm',3 'ml',4 'ml',5 'ml',0 'ml'})
@@ -156,10 +160,14 @@ define decimals_above_max_value_product: Product({99999999999999999999.99999999,
 define decimals_at_min_value_product: Product({-99999999999999999999.99999999, 1.0})
 define decimals_below_min_value_product: Product({-99999999999999999999.99999999, 2.0})
 define quantity_product: Product({1.0 'g', 2.0 'g', 3.0 'g', 4.0 'g'})
-define quantities_at_max_value_product: Product({99999999999999999999.99999999 'g', 1.0 'g'})
-define quantities_above_max_value_product: Product({99999999999999999999.99999999 'g', 2.0 'g'})
-define quantities_at_min_value_product: Product({-99999999999999999999.99999999 'g', 1.0 'g'})
-define quantities_below_min_value_product: Product({-99999999999999999999.99999999 'g', 2.0 'g'})
+// Max/Min-valued quantities are described using the "maximum" and "minimum" operators
+// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+define MaxValueGramQuantity: Quantity { value: maximum Decimal, unit: 'g' }
+define MinValueGramQuantity: Quantity { value: minimum Decimal, unit: 'g' }
+define quantities_at_max_value_product: Product({MaxValueGramQuantity, 1.0 'g'})
+define quantities_above_max_value_product: Product({MaxValueGramQuantity, 2.0 'g'})
+define quantities_at_min_value_product: Product({MinValueGramQuantity, 1.0 'g'})
+define quantities_below_min_value_product: Product({MinValueGramQuantity, 2.0 'g'})
 define quantity_zero_product: Product({1.0 'g', 2.0 'g', 0 'g'})
 define zero_product: Product({0, 5, 10})
 define product_with_null: Product({5, 4, null})
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index f3231bca3..9199f9626 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -499,10 +499,14 @@ define decimals_above_max_value: Sum({99999999999999999999.99999999, 99999999999
 define decimals_at_min_value: Sum({-99999999999999999999.99999999})
 define decimals_below_min_value: Sum({-99999999999999999999.99999999, -99999999999999999999.99999999})
 define quantities: Sum({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
-define quantities_at_max_value: Sum({99999999999999999999.99999999 'ml'})
-define quantities_above_max_value: Sum({99999999999999999999.99999999 'ml', 99999999999999999999.99999999 'ml'})
-define quantities_at_min_value: Sum({-99999999999999999999.99999999 'ml'})
-define quantities_below_min_value: Sum({-99999999999999999999.99999999 'ml', -99999999999999999999.99999999 'ml'})
+// Max/Min-valued quantities are described using the "maximum" and "minimum" operators
+// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+define MaxValueMLQuantity: Quantity { value: maximum Decimal, unit: 'ml' }
+define MinValueMLQuantity: Quantity { value: minimum Decimal, unit: 'ml' }
+define quantities_at_max_value: Sum({MaxValueMLQuantity})
+define quantities_above_max_value: Sum({MaxValueMLQuantity, MaxValueMLQuantity})
+define quantities_at_min_value: Sum({MinValueMLQuantity})
+define quantities_below_min_value: Sum({MinValueMLQuantity, MinValueMLQuantity})
 define has_null: Sum({1,null,null,null,2})
 define has_null_q: Sum({1 'ml',null,null,null,2 'ml'})
 define unmatched_units_q: Min({1 'ml',2 'm',3 'ml',4 'ml',5 'ml',0 'ml'})
@@ -524,7 +528,7 @@ module.exports['Sum'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "682",
+        "r" : "694",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -2285,7 +2289,7 @@ module.exports['Sum'] = {
       }, {
         "localId" : "502",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "quantities_at_max_value",
+        "name" : "MaxValueMLQuantity",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -2293,20 +2297,170 @@ module.exports['Sum'] = {
           "t" : [ ],
           "s" : {
             "r" : "502",
+            "s" : [ {
+              "value" : [ "// Max/Min-valued quantities are described using the \"maximum\" and \"minimum\" operators\n// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal\n", "define ", "MaxValueMLQuantity", ": " ]
+            }, {
+              "r" : "503",
+              "s" : [ {
+                "value" : [ "Quantity", " { " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "value", ": " ]
+                }, {
+                  "r" : "506",
+                  "s" : [ {
+                    "value" : [ "maximum", " " ]
+                  }, {
+                    "r" : "505",
+                    "s" : [ {
+                      "value" : [ "Decimal" ]
+                    } ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "unit", ": " ]
+                }, {
+                  "r" : "507",
+                  "s" : [ {
+                    "value" : [ "'ml'" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ " }" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Instance",
+          "localId" : "503",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "element" : [ {
+            "name" : "value",
+            "value" : {
+              "type" : "MaxValue",
+              "localId" : "506",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "name" : "unit",
+            "value" : {
+              "type" : "Literal",
+              "localId" : "507",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+              "valueType" : "{urn:hl7-org:elm-types:r1}String",
+              "value" : "ml",
+              "annotation" : [ ]
+            }
+          } ]
+        }
+      }, {
+        "localId" : "511",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "MinValueMLQuantity",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "511",
+            "s" : [ {
+              "value" : [ "", "define ", "MinValueMLQuantity", ": " ]
+            }, {
+              "r" : "512",
+              "s" : [ {
+                "value" : [ "Quantity", " { " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "value", ": " ]
+                }, {
+                  "r" : "515",
+                  "s" : [ {
+                    "value" : [ "minimum", " " ]
+                  }, {
+                    "r" : "514",
+                    "s" : [ {
+                      "value" : [ "Decimal" ]
+                    } ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "unit", ": " ]
+                }, {
+                  "r" : "516",
+                  "s" : [ {
+                    "value" : [ "'ml'" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ " }" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Instance",
+          "localId" : "512",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "element" : [ {
+            "name" : "value",
+            "value" : {
+              "type" : "MinValue",
+              "localId" : "515",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "name" : "unit",
+            "value" : {
+              "type" : "Literal",
+              "localId" : "516",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+              "valueType" : "{urn:hl7-org:elm-types:r1}String",
+              "value" : "ml",
+              "annotation" : [ ]
+            }
+          } ]
+        }
+      }, {
+        "localId" : "520",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "quantities_at_max_value",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "520",
             "s" : [ {
               "value" : [ "", "define ", "quantities_at_max_value", ": " ]
             }, {
-              "r" : "511",
+              "r" : "529",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "503",
+                "r" : "521",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "504",
+                  "r" : "522",
                   "s" : [ {
-                    "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
+                    "value" : [ "MaxValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2319,47 +2473,46 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "511",
+          "localId" : "529",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "512",
+            "localId" : "530",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "513",
+              "localId" : "531",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "503",
+            "localId" : "521",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "505",
+              "localId" : "523",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "506",
+                "localId" : "524",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Quantity",
-              "localId" : "504",
+              "type" : "ExpressionRef",
+              "localId" : "522",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "value" : 1.0E20,
-              "unit" : "ml",
+              "name" : "MaxValueMLQuantity",
               "annotation" : [ ]
             } ]
           }
         }
       }, {
-        "localId" : "516",
+        "localId" : "534",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_above_max_value",
         "context" : "Patient",
@@ -2368,28 +2521,28 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "516",
+            "r" : "534",
             "s" : [ {
               "value" : [ "", "define ", "quantities_above_max_value", ": " ]
             }, {
-              "r" : "526",
+              "r" : "544",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "517",
+                "r" : "535",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "518",
+                  "r" : "536",
                   "s" : [ {
-                    "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
+                    "value" : [ "MaxValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "519",
+                  "r" : "537",
                   "s" : [ {
-                    "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
+                    "value" : [ "MaxValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2402,54 +2555,52 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "526",
+          "localId" : "544",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "527",
+            "localId" : "545",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "528",
+              "localId" : "546",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "517",
+            "localId" : "535",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "520",
+              "localId" : "538",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "521",
+                "localId" : "539",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Quantity",
-              "localId" : "518",
+              "type" : "ExpressionRef",
+              "localId" : "536",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "value" : 1.0E20,
-              "unit" : "ml",
+              "name" : "MaxValueMLQuantity",
               "annotation" : [ ]
             }, {
-              "type" : "Quantity",
-              "localId" : "519",
+              "type" : "ExpressionRef",
+              "localId" : "537",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "value" : 1.0E20,
-              "unit" : "ml",
+              "name" : "MaxValueMLQuantity",
               "annotation" : [ ]
             } ]
           }
         }
       }, {
-        "localId" : "531",
+        "localId" : "549",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_at_min_value",
         "context" : "Patient",
@@ -2458,26 +2609,21 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "531",
+            "r" : "549",
             "s" : [ {
               "value" : [ "", "define ", "quantities_at_min_value", ": " ]
             }, {
-              "r" : "542",
+              "r" : "558",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "532",
+                "r" : "550",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "533",
+                  "r" : "551",
                   "s" : [ {
-                    "value" : [ "-" ]
-                  }, {
-                    "r" : "534",
-                    "s" : [ {
-                      "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
-                    } ]
+                    "value" : [ "MinValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2490,59 +2636,46 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "542",
+          "localId" : "558",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "543",
+            "localId" : "559",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "544",
+              "localId" : "560",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "532",
+            "localId" : "550",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "536",
+              "localId" : "552",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "537",
+                "localId" : "553",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Negate",
-              "localId" : "533",
+              "type" : "ExpressionRef",
+              "localId" : "551",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "annotation" : [ ],
-              "signature" : [ {
-                "type" : "NamedTypeSpecifier",
-                "localId" : "535",
-                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "annotation" : [ ]
-              } ],
-              "operand" : {
-                "type" : "Quantity",
-                "localId" : "534",
-                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "value" : 1.0E20,
-                "unit" : "ml",
-                "annotation" : [ ]
-              }
+              "name" : "MinValueMLQuantity",
+              "annotation" : [ ]
             } ]
           }
         }
       }, {
-        "localId" : "547",
+        "localId" : "563",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_below_min_value",
         "context" : "Patient",
@@ -2551,38 +2684,28 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "547",
+            "r" : "563",
             "s" : [ {
               "value" : [ "", "define ", "quantities_below_min_value", ": " ]
             }, {
-              "r" : "561",
+              "r" : "573",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "548",
+                "r" : "564",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "549",
+                  "r" : "565",
                   "s" : [ {
-                    "value" : [ "-" ]
-                  }, {
-                    "r" : "550",
-                    "s" : [ {
-                      "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
-                    } ]
+                    "value" : [ "MinValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "552",
+                  "r" : "566",
                   "s" : [ {
-                    "value" : [ "-" ]
-                  }, {
-                    "r" : "553",
-                    "s" : [ {
-                      "value" : [ "99999999999999999999.99999999 ", "'ml'" ]
-                    } ]
+                    "value" : [ "MinValueMLQuantity" ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2595,78 +2718,52 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "561",
+          "localId" : "573",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "562",
+            "localId" : "574",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "563",
+              "localId" : "575",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "548",
+            "localId" : "564",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "555",
+              "localId" : "567",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "556",
+                "localId" : "568",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Negate",
-              "localId" : "549",
+              "type" : "ExpressionRef",
+              "localId" : "565",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "annotation" : [ ],
-              "signature" : [ {
-                "type" : "NamedTypeSpecifier",
-                "localId" : "551",
-                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "annotation" : [ ]
-              } ],
-              "operand" : {
-                "type" : "Quantity",
-                "localId" : "550",
-                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "value" : 1.0E20,
-                "unit" : "ml",
-                "annotation" : [ ]
-              }
+              "name" : "MinValueMLQuantity",
+              "annotation" : [ ]
             }, {
-              "type" : "Negate",
-              "localId" : "552",
+              "type" : "ExpressionRef",
+              "localId" : "566",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "annotation" : [ ],
-              "signature" : [ {
-                "type" : "NamedTypeSpecifier",
-                "localId" : "554",
-                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "annotation" : [ ]
-              } ],
-              "operand" : {
-                "type" : "Quantity",
-                "localId" : "553",
-                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "value" : 1.0E20,
-                "unit" : "ml",
-                "annotation" : [ ]
-              }
+              "name" : "MinValueMLQuantity",
+              "annotation" : [ ]
             } ]
           }
         }
       }, {
-        "localId" : "566",
+        "localId" : "578",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "has_null",
         "context" : "Patient",
@@ -2675,17 +2772,17 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "566",
+            "r" : "578",
             "s" : [ {
               "value" : [ "", "define ", "has_null", ": " ]
             }, {
-              "r" : "582",
+              "r" : "594",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "567",
+                "r" : "579",
                 "s" : [ {
-                  "r" : "568",
+                  "r" : "580",
                   "value" : [ "{", "1", ",", "null", ",", "null", ",", "null", ",", "2", "}" ]
                 } ]
               }, {
@@ -2696,81 +2793,81 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "582",
+          "localId" : "594",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "583",
+            "localId" : "595",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "584",
+              "localId" : "596",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "567",
+            "localId" : "579",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "576",
+              "localId" : "588",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "577",
+                "localId" : "589",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Literal",
-              "localId" : "568",
+              "localId" : "580",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "1",
               "annotation" : [ ]
             }, {
               "type" : "As",
-              "localId" : "573",
+              "localId" : "585",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "569",
+                "localId" : "581",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "574",
+              "localId" : "586",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "570",
+                "localId" : "582",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "575",
+              "localId" : "587",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "571",
+                "localId" : "583",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "Literal",
-              "localId" : "572",
+              "localId" : "584",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "2",
@@ -2779,7 +2876,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "587",
+        "localId" : "599",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "has_null_q",
         "context" : "Patient",
@@ -2788,27 +2885,27 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "587",
+            "r" : "599",
             "s" : [ {
               "value" : [ "", "define ", "has_null_q", ": " ]
             }, {
-              "r" : "603",
+              "r" : "615",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "588",
+                "r" : "600",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "589",
+                  "r" : "601",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
-                  "r" : "590",
+                  "r" : "602",
                   "value" : [ ",", "null", ",", "null", ",", "null", "," ]
                 }, {
-                  "r" : "593",
+                  "r" : "605",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
@@ -2823,81 +2920,81 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "603",
+          "localId" : "615",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "604",
+            "localId" : "616",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "605",
+              "localId" : "617",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "588",
+            "localId" : "600",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "597",
+              "localId" : "609",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "598",
+                "localId" : "610",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "589",
+              "localId" : "601",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "As",
-              "localId" : "594",
+              "localId" : "606",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "590",
+                "localId" : "602",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "595",
+              "localId" : "607",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "591",
+                "localId" : "603",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "596",
+              "localId" : "608",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "592",
+                "localId" : "604",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "Quantity",
-              "localId" : "593",
+              "localId" : "605",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
@@ -2906,7 +3003,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "608",
+        "localId" : "620",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "unmatched_units_q",
         "context" : "Patient",
@@ -2915,54 +3012,54 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "608",
+            "r" : "620",
             "s" : [ {
               "value" : [ "", "define ", "unmatched_units_q", ": " ]
             }, {
-              "r" : "622",
+              "r" : "634",
               "s" : [ {
                 "value" : [ "Min", "(" ]
               }, {
-                "r" : "609",
+                "r" : "621",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "610",
+                  "r" : "622",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "611",
+                  "r" : "623",
                   "s" : [ {
                     "value" : [ "2 ", "'m'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "612",
+                  "r" : "624",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "613",
+                  "r" : "625",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "614",
+                  "r" : "626",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "615",
+                  "r" : "627",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -2977,73 +3074,73 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Min",
-          "localId" : "622",
+          "localId" : "634",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "623",
+            "localId" : "635",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "624",
+              "localId" : "636",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "609",
+            "localId" : "621",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "616",
+              "localId" : "628",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "617",
+                "localId" : "629",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "610",
+              "localId" : "622",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "611",
+              "localId" : "623",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "m",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "612",
+              "localId" : "624",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "613",
+              "localId" : "625",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "614",
+              "localId" : "626",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "615",
+              "localId" : "627",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -3052,7 +3149,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "627",
+        "localId" : "639",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "empty",
         "context" : "Patient",
@@ -3061,19 +3158,19 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "627",
+            "r" : "639",
             "s" : [ {
               "value" : [ "", "define ", "empty", ": " ]
             }, {
-              "r" : "637",
+              "r" : "649",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "629",
+                "r" : "641",
                 "s" : [ {
                   "value" : [ "List<" ]
                 }, {
-                  "r" : "628",
+                  "r" : "640",
                   "s" : [ {
                     "value" : [ "Integer" ]
                   } ]
@@ -3088,31 +3185,31 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "637",
+          "localId" : "649",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "638",
+            "localId" : "650",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "639",
+              "localId" : "651",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "629",
+            "localId" : "641",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "631",
+              "localId" : "643",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "632",
+                "localId" : "644",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
@@ -3121,7 +3218,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "642",
+        "localId" : "654",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "q_diff_units",
         "context" : "Patient",
@@ -3130,47 +3227,47 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "642",
+            "r" : "654",
             "s" : [ {
               "value" : [ "", "define ", "q_diff_units", ": " ]
             }, {
-              "r" : "655",
+              "r" : "667",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "643",
+                "r" : "655",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "644",
+                  "r" : "656",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "645",
+                  "r" : "657",
                   "s" : [ {
                     "value" : [ "0.002 ", "'l'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "646",
+                  "r" : "658",
                   "s" : [ {
                     "value" : [ "0.03 ", "'dl'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "647",
+                  "r" : "659",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "648",
+                  "r" : "660",
                   "s" : [ {
                     "value" : [ "0.005 ", "'l'" ]
                   } ]
@@ -3185,66 +3282,66 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "655",
+          "localId" : "667",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "656",
+            "localId" : "668",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "657",
+              "localId" : "669",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "643",
+            "localId" : "655",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "649",
+              "localId" : "661",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "650",
+                "localId" : "662",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "644",
+              "localId" : "656",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "645",
+              "localId" : "657",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "l",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "646",
+              "localId" : "658",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.03,
               "unit" : "dl",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "647",
+              "localId" : "659",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "648",
+              "localId" : "660",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.005,
               "unit" : "l",
@@ -3253,7 +3350,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "660",
+        "localId" : "672",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "NumbersAndQuantities",
         "context" : "Patient",
@@ -3262,48 +3359,48 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "660",
+            "r" : "672",
             "s" : [ {
               "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
             }, {
-              "r" : "677",
+              "r" : "689",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "661",
+                "r" : "673",
                 "s" : [ {
-                  "r" : "662",
+                  "r" : "674",
                   "value" : [ "{", "1", " ," ]
                 }, {
-                  "r" : "663",
+                  "r" : "675",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "664",
+                  "r" : "676",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "665",
+                  "r" : "677",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "666",
+                  "r" : "678",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "667",
+                  "r" : "679",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -3318,48 +3415,48 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "677",
+          "localId" : "689",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "678",
+            "localId" : "690",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "679",
+              "localId" : "691",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "661",
+            "localId" : "673",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "671",
+              "localId" : "683",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "672",
+                "localId" : "684",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "ToQuantity",
-              "localId" : "669",
+              "localId" : "681",
               "annotation" : [ ],
               "signature" : [ {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "670",
+                "localId" : "682",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               } ],
               "operand" : {
                 "type" : "Literal",
-                "localId" : "662",
+                "localId" : "674",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
                 "value" : "1",
@@ -3367,35 +3464,35 @@ module.exports['Sum'] = {
               }
             }, {
               "type" : "Quantity",
-              "localId" : "663",
+              "localId" : "675",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "664",
+              "localId" : "676",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "665",
+              "localId" : "677",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "666",
+              "localId" : "678",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "667",
+              "localId" : "679",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -3404,7 +3501,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "682",
+        "localId" : "694",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "IncompatibleUnitsNull",
         "context" : "Patient",
@@ -3413,26 +3510,26 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "682",
+            "r" : "694",
             "s" : [ {
               "value" : [ "", "define ", "IncompatibleUnitsNull", ": " ]
             }, {
-              "r" : "692",
+              "r" : "704",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "683",
+                "r" : "695",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "684",
+                  "r" : "696",
                   "s" : [ {
                     "value" : [ "1 ", "'mg/d'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "685",
+                  "r" : "697",
                   "s" : [ {
                     "value" : [ "0.002 ", "'/d'" ]
                   } ]
@@ -3447,45 +3544,45 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "692",
+          "localId" : "704",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "693",
+            "localId" : "705",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "694",
+              "localId" : "706",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "683",
+            "localId" : "695",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "686",
+              "localId" : "698",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "687",
+                "localId" : "699",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "684",
+              "localId" : "696",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "mg/d",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "685",
+              "localId" : "697",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "/d",
@@ -15140,10 +15237,14 @@ define decimals_above_max_value_product: Product({99999999999999999999.99999999,
 define decimals_at_min_value_product: Product({-99999999999999999999.99999999, 1.0})
 define decimals_below_min_value_product: Product({-99999999999999999999.99999999, 2.0})
 define quantity_product: Product({1.0 'g', 2.0 'g', 3.0 'g', 4.0 'g'})
-define quantities_at_max_value_product: Product({99999999999999999999.99999999 'g', 1.0 'g'})
-define quantities_above_max_value_product: Product({99999999999999999999.99999999 'g', 2.0 'g'})
-define quantities_at_min_value_product: Product({-99999999999999999999.99999999 'g', 1.0 'g'})
-define quantities_below_min_value_product: Product({-99999999999999999999.99999999 'g', 2.0 'g'})
+// Max/Min-valued quantities are described using the "maximum" and "minimum" operators
+// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+define MaxValueGramQuantity: Quantity { value: maximum Decimal, unit: 'g' }
+define MinValueGramQuantity: Quantity { value: minimum Decimal, unit: 'g' }
+define quantities_at_max_value_product: Product({MaxValueGramQuantity, 1.0 'g'})
+define quantities_above_max_value_product: Product({MaxValueGramQuantity, 2.0 'g'})
+define quantities_at_min_value_product: Product({MinValueGramQuantity, 1.0 'g'})
+define quantities_below_min_value_product: Product({MinValueGramQuantity, 2.0 'g'})
 define quantity_zero_product: Product({1.0 'g', 2.0 'g', 0 'g'})
 define zero_product: Product({0, 5, 10})
 define product_with_null: Product({5, 4, null})
@@ -15166,7 +15267,7 @@ module.exports['Product'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "670",
+        "r" : "684",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -16683,7 +16784,7 @@ module.exports['Product'] = {
       }, {
         "localId" : "475",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "quantities_at_max_value_product",
+        "name" : "MaxValueGramQuantity",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -16692,24 +16793,174 @@ module.exports['Product'] = {
           "s" : {
             "r" : "475",
             "s" : [ {
-              "value" : [ "", "define ", "quantities_at_max_value_product", ": " ]
+              "value" : [ "// Max/Min-valued quantities are described using the \"maximum\" and \"minimum\" operators\n// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal\n", "define ", "MaxValueGramQuantity", ": " ]
+            }, {
+              "r" : "476",
+              "s" : [ {
+                "value" : [ "Quantity", " { " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "value", ": " ]
+                }, {
+                  "r" : "479",
+                  "s" : [ {
+                    "value" : [ "maximum", " " ]
+                  }, {
+                    "r" : "478",
+                    "s" : [ {
+                      "value" : [ "Decimal" ]
+                    } ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "unit", ": " ]
+                }, {
+                  "r" : "480",
+                  "s" : [ {
+                    "value" : [ "'g'" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ " }" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Instance",
+          "localId" : "476",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "element" : [ {
+            "name" : "value",
+            "value" : {
+              "type" : "MaxValue",
+              "localId" : "479",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "name" : "unit",
+            "value" : {
+              "type" : "Literal",
+              "localId" : "480",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+              "valueType" : "{urn:hl7-org:elm-types:r1}String",
+              "value" : "g",
+              "annotation" : [ ]
+            }
+          } ]
+        }
+      }, {
+        "localId" : "484",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "MinValueGramQuantity",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "484",
+            "s" : [ {
+              "value" : [ "", "define ", "MinValueGramQuantity", ": " ]
             }, {
               "r" : "485",
+              "s" : [ {
+                "value" : [ "Quantity", " { " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "value", ": " ]
+                }, {
+                  "r" : "488",
+                  "s" : [ {
+                    "value" : [ "minimum", " " ]
+                  }, {
+                    "r" : "487",
+                    "s" : [ {
+                      "value" : [ "Decimal" ]
+                    } ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "s" : [ {
+                  "value" : [ "unit", ": " ]
+                }, {
+                  "r" : "489",
+                  "s" : [ {
+                    "value" : [ "'g'" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ " }" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Instance",
+          "localId" : "485",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "element" : [ {
+            "name" : "value",
+            "value" : {
+              "type" : "MinValue",
+              "localId" : "488",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "name" : "unit",
+            "value" : {
+              "type" : "Literal",
+              "localId" : "489",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+              "valueType" : "{urn:hl7-org:elm-types:r1}String",
+              "value" : "g",
+              "annotation" : [ ]
+            }
+          } ]
+        }
+      }, {
+        "localId" : "493",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "quantities_at_max_value_product",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "493",
+            "s" : [ {
+              "value" : [ "", "define ", "quantities_at_max_value_product", ": " ]
+            }, {
+              "r" : "503",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "476",
+                "r" : "494",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "477",
+                  "r" : "495",
                   "s" : [ {
-                    "value" : [ "99999999999999999999.99999999 ", "'g'" ]
+                    "value" : [ "MaxValueGramQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "478",
+                  "r" : "496",
                   "s" : [ {
                     "value" : [ "1.0 ", "'g'" ]
                   } ]
@@ -16724,45 +16975,44 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "485",
+          "localId" : "503",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "486",
+            "localId" : "504",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "487",
+              "localId" : "505",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "476",
+            "localId" : "494",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "479",
+              "localId" : "497",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "480",
+                "localId" : "498",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Quantity",
-              "localId" : "477",
+              "type" : "ExpressionRef",
+              "localId" : "495",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "value" : 1.0E20,
-              "unit" : "g",
+              "name" : "MaxValueGramQuantity",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "478",
+              "localId" : "496",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1.0,
               "unit" : "g",
@@ -16771,7 +17021,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "490",
+        "localId" : "508",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_above_max_value_product",
         "context" : "Patient",
@@ -16780,26 +17030,26 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "490",
+            "r" : "508",
             "s" : [ {
               "value" : [ "", "define ", "quantities_above_max_value_product", ": " ]
             }, {
-              "r" : "500",
+              "r" : "518",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "491",
+                "r" : "509",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "492",
+                  "r" : "510",
                   "s" : [ {
-                    "value" : [ "99999999999999999999.99999999 ", "'g'" ]
+                    "value" : [ "MaxValueGramQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "493",
+                  "r" : "511",
                   "s" : [ {
                     "value" : [ "2.0 ", "'g'" ]
                   } ]
@@ -16814,45 +17064,44 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "500",
+          "localId" : "518",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "501",
+            "localId" : "519",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "502",
+              "localId" : "520",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "491",
+            "localId" : "509",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "494",
+              "localId" : "512",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "495",
+                "localId" : "513",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Quantity",
-              "localId" : "492",
+              "type" : "ExpressionRef",
+              "localId" : "510",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "value" : 1.0E20,
-              "unit" : "g",
+              "name" : "MaxValueGramQuantity",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "493",
+              "localId" : "511",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2.0,
               "unit" : "g",
@@ -16861,7 +17110,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "505",
+        "localId" : "523",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_at_min_value_product",
         "context" : "Patient",
@@ -16870,31 +17119,26 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "505",
+            "r" : "523",
             "s" : [ {
               "value" : [ "", "define ", "quantities_at_min_value_product", ": " ]
             }, {
-              "r" : "517",
+              "r" : "533",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "506",
+                "r" : "524",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "507",
+                  "r" : "525",
                   "s" : [ {
-                    "value" : [ "-" ]
-                  }, {
-                    "r" : "508",
-                    "s" : [ {
-                      "value" : [ "99999999999999999999.99999999 ", "'g'" ]
-                    } ]
+                    "value" : [ "MinValueGramQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "510",
+                  "r" : "526",
                   "s" : [ {
                     "value" : [ "1.0 ", "'g'" ]
                   } ]
@@ -16909,57 +17153,44 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "517",
+          "localId" : "533",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "518",
+            "localId" : "534",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "519",
+              "localId" : "535",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "506",
+            "localId" : "524",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "511",
+              "localId" : "527",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "512",
+                "localId" : "528",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Negate",
-              "localId" : "507",
+              "type" : "ExpressionRef",
+              "localId" : "525",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "annotation" : [ ],
-              "signature" : [ {
-                "type" : "NamedTypeSpecifier",
-                "localId" : "509",
-                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "annotation" : [ ]
-              } ],
-              "operand" : {
-                "type" : "Quantity",
-                "localId" : "508",
-                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "value" : 1.0E20,
-                "unit" : "g",
-                "annotation" : [ ]
-              }
+              "name" : "MinValueGramQuantity",
+              "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "510",
+              "localId" : "526",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1.0,
               "unit" : "g",
@@ -16968,7 +17199,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "522",
+        "localId" : "538",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantities_below_min_value_product",
         "context" : "Patient",
@@ -16977,31 +17208,26 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "522",
+            "r" : "538",
             "s" : [ {
               "value" : [ "", "define ", "quantities_below_min_value_product", ": " ]
             }, {
-              "r" : "534",
+              "r" : "548",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "523",
+                "r" : "539",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "524",
+                  "r" : "540",
                   "s" : [ {
-                    "value" : [ "-" ]
-                  }, {
-                    "r" : "525",
-                    "s" : [ {
-                      "value" : [ "99999999999999999999.99999999 ", "'g'" ]
-                    } ]
+                    "value" : [ "MinValueGramQuantity" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "527",
+                  "r" : "541",
                   "s" : [ {
                     "value" : [ "2.0 ", "'g'" ]
                   } ]
@@ -17016,57 +17242,44 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "534",
+          "localId" : "548",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "535",
+            "localId" : "549",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "536",
+              "localId" : "550",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "523",
+            "localId" : "539",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "528",
+              "localId" : "542",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "529",
+                "localId" : "543",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
-              "type" : "Negate",
-              "localId" : "524",
+              "type" : "ExpressionRef",
+              "localId" : "540",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "annotation" : [ ],
-              "signature" : [ {
-                "type" : "NamedTypeSpecifier",
-                "localId" : "526",
-                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "annotation" : [ ]
-              } ],
-              "operand" : {
-                "type" : "Quantity",
-                "localId" : "525",
-                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-                "value" : 1.0E20,
-                "unit" : "g",
-                "annotation" : [ ]
-              }
+              "name" : "MinValueGramQuantity",
+              "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "527",
+              "localId" : "541",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2.0,
               "unit" : "g",
@@ -17075,7 +17288,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "539",
+        "localId" : "553",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "quantity_zero_product",
         "context" : "Patient",
@@ -17084,33 +17297,33 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "539",
+            "r" : "553",
             "s" : [ {
               "value" : [ "", "define ", "quantity_zero_product", ": " ]
             }, {
-              "r" : "550",
+              "r" : "564",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "540",
+                "r" : "554",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "541",
+                  "r" : "555",
                   "s" : [ {
                     "value" : [ "1.0 ", "'g'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "542",
+                  "r" : "556",
                   "s" : [ {
                     "value" : [ "2.0 ", "'g'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "543",
+                  "r" : "557",
                   "s" : [ {
                     "value" : [ "0 ", "'g'" ]
                   } ]
@@ -17125,52 +17338,52 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "550",
+          "localId" : "564",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "551",
+            "localId" : "565",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "552",
+              "localId" : "566",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "540",
+            "localId" : "554",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "544",
+              "localId" : "558",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "545",
+                "localId" : "559",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "541",
+              "localId" : "555",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1.0,
               "unit" : "g",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "542",
+              "localId" : "556",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2.0,
               "unit" : "g",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "543",
+              "localId" : "557",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "g",
@@ -17179,7 +17392,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "555",
+        "localId" : "569",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "zero_product",
         "context" : "Patient",
@@ -17188,17 +17401,17 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "555",
+            "r" : "569",
             "s" : [ {
               "value" : [ "", "define ", "zero_product", ": " ]
             }, {
-              "r" : "566",
+              "r" : "580",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "556",
+                "r" : "570",
                 "s" : [ {
-                  "r" : "557",
+                  "r" : "571",
                   "value" : [ "{", "0", ", ", "5", ", ", "10", "}" ]
                 } ]
               }, {
@@ -17209,52 +17422,52 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "566",
+          "localId" : "580",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "567",
+            "localId" : "581",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "568",
+              "localId" : "582",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "556",
+            "localId" : "570",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "560",
+              "localId" : "574",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "561",
+                "localId" : "575",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Literal",
-              "localId" : "557",
+              "localId" : "571",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "0",
               "annotation" : [ ]
             }, {
               "type" : "Literal",
-              "localId" : "558",
+              "localId" : "572",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "5",
               "annotation" : [ ]
             }, {
               "type" : "Literal",
-              "localId" : "559",
+              "localId" : "573",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "10",
@@ -17263,7 +17476,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "571",
+        "localId" : "585",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "product_with_null",
         "context" : "Patient",
@@ -17272,17 +17485,17 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "571",
+            "r" : "585",
             "s" : [ {
               "value" : [ "", "define ", "product_with_null", ": " ]
             }, {
-              "r" : "583",
+              "r" : "597",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "572",
+                "r" : "586",
                 "s" : [ {
-                  "r" : "573",
+                  "r" : "587",
                   "value" : [ "{", "5", ", ", "4", ", ", "null", "}" ]
                 } ]
               }, {
@@ -17293,58 +17506,58 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "583",
+          "localId" : "597",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "584",
+            "localId" : "598",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "585",
+              "localId" : "599",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "572",
+            "localId" : "586",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "577",
+              "localId" : "591",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "578",
+                "localId" : "592",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Literal",
-              "localId" : "573",
+              "localId" : "587",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "5",
               "annotation" : [ ]
             }, {
               "type" : "Literal",
-              "localId" : "574",
+              "localId" : "588",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "4",
               "annotation" : [ ]
             }, {
               "type" : "As",
-              "localId" : "576",
+              "localId" : "590",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "575",
+                "localId" : "589",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
@@ -17352,7 +17565,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "588",
+        "localId" : "602",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "product_of_nulls",
         "context" : "Patient",
@@ -17361,30 +17574,30 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "588",
+            "r" : "602",
             "s" : [ {
               "value" : [ "", "define ", "product_of_nulls", ": " ]
             }, {
-              "r" : "603",
+              "r" : "617",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "589",
+                "r" : "603",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "590",
+                  "r" : "604",
                   "s" : [ {
-                    "r" : "591",
+                    "r" : "605",
                     "value" : [ "null", " as " ]
                   }, {
-                    "r" : "592",
+                    "r" : "606",
                     "s" : [ {
                       "value" : [ "Integer" ]
                     } ]
                   } ]
                 }, {
-                  "r" : "593",
+                  "r" : "607",
                   "value" : [ ", ", "null", ", ", "null", "}" ]
                 } ]
               }, {
@@ -17395,76 +17608,76 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "603",
+          "localId" : "617",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "604",
+            "localId" : "618",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "605",
+              "localId" : "619",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "589",
+            "localId" : "603",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "597",
+              "localId" : "611",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "598",
+                "localId" : "612",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "As",
-              "localId" : "590",
+              "localId" : "604",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "strict" : false,
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "591",
+                "localId" : "605",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               },
               "asTypeSpecifier" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "592",
+                "localId" : "606",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "595",
+              "localId" : "609",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "593",
+                "localId" : "607",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "596",
+              "localId" : "610",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "594",
+                "localId" : "608",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
@@ -17472,7 +17685,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "608",
+        "localId" : "622",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
         "name" : "product_null",
         "context" : "Patient",
@@ -17481,24 +17694,24 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "608",
+            "r" : "622",
             "s" : [ {
               "value" : [ "", "define ", "product_null", ": " ]
             }, {
-              "r" : "621",
+              "r" : "635",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "609",
+                "r" : "623",
                 "s" : [ {
-                  "r" : "610",
+                  "r" : "624",
                   "value" : [ "null", " as " ]
                 }, {
-                  "r" : "611",
+                  "r" : "625",
                   "s" : [ {
                     "value" : [ "List<" ]
                   }, {
-                    "r" : "612",
+                    "r" : "626",
                     "s" : [ {
                       "value" : [ "Decimal" ]
                     } ]
@@ -17514,32 +17727,32 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "621",
+          "localId" : "635",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "622",
+            "localId" : "636",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "623",
+              "localId" : "637",
               "name" : "{urn:hl7-org:elm-types:r1}Decimal",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "As",
-            "localId" : "609",
+            "localId" : "623",
             "strict" : false,
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "615",
+              "localId" : "629",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "616",
+                "localId" : "630",
                 "name" : "{urn:hl7-org:elm-types:r1}Decimal",
                 "annotation" : [ ]
               }
@@ -17547,28 +17760,28 @@ module.exports['Product'] = {
             "signature" : [ ],
             "operand" : {
               "type" : "Null",
-              "localId" : "610",
+              "localId" : "624",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
               "annotation" : [ ]
             },
             "asTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "611",
+              "localId" : "625",
               "annotation" : [ ],
               "resultTypeSpecifier" : {
                 "type" : "ListTypeSpecifier",
-                "localId" : "613",
+                "localId" : "627",
                 "annotation" : [ ],
                 "elementType" : {
                   "type" : "NamedTypeSpecifier",
-                  "localId" : "614",
+                  "localId" : "628",
                   "name" : "{urn:hl7-org:elm-types:r1}Decimal",
                   "annotation" : [ ]
                 }
               },
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "612",
+                "localId" : "626",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
                 "name" : "{urn:hl7-org:elm-types:r1}Decimal",
                 "annotation" : [ ]
@@ -17577,7 +17790,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "626",
+        "localId" : "640",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "product_quantity_null",
         "context" : "Patient",
@@ -17586,24 +17799,24 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "626",
+            "r" : "640",
             "s" : [ {
               "value" : [ "", "define ", "product_quantity_null", ": " ]
             }, {
-              "r" : "643",
+              "r" : "657",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "627",
+                "r" : "641",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "628",
+                  "r" : "642",
                   "s" : [ {
-                    "r" : "629",
+                    "r" : "643",
                     "value" : [ "null", " as " ]
                   }, {
-                    "r" : "630",
+                    "r" : "644",
                     "s" : [ {
                       "value" : [ "Quantity" ]
                     } ]
@@ -17611,12 +17824,12 @@ module.exports['Product'] = {
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "631",
+                  "r" : "645",
                   "s" : [ {
-                    "r" : "632",
+                    "r" : "646",
                     "value" : [ "null", " as " ]
                   }, {
-                    "r" : "633",
+                    "r" : "647",
                     "s" : [ {
                       "value" : [ "Quantity" ]
                     } ]
@@ -17624,12 +17837,12 @@ module.exports['Product'] = {
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "634",
+                  "r" : "648",
                   "s" : [ {
-                    "r" : "635",
+                    "r" : "649",
                     "value" : [ "null", " as " ]
                   }, {
-                    "r" : "636",
+                    "r" : "650",
                     "s" : [ {
                       "value" : [ "Quantity" ]
                     } ]
@@ -17645,91 +17858,91 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "643",
+          "localId" : "657",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "644",
+            "localId" : "658",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "645",
+              "localId" : "659",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "627",
+            "localId" : "641",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "637",
+              "localId" : "651",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "638",
+                "localId" : "652",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "As",
-              "localId" : "628",
+              "localId" : "642",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "strict" : false,
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "629",
+                "localId" : "643",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               },
               "asTypeSpecifier" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "630",
+                "localId" : "644",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "631",
+              "localId" : "645",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "strict" : false,
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "632",
+                "localId" : "646",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               },
               "asTypeSpecifier" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "633",
+                "localId" : "647",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "634",
+              "localId" : "648",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "strict" : false,
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "635",
+                "localId" : "649",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               },
               "asTypeSpecifier" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "636",
+                "localId" : "650",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
@@ -17738,7 +17951,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "648",
+        "localId" : "662",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "NumbersAndQuantities",
         "context" : "Patient",
@@ -17747,48 +17960,48 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "648",
+            "r" : "662",
             "s" : [ {
               "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
             }, {
-              "r" : "665",
+              "r" : "679",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "649",
+                "r" : "663",
                 "s" : [ {
-                  "r" : "650",
+                  "r" : "664",
                   "value" : [ "{", "1", " ," ]
                 }, {
-                  "r" : "651",
+                  "r" : "665",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "652",
+                  "r" : "666",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "653",
+                  "r" : "667",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "654",
+                  "r" : "668",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "655",
+                  "r" : "669",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -17803,48 +18016,48 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "665",
+          "localId" : "679",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "666",
+            "localId" : "680",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "667",
+              "localId" : "681",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "649",
+            "localId" : "663",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "659",
+              "localId" : "673",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "660",
+                "localId" : "674",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "ToQuantity",
-              "localId" : "657",
+              "localId" : "671",
               "annotation" : [ ],
               "signature" : [ {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "658",
+                "localId" : "672",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               } ],
               "operand" : {
                 "type" : "Literal",
-                "localId" : "650",
+                "localId" : "664",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
                 "value" : "1",
@@ -17852,35 +18065,35 @@ module.exports['Product'] = {
               }
             }, {
               "type" : "Quantity",
-              "localId" : "651",
+              "localId" : "665",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "652",
+              "localId" : "666",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "653",
+              "localId" : "667",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "654",
+              "localId" : "668",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "655",
+              "localId" : "669",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -17889,7 +18102,7 @@ module.exports['Product'] = {
           }
         }
       }, {
-        "localId" : "670",
+        "localId" : "684",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "IncompatibleUnitsNull",
         "context" : "Patient",
@@ -17898,26 +18111,26 @@ module.exports['Product'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "670",
+            "r" : "684",
             "s" : [ {
               "value" : [ "", "define ", "IncompatibleUnitsNull", ": " ]
             }, {
-              "r" : "680",
+              "r" : "694",
               "s" : [ {
                 "value" : [ "Product", "(" ]
               }, {
-                "r" : "671",
+                "r" : "685",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "672",
+                  "r" : "686",
                   "s" : [ {
                     "value" : [ "1 ", "'mg/d'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "673",
+                  "r" : "687",
                   "s" : [ {
                     "value" : [ "0.002 ", "'/d'" ]
                   } ]
@@ -17932,45 +18145,45 @@ module.exports['Product'] = {
         } ],
         "expression" : {
           "type" : "Product",
-          "localId" : "680",
+          "localId" : "694",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "681",
+            "localId" : "695",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "682",
+              "localId" : "696",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "671",
+            "localId" : "685",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "674",
+              "localId" : "688",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "675",
+                "localId" : "689",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "672",
+              "localId" : "686",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "mg/d",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "673",
+              "localId" : "687",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "/d",
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 618265736..774aa91bd 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -211,64 +211,64 @@ describe('Divide', () => {
   });
 
   it('should divide two numbers', async function () {
-    (await this.tenDividedByTwo.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.tenDividedByTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
   });
 
   it("should divide two numbers that don't evenly divide", async function () {
-    (await this.tenDividedByFour.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.tenDividedByFour.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
 
   it('should divide multiple numbers', async function () {
-    (await this.divideMultiple.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.divideMultiple.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
   });
 
   it('should divide variables', async function () {
-    (await this.divideVariables.exec(this.ctx)).should.eql(Decimal.from(25));
+    (await this.divideVariables.exec(this.ctx)).should.equalDecimal(Decimal.from(25));
   });
 
   it('should divide two longs', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoLong.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.tenDividedByTwoLong.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
   });
 
   it('should divide integer by long', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
   });
 
   it('should divide long by integer', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.eql(Decimal.from(5));
+    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
   });
 
   it('should divide two longs with decimal result', async function () {
-    (await this.tenDividedByFourLong.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.tenDividedByFourLong.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
 
   it('should divide integer by long with decimal result', async function () {
-    (await this.tenDividedByFourMixed.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.tenDividedByFourMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
 
   it('should divide long by integer with decimal result', async function () {
-    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.eql(Decimal.from(2.5));
+    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
   });
 
   it('should divide uncertainty by uncertainty', async function () {
     const result = await this.divideUncertainties.exec(this.ctx);
-    result.low.should.eql(Decimal.from(0.42857143)); // 6/14
-    result.high.should.eql(Decimal.from(9));
+    result.low.should.equalDecimal(Decimal.from("0.42857143")); // 6/14
+    result.high.should.equalDecimal(Decimal.from(9));
   });
 
   it('should divide uncertainty by number', async function () {
     const result = await this.divideUncertaintyByNumber.exec(this.ctx);
-    result.low.should.eql(Decimal.from(3));
-    result.high.should.eql(Decimal.from(9));
+    result.low.should.equalDecimal(Decimal.from(3));
+    result.high.should.equalDecimal(Decimal.from(9));
   });
 
   it('should divide number by uncertainty', async function () {
     const result = await this.divideNumberByUncertainty.exec(this.ctx);
-    result.low.should.eql(Decimal.from(2));
-    result.high.should.eql(Decimal.from(6));
+    result.low.should.equalDecimal(Decimal.from(2));
+    result.high.should.equalDecimal(Decimal.from(6));
   });
 });
 
@@ -300,11 +300,11 @@ describe('MathPrecedence', () => {
   });
 
   it('should follow order of operations', async function () {
-    (await this.mixed.exec(this.ctx)).should.eql(Decimal.from(46));
+    (await this.mixed.exec(this.ctx)).should.equalDecimal(Decimal.from(46));
   });
 
   it('should allow parentheses to override order of operations', async function () {
-    (await this.parenthetical.exec(this.ctx)).should.eql(Decimal.from(-10));
+    (await this.parenthetical.exec(this.ctx)).should.equalDecimal(Decimal.from(-10));
   });
 });
 
@@ -318,7 +318,7 @@ describe('Power', () => {
   });
 
   it('should be able to calculate the negative power of a number', async function () {
-    (await this.negPow.exec(this.ctx)).should.eql(Decimal.from(0.1));
+    (await this.negPow.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
   });
 
   it('should be able to calculate the power of a long', async function () {
@@ -334,7 +334,7 @@ describe('Power', () => {
   });
 
   it('should be able to calculate the negative power of a long', async function () {
-    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.eql(Decimal.from(0.1));
+    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
   });
 
   it('should return null when a long power exponent is too large (beyond max Long value)', async function () {
@@ -368,19 +368,12 @@ describe('MinValue', () => {
     String(minLongResult).should.equal(minLongStringValue);
   });
 
-  // JS number doesn't handle limits of decimal precisely, but this ensures we are in the ballpark
-  it('of Decimal should return approximate minimum representable Decimal value', async function () {
-    const minDecimalValue = -99999999999999999999.99999999;
-    const minDecimalResult = await this.minDecimal.exec(this.ctx);
-    minDecimalResult.should.be.approximately(minDecimalValue, 0.000000001);
-  });
-
-  it.skip('of Decimal should return exact minimum representable Decimal value', async function () {
-    const minDecimalValue = -99999999999999999999.99999999;
+  it('of Decimal should return exact minimum representable Decimal value', async function () {
     const minDecimalStringValue = '-99999999999999999999.99999999';
+    const minDecimalValue = Decimal.from(minDecimalStringValue);
     const minDecimalResult = await this.minDecimal.exec(this.ctx);
-    minDecimalResult.should.equal(minDecimalValue);
-    String(minDecimalResult).should.equal(minDecimalStringValue);
+    minDecimalResult.should.equalDecimal(minDecimalValue);
+    minDecimalResult.toString().should.equal(minDecimalStringValue);
   });
 
   it('of DateTime should return minimum representable DateTime value', async function () {
@@ -428,19 +421,12 @@ describe('MaxValue', () => {
     String(maxLongResult).should.equal(maxLongStringValue);
   });
 
-  // JS number doesn't handle limits of decimal precisely, but this ensures we are in the ballpark
-  it('of Decimal should return approximate maximum representable Decimal value', async function () {
-    const maxDecimalValue = 99999999999999999999.99999999;
-    const maxDecimalResult = await this.maxDecimal.exec(this.ctx);
-    maxDecimalResult.should.be.approximately(maxDecimalValue, 0.000000001);
-  });
-
-  it.skip('of Decimal should return exact maximum representable Decimal value', async function () {
-    const maxDecimalValue = 99999999999999999999.99999999;
+  it('of Decimal should return exact maximum representable Decimal value', async function () {
     const maxDecimalStringValue = '99999999999999999999.99999999';
+    const maxDecimalValue = Decimal.from(maxDecimalStringValue);
     const maxDecimalResult = await this.maxDecimal.exec(this.ctx);
-    maxDecimalResult.should.equal(maxDecimalValue, 0.000000001);
-    String(maxDecimalResult).should.equal(maxDecimalStringValue);
+    maxDecimalResult.should.equalDecimal(maxDecimalValue);
+    maxDecimalResult.toString().should.equal(maxDecimalStringValue);
   });
 
   it('of DateTime should return maximum representable DateTime value', async function () {
@@ -551,11 +537,13 @@ describe('Ln', () => {
   });
 
   it('should be able to return the natural log of a number', async function () {
-    (await this.ln.exec(this.ctx)).should.eql(Decimal.from(Math.log(4)));
+    const log4 = Decimal.from("1.3862943611198906").normalized();
+    (await this.ln.exec(this.ctx)).should.equalDecimal(log4);
   });
 
   it('should be able to return the natural log of a long', async function () {
-    (await this.lnFourLong.exec(this.ctx)).should.eql(Decimal.from(Math.log(4)));
+    const log4 = Decimal.from("1.3862943611198906").normalized();
+    (await this.lnFourLong.exec(this.ctx)).should.equalDecimal(log4);
   });
 });
 
@@ -565,11 +553,11 @@ describe('Log', () => {
   });
 
   it('should be able to return the log of a number based on an arbitrary base value', async function () {
-    (await this.log.exec(this.ctx)).should.eql(Decimal.from(0.25));
+    (await this.log.exec(this.ctx)).should.equalDecimal(Decimal.from(0.25));
   });
 
   it('should be able to return the log of a long based on an arbitrary base value', async function () {
-    (await this.logLong.exec(this.ctx)).should.eql(Decimal.from(0.25));
+    (await this.logLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.25));
   });
 });
 
@@ -638,12 +626,12 @@ describe('Round', () => {
   });
 
   it('should be able to round a number up or down to the closest integer value', async function () {
-    (await this.up.exec(this.ctx)).should.eql(Decimal.from(5));
-    (await this.down.exec(this.ctx)).should.eql(Decimal.from(4));
+    (await this.up.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.down.exec(this.ctx)).should.equalDecimal(Decimal.from(4));
   });
   it('should be able to round a number up or down to the closest decimal place ', async function () {
-    (await this.up_percent.exec(this.ctx)).should.eql(Decimal.from(4.6));
-    (await this.down_percent.exec(this.ctx)).should.eql(Decimal.from(4.4));
+    (await this.up_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.6));
+    (await this.down_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.4));
   });
 });
 
@@ -661,7 +649,7 @@ describe('Successor', () => {
   });
 
   it('should be able to get Real Successor', async function () {
-    (await this.rs.exec(this.ctx)).should.eql(Decimal.from(2.2 + Math.pow(10, -8)));
+    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from(2.2 + Math.pow(10, -8)));
   });
 
   it('should return null for Successor greater than Integer Max value', async function () {
@@ -764,7 +752,7 @@ describe('Predecessor', () => {
   });
 
   it('should be able to get Real Predecessor', async function () {
-    (await this.rs.exec(this.ctx)).should.eql(Decimal.from(2.2 - Math.pow(10, -8)));
+    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from("2.19999999"));
   });
 
   it('should return null for Predecessor greater than Integer Max value', async function () {
@@ -891,13 +879,13 @@ describe('Quantity', () => {
 
   it('should be able to perform Quantity Absolution', async function () {
     const q = await this.abs.exec(this.ctx);
-    q.value.should.eql(Decimal.from(10));
+    q.value.should.equalDecimal(Decimal.from(10));
     q.unit.should.equal('days');
   });
 
   it('should be able to perform Quantity Negation', async function () {
     const q = await this.neg.exec(this.ctx);
-    q.value.should.eql(Decimal.from(-10));
+    q.value.should.equalDecimal(Decimal.from(-10));
     q.unit.should.equal('days');
   });
 
@@ -1023,12 +1011,12 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but more than max integer and near JavaScript max safe number
-      should(await this.integerDivideNearOverflow.exec(this.ctx)).eql(Decimal.from(8589934588000000));
+      should(await this.integerDivideNearOverflow.exec(this.ctx)).equalDecimal(Decimal.from(8589934588000000));
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but less than min integer and near JavaScript min safe number
-      should(await this.integerDivideNearUnderflow.exec(this.ctx)).eql(Decimal.from(-8589934592000000));
+      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equalDecimal(Decimal.from(-8589934592000000));
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1127,12 +1115,15 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but near JavaScript max safe number
-      should(await this.longDivideNearOverflow.exec(this.ctx)).eql(Decimal.from(9007199254740992n));
+      // note that all division in CQL (except truncated division) is really decimal division
+      // note also that MAX_LONG_VALUE is (2^63)-1,
+      // 9223372036854775807 = 7^2 * 73 * 127 * 337 * 92737 * 649657
+      should(await this.longDivideNearOverflow.exec(this.ctx)).equalDecimal(Decimal.from(99457304386111n));
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but near JavaScript min safe number
-      should(await this.longDivideNearUnderflow.exec(this.ctx)).eql(Decimal.from(-9007199254740992n));
+      should(await this.longDivideNearUnderflow.exec(this.ctx)).equalDecimal(Decimal.from(-9007199254740992n));
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1265,13 +1256,12 @@ describe('OutOfBounds', () => {
       should(await this.decimalPredecessorUnderflow.exec(this.ctx)).be.null();
     });
 
-    // NOTE: skipping successor/predecessor tests near overflow due to JS Number imprecision
-    it.skip('should return value for successor near overflow', async function () {
-      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equal(MAX_DECIMAL_VALUE);
+    it('should return value for successor near overflow', async function () {
+      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equalDecimal(MAX_DECIMAL_VALUE);
     });
 
-    it.skip('should return value for predecessor near underflow', async function () {
-      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equal(MIN_DECIMAL_VALUE);
+    it('should return value for predecessor near underflow', async function () {
+      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equalDecimal(MIN_DECIMAL_VALUE);
     });
   });
 
@@ -1369,14 +1359,14 @@ describe('OutOfBounds', () => {
     });
 
     // NOTE: skipping successor/predecessor tests near overflow due to JS Number imprecision
-    it.skip('should return value for successor near overflow', async function () {
+    it('should return value for successor near overflow', async function () {
       const result = await this.quantitySuccessorNearOverflow.exec(this.ctx);
       should(result).not.be.null();
       validateQuantity(result, MAX_DECIMAL_VALUE, 'mm');
     });
 
-    it.skip('should return value for predecessor near underflow', async function () {
-      const result = await this.quantitPpredecessorNearOverflow.exec(this.ctx);
+    it('should return value for predecessor near underflow', async function () {
+      const result = await this.quantityPredecessorNearUnderflow.exec(this.ctx);
       should(result).not.be.null();
       validateQuantity(result, MIN_DECIMAL_VALUE, 'mm');
     });
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 883ad6e33..5f621470a 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -250,7 +250,7 @@ define LongMultiplyNearUnderflow: minimum Long * 1L
 // NOTE: Long division results in decimal, so it must overflow/underflow decimal
 define LongDivideOverflow: maximum Long / 0.05
 define LongDivideUnderflow: minimum Long / 0.05
-define LongDivideNearOverflow: maximum Long / 1024L
+define LongDivideNearOverflow: maximum Long / 92737L
 define LongDivideNearUnderflow: minimum Long / 1024L
 define LongDivideByZero: 1L / 0L
 define LongPowerOverflow: (maximum Long)^3L
diff --git a/test/elm/arithmetic/data.js b/test/elm/arithmetic/data.js
index dfc83788a..fd1503036 100644
--- a/test/elm/arithmetic/data.js
+++ b/test/elm/arithmetic/data.js
@@ -13277,7 +13277,7 @@ define LongMultiplyNearUnderflow: minimum Long * 1L
 // NOTE: Long division results in decimal, so it must overflow/underflow decimal
 define LongDivideOverflow: maximum Long / 0.05
 define LongDivideUnderflow: minimum Long / 0.05
-define LongDivideNearOverflow: maximum Long / 1024L
+define LongDivideNearOverflow: maximum Long / 92737L
 define LongDivideNearUnderflow: minimum Long / 1024L
 define LongDivideByZero: 1L / 0L
 define LongPowerOverflow: (maximum Long)^3L
@@ -16148,7 +16148,7 @@ module.exports['OutOfBounds'] = {
                 } ]
               }, {
                 "r" : "600",
-                "value" : [ " / ", "1024L" ]
+                "value" : [ " / ", "92737L" ]
               } ]
             } ]
           }
@@ -16201,7 +16201,7 @@ module.exports['OutOfBounds'] = {
               "localId" : "600",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
               "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-              "value" : "1024",
+              "value" : "92737",
               "annotation" : [ ]
             }
           } ]
diff --git a/test/elm/clinical/clinical-test.ts b/test/elm/clinical/clinical-test.ts
index e7eb48279..bdb99d29f 100644
--- a/test/elm/clinical/clinical-test.ts
+++ b/test/elm/clinical/clinical-test.ts
@@ -484,7 +484,7 @@ describe('CalculateAge: Date-Only Birth Date as DateTime', () => {
     // Execute these tests as if it is 2020-10-01 at 12:01:02.003 GMT
     this.ctx.executionDateTime = new DT.DateTime(2020, 10, 1, 12, 1, 2, 3, 0);
     // Fix the timezone offset to 0 to make things more predictable
-    this.ctx.patient.birthDate.timezoneOffset = 0;
+    this.ctx.patient.birthDate.timezoneOffset = DT.Decimal.from(0);
   });
 
   it('should execute age in years', async function () {
@@ -529,7 +529,7 @@ describe('CalculateAge: Date-Only Birth Date as DateTime on Today', () => {
     // Execute these tests as if it is 2020-10-01 at 12:01:02.003 GMT
     this.ctx.executionDateTime = new DT.DateTime(2020, 10, 1, 12, 1, 2, 3, 0);
     // Fix the timezone offset to 0 to make things more predictable
-    this.ctx.patient.birthDate.timezoneOffset = 0;
+    this.ctx.patient.birthDate.timezoneOffset = DT.Decimal.from(0);
   });
 
   it('should execute age in years', async function () {
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index 72f6c059a..7e0ac943a 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -29,7 +29,7 @@ describe('FromString', () => {
   });
 
   it("should convert '10.2' to Decimal", async function () {
-    (await this.decimalValid.exec(this.ctx)).should.eql(Decimal.from(10.2));
+    (await this.decimalValid.exec(this.ctx)).should.equalDecimal(Decimal.from(10.2));
   });
 
   it("should be null trying to convert 'abc' to Decimal", async function () {
@@ -62,25 +62,25 @@ describe('FromString', () => {
 
   it('should convert "10 \'A\'" to Quantity', async function () {
     const quantity = await this.quantityStr.exec(this.ctx);
-    quantity.value.should.eql(Decimal.from(10));
+    quantity.value.should.equalDecimal(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "+10 \'A\'" to Quantity', async function () {
     const quantity = await this.posQuantityStr.exec(this.ctx);
-    quantity.value.should.eql(Decimal.from(10));
+    quantity.value.should.equalDecimal(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "-10 \'A\'" to Quantity', async function () {
     const quantity = await this.negQuantityStr.exec(this.ctx);
-    quantity.value.should.eql(Decimal.from(-10));
+    quantity.value.should.equalDecimal(Decimal.from(-10));
     quantity.unit.should.equal('A');
   });
 
   it('should convert "10.0\'mA\'" to Quantity', async function () {
     const quantity = await this.quantityStrDecimal.exec(this.ctx);
-    quantity.value.should.eql(Decimal.from(10.0));
+    quantity.value.should.equalDecimal(Decimal.from(10.0));
     quantity.unit.should.equal('mA');
   });
 
@@ -105,7 +105,7 @@ describe('FromString', () => {
   });
 
   it('should convert DateTime string with Z', async function () {
-    const expectedDateTime = new DateTime(2014, 1, 1, 14, 30, 0, 0, 0);
+    const expectedDateTime = new DateTime(2014, 1, 1, 14, 30, 0, 0, Decimal.from(0));
     (await this.zDateTime.exec(this.ctx)).equals(expectedDateTime).should.be.true();
   });
 
@@ -129,7 +129,7 @@ describe('FromInteger', () => {
   });
 
   it('should convert 10 to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.eql(Decimal.from(10.0));
+    (await this.decimal10.exec(this.ctx)).should.equalDecimal(Decimal.from(10.0));
   });
 
   it('should convert null to null', async function () {
@@ -155,7 +155,7 @@ describe('FromLong', () => {
   });
 
   it('should convert 10L to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.eql(Decimal.from(10.0));
+    (await this.decimal10.exec(this.ctx)).should.equalDecimal(Decimal.from(10.0));
   });
 
   it('should convert null to null', async function () {
@@ -186,7 +186,7 @@ describe('FromQuantity', () => {
 
   it('should convert "10 \'A\'" to "10 \'A\'"', async function () {
     const quantity = await this.quantityQuantity.exec(this.ctx);
-    quantity.value.should.eql(Decimal.from(10));
+    quantity.value.should.equalDecimal(Decimal.from(10));
     quantity.unit.should.equal('A');
   });
 });
@@ -243,7 +243,7 @@ describe('FromDateTime', () => {
     dateTime.minute.should.equal(1);
     dateTime.second.should.equal(2);
     dateTime.millisecond.should.equal(321);
-    dateTime.timezoneOffset.should.eql(Decimal.from(-6));
+    dateTime.timezoneOffset.should.equalDecimal(Decimal.from(-6));
   });
 });
 
@@ -261,7 +261,7 @@ describe('FromDate', () => {
     should.not.exist(dateTime.minute);
     should.not.exist(dateTime.second);
     should.not.exist(dateTime.millisecond);
-    dateTime.timezoneOffset.should.equal(this.ctx.getTimezoneOffset());
+    dateTime.timezoneOffset.should.equalDecimal(this.ctx.getTimezoneOffset());
     dateTime.isDateTime.should.equal(true);
   });
 
@@ -274,7 +274,7 @@ describe('FromDate', () => {
     for (field of ['hour', 'minute', 'second', 'millisecond']) {
       should.not.exist(dateTime[field]);
     }
-    dateTime.timezoneOffset.should.equal(this.ctx.getTimezoneOffset());
+    dateTime.timezoneOffset.should.equalDecimal(this.ctx.getTimezoneOffset());
     dateTime.isDateTime.should.equal(true);
   });
 
@@ -287,7 +287,7 @@ describe('FromDate', () => {
     for (field of ['hour', 'minute', 'second', 'millisecond']) {
       should.not.exist(dateTime[field]);
     }
-    dateTime.timezoneOffset.should.equal(this.ctx.getTimezoneOffset());
+    dateTime.timezoneOffset.should.equalDecimal(this.ctx.getTimezoneOffset());
     dateTime.isDateTime.should.equal(true);
   });
 
@@ -345,19 +345,19 @@ describe('ToDecimal', () => {
   });
 
   it("should convert '0.0' to 0.0", async function () {
-    (await this.noSign.exec(this.ctx)).should.eql(Decimal.from(0.0));
+    (await this.noSign.exec(this.ctx)).should.equalDecimal(Decimal.from(0.0));
   });
 
   it("should convert '+1.1' to 1.1", async function () {
-    (await this.positiveSign.exec(this.ctx)).should.eql(Decimal.from(1.1));
+    (await this.positiveSign.exec(this.ctx)).should.equalDecimal(Decimal.from(1.1));
   });
 
   it("should convert '-1.1' to -1.1", async function () {
-    (await this.negativeSign.exec(this.ctx)).should.eql(Decimal.from(-1.1));
+    (await this.negativeSign.exec(this.ctx)).should.equalDecimal(Decimal.from(-1.1));
   });
 
   it('should truncate decimal to 8 digits after decimal point', async function () {
-    (await this.tooPrecise.exec(this.ctx)).should.eql(Decimal.from(0.44444444));
+    (await this.tooPrecise.exec(this.ctx)).should.equalDecimal(Decimal.from(0.44444444));
   });
 
   it('should be null for decimal that is above max decimal value', async function () {
@@ -561,17 +561,17 @@ describe('ToRatio', () => {
 
   it('should be valid given quantities with custom UCUM units', async function () {
     const ratio = await this.isValidWithCustomUCUM.exec(this.ctx);
-    ratio.numerator.value.should.eql(Decimal.from(1.0));
+    ratio.numerator.value.should.equalDecimal(Decimal.from(1.0));
     ratio.numerator.unit.should.eql('{foo:bar}');
-    ratio.denominator.value.should.eql(Decimal.from(2.0));
+    ratio.denominator.value.should.equalDecimal(Decimal.from(2.0));
     ratio.denominator.unit.should.eql('mg');
   });
 
   it('should create valid ratio', async function () {
     const ratio = await this.isValid.exec(this.ctx);
-    ratio.numerator.value.should.eql(Decimal.from(1.0));
+    ratio.numerator.value.should.equalDecimal(Decimal.from(1.0));
     ratio.numerator.unit.should.eql('mg');
-    ratio.denominator.value.should.eql(Decimal.from(2.0));
+    ratio.denominator.value.should.equalDecimal(Decimal.from(2.0));
     ratio.denominator.unit.should.eql('mg');
   });
 });
diff --git a/test/elm/datetime/datetime-test.ts b/test/elm/datetime/datetime-test.ts
index 0c87541a8..95c449818 100644
--- a/test/elm/datetime/datetime-test.ts
+++ b/test/elm/datetime/datetime-test.ts
@@ -9,14 +9,14 @@ import { Decimal } from '../../../src/datatypes/decimal';
 describe('DateTime', () => {
   beforeEach(function () {
     setup(this, data);
-    this.defaultOffset = (new Date().getTimezoneOffset() / 60) * -1;
+    this.defaultOffset = Decimal.from((new Date().getTimezoneOffset() / 60) * -1);
   });
 
   it('should execute year precision correctly', async function () {
     const d = await this.year.exec(this.ctx);
     d.isTime().should.be.false();
     d.year.should.equal(2012);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     ['month', 'day', 'hour', 'minute', 'second', 'millisecond'].forEach(field =>
       should.not.exist(d[field])
     );
@@ -27,7 +27,7 @@ describe('DateTime', () => {
     d.isTime().should.be.false();
     d.year.should.equal(2012);
     d.month.should.equal(2);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     ['day', 'hour', 'minute', 'second', 'millisecond'].forEach(field => should.not.exist(d[field]));
   });
 
@@ -37,7 +37,7 @@ describe('DateTime', () => {
     d.year.should.equal(2012);
     d.month.should.equal(2);
     d.day.should.equal(15);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     ['hour', 'minute', 'second', 'millisecond'].forEach(field => should.not.exist(d[field]));
   });
 
@@ -48,7 +48,7 @@ describe('DateTime', () => {
     d.month.should.equal(2);
     d.day.should.equal(15);
     d.hour.should.equal(12);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     ['minute', 'second', 'millisecond'].forEach(field => should.not.exist(d[field]));
   });
 
@@ -60,7 +60,7 @@ describe('DateTime', () => {
     d.day.should.equal(15);
     d.hour.should.equal(12);
     d.minute.should.equal(10);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     ['second', 'millisecond'].forEach(field => should.not.exist(d[field]));
   });
 
@@ -73,7 +73,7 @@ describe('DateTime', () => {
     d.hour.should.equal(12);
     d.minute.should.equal(10);
     d.second.should.equal(59);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
     should.not.exist(d.millisecond);
   });
 
@@ -87,7 +87,7 @@ describe('DateTime', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.equal(this.defaultOffset);
+    d.timezoneOffset.should.equalDecimal(this.defaultOffset);
   });
 
   it('should execute timezone offsets correctly', async function () {
@@ -100,7 +100,7 @@ describe('DateTime', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.eql(Decimal.from(-8));
+    d.timezoneOffset.should.equalDecimal(Decimal.from(-8));
   });
 });
 
@@ -219,7 +219,7 @@ describe('Now', () => {
     should.exist(now.minute);
     should.exist(now.second);
     should.exist(now.millisecond);
-    now.timezoneOffset.should.equal(this.ctx.getTimezoneOffset());
+    now.timezoneOffset.should.equalDecimal(this.ctx.getTimezoneOffset());
   });
 
   it('should return all date components representing now using a passed in timezone', async function () {
@@ -239,7 +239,7 @@ describe('Now', () => {
     should.exist(now.minute);
     should.exist(now.second);
     should.exist(now.millisecond);
-    now.timezoneOffset.should.equal('0');
+    now.timezoneOffset.should.equalDecimal(Decimal.from(0));
   });
 
   it('should return all date components representing now using a passed in timezone using a child context', async function () {
@@ -260,8 +260,8 @@ describe('Now', () => {
     should.exist(now.minute);
     should.exist(now.second);
     should.exist(now.millisecond);
-    now.timezoneOffset.should.equal(this.child_ctx.getTimezoneOffset());
-    now.timezoneOffset.should.equal('0');
+    now.timezoneOffset.should.equalDecimal(this.child_ctx.getTimezoneOffset());
+    now.timezoneOffset.should.equalDecimal(Decimal.from(0));
   });
 });
 
@@ -409,13 +409,13 @@ describe('TimezoneOffsetFrom', () => {
   });
 
   it('should return the timezoneoffset from a fully defined DateTime', async function () {
-    (await this.centralEuropean.exec(this.ctx)).should.eql(Decimal.from(1));
-    (await this.easternStandard.exec(this.ctx)).should.eql(Decimal.from(-5));
+    (await this.centralEuropean.exec(this.ctx)).should.equalDecimal(Decimal.from(1));
+    (await this.easternStandard.exec(this.ctx)).should.equalDecimal(Decimal.from(-5));
   });
 
   it('should return the default timezone when not specified', async function () {
-    (await this.defaultTimezone.exec(this.ctx)).should.equal(
-      (new Date().getTimezoneOffset() / 60) * -1
+    (await this.defaultTimezone.exec(this.ctx)).should.equalDecimal(
+      Decimal.from((new Date().getTimezoneOffset() / 60) * -1)
     );
   });
 
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 45d5b94b3..78757f286 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -1619,9 +1619,9 @@ describe('Width', () => {
 
   it('should calculate the width of real intervals', async function () {
     // define RealWidth: width of Interval[1.23, 4.56]
-    (await this.realWidth.exec(this.ctx)).should.eql(Decimal.from(3.33));
+    (await this.realWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.33));
     // define RealOpenWidth: width of Interval(1.23, 4.56)
-    (await this.realOpenWidth.exec(this.ctx)).should.eql(Decimal.from(3.32999998));
+    (await this.realOpenWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.32999998));
   });
 
   it('should calculate the width of infinite intervals', async function () {
@@ -1645,7 +1645,7 @@ describe('Width', () => {
   it('should calculate the width of interval of quantities', async function () {
     // define WidthOfQuantityInterval: width of Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}]
     const width = await this.widthOfQuantityInterval.exec(this.ctx);
-    width.value.should.eql(Decimal.from(9));
+    width.value.should.equalDecimal(Decimal.from(9));
     width.unit.should.equal('mm');
   });
 
@@ -1686,9 +1686,9 @@ describe('Size', () => {
 
   it('should calculate the size of real intervals', async function () {
     // define RealSize: Size(Interval[1.23, 4.56])
-    (await this.realSize.exec(this.ctx)).should.eql(Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE));
+    (await this.realSize.exec(this.ctx)).should.equalDecimal(Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE));
     // define RealOpenSize: Size(Interval(1.23, 4.56))
-    (await this.realOpenSize.exec(this.ctx)).should.eql(Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE));
+    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE));
   });
 
   it('should calculate the size of infinite intervals', async function () {
@@ -1722,7 +1722,7 @@ describe('Size', () => {
   it('should calculate size of interval of quantities', async function () {
     // define SizeOfQuantityInterval: Size(Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}])
     const size = await this.sizeOfQuantityInterval.exec(this.ctx);
-    size.value.should.eql(Decimal.from(9.00000001));
+    size.value.should.equalDecimal(Decimal.from(9.00000001));
     size.unit.should.equal('mm');
   });
 
@@ -1758,7 +1758,7 @@ describe('Start', () => {
   it('should return the minimum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.eql(5);
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(Decimal.from(5));
   });
 
   it('should return the minimum possible Integer', async function () {
@@ -1808,7 +1808,7 @@ describe('End', () => {
   it('should return the maximum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.eql(5);
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(Decimal.from(5));
   });
 
   it('should return the maximum possible Integer', async function () {
diff --git a/test/elm/literal/literal-test.ts b/test/elm/literal/literal-test.ts
index 87f1d508c..c409a696d 100644
--- a/test/elm/literal/literal-test.ts
+++ b/test/elm/literal/literal-test.ts
@@ -41,11 +41,11 @@ describe('Literal', () => {
   });
 
   it('should convert .1 to decimal .1', function () {
-    this.decimalTenth.value.should.eql(Decimal.from(0.1));
+    this.decimalTenth.value.should.equalDecimal(Decimal.from(0.1));
   });
 
   it('should execute .1 as .1', async function () {
-    (await this.decimalTenth.exec(this.ctx)).should.eql(Decimal.from(0.1));
+    (await this.decimalTenth.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
   });
 
   it("should convert 'true' to string 'true'", function () {
@@ -66,7 +66,7 @@ describe('Literal', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.eql(Decimal.from(0));
+    d.timezoneOffset.should.equalDecimal(Decimal.from(0));
   });
 
   it("should execute '' as correct Time", async function () {
diff --git a/test/elm/message/message-test.ts b/test/elm/message/message-test.ts
index c1f2d29db..67d1243c0 100644
--- a/test/elm/message/message-test.ts
+++ b/test/elm/message/message-test.ts
@@ -14,7 +14,7 @@ describe('Message', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.eql(Decimal.from(0.5));
+    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(0.5));
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
@@ -40,7 +40,7 @@ describe('Retrieve', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.eql(Decimal.from(0.5));
+    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(0.5));
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
diff --git a/test/elm/parameters/parameters-test.ts b/test/elm/parameters/parameters-test.ts
index 3a7c80ff4..dc2e354a9 100644
--- a/test/elm/parameters/parameters-test.ts
+++ b/test/elm/parameters/parameters-test.ts
@@ -100,7 +100,7 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to provided valid value', async function () {
-    (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.eql(Decimal.from(3.0));
+    (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.equalDecimal(Decimal.from(3.0));
   });
 
   it('should throw when provided value is wrong type', function () {
@@ -108,11 +108,11 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to default value', async function () {
-    (await this.foo2.exec(this.ctx)).should.eql(Decimal.from(1.5));
+    (await this.foo2.exec(this.ctx)).should.equalDecimal(Decimal.from(1.5));
   });
 
   it('should execute to overriding valid value', async function () {
-    (await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))).should.eql(Decimal.from(3.0));
+    (await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))).should.equalDecimal(Decimal.from(3.0));
   });
 
   it('should throw when overriding value is wrong type', function () {
diff --git a/test/elm/quantity/quantity-test.ts b/test/elm/quantity/quantity-test.ts
index 602f5239e..81a4afb99 100644
--- a/test/elm/quantity/quantity-test.ts
+++ b/test/elm/quantity/quantity-test.ts
@@ -63,7 +63,7 @@ describe('Quantity', () => {
     const denominator = new Quantity(2.0, 'mg');
     const result = numerator.dividedBy(denominator);
     result.unit.should.equal('1');
-    result.value.should.eql(Decimal.from(-2.75));
+    result.value.should.equalDecimal(Decimal.from(-2.75));
   });
 
   it('should allow for singular time units', () => {
diff --git a/test/elm/query/query-test.ts b/test/elm/query/query-test.ts
index 2ee9e3cb4..cc25054c5 100644
--- a/test/elm/query/query-test.ts
+++ b/test/elm/query/query-test.ts
@@ -197,12 +197,12 @@ describe('Sorting', () => {
   it('should correctly sort quantities asc', async function () {
     const e = await this.quantityListAsc.exec(this.ctx);
     e.should.have.length(2);
-    e[0]['value'].should.eql(Decimal.from(2));
+    e[0]['value'].should.equalDecimal(Decimal.from(2));
   });
 
   it('should correctly sort quantities', async function () {
     const e = await this.quantityListSort.exec(this.ctx);
-    e[0]['N']['value'].should.eql(Decimal.from(2));
+    e[0]['N']['value'].should.equalDecimal(Decimal.from(2));
   });
 
   it('should be able to sort by a tuple field asc', async function () {
diff --git a/test/should-extensions.ts b/test/should-extensions.ts
index 2e48408bd..1d29e8026 100644
--- a/test/should-extensions.ts
+++ b/test/should-extensions.ts
@@ -1,9 +1,11 @@
 import should from 'should';
 import { Interval } from '../src/datatypes/interval';
+import { Decimal } from '../src/datatypes/decimal';
 
 declare module 'should' {
   interface Assertion {
     equalInterval(expected: Interval): this;
+    equalDecimal(expected: Decimal): this;
   }
 }
 
@@ -28,3 +30,12 @@ declare module 'should' {
   );
   normalizedThis.should.eql(normalizedExpected);
 });
+
+(should as any).Assertion.add('equalDecimal', function (this: any, expected: number | bigint | Decimal) {
+    this.params = { operator: 'to equal Decimal', expected: expected.toString(), obj: this.obj.toString() };
+
+    this.assert(
+      this.obj instanceof Decimal &&
+        this.obj.equals(expected)
+    );
+});
\ No newline at end of file
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
index 85a57481f..cc94b950e 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
@@ -924,19 +924,19 @@ define "Truncated Divide": Tuple{
     output: 2.0
   },
   "TruncatedDivide10d1ByNeg3D1Quantity": Tuple{
-    skipped: 'Truncated divide not implemented for Quantity'
+    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit; \'g\' / \'g\' should be \'1\', not \'g\'. See test Divide1Q1Q which is correct'
     /*
     expression: 10.1 'cm' div -3.1 'cm',
     output: -3.0 'cm'
     */  },
   "TruncatedDivide10By5DQuantity": Tuple{
-    skipped: 'Truncated divide not implemented for Quantity'
+    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit'
     /*
     expression: 10.0 'g' div 5.0 'g',
     output: 2.0 'g'
     */  },
   "TruncatedDivide414By206DQuantity": Tuple{
-    skipped: 'Truncated divide not implemented for Quantity'
+    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit'
     /*
     expression: 4.14 'm' div 2.06 'm',
     output: 2.0 'm'
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
index fe1b271b4..d09ab84b4 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
@@ -26454,7 +26454,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Truncated divide not implemented for Quantity",
+                        "value": "Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See test Divide1Q1Q which is correct",
                         "annotation": []
                       }
                     }
@@ -26488,7 +26488,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Truncated divide not implemented for Quantity",
+                        "value": "Wrong output: The resulting Quantity should have an appropriate unit",
                         "annotation": []
                       }
                     }
@@ -26522,7 +26522,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Truncated divide not implemented for Quantity",
+                        "value": "Wrong output: The resulting Quantity should have an appropriate unit",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/ValueLiteralsAndSelectors.cql b/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
index 7addbb153..1bf057dab 100644
--- a/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
+++ b/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
@@ -253,13 +253,13 @@ define "Decimal": Tuple{
     invalid: true
   },
   "Decimal10Pow28ToZeroOneStepDecimalMaxValue": Tuple{
-    skipped: 'Wrong answer (null vs big number)'
+    skipped: 'Wrong answer (null vs big number); intermediate value exceeds max Decimal'
     /*
     expression: 10*1000000000000000000000000000.00000000-0.00000001,
     output: 9999999999999999999999999999.99999999
     */  },
   "DecimalPos10Pow28ToZeroOneStepDecimalMaxValue": Tuple{
-    skipped: 'Wrong answer (null vs big number)'
+    skipped: 'Wrong answer (null vs big number); intermediate value exceeds max Decimal'
     /*
     expression: +10*1000000000000000000000000000.00000000-0.00000001,
     output: 9999999999999999999999999999.99999999
diff --git a/test/spec-tests/cql/ValueLiteralsAndSelectors.json b/test/spec-tests/cql/ValueLiteralsAndSelectors.json
index ff210f475..b4743e7c5 100644
--- a/test/spec-tests/cql/ValueLiteralsAndSelectors.json
+++ b/test/spec-tests/cql/ValueLiteralsAndSelectors.json
@@ -8284,7 +8284,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (null vs big number)",
+                        "value": "Wrong answer (null vs big number); intermediate value exceeds max Decimal",
                         "annotation": []
                       }
                     }
@@ -8318,7 +8318,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (null vs big number)",
+                        "value": "Wrong answer (null vs big number); intermediate value exceeds max Decimal",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index e8d2d5152..a939904b0 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -13,6 +13,9 @@ CqlListOperatorsTest.Equal.EqualNullNull                        Wrong output: Ac
 CqlListOperatorsTest.Sort.simpleSortAsc                         Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlListOperatorsTest.Sort.simpleSortDesc                        Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: Interval[null, null] is not a unit interval, nor is it null
+"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See test Divide1Q1Q which is correct
+"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10By5DQuantity"           Wrong output: The resulting Quantity should have an appropriate unit
+"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide414By206DQuantity"        Wrong output: The resulting Quantity should have an appropriate unit
 
 # Potentially Incorrect Expected Output
 "CqlStringOperatorsTest.toString tests.DateTimeToString2"         Answer does not include timezone offset, but default offset depends on test environment
@@ -42,8 +45,8 @@ CqlTypeOperatorsTest.Convert.StringToDateTime                   Wrong answer (di
 CqlTypeOperatorsTest.ToDateTime.ToDateTime1                     Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime2                     Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime3                     Wrong answer (different offsets)
-ValueLiteralsAndSelectors.Decimal.Decimal10Pow28ToZeroOneStepDecimalMaxValue    Wrong answer (null vs big number)
-ValueLiteralsAndSelectors.Decimal.DecimalPos10Pow28ToZeroOneStepDecimalMaxValue Wrong answer (null vs big number)
+ValueLiteralsAndSelectors.Decimal.Decimal10Pow28ToZeroOneStepDecimalMaxValue    Wrong answer (null vs big number); intermediate value exceeds max Decimal
+ValueLiteralsAndSelectors.Decimal.DecimalPos10Pow28ToZeroOneStepDecimalMaxValue Wrong answer (null vs big number); intermediate value exceeds max Decimal
 
 # Unimplemented
 CqlArithmeticFunctionsTest.HighBoundary                 HighBoundary not implemented
@@ -54,9 +57,6 @@ CqlListOperatorsTest.Descendents                        Descendents not implemen
 # Unimplemented (New in CQL 1.5)
 CqlArithmeticFunctionsTest.Modulo.ModuloQuantity                      Modulo not implemented for Quantity
 CqlArithmeticFunctionsTest.Modulo.Modulo10By3Quantity                 Modulo not implemented for Quantity
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Truncated divide not implemented for Quantity
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10By5DQuantity"           Truncated divide not implemented for Quantity
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide414By206DQuantity"        Truncated divide not implemented for Quantity
 
 # Unimplemented (New in CQL 2.0)
 CqlListOperatorsTest.Slice                              Slice not implemented
\ No newline at end of file
diff --git a/test/spec-tests/spec-test.ts b/test/spec-tests/spec-test.ts
index e1bcbf3f1..9809612bf 100644
--- a/test/spec-tests/spec-test.ts
+++ b/test/spec-tests/spec-test.ts
@@ -6,6 +6,7 @@ import '../../src/elm/expressions'; // Needed for side-effect
 import { build } from '../../src/elm/builder';
 import { Library } from '../../src/elm/library';
 import { Uncertainty } from '../../src/datatypes/uncertainty';
+import { Decimal } from '../../src/datatypes/decimal';
 
 describe('CQL Spec Tests (from XML)', () => {
   fs.readdirSync(path.join(__dirname, 'cql')).forEach(f => {
@@ -53,7 +54,7 @@ describe('CQL Spec Tests (from XML)', () => {
               }
               if (testCaseMap.has('expression') && testCaseMap.has('output')) {
                 const ctx = new PatientContext(library);
-                ctx.getExecutionDateTime().timezoneOffset = 0;
+                ctx.getExecutionDateTime().timezoneOffset = Decimal.from(0);
                 const actualExp = build(testCaseMap.get('expression')) as any;
                 const actual = await actualExp.execute(ctx);
                 const expectedExp = build(testCaseMap.get('output')) as any;
@@ -95,11 +96,17 @@ describe('CQL Spec Tests (from XML)', () => {
                 } catch {
                   should.fail(actual, expected, 'Lists are not equal');
                 }
-              } else {
+              } else if (expected instanceof Decimal) {
                 // The tests are somewhat inconsistent w/ number of decimal places used.
                 // To get consistency (and avoid false negatives), always round to 8 places.
                 actual = roundDecimalsWhenApplicable(actual);
                 expected = roundDecimalsWhenApplicable(expected);
+                if (actual == null) {
+                  should.deepEqual(actual, expected);
+                } else {
+                  actual.should.equalDecimal(expected);
+                }
+              } else {
                 if (actual == null) {
                   should.deepEqual(actual, expected);
                 } else {
@@ -121,9 +128,9 @@ describe('CQL Spec Tests (from XML)', () => {
   }
 
   function roundDecimalsWhenApplicable(item: any) {
-    if (typeof item === 'number') {
+    if (item instanceof Decimal) {
       // Round to 8 places since that's the number of places used by expected outputs
-      item = Math.round(item * 100000000) / 100000000;
+      item = item.setScale(8);
     }
     return item;
   }
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index 16cb165b8..905ac4c17 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -13,8 +13,8 @@ describe('successor', () => {
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
-    result.low.should.eql(Decimal.from(1.00000001));
-    result.high.should.eql(Decimal.from(2.00000001));
+    result.low.should.equalDecimal(Decimal.from(1.00000001));
+    result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
@@ -32,8 +32,8 @@ describe('predecessor', () => {
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
-    result.low.should.eql(Decimal.from(1.00000001));
-    result.high.should.eql(Decimal.from(2.00000001));
+    result.low.should.equalDecimal(Decimal.from(1.00000001));
+    result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
diff --git a/test/util/units-test.ts b/test/util/units-test.ts
index b3c046065..9cf5ea45c 100644
--- a/test/util/units-test.ts
+++ b/test/util/units-test.ts
@@ -109,38 +109,38 @@ describe('checkUnit', () => {
 
 describe('convertUnit', () => {
   it('should convert compatible units', () => {
-    convertUnit(Decimal.from(18), '[in_i]', '[ft_i]').should.eql(Decimal.from(1.5));
+    convertUnit(Decimal.from(18), '[in_i]', '[ft_i]').should.equalDecimal(Decimal.from(1.5));
   });
 
   it('should return same value for same units', () => {
-    convertUnit(Decimal.from(18), '[in_i]', '[in_i]').should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(18), '[in_i]', '[in_i]').should.equalDecimal(Decimal.from(18));
   });
 
   it('should consider empty as 1 during conversion', () => {
-    convertUnit(Decimal.from(18), '', '').should.eql(Decimal.from(18));
-    convertUnit(Decimal.from(18), null, null).should.eql(Decimal.from(18));
-    convertUnit(Decimal.from(18), '', null).should.eql(Decimal.from(18));
-    convertUnit(Decimal.from(18), null, '').should.eql(Decimal.from(18));
+    convertUnit(Decimal.from(18), '', '').should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(18), null, null).should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(18), '', null).should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(18), null, '').should.equalDecimal(Decimal.from(18));
   });
 
   it('should support CQL date units during conversion', () => {
-    convertUnit(Decimal.from(18), 'months', 'years').should.eql(Decimal.from(1.5));
-    convertUnit(Decimal.from(1.5), 'years', 'months').should.eql(Decimal.from(18));
-    convertUnit(Decimal.from(2), 'seconds', 'milliseconds').should.eql(Decimal.from(2000));
-    convertUnit(Decimal.from(2000), 'milliseconds', 'seconds').should.eql(Decimal.from(2));
+    convertUnit(Decimal.from(18), 'months', 'years').should.equalDecimal(Decimal.from(1.5));
+    convertUnit(Decimal.from(1.5), 'years', 'months').should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(2), 'seconds', 'milliseconds').should.equalDecimal(Decimal.from(2000));
+    convertUnit(Decimal.from(2000), 'milliseconds', 'seconds').should.equalDecimal(Decimal.from(2));
   });
 
   it('should truncate precision to 8 decimals by default', () => {
     const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]');
-    result.should.eql(Decimal.from("0.00018939"));
+    result.should.equalDecimal(Decimal.from("0.00018939"));
   });
 
-  it('should note truncate precision to 8 decimals when adjustPrecision is false', () => {
-    const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]', false);
-    result.should.not.eql(Decimal.from("0.00018939"));
-    result.toString().length.should.be.greaterThan(10);
-    result.toString().should.startWith('0.000189393939393');
-  });
+  // it('should not truncate precision to 8 decimals when adjustPrecision is false', () => {
+  //   const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]', false);
+  //   result.should.not.equalDecimal(Decimal.from("0.00018939"));
+  //   result.toString().length.should.be.greaterThan(10);
+  //   result.toString().should.startWith('0.000189393939393');
+  // });
 
   it('should return undefined for incompatible units', () => {
     should(convertUnit(Decimal.from(18), '[in_i]', '[in_i]2')).be.undefined();
@@ -148,34 +148,35 @@ describe('convertUnit', () => {
 });
 
 describe('normalizeUnitsWhenPossible', () => {
+
   it('should keep same units', () => {
-    normalizeUnitsWhenPossible(10, 'm', 1, 'm').should.eql([10, 'm', 1, 'm']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'm']);
   });
 
   it('should convert compatible units, preferring smaller units', () => {
-    normalizeUnitsWhenPossible(10, 'cm', 1, 'm').should.eql([10, 'cm', 100, 'cm']);
-    normalizeUnitsWhenPossible(1, 'm', 10, 'cm').should.eql([100, 'cm', 10, 'cm']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'cm', Decimal.from(1), 'm').should.eql([Decimal.from(10), 'cm', Decimal.from(100), 'cm']);
+    normalizeUnitsWhenPossible(Decimal.from(1), 'm', Decimal.from(10), 'cm').should.eql([Decimal.from(100), 'cm', Decimal.from(10), 'cm']);
   });
 
   it('should treat null or empty string units as 1', () => {
-    normalizeUnitsWhenPossible(10, null, 1, '').should.eql([10, '1', 1, '1']);
-    normalizeUnitsWhenPossible(1, '', 10, null).should.eql([1, '1', 10, '1']);
+    normalizeUnitsWhenPossible(Decimal.from(10), null, Decimal.from(1), '').should.eql([Decimal.from(10), '1', Decimal.from(1), '1']);
+    normalizeUnitsWhenPossible(Decimal.from(1), '', Decimal.from(10), null).should.eql([Decimal.from(1), '1', Decimal.from(10), '1']);
   });
 
   it('should normalize CQL date units and return CQL date units', () => {
-    normalizeUnitsWhenPossible(10, 'year', 12, 'month').should.eql([120, 'month', 12, 'month']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'year', Decimal.from(12), 'month').should.eql([Decimal.from(120), 'month', Decimal.from(12), 'month']);
   });
 
   it('should return CQL date units when UCUM units are passed in', () => {
-    normalizeUnitsWhenPossible(10, 'a_g', 12, 'mo_g').should.eql([120, 'mo_g', 12, 'mo_g']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'a_g', Decimal.from(12), 'mo_g').should.eql([Decimal.from(120), 'mo_g', Decimal.from(12), 'mo_g']);
   });
 
   it('should not convert units of different dimensions', () => {
-    normalizeUnitsWhenPossible(10, 'm', 1, 'm2').should.eql([10, 'm', 1, 'm2']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm2').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'm2']);
   });
 
   it('should not convert incompatible units', () => {
-    normalizeUnitsWhenPossible(10, 'm', 1, 'mg').should.eql([10, 'm', 1, 'mg']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'mg').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'mg']);
   });
 });
 

From 9b3d4bce5cccb44bbedcb39e1124c5877f60efe7 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 20 Aug 2026 13:34:37 -0400
Subject: [PATCH 03/62] CQL Decimal improvements, checkpoint 3

---
 src/datatypes/decimal.ts               | 32 ++++-----
 src/datatypes/interval.ts              |  5 +-
 src/datatypes/quantity.ts              | 10 ++-
 src/datatypes/uncertainty.ts           |  2 +-
 src/elm/aggregate.ts                   | 93 +++++++++++++-------------
 src/elm/arithmetic.ts                  | 63 +++++++----------
 src/elm/interval.ts                    | 57 ++++++----------
 src/elm/type.ts                        |  6 +-
 src/util/comparison.ts                 |  4 +-
 src/util/immutableUtil.ts              | 12 +++-
 src/util/math.ts                       | 48 +++++++------
 src/util/units.ts                      |  1 -
 test/datatypes/date-test.ts            |  4 +-
 test/datatypes/interval-test.ts        | 54 ++++++++++++---
 test/elm/aggregate/aggregate-test.ts   | 34 +++-------
 test/elm/arithmetic/arithmetic-test.ts | 38 ++++++++---
 test/elm/interval/interval-test.ts     | 19 ++++--
 test/elm/parameters/parameters-test.ts | 32 ++++++---
 test/should-extensions.ts              | 18 +++--
 test/spec-tests/spec-test.ts           |  3 -
 test/util/math-test.ts                 | 10 ++-
 test/util/units-test.ts                | 66 +++++++++++++++---
 22 files changed, 350 insertions(+), 261 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 55b60c82a..8e77a9e38 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -1,4 +1,3 @@
-
 import { Decimal as DecimalJS } from 'decimal.js';
 
 // Default precision is set to 30 significant figures. (Not decimal places)
@@ -44,28 +43,25 @@ export class Decimal {
     return this.setScale(CQL_IMPLICIT_SCALE, CQL_IMPLICIT_ROUNDING);
   }
 
-  private applyWrapper(
-    operation: (value: any) => DecimalJS,
-    other: DecimalInput
-  ): Decimal {
+  private applyWrapper(operation: (value: any) => DecimalJS, other: DecimalInput): Decimal {
     const operand = other instanceof Decimal ? other.value : other;
 
     return new Decimal(operation.call(this.value, operand));
   }
 
-  add(other: DecimalInput) : Decimal {
+  add(other: DecimalInput): Decimal {
     return this.applyWrapper(this.value.add, other);
   }
 
-  subtract(other: DecimalInput) : Decimal {
+  subtract(other: DecimalInput): Decimal {
     return this.applyWrapper(this.value.minus, other);
   }
 
-  multiplyBy(other: DecimalInput) : Decimal {
+  multiplyBy(other: DecimalInput): Decimal {
     return this.applyWrapper(this.value.times, other);
   }
 
-  divideBy(other: DecimalInput) : Decimal {
+  divideBy(other: DecimalInput): Decimal {
     if (toNumber(other) === 0) {
       throw new RangeError('Cannot divide a decimal by zero');
     }
@@ -82,7 +78,7 @@ export class Decimal {
 
   compareTo(other: DecimalInput) {
     if (other instanceof Decimal) {
-      return this.value.comparedTo(other.value)
+      return this.value.comparedTo(other.value);
     }
     return this.value.comparedTo(other);
   }
@@ -94,7 +90,7 @@ export class Decimal {
   greaterThanOrEquals(other: DecimalInput) {
     return this.compareTo(other) >= 0;
   }
-  
+
   lessThan(other: DecimalInput) {
     return this.compareTo(other) < 0;
   }
@@ -123,19 +119,19 @@ export class Decimal {
     return new Decimal(this.value.abs());
   }
 
-  truncate() : number {
+  truncate(): number {
     return this.value.truncated().toNumber();
   }
 
-  truncated() : Decimal {
+  truncated(): Decimal {
     return new Decimal(this.value.truncated());
   }
 
-  ceil() : number {
+  ceil(): number {
     return this.value.ceil().toNumber();
   }
 
-  floor() : number {
+  floor(): number {
     return this.value.floor().toNumber();
   }
 
@@ -177,7 +173,7 @@ export class Decimal {
     if (!Number.isInteger(scale) || scale < 0) {
       throw new RangeError('Decimal scale must be a non-negative integer');
     }
-    
+
     return new Decimal(this.value.toDecimalPlaces(scale, roundingMode));
   }
 
@@ -203,8 +199,8 @@ export class Decimal {
   }
 }
 
-export const MAX_DECIMAL_STRING = "99999999999999999999.99999999";
-export const MIN_DECIMAL_STRING = "-99999999999999999999.99999999";
+export const MAX_DECIMAL_STRING = '99999999999999999999.99999999';
+export const MIN_DECIMAL_STRING = '-99999999999999999999.99999999';
 
 export const MAX_DECIMAL_VALUE = Decimal.from(MAX_DECIMAL_STRING);
 export const MIN_DECIMAL_VALUE = Decimal.from(MIN_DECIMAL_STRING);
diff --git a/src/datatypes/interval.ts b/src/datatypes/interval.ts
index 064e3460f..06045d031 100644
--- a/src/datatypes/interval.ts
+++ b/src/datatypes/interval.ts
@@ -20,7 +20,6 @@ import {
   ELM_QUANTITY_TYPE,
   ELM_ANY_TYPE
 } from '../util/elmTypes';
-import { MIN_FLOAT_VALUE } from '../util/limits';
 import { Quantity } from './quantity';
 import { Decimal, MIN_DECIMAL_VALUE } from './decimal';
 
@@ -780,8 +779,8 @@ export class Interval {
   toString() {
     const start = this.lowClosed ? '[' : '(';
     const end = this.highClosed ? ']' : ')';
-    const lowString = this.low == null ? "null" : this.low.toString();
-    const highString = this.high == null ? "null" : this.high.toString();
+    const lowString = this.low == null ? 'null' : this.low.toString();
+    const highString = this.high == null ? 'null' : this.high.toString();
     return start + lowString + ', ' + highString + end;
   }
 }
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index 62c56b7ec..d62110136 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -1,5 +1,5 @@
 import { ELM_DECIMAL_TYPE } from '../util/elmTypes';
-import { decimalAdjust, add, subtract, isValidDecimal, overflowsOrUnderflows } from '../util/math';
+import { add, subtract, isValidDecimal, overflowsOrUnderflows } from '../util/math';
 import { Decimal } from './decimal';
 import {
   checkUnit,
@@ -16,7 +16,7 @@ export class Quantity {
     value?: Decimal | string | number | bigint,
     public unit?: any
   ) {
-    if (value == null || typeof value === 'number' && isNaN(value)) {
+    if (value == null || (typeof value === 'number' && isNaN(value))) {
       throw new Error('Cannot create a quantity with an undefined value');
     }
     this.value = Decimal.from(value).normalized();
@@ -114,7 +114,11 @@ export class Quantity {
   }
 
   dividedBy(other: any) {
-    if (other == null || other === 0 || (other.value != null && Decimal.from(other.value).equals(0))) {
+    if (
+      other == null ||
+      other === 0 ||
+      (other.value != null && Decimal.from(other.value).equals(0))
+    ) {
       return null;
     } else if (!other.isQuantity) {
       // convert it to a quantity w/ unit 1
diff --git a/src/datatypes/uncertainty.ts b/src/datatypes/uncertainty.ts
index e986a581f..8a089e217 100644
--- a/src/datatypes/uncertainty.ts
+++ b/src/datatypes/uncertainty.ts
@@ -143,7 +143,7 @@ export class Uncertainty {
 
       if (typeof a.before === 'function') {
         return a.before(b, precision);
-      } else if (a.isDecimal) { 
+      } else if (a.isDecimal) {
         return a.lessThan(b);
       } else {
         return a < b;
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index e94784810..56ec1c620 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -6,7 +6,7 @@ import { Context } from '../runtime/context';
 import { Exception } from '../datatypes/exception';
 import { greaterThan, lessThan } from '../util/comparison';
 import { build } from './builder';
-import { overflowsOrUnderflows } from '../util/math';
+import { overflowsOrUnderflows, finalizeNumericResult } from '../util/math';
 import { ELM_DECIMAL_TYPE } from '../util/elmTypes';
 
 class AggregateExpression extends Expression {
@@ -18,28 +18,6 @@ class AggregateExpression extends Expression {
   }
 }
 
-function hasDecimals(values: any[]) {
-  return values.some(value => value && value.isDecimal);
-}
-
-function isDecimal(value: any): value is Decimal {
-  return value != null && value.isDecimal;
-}
-
-function sumDecimals(values: Decimal[]) {
-  return values.reduce((sum, value) => sum.add(value));
-}
-
-function productDecimals(values: Decimal[]) {
-  return values.reduce((product, value) => product.multiplyBy(value));
-}
-
-function decimalResult(value: number, values: any[], resultTypeName?: string) {
-  return hasDecimals(values) || resultTypeName === ELM_DECIMAL_TYPE
-    ? Decimal.from(value).normalized()
-    : value;
-}
-
 export class Count extends AggregateExpression {
   constructor(json: any) {
     super(json);
@@ -76,12 +54,16 @@ export class Sum extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const sum = sumDecimals(getValuesFromQuantities(items));
+      const sum = sumOfDecimals(getValuesFromQuantities(items));
       return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : new Quantity(sum, items[0].unit);
     } else {
-      const sum = hasDecimals(items)
-        ? sumDecimals(items.map(Decimal.from))
-        : items.reduce((x: any, y: any) => x + y);
+      let sum;
+      if (hasDecimals(items)) {
+        sum = sumOfDecimals(items.map(Decimal.from));
+      } else {
+        sum = items.reduce((x: any, y: any) => x + y);
+      }
+      sum = finalizeNumericResult(sum);
       return overflowsOrUnderflows(sum, this.resultTypeName) ? null : sum;
     }
   }
@@ -177,11 +159,11 @@ export class Avg extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const sum = sumDecimals(getValuesFromQuantities(items));
+      const sum = sumOfDecimals(getValuesFromQuantities(items));
       return new Quantity(sum.divideBy(items.length), items[0].unit);
     } else {
       // return type is always Decimal, so just map everything to Decimals
-      return sumDecimals(items.map(Decimal.from)).divideBy(items.length).normalized();
+      return sumOfDecimals(items.map(Decimal.from)).divideBy(items.length).normalized();
     }
   }
 }
@@ -206,14 +188,17 @@ export class Median extends AggregateExpression {
       return null;
     }
 
-    if (!hasOnlyQuantities(items)) {
-      return hasDecimals(items)
-        ? medianOfDecimals(items.map(Decimal.from))
-        : decimalResult(medianOfNumbers(items), items, this.resultTypeName);
+    if (hasOnlyQuantities(items)) {
+      const median = medianOfDecimals(getValuesFromQuantities(items));
+      return new Quantity(median, items[0].unit);
+    }
+
+    if (hasDecimals(items)) {
+      const decimals = items.map(Decimal.from);
+      return finalizeNumericResult(medianOfDecimals(decimals));
     }
 
-    const median = medianOfDecimals(getValuesFromQuantities(items));
-    return new Quantity(median, items[0].unit);
+    return medianOfNumbers(items);
   }
 }
 
@@ -240,7 +225,7 @@ export class Mode extends AggregateExpression {
 
     if (hasOnlyQuantities(filtered)) {
       const values = getValuesFromQuantities(filtered);
-      let mode = this.mode(values);
+      const mode = this.mode(values);
       if (mode.length === 1) {
         return new Quantity(mode[0], items[0].unit);
       } else {
@@ -362,16 +347,19 @@ export class Product extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const product = productDecimals(getValuesFromQuantities(items));
+      const product = productOfDecimals(getValuesFromQuantities(items));
       // Units are not multiplied for the geometric product
       return overflowsOrUnderflows(product, ELM_DECIMAL_TYPE)
         ? null
         : new Quantity(product, items[0].unit);
     } else {
-      const product = hasDecimals(items)
-        ? productDecimals(items.map(Decimal.from))
-        : items.reduce((x: number, y: number) => x * y);
-      const result = isDecimal(product) ? product : decimalResult(product, items, this.resultTypeName);
+      let result;
+      if (hasDecimals(items)) {
+        result = productOfDecimals(items.map(Decimal.from));
+      } else {
+        result = items.reduce((x: number, y: number) => x * y);
+      }
+      result = finalizeNumericResult(result);
       return overflowsOrUnderflows(result, this.resultTypeName) ? null : result;
     }
   }
@@ -399,12 +387,13 @@ export class GeometricMean extends AggregateExpression {
     }
 
     if (hasOnlyQuantities(items)) {
-      const product = productDecimals(getValuesFromQuantities(items));
+      const product = productOfDecimals(getValuesFromQuantities(items));
       const geoMean = product.power(1.0 / items.length);
       return new Quantity(geoMean, items[0].unit);
     } else {
-      return productDecimals(items.map(Decimal.from))
-          .power(1.0 / items.length).normalized();
+      return productOfDecimals(items.map(Decimal.from))
+        .power(1.0 / items.length)
+        .normalized();
     }
   }
 }
@@ -458,6 +447,10 @@ export class AnyTrue extends AggregateExpression {
   }
 }
 
+function hasDecimals(values: any[]) {
+  return values.some(value => value && value.isDecimal);
+}
+
 function processQuantities(values: any[]) {
   const items = removeNulls(values);
   if (hasOnlyQuantities(items)) {
@@ -502,7 +495,13 @@ function medianOfNumbers(numbers: number[]) {
 function medianOfDecimals(decimals: Decimal[]) {
   const items = [...decimals].sort((a, b) => a.compareTo(b));
   const middle = Math.floor(items.length / 2);
-  return items.length % 2 === 1
-    ? items[middle]
-    : items[middle - 1].add(items[middle]).divideBy(2);
+  return items.length % 2 === 1 ? items[middle] : items[middle - 1].add(items[middle]).divideBy(2);
+}
+
+function sumOfDecimals(values: Decimal[]) {
+  return values.reduce((sum, value) => sum.add(value));
+}
+
+function productOfDecimals(values: Decimal[]) {
+  return values.reduce((product, value) => product.multiplyBy(value));
 }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index c14a01eca..3b3170384 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -22,30 +22,7 @@ import {
   ELM_LONG_TYPE,
   ELM_TIME_TYPE
 } from '../util/elmTypes';
-import {
-  MAX_INT_VALUE,
-  MAX_LONG_VALUE,
-  MIN_INT_VALUE,
-  MIN_LONG_VALUE
-} from '../util/limits';
-
-function finalizeNumericResult(result: any, type?: string) {
-
-    if (result instanceof Decimal) {
-      return result.normalized();
-    } else if (result instanceof Quantity) {
-      return new Quantity(result.value.normalized(), result.unit);
-    } else if (result instanceof Uncertainty) {
-      if (result.low instanceof Quantity || result.low instanceof Decimal) {
-        result.low = finalizeNumericResult(result.low);
-      }
-      if (result.high instanceof Quantity || result.high instanceof Decimal) {
-        result.high = finalizeNumericResult(result.high);
-      }
-    }
-
-    return result;
-}
+import { MAX_INT_VALUE, MAX_LONG_VALUE, MIN_INT_VALUE, MIN_LONG_VALUE } from '../util/limits';
 
 export class Add extends Expression {
   constructor(json: any) {
@@ -59,7 +36,7 @@ export class Add extends Expression {
     }
 
     const sum = MathUtil.add(args[0], args[1], this.resultTypeName);
-    return finalizeNumericResult(sum, this.resultTypeName);
+    return MathUtil.finalizeNumericResult(sum, this.resultTypeName);
   }
 }
 
@@ -75,7 +52,7 @@ export class Subtract extends Expression {
     }
 
     const difference = MathUtil.subtract(args[0], args[1], this.resultTypeName);
-    return finalizeNumericResult(difference, this.resultTypeName);
+    return MathUtil.finalizeNumericResult(difference, this.resultTypeName);
   }
 }
 
@@ -91,7 +68,7 @@ export class Multiply extends Expression {
     }
 
     let [x, y] = args;
-    
+
     if (x.isUncertainty && !y.isUncertainty) {
       y = new Uncertainty(y, y);
     } else if (y.isUncertainty && !x.isUncertainty) {
@@ -105,7 +82,10 @@ export class Multiply extends Expression {
       if (x.low.isQuantity) {
         product = new Uncertainty(doMultiplication(x.low, y.low), doMultiplication(x.high, y.high));
       } else {
-        product = new Uncertainty(MathUtil.multiply(x.low, y.low), MathUtil.multiply(x.high, y.high));
+        product = new Uncertainty(
+          MathUtil.multiply(x.low, y.low),
+          MathUtil.multiply(x.high, y.high)
+        );
       }
     } else {
       product = MathUtil.multiply(x, y);
@@ -114,8 +94,8 @@ export class Multiply extends Expression {
     if (MathUtil.overflowsOrUnderflows(product, this.resultTypeName)) {
       return null;
     }
-    
-    return finalizeNumericResult(product, this.resultTypeName);
+
+    return MathUtil.finalizeNumericResult(product, this.resultTypeName);
   }
 }
 
@@ -163,7 +143,7 @@ export class Divide extends Expression {
     if (MathUtil.overflowsOrUnderflows(quotient, this.resultTypeName)) {
       return null;
     }
-    return finalizeNumericResult(quotient, this.resultTypeName);
+    return MathUtil.finalizeNumericResult(quotient, this.resultTypeName);
   }
 }
 
@@ -177,8 +157,8 @@ export class TruncatedDivide extends Expression {
     if (args == null || args.some((x: any) => x == null)) {
       return null;
     }
-    
-    let [x, y] = args;
+
+    const [x, y] = args;
     let quotient;
     if (x.isQuantity) {
       quotient = doDivision(x, y);
@@ -189,7 +169,10 @@ export class TruncatedDivide extends Expression {
       quotient = MathUtil.divide(x, y);
 
       // MathUtil.divide performs truncated division for Integers and Longs implicitly
-      if (quotient != null && (x.isDecimal || y.isDecimal || this.resultTypeName === ELM_DECIMAL_TYPE)) {
+      if (
+        quotient != null &&
+        (x.isDecimal || y.isDecimal || this.resultTypeName === ELM_DECIMAL_TYPE)
+      ) {
         quotient = (quotient as Decimal).truncated();
       }
     }
@@ -215,14 +198,13 @@ export class Modulo extends Expression {
     let modulo: number | bigint | Decimal;
     const [x, y] = args;
     try {
-      modulo = 
-        x.isDecimal || y.isDecimal ? Decimal.from(x).modulo(y) : x % y;
+      modulo = x.isDecimal || y.isDecimal ? Decimal.from(x).modulo(y) : x % y;
     } catch {
       // modulo divide by zero results in null according to specification
       return null;
     }
 
-    return MathUtil.decimalLongOrNull(finalizeNumericResult(modulo, this.resultTypeName))
+    return MathUtil.decimalLongOrNull(MathUtil.finalizeNumericResult(modulo, this.resultTypeName));
   }
 }
 
@@ -439,7 +421,12 @@ export class Power extends Expression {
 }
 
 function doPower(x: any, y: any) {
-  if (x.isDecimal || y.isDecimal || (typeof y == 'number' && y < 0) || (typeof y === 'bigint' && y < 0n)) {
+  if (
+    x.isDecimal ||
+    y.isDecimal ||
+    (typeof y == 'number' && y < 0) ||
+    (typeof y === 'bigint' && y < 0n)
+  ) {
     // Decimal values or negative powers always produce Decimal result
     return Decimal.from(x).power(y);
   }
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index 14a109f44..234d2ae4a 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -623,11 +623,7 @@ export class Expand extends Expression {
       return null;
     }
 
-    const results = this.makeDecimalIntervalList(
-      low_value,
-      high_value,
-      per_value
-    );
+    const results = this.makeDecimalIntervalList(low_value, high_value, per_value);
 
     for (const itvl of results) {
       itvl.low = new Quantity(itvl.low, result_units);
@@ -636,31 +632,27 @@ export class Expand extends Expression {
     return results;
   }
 
-  expandIntegerInterval(interval: any, per: any) { 
+  expandIntegerInterval(interval: any, per: any) {
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
     const low = interval.lowClosed ? interval.low : successor(interval.low);
     const high = interval.highClosed ? interval.high : predecessor(interval.high);
 
-    return this.makeDecimalIntervalList(
-      low, high, per.value
-    );
+    return this.makeDecimalIntervalList(low, high, per.value);
   }
 
-  expandDecimalInterval(interval: any, per: any) { 
+  expandDecimalInterval(interval: any, per: any) {
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
     const low = interval.lowClosed ? interval.low : successor(interval.low);
     const high = interval.highClosed ? interval.high : predecessor(interval.high);
 
-    return this.makeDecimalIntervalList(
-      low, high, per.value
-    );
+    return this.makeDecimalIntervalList(low, high, per.value);
   }
 
-  expandLongInterval(interval: any, per: any) { 
+  expandLongInterval(interval: any, per: any) {
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
@@ -668,35 +660,32 @@ export class Expand extends Expression {
     const low = interval.lowClosed ? interval.low : successor(interval.low);
     const high = interval.highClosed ? interval.high : predecessor(interval.high);
 
-    return this.makeDecimalIntervalList(
-      low, high, per.value
-    );
+    return this.makeDecimalIntervalList(low, high, per.value);
   }
 
-  makeDecimalIntervalList(
-    low: any,
-    high: any,
-    perValue: any
-  ) {
+  makeDecimalIntervalList(low: any, high: any, perValue: any) {
     // If the per value is a decimal, 8 decimal places are appropriate
     // Integers should have 0 Decimal places
     const perIsIntegral = perValue.isInteger();
-    const decimalPrecision = perIsIntegral ? 0 : 8;    
+    const decimalPrecision = perIsIntegral ? 0 : 8;
 
     // For the purposes of this function, we'll perform all the arithmetic using Decimals,
     // then convert the results back to the required type if necessary
-    let makeInterval: Function;
+    let makeInterval: (l: Decimal, h: Decimal) => dtivl.Interval;
     if (!perIsIntegral) {
       // If per is not an integer value, then regardless of the original point types, the values will be Decimals
       makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l, h, true, true);
     } else if (typeof low === 'bigint' || typeof high === 'bigint') {
-      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toLong(), h.toLong(), true, true);
+      makeInterval = (l: Decimal, h: Decimal) =>
+        new dtivl.Interval(l.toLong(), h.toLong(), true, true);
     } else if (typeof low === 'number' || typeof high === 'number') {
-      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
+      makeInterval = (l: Decimal, h: Decimal) =>
+        new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
     } else {
       // per is an integer but the original bounds of the interval were Decimal.
       // TODO: for now just make them integers
-      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
+      makeInterval = (l: Decimal, h: Decimal) =>
+        new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
     }
 
     // treat everything as a Decimal, convert back later if needed
@@ -843,7 +832,9 @@ function collapseIntervals(intervals: any, perWidth: any) {
             a.high = b.high;
           }
         } else if (
-          perWidth.value.greaterThanOrEquals(a.high != null ? a.high.durationBetween(b.low, perWidth.unit).high : undefined)
+          perWidth.value.greaterThanOrEquals(
+            a.high != null ? a.high.durationBetween(b.low, perWidth.unit).high : undefined
+          )
         ) {
           a.high = b.high;
         } else {
@@ -860,13 +851,12 @@ function collapseIntervals(intervals: any, perWidth: any) {
           a = b;
         }
       } else {
-        
         const distance = subtract(b.low, a.high);
         // TODO: perWidth.value is a Decimal, but distance could be anything
         // lessThanOrEquals requires that its args be the same type
         // so I guess for now, make distance a Decimal
         const distanceDecimal = Decimal.from(distance);
-        const withinPerWidth = lessThanOrEquals(distanceDecimal, perWidth.value); 
+        const withinPerWidth = lessThanOrEquals(distanceDecimal, perWidth.value);
         if (withinPerWidth) {
           if (greaterThan(b.high, a.high) || b.high == null) {
             a.high = b.high;
@@ -882,10 +872,3 @@ function collapseIntervals(intervals: any, perWidth: any) {
     return collapsedIntervals;
   }
 }
-
-function truncateDecimal(decimal: any, decimalPlaces: number) {
-  // like parseFloat().toFixed() but floor rather than round
-  // Needed for when per precision is less than the interval input precision
-  const re = new RegExp('^-?\\d+(?:.\\d{0,' + (decimalPlaces || -1) + '})?');
-  return Decimal.from(decimal.toString().match(re)[0]);
-}
diff --git a/src/elm/type.ts b/src/elm/type.ts
index 2215be8b4..c68982d1c 100644
--- a/src/elm/type.ts
+++ b/src/elm/type.ts
@@ -6,7 +6,7 @@ import { Concept } from '../datatypes/clinical';
 import { Interval as dtInterval } from '../datatypes/interval';
 import { Quantity, parseQuantity } from '../datatypes/quantity';
 import { Decimal } from '../datatypes/decimal';
-import { isValidDecimal, isValidInteger, isValidLong, limitDecimalPrecision } from '../util/math';
+import { isValidDecimal, isValidInteger, isValidLong } from '../util/math';
 import { normalizeMillisecondsField } from '../util/util';
 import { Ratio } from '../datatypes/ratio';
 import {
@@ -166,7 +166,7 @@ export class ToDecimal extends Expression {
     const arg = await this.execArgs(ctx);
     if (arg != null) {
       if (arg.isUncertainty) {
-        const low = Decimal.from(arg.low).normalized()
+        const low = Decimal.from(arg.low).normalized();
         const high = Decimal.from(arg.high).normalized();
         return new Uncertainty(low, high);
       } else {
@@ -175,7 +175,7 @@ export class ToDecimal extends Expression {
           if (isValidDecimal(decimal)) {
             return decimal.normalized();
           }
-        } catch (_e) {
+        } catch {
           return null;
         }
       }
diff --git a/src/util/comparison.ts b/src/util/comparison.ts
index 467bb2e82..ce1cf55ab 100644
--- a/src/util/comparison.ts
+++ b/src/util/comparison.ts
@@ -47,9 +47,9 @@ export function lessThan(a: any, b: any, precision?: any) {
 export function lessThanOrEquals(a: any, b: any, precision?: any) {
   if (areNumbers(a, b) || areBigInts(a, b) || areStrings(a, b)) {
     return a <= b;
-  }else if (areDecimals(a, b)) {
+  } else if (areDecimals(a, b)) {
     return a.lessThanOrEquals(b);
-  }  else if (areDateTimesOrQuantities(a, b)) {
+  } else if (areDateTimesOrQuantities(a, b)) {
     return a.sameOrBefore(b, precision);
   } else if (isUncertainty(a)) {
     return a.lessThanOrEquals(b, precision);
diff --git a/src/util/immutableUtil.ts b/src/util/immutableUtil.ts
index d57e80772..14d6c7d01 100644
--- a/src/util/immutableUtil.ts
+++ b/src/util/immutableUtil.ts
@@ -1,6 +1,14 @@
 import * as ucum from '@lhncbc/ucum-lhc';
 import { type Collection, Map as ImmutableMap, Seq as ImmutableSeq } from 'immutable';
-import { Code, DateTime, Decimal, Interval, Quantity, Ratio, Uncertainty } from '../datatypes/datatypes';
+import {
+  Code,
+  DateTime,
+  Decimal,
+  Interval,
+  Quantity,
+  Ratio,
+  Uncertainty
+} from '../datatypes/datatypes';
 import { decimalAdjust } from './math';
 import { convertUnit } from './units';
 
@@ -95,7 +103,7 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
       if (!baseUnitKey) {
         // No units found - normalization not possible and use provided values
         return ImmutableMap({
-          value:  js.value ? toNormalizedKey(js.value) : null,
+          value: js.value ? toNormalizedKey(js.value) : null,
           unit: js.unit ?? null,
           __instance: js.constructor
         });
diff --git a/src/util/math.ts b/src/util/math.ts
index d70db1bc3..62216c002 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -9,11 +9,7 @@ import {
   MAX_TIME_VALUE
 } from '../datatypes/datetime';
 
-import { 
-  Decimal,
-  MAX_DECIMAL_VALUE,
-  MIN_DECIMAL_VALUE
-} from '../datatypes/decimal';
+import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../datatypes/decimal';
 
 import { Uncertainty } from '../datatypes/uncertainty';
 import {
@@ -25,12 +21,7 @@ import {
   ELM_TIME_TYPE,
   ELM_QUANTITY_TYPE
 } from './elmTypes';
-import {
-  MAX_INT_VALUE,
-  MAX_LONG_VALUE,
-  MIN_INT_VALUE,
-  MIN_LONG_VALUE
-} from './limits';
+import { MAX_INT_VALUE, MAX_LONG_VALUE, MIN_INT_VALUE, MIN_LONG_VALUE } from './limits';
 import { convertToCQLDateUnit, normalizeUnitsWhenPossible } from './units';
 
 export function overflowsOrUnderflows(value: any, type?: string): boolean {
@@ -67,10 +58,10 @@ export function overflowsOrUnderflows(value: any, type?: string): boolean {
       return true;
     }
   } else if (typeof value === 'number') {
-      if (!isValidInteger(value)) {
-        return true;
-      }
-  } else if (value.isDecimal) { 
+    if (!isValidInteger(value)) {
+      return true;
+    }
+  } else if (value.isDecimal) {
     if (!isValidDecimal(value)) {
       return true;
     }
@@ -236,13 +227,13 @@ export function divide(a: any, b: any, type?: string) {
     const quotient = Math.trunc(a / b);
     return overflowsOrUnderflows(quotient, ELM_INTEGER_TYPE) ? null : quotient;
   }
-  
+
   throw new Error('Unsupported argument types.');
 }
 
-export function limitDecimalPrecision<T extends number | bigint | Quantity | Uncertainty | Decimal | undefined>(
-  val?: T
-): T | undefined {
+export function limitDecimalPrecision<
+  T extends number | bigint | Quantity | Uncertainty | Decimal | undefined
+>(val?: T): T | undefined {
   if (val == null) {
     return val;
   } else if (typeof val === 'number') {
@@ -454,8 +445,25 @@ export function decimalOrNull(value: any) {
 
 export function decimalLongOrNull(value: any) {
   return (typeof value === 'number' && Number.isFinite(value)) ||
-    ((value && value.isDecimal) && isValidDecimal(value)) ||
+    (value && value.isDecimal && isValidDecimal(value)) ||
     (typeof value === 'bigint' && isValidLong(value))
     ? value
     : null;
 }
+
+export function finalizeNumericResult(result: any, _type?: string) {
+  if (result instanceof Decimal) {
+    return result.normalized();
+  } else if (result instanceof Quantity) {
+    return new Quantity(result.value.normalized(), result.unit);
+  } else if (result instanceof Uncertainty) {
+    if (result.low instanceof Quantity || result.low instanceof Decimal) {
+      result.low = finalizeNumericResult(result.low);
+    }
+    if (result.high instanceof Quantity || result.high instanceof Decimal) {
+      result.high = finalizeNumericResult(result.high);
+    }
+  }
+
+  return result;
+}
diff --git a/src/util/units.ts b/src/util/units.ts
index 688ef2f6f..20abc8435 100644
--- a/src/util/units.ts
+++ b/src/util/units.ts
@@ -1,5 +1,4 @@
 import * as ucum from '@lhncbc/ucum-lhc';
-import { decimalAdjust } from './math';
 import { Decimal } from '../datatypes/decimal';
 const utils = ucum.UcumLhcUtils.getInstance();
 
diff --git a/test/datatypes/date-test.ts b/test/datatypes/date-test.ts
index 90080282f..dd8150016 100644
--- a/test/datatypes/date-test.ts
+++ b/test/datatypes/date-test.ts
@@ -898,7 +898,9 @@ describe('Date.getDateTime', () => {
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);
-    dateTime.timezoneOffset.should.equalDecimal(Decimal.from((new jsDate().getTimezoneOffset() / 60) * -1));
+    dateTime.timezoneOffset.should.equalDecimal(
+      Decimal.from((new jsDate().getTimezoneOffset() / 60) * -1)
+    );
   });
 
   it('should return a DateTime without a timeZoneOffset when a null timeZoneOffset is passed in', () => {
diff --git a/test/datatypes/interval-test.ts b/test/datatypes/interval-test.ts
index 57f1e15de..7772a8ac1 100644
--- a/test/datatypes/interval-test.ts
+++ b/test/datatypes/interval-test.ts
@@ -132,7 +132,9 @@ describe('Interval', () => {
     });
 
     it('should return the point size for Decimal intervals', () => {
-      new Interval(Decimal.from(0.5), Decimal.from(9.5)).getPointSize().should.equalDecimal(Decimal.from(0.00000001));
+      new Interval(Decimal.from(0.5), Decimal.from(9.5))
+        .getPointSize()
+        .should.equalDecimal(Decimal.from(0.00000001));
     });
 
     it('should return the point size for Quantity intervals', () => {
@@ -164,7 +166,9 @@ describe('Interval', () => {
 
     it('should return successor of low for intervals with open low', () => {
       d.zeroToHundred.openClosed.start().should.equal(1);
-      d.zeroPointFiveToNinePointFive.openClosed.start().should.equalDecimal(Decimal.from("0.50000001"));
+      d.zeroPointFiveToNinePointFive.openClosed
+        .start()
+        .should.equalDecimal(Decimal.from('0.50000001'));
       d.zeroToHundredLong.openClosed.start().should.equal(1n);
       d.zeroToHundredMg.openClosed.start().should.eql(new Quantity(0.00000001, 'mg'));
       d.all2012date.openClosed.start().should.eql(Date.parse('2012-01-02'));
@@ -177,7 +181,9 @@ describe('Interval', () => {
     it('should return type minimum for closed null low endpoints', () => {
       d.zeroToHundred.withNullStart.closed.start().should.equal(MIN_INT_VALUE);
       d.zeroToHundredLong.withNullStart.closed.start().should.equal(MIN_LONG_VALUE);
-      d.zeroPointFiveToNinePointFive.withNullStart.closed.start().should.equalDecimal(MIN_DECIMAL_VALUE);
+      d.zeroPointFiveToNinePointFive.withNullStart.closed
+        .start()
+        .should.equalDecimal(MIN_DECIMAL_VALUE);
       d.zeroToHundredMg.withNullStart.closed
         .start()
         .should.eql(new Quantity(MIN_DECIMAL_VALUE, 'mg'));
@@ -203,7 +209,9 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, Decimal.from(9.5)));
       d.zeroToHundredMg.withNullStart.openClosed
         .start()
-        .should.eql(new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(100, 'mg')));
+        .should.eql(
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(100, 'mg'))
+        );
       d.all2012date.withNullStart.openClosed
         .start()
         .should.eql(new Uncertainty(MIN_DATE_VALUE, Date.parse('2012-12-31')));
@@ -275,7 +283,10 @@ describe('Interval', () => {
       new Interval(null, null, false, false, ELM_QUANTITY_TYPE)
         .start()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
+          new Uncertainty(
+            new Quantity(MIN_DECIMAL_VALUE, '1'),
+            new Quantity(MAX_DECIMAL_VALUE, '1')
+          )
         );
       new Interval(null, null, false, false, ELM_DATETIME_TYPE)
         .start()
@@ -405,7 +416,10 @@ describe('Interval', () => {
       new Interval(null, null, false, false, ELM_QUANTITY_TYPE)
         .end()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, '1'), new Quantity(MAX_DECIMAL_VALUE, '1'))
+          new Uncertainty(
+            new Quantity(MIN_DECIMAL_VALUE, '1'),
+            new Quantity(MAX_DECIMAL_VALUE, '1')
+          )
         );
       new Interval(null, null, false, false, ELM_DATETIME_TYPE)
         .end()
@@ -7002,10 +7016,16 @@ describe('DecimalInterval', () => {
   });
 
   it('should calculate width and size outside the Integer range', () => {
-    const interval = new Interval(Decimal.from(0.0), Decimal.from(3000000000.0), true, true, ELM_DECIMAL_TYPE);
+    const interval = new Interval(
+      Decimal.from(0.0),
+      Decimal.from(3000000000.0),
+      true,
+      true,
+      ELM_DECIMAL_TYPE
+    );
 
-    interval.width().should.equalDecimal(Decimal.from("3000000000.0"));
-    interval.size().should.equalDecimal(Decimal.from("3000000000.00000001"));
+    interval.width().should.equalDecimal(Decimal.from('3000000000.0'));
+    interval.size().should.equalDecimal(Decimal.from('3000000000.00000001'));
   });
 
   it('should close open decimal uncertainty endpoints using decimal point size', () => {
@@ -7025,13 +7045,25 @@ describe('DecimalInterval', () => {
 
   it('should use decimal point size for meetsBefore decimal uncertainty bounds', () => {
     const earlier = new Interval(Decimal.from(1), Decimal.from(1.99999999));
-    const later = new Interval(new Uncertainty(Decimal.from(2), Decimal.from(2)), null, true, false, ELM_DECIMAL_TYPE);
+    const later = new Interval(
+      new Uncertainty(Decimal.from(2), Decimal.from(2)),
+      null,
+      true,
+      false,
+      ELM_DECIMAL_TYPE
+    );
 
     earlier.meetsBefore(later).should.be.true();
   });
 
   it('should use decimal point size for meetsAfter decimal uncertainty bounds', () => {
-    const earlier = new Interval(null, new Uncertainty(Decimal.from(1), Decimal.from(1)), false, true, ELM_DECIMAL_TYPE);
+    const earlier = new Interval(
+      null,
+      new Uncertainty(Decimal.from(1), Decimal.from(1)),
+      false,
+      true,
+      ELM_DECIMAL_TYPE
+    );
     const later = new Interval(Decimal.from(1.00000001), Decimal.from(2));
 
     later.meetsAfter(earlier).should.be.true();
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 6adc191e6..22292ffdb 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -98,11 +98,7 @@ describe('Sum', () => {
   });
 
   it('should be able to sum quantities up to max decimal value', async function () {
-    validateQuantity(
-      await this.quantities_at_max_value.exec(this.ctx),
-      MAX_DECIMAL_VALUE,
-      'ml'
-    );
+    validateQuantity(await this.quantities_at_max_value.exec(this.ctx), MAX_DECIMAL_VALUE, 'ml');
   });
 
   it('should return null when overflowing the max quantity value', async function () {
@@ -110,11 +106,7 @@ describe('Sum', () => {
   });
 
   it('should be able to sum quantities down to min decimal value', async function () {
-    validateQuantity(
-      await this.quantities_at_min_value.exec(this.ctx),
-      MIN_DECIMAL_VALUE,
-      'ml'
-    );
+    validateQuantity(await this.quantities_at_min_value.exec(this.ctx), MIN_DECIMAL_VALUE, 'ml');
   });
 
   it('should return null when underflowing the min quantity value', async function () {
@@ -480,13 +472,13 @@ describe('StdDev', () => {
     setup(this, data);
   });
   it('should be able to find Standard Dev of a list ', async function () {
-    (await this.std.exec(this.ctx)).should.equalDecimal(Decimal.from("1.58113883"));
+    (await this.std.exec(this.ctx)).should.equalDecimal(Decimal.from('1.58113883'));
   });
   it('should be able to find Standard Dev of a list of like quantities', async function () {
-    validateQuantity(await this.std_q.exec(this.ctx), "1.58113883", 'ml');
+    validateQuantity(await this.std_q.exec(this.ctx), '1.58113883', 'ml');
   });
   it('should be able to find Standard Dev of a list of related quantities', async function () {
-    validateQuantity(await this.q_diff_units.exec(this.ctx), "1.58113883", 'ml');
+    validateQuantity(await this.q_diff_units.exec(this.ctx), '1.58113883', 'ml');
   });
   it('should be null if some are numbers and some are quantities', async function () {
     should(await this.numbersAndQuantities.exec(this.ctx)).be.null();
@@ -501,13 +493,13 @@ describe('PopulationStdDev', () => {
     setup(this, data);
   });
   it('should be able to find Population Standard Dev of a list ', async function () {
-    (await this.dev.exec(this.ctx)).should.equalDecimal(Decimal.from("1.41421356"));
+    (await this.dev.exec(this.ctx)).should.equalDecimal(Decimal.from('1.41421356'));
   });
   it('should be able to find Population Standard Dev of a list of quantities', async function () {
-    validateQuantity(await this.dev_q.exec(this.ctx), "1.41421356", 'ml');
+    validateQuantity(await this.dev_q.exec(this.ctx), '1.41421356', 'ml');
   });
   it('should be able to find Population Standard Dev of a list of related quantities', async function () {
-    validateQuantity(await this.q_diff_units.exec(this.ctx), "1.41421356", 'ml');
+    validateQuantity(await this.q_diff_units.exec(this.ctx), '1.41421356', 'ml');
   });
   it('should be null if some are numbers and some are quantities', async function () {
     should(await this.numbersAndQuantities.exec(this.ctx)).be.null();
@@ -567,9 +559,7 @@ describe('Product', () => {
   });
 
   it('should return decimal product up to max decimal value', async function () {
-    (await this.decimals_at_max_value_product.exec(this.ctx)).should.eql(
-      MAX_DECIMAL_VALUE
-    );
+    (await this.decimals_at_max_value_product.exec(this.ctx)).should.eql(MAX_DECIMAL_VALUE);
   });
 
   it('should return null when decimal product overflows max decimal value', async function () {
@@ -577,9 +567,7 @@ describe('Product', () => {
   });
 
   it('should return decimal product down to min decimal value', async function () {
-    (await this.decimals_at_min_value_product.exec(this.ctx)).should.eql(
-      MIN_DECIMAL_VALUE
-    );
+    (await this.decimals_at_min_value_product.exec(this.ctx)).should.eql(MIN_DECIMAL_VALUE);
   });
 
   it('should return null when decimal product underflows min decimal value', async function () {
@@ -662,7 +650,7 @@ describe('GeometricMean', () => {
   });
 
   it('should return value when pass in list that contains nulls', async function () {
-    (await this.null_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from("1.41421356"));
+    (await this.null_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from('1.41421356'));
   });
 
   it('should return null when list is all null', async function () {
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 774aa91bd..1671c64c5 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -26,7 +26,11 @@ import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/data
 
 const data = require('./data');
 
-const validateQuantity = function (object: any, expectedValue: number | Decimal, expectedUnit: string) {
+const validateQuantity = function (
+  object: any,
+  expectedValue: number | Decimal,
+  expectedUnit: string
+) {
   object.isQuantity.should.be.true();
   const q = new Quantity(expectedValue, expectedUnit);
   q.equals(object).should.be.true('Expected ' + object + ' to equal ' + q);
@@ -255,7 +259,7 @@ describe('Divide', () => {
 
   it('should divide uncertainty by uncertainty', async function () {
     const result = await this.divideUncertainties.exec(this.ctx);
-    result.low.should.equalDecimal(Decimal.from("0.42857143")); // 6/14
+    result.low.should.equalDecimal(Decimal.from('0.42857143')); // 6/14
     result.high.should.equalDecimal(Decimal.from(9));
   });
 
@@ -537,12 +541,12 @@ describe('Ln', () => {
   });
 
   it('should be able to return the natural log of a number', async function () {
-    const log4 = Decimal.from("1.3862943611198906").normalized();
+    const log4 = Decimal.from('1.3862943611198906').normalized();
     (await this.ln.exec(this.ctx)).should.equalDecimal(log4);
   });
 
   it('should be able to return the natural log of a long', async function () {
-    const log4 = Decimal.from("1.3862943611198906").normalized();
+    const log4 = Decimal.from('1.3862943611198906').normalized();
     (await this.lnFourLong.exec(this.ctx)).should.equalDecimal(log4);
   });
 });
@@ -752,7 +756,7 @@ describe('Predecessor', () => {
   });
 
   it('should be able to get Real Predecessor', async function () {
-    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from("2.19999999"));
+    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from('2.19999999'));
   });
 
   it('should return null for Predecessor greater than Integer Max value', async function () {
@@ -1011,12 +1015,16 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but more than max integer and near JavaScript max safe number
-      should(await this.integerDivideNearOverflow.exec(this.ctx)).equalDecimal(Decimal.from(8589934588000000));
+      should(await this.integerDivideNearOverflow.exec(this.ctx)).equalDecimal(
+        Decimal.from(8589934588000000)
+      );
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but less than min integer and near JavaScript min safe number
-      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equalDecimal(Decimal.from(-8589934592000000));
+      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equalDecimal(
+        Decimal.from(-8589934592000000)
+      );
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1118,12 +1126,16 @@ describe('OutOfBounds', () => {
       // note that all division in CQL (except truncated division) is really decimal division
       // note also that MAX_LONG_VALUE is (2^63)-1,
       // 9223372036854775807 = 7^2 * 73 * 127 * 337 * 92737 * 649657
-      should(await this.longDivideNearOverflow.exec(this.ctx)).equalDecimal(Decimal.from(99457304386111n));
+      should(await this.longDivideNearOverflow.exec(this.ctx)).equalDecimal(
+        Decimal.from(99457304386111n)
+      );
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but near JavaScript min safe number
-      should(await this.longDivideNearUnderflow.exec(this.ctx)).equalDecimal(Decimal.from(-9007199254740992n));
+      should(await this.longDivideNearUnderflow.exec(this.ctx)).equalDecimal(
+        Decimal.from(-9007199254740992n)
+      );
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1257,11 +1269,15 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for successor near overflow', async function () {
-      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equalDecimal(MAX_DECIMAL_VALUE);
+      should(await this.decimalSuccessorNearOverflow.exec(this.ctx)).equalDecimal(
+        MAX_DECIMAL_VALUE
+      );
     });
 
     it('should return value for predecessor near underflow', async function () {
-      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equalDecimal(MIN_DECIMAL_VALUE);
+      should(await this.decimalPredecessorNearUnderflow.exec(this.ctx)).equalDecimal(
+        MIN_DECIMAL_VALUE
+      );
     });
   });
 
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 78757f286..791b951d9 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -1686,9 +1686,13 @@ describe('Size', () => {
 
   it('should calculate the size of real intervals', async function () {
     // define RealSize: Size(Interval[1.23, 4.56])
-    (await this.realSize.exec(this.ctx)).should.equalDecimal(Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE));
+    (await this.realSize.exec(this.ctx)).should.equalDecimal(
+      Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE)
+    );
     // define RealOpenSize: Size(Interval(1.23, 4.56))
-    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE));
+    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(
+      Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE)
+    );
   });
 
   it('should calculate the size of infinite intervals', async function () {
@@ -1758,7 +1762,9 @@ describe('Start', () => {
   it('should return the minimum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(Decimal.from(5));
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(
+      Decimal.from(5)
+    );
   });
 
   it('should return the minimum possible Integer', async function () {
@@ -1808,7 +1814,9 @@ describe('End', () => {
   it('should return the maximum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(Decimal.from(5));
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(
+      Decimal.from(5)
+    );
   });
 
   it('should return the maximum possible Integer', async function () {
@@ -3490,9 +3498,6 @@ describe('QuantityIntervalExpand', () => {
   });
 
   it('returns null when per zero, not applicable, or mismatch interval', async function () {
-
-    console.log('debuggger')
-    
     // define perZero: expand { Interval[2 'g', 4 'g'] } per 0 'g'
     let a = await this.perZero.exec(this.ctx);
     should.not.exist(a);
diff --git a/test/elm/parameters/parameters-test.ts b/test/elm/parameters/parameters-test.ts
index dc2e354a9..b450a217e 100644
--- a/test/elm/parameters/parameters-test.ts
+++ b/test/elm/parameters/parameters-test.ts
@@ -100,7 +100,9 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to provided valid value', async function () {
-    (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.equalDecimal(Decimal.from(3.0));
+    (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.equalDecimal(
+      Decimal.from(3.0)
+    );
   });
 
   it('should throw when provided value is wrong type', function () {
@@ -112,7 +114,9 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to overriding valid value', async function () {
-    (await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))).should.equalDecimal(Decimal.from(3.0));
+    (
+      await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))
+    ).should.equalDecimal(Decimal.from(3.0));
   });
 
   it('should throw when overriding value is wrong type', function () {
@@ -130,7 +134,9 @@ describe('IntegerParameterTypes', () => {
   });
 
   it('should throw when provided value is wrong type', function () {
-    should(() => this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.5) }))).throw(/.*wrong type.*/);
+    should(() => this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.5) }))).throw(
+      /.*wrong type.*/
+    );
   });
 
   it('should execute to default value', async function () {
@@ -142,7 +148,9 @@ describe('IntegerParameterTypes', () => {
   });
 
   it('should throw when overriding value is wrong type', function () {
-    should(() => this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.5) }))).throw(/.*wrong type.*/);
+    should(() => this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.5) }))).throw(
+      /.*wrong type.*/
+    );
   });
 });
 
@@ -424,9 +432,11 @@ describe('IntervalParameterTypes', () => {
   });
 
   it('should throw when interval contains a wrong point type', async function () {
-    should(() => this.foo.exec(this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) }))).throw(
-      /.*wrong type.*/
-    );
+    should(() =>
+      this.foo.exec(
+        this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) })
+      )
+    ).throw(/.*wrong type.*/);
   });
 
   it('should execute to default value', async function () {
@@ -444,9 +454,11 @@ describe('IntervalParameterTypes', () => {
   });
 
   it('should throw when overriding interval contains a wrong point type', async function () {
-    should(() => this.foo2.exec(this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) }))).throw(
-      /.*wrong type.*/
-    );
+    should(() =>
+      this.foo2.exec(
+        this.ctx.withParameters({ FooP: new Interval(Decimal.from(1.5), Decimal.from(5.5)) })
+      )
+    ).throw(/.*wrong type.*/);
   });
 });
 
diff --git a/test/should-extensions.ts b/test/should-extensions.ts
index 1d29e8026..f57ba3890 100644
--- a/test/should-extensions.ts
+++ b/test/should-extensions.ts
@@ -31,11 +31,15 @@ declare module 'should' {
   normalizedThis.should.eql(normalizedExpected);
 });
 
-(should as any).Assertion.add('equalDecimal', function (this: any, expected: number | bigint | Decimal) {
-    this.params = { operator: 'to equal Decimal', expected: expected.toString(), obj: this.obj.toString() };
+(should as any).Assertion.add(
+  'equalDecimal',
+  function (this: any, expected: number | bigint | Decimal) {
+    this.params = {
+      operator: 'to equal Decimal',
+      expected: expected.toString(),
+      obj: this.obj.toString()
+    };
 
-    this.assert(
-      this.obj instanceof Decimal &&
-        this.obj.equals(expected)
-    );
-});
\ No newline at end of file
+    this.assert(this.obj instanceof Decimal && this.obj.equals(expected));
+  }
+);
diff --git a/test/spec-tests/spec-test.ts b/test/spec-tests/spec-test.ts
index 9809612bf..b68768ded 100644
--- a/test/spec-tests/spec-test.ts
+++ b/test/spec-tests/spec-test.ts
@@ -45,9 +45,6 @@ describe('CQL Spec Tests (from XML)', () => {
           }
           suite.expression.element.forEach((t: any) => {
             it(`should properly evaluate ${t.name}`, async function () {
-              if (t.name === 'beans') {
-                debugger;
-              }
               const testCaseMap = convertTupleToMap(t.value);
               if (testCaseMap.has('skipped')) {
                 this.skip();
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index 905ac4c17..5071fd60d 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -12,7 +12,10 @@ describe('successor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
+    const result = successor(
+      new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)),
+      ELM_DECIMAL_TYPE
+    );
     result.low.should.equalDecimal(Decimal.from(1.00000001));
     result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
@@ -31,7 +34,10 @@ describe('predecessor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)), ELM_DECIMAL_TYPE);
+    const result = successor(
+      new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)),
+      ELM_DECIMAL_TYPE
+    );
     result.low.should.equalDecimal(Decimal.from(1.00000001));
     result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
diff --git a/test/util/units-test.ts b/test/util/units-test.ts
index 9cf5ea45c..3550a6f25 100644
--- a/test/util/units-test.ts
+++ b/test/util/units-test.ts
@@ -132,7 +132,7 @@ describe('convertUnit', () => {
 
   it('should truncate precision to 8 decimals by default', () => {
     const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]');
-    result.should.equalDecimal(Decimal.from("0.00018939"));
+    result.should.equalDecimal(Decimal.from('0.00018939'));
   });
 
   // it('should not truncate precision to 8 decimals when adjustPrecision is false', () => {
@@ -148,35 +148,79 @@ describe('convertUnit', () => {
 });
 
 describe('normalizeUnitsWhenPossible', () => {
-
   it('should keep same units', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'm']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm').should.eql([
+      Decimal.from(10),
+      'm',
+      Decimal.from(1),
+      'm'
+    ]);
   });
 
   it('should convert compatible units, preferring smaller units', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'cm', Decimal.from(1), 'm').should.eql([Decimal.from(10), 'cm', Decimal.from(100), 'cm']);
-    normalizeUnitsWhenPossible(Decimal.from(1), 'm', Decimal.from(10), 'cm').should.eql([Decimal.from(100), 'cm', Decimal.from(10), 'cm']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'cm', Decimal.from(1), 'm').should.eql([
+      Decimal.from(10),
+      'cm',
+      Decimal.from(100),
+      'cm'
+    ]);
+    normalizeUnitsWhenPossible(Decimal.from(1), 'm', Decimal.from(10), 'cm').should.eql([
+      Decimal.from(100),
+      'cm',
+      Decimal.from(10),
+      'cm'
+    ]);
   });
 
   it('should treat null or empty string units as 1', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), null, Decimal.from(1), '').should.eql([Decimal.from(10), '1', Decimal.from(1), '1']);
-    normalizeUnitsWhenPossible(Decimal.from(1), '', Decimal.from(10), null).should.eql([Decimal.from(1), '1', Decimal.from(10), '1']);
+    normalizeUnitsWhenPossible(Decimal.from(10), null, Decimal.from(1), '').should.eql([
+      Decimal.from(10),
+      '1',
+      Decimal.from(1),
+      '1'
+    ]);
+    normalizeUnitsWhenPossible(Decimal.from(1), '', Decimal.from(10), null).should.eql([
+      Decimal.from(1),
+      '1',
+      Decimal.from(10),
+      '1'
+    ]);
   });
 
   it('should normalize CQL date units and return CQL date units', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'year', Decimal.from(12), 'month').should.eql([Decimal.from(120), 'month', Decimal.from(12), 'month']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'year', Decimal.from(12), 'month').should.eql([
+      Decimal.from(120),
+      'month',
+      Decimal.from(12),
+      'month'
+    ]);
   });
 
   it('should return CQL date units when UCUM units are passed in', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'a_g', Decimal.from(12), 'mo_g').should.eql([Decimal.from(120), 'mo_g', Decimal.from(12), 'mo_g']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'a_g', Decimal.from(12), 'mo_g').should.eql([
+      Decimal.from(120),
+      'mo_g',
+      Decimal.from(12),
+      'mo_g'
+    ]);
   });
 
   it('should not convert units of different dimensions', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm2').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'm2']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'm2').should.eql([
+      Decimal.from(10),
+      'm',
+      Decimal.from(1),
+      'm2'
+    ]);
   });
 
   it('should not convert incompatible units', () => {
-    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'mg').should.eql([Decimal.from(10), 'm', Decimal.from(1), 'mg']);
+    normalizeUnitsWhenPossible(Decimal.from(10), 'm', Decimal.from(1), 'mg').should.eql([
+      Decimal.from(10),
+      'm',
+      Decimal.from(1),
+      'mg'
+    ]);
   });
 });
 

From e47383f37bb0690a3a6812ea93b9722949b1b2a3 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 20 Aug 2026 13:38:25 -0400
Subject: [PATCH 04/62] fix package-lock

---
 package-lock.json | 24 ++++++++++++++++++++++++
 1 file changed, 24 insertions(+)

diff --git a/package-lock.json b/package-lock.json
index e3c125fad..4de37c4a3 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -1062,6 +1062,9 @@
         "arm64"
       ],
       "dev": true,
+      "libc": [
+        "glibc"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1079,6 +1082,9 @@
         "arm64"
       ],
       "dev": true,
+      "libc": [
+        "musl"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1096,6 +1102,9 @@
         "ppc64"
       ],
       "dev": true,
+      "libc": [
+        "glibc"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1113,6 +1122,9 @@
         "riscv64"
       ],
       "dev": true,
+      "libc": [
+        "glibc"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1130,6 +1142,9 @@
         "riscv64"
       ],
       "dev": true,
+      "libc": [
+        "musl"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1147,6 +1162,9 @@
         "s390x"
       ],
       "dev": true,
+      "libc": [
+        "glibc"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1164,6 +1182,9 @@
         "x64"
       ],
       "dev": true,
+      "libc": [
+        "glibc"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [
@@ -1181,6 +1202,9 @@
         "x64"
       ],
       "dev": true,
+      "libc": [
+        "musl"
+      ],
       "license": "MIT",
       "optional": true,
       "os": [

From b77728e47d9a7576ef24f4a55f21267e3b855084 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 20 Aug 2026 13:44:30 -0400
Subject: [PATCH 05/62] actually fix package-lock

---
 package-lock.json | 630 ++++++++++++++++++++++++----------------------
 1 file changed, 330 insertions(+), 300 deletions(-)

diff --git a/package-lock.json b/package-lock.json
index 4de37c4a3..4e391eb81 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -109,14 +109,14 @@
       }
     },
     "node_modules/@babel/generator": {
-      "version": "7.29.7",
-      "resolved": "https://registry.npmjs.org/@babel/generator/-/generator-7.29.7.tgz",
-      "integrity": "sha512-DkXD5OJQaAQIdZ1bt3UZdEnHAn9Imd3IVBdX03UFe+ony9Ojw5pzr9YVKGDY1jt+Gcn/FnGkNf8r+Vj5NOJWtQ==",
+      "version": "7.29.8",
+      "resolved": "https://registry.npmjs.org/@babel/generator/-/generator-7.29.8.tgz",
+      "integrity": "sha512-gZbepsdh3WDtgZKWL+vTPh71LSBrm/Y4/QDZBVCcYfmeTEEuoOYwlSy+G1StfJg+/Zy550u/3TATbm7qDbbMtg==",
       "dev": true,
       "license": "MIT",
       "dependencies": {
-        "@babel/parser": "^7.29.7",
-        "@babel/types": "^7.29.7",
+        "@babel/parser": "^7.29.8",
+        "@babel/types": "^7.29.8",
         "@jridgewell/gen-mapping": "^0.3.12",
         "@jridgewell/trace-mapping": "^0.3.28",
         "jsesc": "^3.0.2"
@@ -239,13 +239,13 @@
       }
     },
     "node_modules/@babel/parser": {
-      "version": "7.29.7",
-      "resolved": "https://registry.npmjs.org/@babel/parser/-/parser-7.29.7.tgz",
-      "integrity": "sha512-hnORnjP/1P/zFEndoeX+n+t1RwWRJiJpM/jO7FW32Kn9r5+sJB2JWOdYo4L6k78j15eCwY3Gm/7364B1EMwtNg==",
+      "version": "7.29.8",
+      "resolved": "https://registry.npmjs.org/@babel/parser/-/parser-7.29.8.tgz",
+      "integrity": "sha512-E8lTAYNB1KW+FH+VGJuZM1ioAx2E6oVlvQFRrf5P8ZZmsiJXYAD9vTFV7yyEURNzgh1dFqMZuO6tUwcARbqFCA==",
       "dev": true,
       "license": "MIT",
       "dependencies": {
-        "@babel/types": "^7.29.7"
+        "@babel/types": "^7.29.8"
       },
       "bin": {
         "parser": "bin/babel-parser.js"
@@ -270,18 +270,18 @@
       }
     },
     "node_modules/@babel/traverse": {
-      "version": "7.29.7",
-      "resolved": "https://registry.npmjs.org/@babel/traverse/-/traverse-7.29.7.tgz",
-      "integrity": "sha512-EhlfNQtZ+NK22w5BM61ciuiq1m58ed33Wr1Xan//ZRTy6hgjnwyCffRYwzsGXdASJSUJ1guZILsErh1eQcl+zw==",
+      "version": "7.29.8",
+      "resolved": "https://registry.npmjs.org/@babel/traverse/-/traverse-7.29.8.tgz",
+      "integrity": "sha512-I5z7H3bf/41ktsNVLtpN0wAa336HkqIHQ5BuPLEhTkt1jVSyZpeNKIzTgEWmlxjdg81R0IgUCcaE+Ok3NvrfZg==",
       "dev": true,
       "license": "MIT",
       "dependencies": {
         "@babel/code-frame": "^7.29.7",
-        "@babel/generator": "^7.29.7",
+        "@babel/generator": "^7.29.8",
         "@babel/helper-globals": "^7.29.7",
-        "@babel/parser": "^7.29.7",
+        "@babel/parser": "^7.29.8",
         "@babel/template": "^7.29.7",
-        "@babel/types": "^7.29.7",
+        "@babel/types": "^7.29.8",
         "debug": "^4.3.1"
       },
       "engines": {
@@ -289,9 +289,9 @@
       }
     },
     "node_modules/@babel/types": {
-      "version": "7.29.7",
-      "resolved": "https://registry.npmjs.org/@babel/types/-/types-7.29.7.tgz",
-      "integrity": "sha512-4zBIxpPzowiZpusoFkyGVwakdRJUyuH5PxQ/PrqghfdFWWasvnCdPfQXHrenDai+gyLARulZjZowCOj6fjT4pA==",
+      "version": "7.29.8",
+      "resolved": "https://registry.npmjs.org/@babel/types/-/types-7.29.8.tgz",
+      "integrity": "sha512-Vj1jF3cPfxg7OAfoI7QnVKLoILlm2JF9pnVHrX8qx7AHMiYWT+NDAA7jChlNgRS4WTLc/fD1lXLmPixluj+3Gg==",
       "dev": true,
       "license": "MIT",
       "dependencies": {
@@ -310,9 +310,9 @@
       "license": "MIT"
     },
     "node_modules/@esbuild/aix-ppc64": {
-      "version": "0.28.1",
-      "resolved": "https://registry.npmjs.org/@esbuild/aix-ppc64/-/aix-ppc64-0.28.1.tgz",
-      "integrity": "sha512-Svl7tq8k/08+p6CXPpRjQ1fKX+1odH/BQbb48fV6fj3CWHhsoIOoY87w1oHXm0qEpkIK3ZfVgp0hed3XBXzXMQ==",
+      "version": "0.28.2",
+      "resolved": "https://registry.npmjs.org/@esbuild/aix-ppc64/-/aix-ppc64-0.28.2.tgz",
+      "integrity": "sha512-XExcO+dvLKvVtNTibSTBej1NCAbaGhWn9Ww1ZPx80qsahhPFe/8jgWP0IchNe0F3HwkU7n8ejhH8bjonqht8mQ==",
       "cpu": [
         "ppc64"
       ],
@@ -327,9 +327,9 @@
       }
     },
     "node_modules/@esbuild/android-arm": {
-      "version": "0.28.1",
-      "resolved": "https://registry.npmjs.org/@esbuild/android-arm/-/android-arm-0.28.1.tgz",
-      "integrity": "sha512-0k2F129Xdio1TdJfzJ8sy1Q47vUD2NnwdhiAf7drUN1EBTfPf4hsFCtmMgu/6m8JSzsBrlmVjudMBQqOfG8usQ==",
+      "version": "0.28.2",
+      "resolved": "https://registry.npmjs.org/@esbuild/android-arm/-/android-arm-0.28.2.tgz",
+      "integrity": "sha512-kXXoiPVVGQcnIYGOeaovwOURpniDBpSq4A03qkQ+BMQqtGG6HYap3xne9C1O1yo4TR3qxlCX5IqqmX6fFo2Lqg==",
       "cpu": [
         "arm"
       ],
@@ -344,9 +344,9 @@
       }
     },
     "node_modules/@esbuild/android-arm64": {
-      "version": "0.28.1",
-      "resolved": "https://registry.npmjs.org/@esbuild/android-arm64/-/android-arm64-0.28.1.tgz",
-      "integrity": "sha512-34EGEbCIAgosYz6goLcopX6Mo7NyGv9tfwEM2/7Ce2VcVRk568iSvniGWcUXIy7wEDR1wzolcxcriFVrWYcwBg==",
+      "version": "0.28.2",
+      "resolved": "https://registry.npmjs.org/@esbuild/android-arm64/-/android-arm64-0.28.2.tgz",
+      "integrity": "sha512-5YfKeeI8qWfBZIX+u2xZC3Zlb3Os/gLS2sbEKM+I4ZOcsWmHS2WLysCcQZDAFRslDUU5Oiq44gf6PYN1vGwG5A==",
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+      "integrity": "sha512-UjgapumWlbMhkBgzT7Ykc5YXUT46F0iKu8SGXq0bcwP5dz/h0Plj6enJqjz1Zbq2l5WaqYnrVbwWOWMyF3F47g==",
+      "dev": true,
+      "license": "BSD-3-Clause",
+      "engines": {
+        "node": ">=0.10.0"
+      }
+    },
     "node_modules/spawn-wrap": {
       "version": "3.0.0",
       "resolved": "https://registry.npmjs.org/spawn-wrap/-/spawn-wrap-3.0.0.tgz",
@@ -3639,6 +3561,15 @@
       "integrity": "sha512-3HXId/0W8sktQnQM6rOZf2LuDDMbakMgAjpViLk758/h0br+iGqZFFfUxxJSqEvGvT742PyFr4v/TBXUtowdCg==",
       "license": "BSD-3-Clause"
     },
+    "node_modules/string_decoder": {
+      "version": "1.1.1",
+      "resolved": "https://registry.npmjs.org/string_decoder/-/string_decoder-1.1.1.tgz",
+      "integrity": "sha512-n/ShnvDi6FHbbVfviro+WojiFzv+s8MPMHBczVePfUpDJLwoLT0ht1l4YwBCbi8pJAveEEdnkHyPyTP/mzRfwg==",
+      "license": "MIT",
+      "dependencies": {
+        "safe-buffer": "~5.1.0"
+      }
+    },
     "node_modules/string-to-stream": {
       "version": "1.1.1",
       "resolved": "https://registry.npmjs.org/string-to-stream/-/string-to-stream-1.1.1.tgz",
@@ -3738,22 +3669,6 @@
         "node": "20 || >=22"
       }
     },
-    "node_modules/test-exclude/node_modules/minimatch": {
-      "version": "10.2.4",
-      "resolved": "https://registry.npmjs.org/minimatch/-/minimatch-10.2.4.tgz",
-      "integrity": "sha512-oRjTw/97aTBN0RHbYCdtF1MQfvusSIBQM0IZEgzl6426+8jSC0nF1a/GmnVLpfB9yyr6g6FTqWqiZVbxrtaCIg==",
-      "dev": true,
-      "license": "BlueOak-1.0.0",
-      "dependencies": {
-        "brace-expansion": "^5.0.2"
-      },
-      "engines": {
-        "node": "18 || 20 || >=22"
-      },
-      "funding": {
-        "url": "https://github.com/sponsors/isaacs"
-      }
-    },
     "node_modules/tsx": {
       "version": "4.23.12",
       "resolved": "https://registry.npmjs.org/tsx/-/tsx-4.23.12.tgz",
@@ -3846,9 +3761,9 @@
       "license": "MIT"
     },
     "node_modules/update-browserslist-db": {
-      "version": "1.2.3",
-      "resolved": "https://registry.npmjs.org/update-browserslist-db/-/update-browserslist-db-1.2.3.tgz",
-      "integrity": "sha512-Js0m9cx+qOgDxo0eMiFGEueWztz+d4+M3rGlmKPT+T4IS/jP4ylw3Nwpu6cpTTP8R1MAC1kF4VbdLt3ARf209w==",
+      "version": "1.3.1",
+      "resolved": "https://registry.npmjs.org/update-browserslist-db/-/update-browserslist-db-1.3.1.tgz",
+      "integrity": "sha512-ZZ61DsRsOnakl74HAmp3oSN4aXUmEWXf+i/yv0h7tIBfICc3VdrFErQKUUKPgu3AMsTUMbcongALEN4l6GSUrQ==",
       "dev": true,
       "funding": [
         {
@@ -3912,6 +3827,21 @@
       "dev": true,
       "license": "Apache-2.0"
     },
+    "node_modules/wrap-ansi": {
+      "version": "6.2.0",
+      "resolved": "https://registry.npmjs.org/wrap-ansi/-/wrap-ansi-6.2.0.tgz",
+      "integrity": "sha512-r6lPcBGxZXlIcymEu7InxDMhdW0KDxpLgoFLcguasxCaJ/SOIZwINatK9KY/tf+ZrlywOKU0UDj3ATXUBfxJXA==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "ansi-styles": "^4.0.0",
+        "string-width": "^4.1.0",
+        "strip-ansi": "^6.0.0"
+      },
+      "engines": {
+        "node": ">=8"
+      }
+    },
     "node_modules/write-file-atomic": {
       "version": "3.0.3",
       "resolved": "https://registry.npmjs.org/write-file-atomic/-/write-file-atomic-3.0.3.tgz",
@@ -3953,6 +3883,13 @@
       "integrity": "sha512-8zci48uUQyfqynGDSkUMD7FCJB96hwLnlZOXlgs1l3TX+LW27t3psSWKUxC0fxVgA86i8tL4NwGcY1h/6t3ESg==",
       "license": "ISC"
     },
+    "node_modules/y18n": {
+      "version": "4.0.3",
+      "resolved": "https://registry.npmjs.org/y18n/-/y18n-4.0.3.tgz",
+      "integrity": "sha512-JKhqTOwSrqNA1NY5lSztJ1GrBiUodLMmIZuLiDaMRJ+itFd+ABVE8XBjOvIWL+rSqNDC74LCSFmlb/U4UZ4hJQ==",
+      "dev": true,
+      "license": "ISC"
+    },
     "node_modules/yallist": {
       "version": "3.1.1",
       "resolved": "https://registry.npmjs.org/yallist/-/yallist-3.1.1.tgz",
@@ -3960,6 +3897,99 @@
       "dev": true,
       "license": "ISC"
     },
+    "node_modules/yargs": {
+      "version": "15.4.1",
+      "resolved": "https://registry.npmjs.org/yargs/-/yargs-15.4.1.tgz",
+      "integrity": "sha512-aePbxDmcYW++PaqBsJ+HYUFwCdv4LVvdnhBy78E57PIor8/OVvhMrADFFEDh8DHDFRv/O9i3lPhsENjO7QX0+A==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "cliui": "^6.0.0",
+        "decamelize": "^1.2.0",
+        "find-up": "^4.1.0",
+        "get-caller-file": "^2.0.1",
+        "require-directory": "^2.1.1",
+        "require-main-filename": "^2.0.0",
+        "set-blocking": "^2.0.0",
+        "string-width": "^4.2.0",
+        "which-module": "^2.0.0",
+        "y18n": "^4.0.0",
+        "yargs-parser": "^18.1.2"
+      },
+      "engines": {
+        "node": ">=8"
+      }
+    },
+    "node_modules/yargs-parser": {
+      "version": "18.1.3",
+      "resolved": "https://registry.npmjs.org/yargs-parser/-/yargs-parser-18.1.3.tgz",
+      "integrity": "sha512-o50j0JeToy/4K6OZcaQmW6lyXXKhq7csREXcDwk2omFPJEwUNOVtJKvmDr9EI1fAJZUyZcRF7kxGBWmRXudrCQ==",
+      "dev": true,
+      "license": "ISC",
+      "dependencies": {
+        "camelcase": "^5.0.0",
+        "decamelize": "^1.2.0"
+      },
+      "engines": {
+        "node": ">=6"
+      }
+    },
+    "node_modules/yargs/node_modules/find-up": {
+      "version": "4.1.0",
+      "resolved": "https://registry.npmjs.org/find-up/-/find-up-4.1.0.tgz",
+      "integrity": "sha512-PpOwAdQ/YlXQ2vj8a3h8IipDuYRi3wceVQQGYWxNINccq40Anw7BlsEXCMbt1Zt+OLA6Fq9suIpIWD0OsnISlw==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "locate-path": "^5.0.0",
+        "path-exists": "^4.0.0"
+      },
+      "engines": {
+        "node": ">=8"
+      }
+    },
+    "node_modules/yargs/node_modules/locate-path": {
+      "version": "5.0.0",
+      "resolved": "https://registry.npmjs.org/locate-path/-/locate-path-5.0.0.tgz",
+      "integrity": "sha512-t7hw9pI+WvuwNJXwk5zVHpyhIqzg2qTlklJOf0mVxGSbe3Fp2VieZcduNYjaLDoy6p9uGpQEGWG87WpMKlNq8g==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "p-locate": "^4.1.0"
+      },
+      "engines": {
+        "node": ">=8"
+      }
+    },
+    "node_modules/yargs/node_modules/p-limit": {
+      "version": "2.3.0",
+      "resolved": "https://registry.npmjs.org/p-limit/-/p-limit-2.3.0.tgz",
+      "integrity": "sha512-//88mFWSJx8lxCzwdAABTJL2MyWB12+eIY7MDL2SqLmAkeKU9qxRvWuSyTjm3FUmpBEMuFfckAIqEaVGUDxb6w==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "p-try": "^2.0.0"
+      },
+      "engines": {
+        "node": ">=6"
+      },
+      "funding": {
+        "url": "https://github.com/sponsors/sindresorhus"
+      }
+    },
+    "node_modules/yargs/node_modules/p-locate": {
+      "version": "4.1.0",
+      "resolved": "https://registry.npmjs.org/p-locate/-/p-locate-4.1.0.tgz",
+      "integrity": "sha512-R79ZZ/0wAxKGu3oYMlz8jy/kbhsNrS7SKZ7PxEHBgJ5+F2mtFW2fK2cOtBh1cHYkQsbzFV7I+EoRKe6Yt0oK7A==",
+      "dev": true,
+      "license": "MIT",
+      "dependencies": {
+        "p-limit": "^2.2.0"
+      },
+      "engines": {
+        "node": ">=8"
+      }
+    },
     "node_modules/yocto-queue": {
       "version": "0.1.0",
       "resolved": "https://registry.npmjs.org/yocto-queue/-/yocto-queue-0.1.0.tgz",

From ffc8949637027564f983acaa279d96a424430848 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 25 Aug 2026 11:30:34 -0400
Subject: [PATCH 06/62] Skip interval expand tests for now

---
 src/elm/interval.ts                | 10 ----------
 test/elm/interval/interval-test.ts | 20 ++++++++++++++++++--
 2 files changed, 18 insertions(+), 12 deletions(-)

diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index 234d2ae4a..c3c4922d2 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -707,16 +707,6 @@ export class Expand extends Expression {
 
     const perUnitSize = perIsIntegral ? 1 : 0.00000001;
 
-    // TODO: this supports one test case but it's not clear if the test case is correct
-    // if (
-    //   low === high &&
-    //   Number.isInteger(low) &&
-    //   Number.isInteger(high) &&
-    //   !Number.isInteger(perValue)
-    // ) {
-    //   high = parseFloat((high + 1).toFixed(decimalPrecision));
-    // }
-
     let current_low = low;
     const results = [];
 
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 791b951d9..4a1660041 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -3599,7 +3599,15 @@ describe('IntegerIntervalExpand', () => {
     should.not.exist(a);
   });
 
-  it('produces a more precise value for output intervals', async function () {
+  it.skip('produces a more precise value for output intervals', async function () {
+    // This example from the spec is incorrect.
+    // Skip for now until we have more clarity on what the expected result should be
+    // https://jira.hl7.org/browse/FHIR-58705 and
+    // https://chat.fhir.org/#narrow/channel/179220-cql/topic/Interval.20Expand.20example/with/619051021
+    // Note that as of this writing the produced result is { } (empty list)
+    // which I believe is the correct result.
+    // But an empty list doesn't clearly show the intent of the test.
+
     // define PerDecimalMorePrecise: expand { Interval[10, 10] } per 0.1
     const a = await this.perDecimalMorePrecise.exec(this.ctx);
     // JavaScript truncates 10.0 to 10.
@@ -3673,7 +3681,15 @@ describe('LongIntervalExpand', () => {
     should.not.exist(a);
   });
 
-  it('produces a more precise value for output intervals', async function () {
+  it.skip('produces a more precise value for output intervals', async function () {
+    // This example from the spec is incorrect.
+    // Skip for now until we have more clarity on what the expected result should be
+    // https://jira.hl7.org/browse/FHIR-58705 and
+    // https://chat.fhir.org/#narrow/channel/179220-cql/topic/Interval.20Expand.20example/with/619051021
+    // Note that as of this writing the produced result is { } (empty list)
+    // which I believe is the correct result.
+    // But an empty list doesn't clearly show the intent of the test.
+
     const a = await this.longPerDecimalMorePrecise.exec(this.ctx);
     prettyList(a).should.equal(
       '{ [10, 10.09999999], [10.1, 10.19999999], [10.2, 10.29999999], [10.3, 10.39999999], [10.4, 10.49999999], [10.5, 10.59999999], [10.6, 10.69999999], [10.7, 10.79999999], [10.8, 10.89999999], [10.9, 10.99999999] }'

From fbc1f989c8edb22eedd3e59631c6f3ca850c4d70 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 25 Aug 2026 12:51:43 -0400
Subject: [PATCH 07/62] fix test-server

---
 src/cql.ts                                 |  3 +++
 test-server/src/convert/convert.ts         | 14 ++++++++++----
 test-server/src/convert/cqlTypes.ts        |  8 ++++----
 test-server/tests/convert/convert.test.ts  |  5 +++--
 test-server/tests/convert/cqlTypes.test.ts |  7 ++++---
 5 files changed, 24 insertions(+), 13 deletions(-)

diff --git a/src/cql.ts b/src/cql.ts
index 33d47d829..e76b08e9f 100644
--- a/src/cql.ts
+++ b/src/cql.ts
@@ -22,6 +22,7 @@ import {
   Concept,
   Date,
   DateTime,
+  Decimal,
   Interval,
   Quantity,
   Ratio,
@@ -54,6 +55,7 @@ export {
   Concept,
   Date,
   DateTime,
+  Decimal,
   Interval,
   Quantity,
   Ratio,
@@ -81,6 +83,7 @@ export default {
   Concept,
   Date,
   DateTime,
+  Decimal,
   Interval,
   Quantity,
   Ratio,
diff --git a/test-server/src/convert/convert.ts b/test-server/src/convert/convert.ts
index e74fc54ad..412d22b50 100644
--- a/test-server/src/convert/convert.ts
+++ b/test-server/src/convert/convert.ts
@@ -15,6 +15,7 @@ import {
   Concept,
   Date as CqlDate,
   DateTime as CqlDateTime,
+  Decimal as CqlDecimal,
   Quantity as CqlQuantity,
   Ratio as CqlRatio,
   Interval,
@@ -170,9 +171,9 @@ function toLongParameter(name: string, result: number): ParametersParameter {
   return { name, valueString: String(result) };
 }
 
-function toDecimalParameter(name: string, result: number): ParametersParameter {
+function toDecimalParameter(name: string, result: CqlDecimal | number): ParametersParameter {
   // TODO: use the quantity-precision extension to communicate precision of the value
-  return { name, valueDecimal: result };
+  return { name, valueDecimal: result instanceof CqlDecimal ? result.toNumber() : result };
 }
 
 function toDateParameter(name: string, result: CqlDate) {
@@ -302,15 +303,20 @@ function toChoiceParameter(name: string, result: any, typeSpecifier: AnyTypeSpec
   return { name };
 }
 
-function toFhirQuantity(val: CqlQuantity | number, isIntegerOrLong = false): FhirQuantity {
+function toFhirQuantity(
+  val: CqlQuantity | CqlDecimal | number,
+  isIntegerOrLong = false
+): FhirQuantity {
   let fq: FhirQuantity;
   if (typeof val === 'number') {
     fq = { value: val, system: 'http://unitsofmeasure.org', code: '1' };
   } else if (typeof val === 'bigint') {
     fq = { value: Number(val), system: 'http://unitsofmeasure.org', code: '1' };
+  } else if (val instanceof CqlDecimal) {
+    fq = { value: val.toNumber(), system: 'http://unitsofmeasure.org', code: '1' };
   } else {
     const cq = val as CqlQuantity;
-    fq = { value: cq.value } as FhirQuantity;
+    fq = { value: cq.value.toNumber() };
     if (cq.unit != null) {
       fq.unit = fq.code = cq.unit;
       if (
diff --git a/test-server/src/convert/cqlTypes.ts b/test-server/src/convert/cqlTypes.ts
index dfdba0fae..ebc895803 100644
--- a/test-server/src/convert/cqlTypes.ts
+++ b/test-server/src/convert/cqlTypes.ts
@@ -6,6 +6,7 @@ import {
   TupleTypeSpecifier,
   TupleElementDefinition,
   AnyTypeSpecifier,
+  Decimal,
   Interval
 } from '../../..';
 import { ELM_ANY_TYPE } from '../../../lib/util/elmTypes';
@@ -60,11 +61,10 @@ export function guessSpecifierType(val: any): AnyTypeSpecifier | undefined {
     return typeHierarchy[0];
   } else if (typeof val === 'boolean') {
     return { type: 'NamedTypeSpecifier', name: '{urn:hl7-org:elm-types:r1}Boolean' };
-  } else if (typeof val === 'number' && Math.floor(val) === val) {
-    // It could still be a decimal, but we have to just take our best guess!
-    return { type: 'NamedTypeSpecifier', name: '{urn:hl7-org:elm-types:r1}Integer' };
-  } else if (typeof val === 'number') {
+  } else if (val instanceof Decimal) {
     return { type: 'NamedTypeSpecifier', name: '{urn:hl7-org:elm-types:r1}Decimal' };
+  } else if (typeof val === 'number') {
+    return { type: 'NamedTypeSpecifier', name: '{urn:hl7-org:elm-types:r1}Integer' };
   } else if (typeof val === 'string') {
     return { type: 'NamedTypeSpecifier', name: '{urn:hl7-org:elm-types:r1}String' };
   } else if (val.isConcept) {
diff --git a/test-server/tests/convert/convert.test.ts b/test-server/tests/convert/convert.test.ts
index a4cdf96c6..0cdcc5161 100644
--- a/test-server/tests/convert/convert.test.ts
+++ b/test-server/tests/convert/convert.test.ts
@@ -6,6 +6,7 @@ import {
   Concept,
   Date as CqlDate,
   DateTime,
+  Decimal,
   Interval,
   IntervalTypeSpecifier,
   ListTypeSpecifier,
@@ -66,7 +67,7 @@ describe('convert.toParameters', () => {
     });
 
     it('converts decimal to valueDecimal', () => {
-      expect(toParameters(3.14159, 'System.Decimal')).toEqual({
+      expect(toParameters(Decimal.from('3.14159'), 'System.Decimal')).toEqual({
         resourceType: 'Parameters',
         parameter: [
           { extension: cqlTypeExt('System.Decimal'), name: 'return', valueDecimal: 3.14159 }
@@ -686,7 +687,7 @@ describe('convert.toParameters', () => {
     });
 
     it('guesses type when no type is passed in and converts value (Decimal example)', () => {
-      expect(toParameters(1.25)).toEqual({
+      expect(toParameters(Decimal.from('1.25'))).toEqual({
         resourceType: 'Parameters',
         parameter: [
           {
diff --git a/test-server/tests/convert/cqlTypes.test.ts b/test-server/tests/convert/cqlTypes.test.ts
index 5c8ec76df..7a9dcdb8c 100644
--- a/test-server/tests/convert/cqlTypes.test.ts
+++ b/test-server/tests/convert/cqlTypes.test.ts
@@ -11,6 +11,7 @@ import {
   Concept,
   Date as CqlDate,
   DateTime,
+  Decimal,
   Interval,
   IntervalTypeSpecifier,
   ListTypeSpecifier,
@@ -137,7 +138,7 @@ describe('guessSpecifierType', () => {
       type: 'NamedTypeSpecifier',
       name: '{urn:hl7-org:elm-types:r1}Integer'
     } as NamedTypeSpecifier);
-    expect(guessSpecifierType(3.14)).toEqual({
+    expect(guessSpecifierType(Decimal.from('3.14'))).toEqual({
       type: 'NamedTypeSpecifier',
       name: '{urn:hl7-org:elm-types:r1}Decimal'
     } as NamedTypeSpecifier);
@@ -178,7 +179,7 @@ describe('guessSpecifierType', () => {
   });
 
   it('returns the correct type for Uncertainty values', () => {
-    const spec = guessSpecifierType(new Uncertainty(1.5, 2.5))!;
+    const spec = guessSpecifierType(new Uncertainty(Decimal.from(1.5), Decimal.from(2.5)))!;
     expect(spec).toEqual({
       type: 'NamedTypeSpecifier',
       name: '{urn:hl7-org:elm-types:r1}Decimal'
@@ -194,7 +195,7 @@ describe('guessSpecifierType', () => {
   });
 
   it('returns ListTypeSpecifier with Choice for arrays with mixed types', () => {
-    const spec = guessSpecifierType([1, 2.5, true])!;
+    const spec = guessSpecifierType([1, Decimal.from(2.5), true])!;
     expect(spec).toEqual({
       type: 'ListTypeSpecifier',
       elementType: {

From fdf0c52457b813943d226ef044b22b754c1932d6 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 11:53:34 -0400
Subject: [PATCH 08/62] clean up some TODOs

---
 src/datatypes/decimal.ts               | 12 +++---
 src/datatypes/interval.ts              | 11 +----
 src/datatypes/quantity.ts              |  5 +--
 src/elm/aggregate.ts                   | 24 +++++++----
 src/elm/arithmetic.ts                  | 59 +++++++++++---------------
 src/elm/interval.ts                    | 50 +++++++++++++---------
 src/util/math.ts                       | 36 ++++++++--------
 test/elm/arithmetic/arithmetic-test.ts |  5 +--
 8 files changed, 99 insertions(+), 103 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 8e77a9e38..53c6b66e5 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -9,7 +9,7 @@ export type DecimalInput = Decimal | string | number | bigint;
 
 export type DecimalRoundingMode = DecimalJS.Rounding;
 
-const MIN_FLOAT_PRECISION_VALUE = DecimalJS.pow(10, -8);
+const MIN_PRECISION_VALUE = DecimalJS.pow(10, -8);
 
 const CQL_IMPLICIT_SCALE = 8;
 const CQL_IMPLICIT_ROUNDING = DecimalJS.ROUND_HALF_UP;
@@ -43,6 +43,8 @@ export class Decimal {
     return this.setScale(CQL_IMPLICIT_SCALE, CQL_IMPLICIT_ROUNDING);
   }
 
+  // Helper function to reduce repeated boilerplate.
+  // Apply the given function with the given operand, and wrap the result in a Decimal.
   private applyWrapper(operation: (value: any) => DecimalJS, other: DecimalInput): Decimal {
     const operand = other instanceof Decimal ? other.value : other;
 
@@ -104,11 +106,11 @@ export class Decimal {
   }
 
   successor() {
-    return new Decimal(this.value.add(MIN_FLOAT_PRECISION_VALUE));
+    return new Decimal(this.value.add(MIN_PRECISION_VALUE));
   }
 
   predecessor() {
-    return new Decimal(this.value.minus(MIN_FLOAT_PRECISION_VALUE));
+    return new Decimal(this.value.minus(MIN_PRECISION_VALUE));
   }
 
   negate() {
@@ -186,8 +188,8 @@ export class Decimal {
   }
 
   toLong() {
-    // TODO
-    return BigInt(this.toString());
+    // note that this is permissive and converts non-integral values
+    return BigInt(this.value.truncated().toString());
   }
 
   toString() {
diff --git a/src/datatypes/interval.ts b/src/datatypes/interval.ts
index 06045d031..2ec03243e 100644
--- a/src/datatypes/interval.ts
+++ b/src/datatypes/interval.ts
@@ -21,7 +21,6 @@ import {
   ELM_ANY_TYPE
 } from '../util/elmTypes';
 import { Quantity } from './quantity';
-import { Decimal, MIN_DECIMAL_VALUE } from './decimal';
 
 export class Interval {
   constructor(
@@ -703,15 +702,7 @@ export class Interval {
   // https://cql.hl7.org/R2/09-b-cqlreference.html#size
   getPointSize() {
     // "... point-size is determined by successor of minimum T - minimum T"
-    let minValue = minValueForType(this.pointType, getQuantityInstanceForMinMax(this));
-
-    // due to floating point issues in JS, we must use 0.0 for Decimal/Quantity instead of min
-    // TODO: remove this when changing to decimal.js
-    if (minValue === MIN_DECIMAL_VALUE) {
-      minValue = Decimal.from(0.0);
-    } else if ((minValue as any)?.isQuantity) {
-      minValue = new Quantity(0.0, (minValue as Quantity)?.unit);
-    }
+    const minValue = minValueForType(this.pointType, getQuantityInstanceForMinMax(this));
 
     if (minValue != null) {
       if ((minValue as any).isDate || (minValue as any).isDatetime || (minValue as any).isTime) {
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index d62110136..190cc1e4e 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -1,4 +1,3 @@
-import { ELM_DECIMAL_TYPE } from '../util/elmTypes';
 import { add, subtract, isValidDecimal, overflowsOrUnderflows } from '../util/math';
 import { Decimal } from './decimal';
 import {
@@ -135,7 +134,7 @@ export class Quantity {
     const resultUnit = getQuotientOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
-    if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
+    if (resultUnit == null || overflowsOrUnderflows(resultValue)) {
       return null;
     }
     return new Quantity(resultValue, resultUnit);
@@ -159,7 +158,7 @@ export class Quantity {
     const resultUnit = getProductOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
-    if (resultUnit == null || overflowsOrUnderflows(resultValue, ELM_DECIMAL_TYPE)) {
+    if (resultUnit == null || overflowsOrUnderflows(resultValue)) {
       return null;
     }
     return new Quantity(resultValue, resultUnit);
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 56ec1c620..7d233f2ed 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -7,7 +7,6 @@ import { Exception } from '../datatypes/exception';
 import { greaterThan, lessThan } from '../util/comparison';
 import { build } from './builder';
 import { overflowsOrUnderflows, finalizeNumericResult } from '../util/math';
-import { ELM_DECIMAL_TYPE } from '../util/elmTypes';
 
 class AggregateExpression extends Expression {
   source: any;
@@ -55,7 +54,7 @@ export class Sum extends AggregateExpression {
 
     if (hasOnlyQuantities(items)) {
       const sum = sumOfDecimals(getValuesFromQuantities(items));
-      return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : new Quantity(sum, items[0].unit);
+      return overflowsOrUnderflows(sum) ? null : new Quantity(sum, items[0].unit);
     } else {
       let sum;
       if (hasDecimals(items)) {
@@ -64,7 +63,7 @@ export class Sum extends AggregateExpression {
         sum = items.reduce((x: any, y: any) => x + y);
       }
       sum = finalizeNumericResult(sum);
-      return overflowsOrUnderflows(sum, this.resultTypeName) ? null : sum;
+      return overflowsOrUnderflows(sum) ? null : sum;
     }
   }
 }
@@ -290,10 +289,13 @@ export class StdDev extends AggregateExpression {
     if (hasOnlyQuantities(items)) {
       const values = getValuesFromQuantities(items);
       const stdDev = this.standardDeviation(values);
+      if (stdDev === null) {
+        return null;
+      }
       return new Quantity(stdDev, items[0].unit);
     } else {
       const standardDeviation = this.standardDeviation(items.map(Decimal.from));
-      return standardDeviation?.normalized(); // TODO: review function signatures. always return Decimal makes sense but is it correct?
+      return standardDeviation?.normalized();
     }
   }
 
@@ -305,6 +307,14 @@ export class StdDev extends AggregateExpression {
   }
 
   stats(list: Decimal[]) {
+    if (list.length === 1) {
+      return {
+        standard_variance: null,
+        population_variance: Decimal.from(0),
+        standard_deviation: null,
+        population_deviation: Decimal.from(0)
+      };
+    }
     const sum = list.reduce((x, y) => x.add(y), Decimal.from(0));
     const mean = sum.divideBy(list.length);
 
@@ -349,9 +359,7 @@ export class Product extends AggregateExpression {
     if (hasOnlyQuantities(items)) {
       const product = productOfDecimals(getValuesFromQuantities(items));
       // Units are not multiplied for the geometric product
-      return overflowsOrUnderflows(product, ELM_DECIMAL_TYPE)
-        ? null
-        : new Quantity(product, items[0].unit);
+      return overflowsOrUnderflows(product) ? null : new Quantity(product, items[0].unit);
     } else {
       let result;
       if (hasDecimals(items)) {
@@ -360,7 +368,7 @@ export class Product extends AggregateExpression {
         result = items.reduce((x: number, y: number) => x * y);
       }
       result = finalizeNumericResult(result);
-      return overflowsOrUnderflows(result, this.resultTypeName) ? null : result;
+      return overflowsOrUnderflows(result) ? null : result;
     }
   }
 }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index 3b3170384..72f00c8be 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -91,7 +91,7 @@ export class Multiply extends Expression {
       product = MathUtil.multiply(x, y);
     }
 
-    if (MathUtil.overflowsOrUnderflows(product, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(product)) {
       return null;
     }
 
@@ -123,7 +123,6 @@ export class Divide extends Expression {
         quotient = doDivision(x, y);
       } else if (x.isUncertainty && y.isUncertainty) {
         let low, high;
-        // TODO change this section back
         if (x.low.isQuantity) {
           low = doDivision(x.low, y.high);
           high = doDivision(x.high, y.low);
@@ -140,7 +139,7 @@ export class Divide extends Expression {
       return null;
     }
 
-    if (MathUtil.overflowsOrUnderflows(quotient, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(quotient)) {
       return null;
     }
     return MathUtil.finalizeNumericResult(quotient, this.resultTypeName);
@@ -177,7 +176,7 @@ export class TruncatedDivide extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(quotient, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(quotient)) {
       return null;
     }
     return quotient;
@@ -265,19 +264,13 @@ export class Abs extends Expression {
       return new Quantity(arg.value.abs(), arg.unit);
     } else if (typeof arg === 'bigint') {
       const absoluteValue = arg < 0n ? -arg : arg;
-      return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
-        ? null
-        : absoluteValue;
+      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
     } else if (arg.isDecimal) {
       const absoluteValue = arg.abs();
-      return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
-        ? null
-        : absoluteValue;
+      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
     } else {
       const absoluteValue = Math.abs(arg);
-      return MathUtil.overflowsOrUnderflows(absoluteValue, this.resultTypeName)
-        ? null
-        : absoluteValue;
+      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
     }
   }
 }
@@ -295,19 +288,13 @@ export class Negate extends Expression {
       return new Quantity(arg.value.negate(), arg.unit);
     } else if (typeof arg === 'bigint') {
       const negatedValue = arg * -1n;
-      return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
-        ? null
-        : negatedValue;
+      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
     } else if (arg.isDecimal) {
       const negatedValue = arg.negate();
-      return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
-        ? null
-        : negatedValue;
+      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
     } else {
       const negatedValue = arg * -1;
-      return MathUtil.overflowsOrUnderflows(negatedValue, this.resultTypeName)
-        ? null
-        : negatedValue;
+      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
     }
   }
 }
@@ -343,8 +330,11 @@ export class Ln extends Expression {
     }
 
     try {
-      const ln = Decimal.from(arg).ln().normalized();
-      return MathUtil.decimalOrNull(ln);
+      const ln = Decimal.from(arg).ln();
+      if (MathUtil.overflowsOrUnderflows(ln)) {
+        return null;
+      }
+      return MathUtil.finalizeNumericResult(ln);
     } catch {
       return null;
     }
@@ -369,10 +359,10 @@ export class Exp extends Expression {
       return null;
     }
 
-    if (MathUtil.overflowsOrUnderflows(power, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(power)) {
       return null;
     }
-    return power;
+    return MathUtil.finalizeNumericResult(power);
   }
 }
 
@@ -389,7 +379,7 @@ export class Log extends Expression {
 
     try {
       const log = Decimal.from(args[0]).log(args[1]);
-      return MathUtil.decimalOrNull(log);
+      return MathUtil.finalizeNumericResult(log);
     } catch {
       return null;
     }
@@ -406,14 +396,13 @@ export class Power extends Expression {
     if (args == null || args.some((x: any) => x == null)) {
       return null;
     }
-    // TODO: cql spec shows the return type is always Decimal, but that's not true
-    const [x, y] = args;
-    const power = doPower(x, y);
 
-    // Note: The resultTypeName may be wrong if the exponent is a negative number. Math.overflowsOrUnderflows
-    // already accounts for this possibility by only considering it an integer if Number.isInteger(value).
+    // Note: The resultTypeName may be wrong if the exponent is a negative number.
     // E.g., CQL-to-ELM says 10^-1 is an Integer result type, but the correct result is a 0.1 (a Decimal)
-    if (MathUtil.overflowsOrUnderflows(power, this.resultTypeName)) {
+    // doPower handles this scenario
+    const power = doPower(args[0], args[1]);
+
+    if (MathUtil.overflowsOrUnderflows(power)) {
       return null;
     }
     return power;
@@ -525,7 +514,7 @@ export class Successor extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(successor, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(successor)) {
       return null;
     }
     return successor;
@@ -554,7 +543,7 @@ export class Predecessor extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(predecessor, this.resultTypeName)) {
+    if (MathUtil.overflowsOrUnderflows(predecessor)) {
       return null;
     }
     return predecessor;
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index c3c4922d2..b48b26775 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -2,7 +2,7 @@ import { Expression } from './expression';
 import { MAX_DATETIME_VALUE, MIN_DATETIME_VALUE } from '../datatypes/datetime';
 import { Quantity } from '../datatypes/quantity';
 import { add, successor, predecessor, subtract } from '../util/math';
-import { greaterThan, lessThan, lessThanOrEquals } from '../util/comparison';
+import { greaterThan, lessThan } from '../util/comparison';
 import { convertUnit, compareUnits, convertToCQLDateUnit } from '../util/units';
 import * as dtivl from '../datatypes/interval';
 import { Context } from '../runtime/context';
@@ -10,6 +10,7 @@ import { build } from './builder';
 import { IntervalTypeSpecifier, NamedTypeSpecifier } from '../types/type-specifiers.interfaces';
 import { ELM_ANY_TYPE, ELM_NAMED_TYPE_SPECIFIER } from '../util/elmTypes';
 import { Decimal } from '../datatypes/decimal';
+import { MAX_INT_VALUE, MIN_INT_VALUE } from '../util/limits';
 
 export class Interval extends Expression {
   lowClosed: boolean;
@@ -670,27 +671,38 @@ export class Expand extends Expression {
     const decimalPrecision = perIsIntegral ? 0 : 8;
 
     // For the purposes of this function, we'll perform all the arithmetic using Decimals,
-    // then convert the results back to the required type if necessary
-    let makeInterval: (l: Decimal, h: Decimal) => dtivl.Interval;
+    // then convert the results back to the required type as necessary
+    const origLow = low;
+    const origHigh = high;
+
+    low = Decimal.from(low);
+    high = Decimal.from(high);
+
+    let convertBound: (d: Decimal) => Decimal | number | bigint = d => d.toInteger();
     if (!perIsIntegral) {
       // If per is not an integer value, then regardless of the original point types, the values will be Decimals
-      makeInterval = (l: Decimal, h: Decimal) => new dtivl.Interval(l, h, true, true);
-    } else if (typeof low === 'bigint' || typeof high === 'bigint') {
-      makeInterval = (l: Decimal, h: Decimal) =>
-        new dtivl.Interval(l.toLong(), h.toLong(), true, true);
-    } else if (typeof low === 'number' || typeof high === 'number') {
-      makeInterval = (l: Decimal, h: Decimal) =>
-        new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
+      convertBound = d => d;
+    } else if (typeof origLow === 'bigint' || typeof origHigh === 'bigint') {
+      convertBound = d => d.toLong();
+    } else if (typeof origLow === 'number' || typeof origHigh === 'number') {
+      convertBound = d => d.toInteger();
     } else {
       // per is an integer but the original bounds of the interval were Decimal.
-      // TODO: for now just make them integers
-      makeInterval = (l: Decimal, h: Decimal) =>
-        new dtivl.Interval(l.toInteger(), h.toInteger(), true, true);
+      // Make the resulting intervals either Long or Integer based on the original bounds.
+      if (
+        low.lessThan(MIN_INT_VALUE) ||
+        low.greaterThan(MAX_INT_VALUE) ||
+        high.lessThan(MIN_INT_VALUE) ||
+        high.greaterThan(MAX_INT_VALUE)
+      ) {
+        convertBound = d => d.toLong();
+      } else {
+        convertBound = d => d.toInteger();
+      }
     }
 
-    // treat everything as a Decimal, convert back later if needed
-    low = Decimal.from(low);
-    high = Decimal.from(high);
+    const makeInterval = (l: Decimal, h: Decimal) =>
+      new dtivl.Interval(convertBound(l), convertBound(h), true, true);
 
     // If the interval boundaries are more precise than the per quantity, the
     // more precise values will be truncated to the precision specified by the
@@ -842,11 +854,7 @@ function collapseIntervals(intervals: any, perWidth: any) {
         }
       } else {
         const distance = subtract(b.low, a.high);
-        // TODO: perWidth.value is a Decimal, but distance could be anything
-        // lessThanOrEquals requires that its args be the same type
-        // so I guess for now, make distance a Decimal
-        const distanceDecimal = Decimal.from(distance);
-        const withinPerWidth = lessThanOrEquals(distanceDecimal, perWidth.value);
+        const withinPerWidth = perWidth.value.greaterThanOrEquals(distance);
         if (withinPerWidth) {
           if (greaterThan(b.high, a.high) || b.high == null) {
             a.high = b.high;
diff --git a/src/util/math.ts b/src/util/math.ts
index 62216c002..06d9dcb4f 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -24,7 +24,7 @@ import {
 import { MAX_INT_VALUE, MAX_LONG_VALUE, MIN_INT_VALUE, MIN_LONG_VALUE } from './limits';
 import { convertToCQLDateUnit, normalizeUnitsWhenPossible } from './units';
 
-export function overflowsOrUnderflows(value: any, type?: string): boolean {
+export function overflowsOrUnderflows(value: any): boolean {
   if (value == null) {
     return false;
   }
@@ -66,7 +66,7 @@ export function overflowsOrUnderflows(value: any, type?: string): boolean {
       return true;
     }
   } else if (value.isUncertainty) {
-    return overflowsOrUnderflows(value.low, type) || overflowsOrUnderflows(value.high, type);
+    return overflowsOrUnderflows(value.low) || overflowsOrUnderflows(value.high);
   }
   return false;
 }
@@ -126,15 +126,15 @@ export function add(a: any, b: any, type?: string): any {
 
   if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
     const sum = Decimal.from(a).add(Decimal.from(b));
-    return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : sum;
+    return overflowsOrUnderflows(sum) ? null : sum;
   }
   if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
     const sum = BigInt(a) + BigInt(b);
-    return overflowsOrUnderflows(sum, ELM_LONG_TYPE) ? null : sum;
+    return overflowsOrUnderflows(sum) ? null : sum;
   }
   if (typeof a === 'number' && typeof b === 'number') {
     const sum = a + b;
-    return overflowsOrUnderflows(sum, ELM_INTEGER_TYPE) ? null : sum;
+    return overflowsOrUnderflows(sum) ? null : sum;
   }
   if (a?.isQuantity && b?.isQuantity) {
     const [aValue, aUnit, bValue, bUnit] = normalizeUnitsWhenPossible(
@@ -147,7 +147,7 @@ export function add(a: any, b: any, type?: string): any {
       return null;
     }
     const sum = aValue.add(bValue);
-    return overflowsOrUnderflows(sum, ELM_DECIMAL_TYPE) ? null : new Quantity(sum, aUnit);
+    return overflowsOrUnderflows(sum) ? null : new Quantity(sum, aUnit);
   }
   if (b?.isQuantity && (a?.isDate || a?.isDateTime || (a?.isTime && a.isTime()))) {
     const unit = convertToCQLDateUnit(b.unit) || b.unit;
@@ -188,15 +188,15 @@ export function subtract(a: any, b: any, type?: string): any {
 export function multiply(a: any, b: any, type?: string) {
   if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
     const product = Decimal.from(a).multiplyBy(b);
-    return overflowsOrUnderflows(product, ELM_DECIMAL_TYPE) ? null : product;
+    return overflowsOrUnderflows(product) ? null : product;
   }
   if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
     const product = BigInt(a) * BigInt(b);
-    return overflowsOrUnderflows(product, ELM_LONG_TYPE) ? null : product;
+    return overflowsOrUnderflows(product) ? null : product;
   }
   if (typeof a === 'number' && typeof b === 'number') {
     const product = a * b;
-    return overflowsOrUnderflows(product, ELM_INTEGER_TYPE) ? null : product;
+    return overflowsOrUnderflows(product) ? null : product;
   }
 
   throw new Error('Unsupported argument types.');
@@ -209,7 +209,7 @@ export function divide(a: any, b: any, type?: string) {
       return null;
     }
     const quotient = Decimal.from(a).divideBy(b);
-    return overflowsOrUnderflows(quotient, ELM_DECIMAL_TYPE) ? null : quotient;
+    return overflowsOrUnderflows(quotient) ? null : quotient;
   }
   if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
     if (b === 0 || b === 0n) {
@@ -217,7 +217,7 @@ export function divide(a: any, b: any, type?: string) {
     }
     // BigInt division is inherently truncated, eg 10n / 3n = 3n
     const quotient = BigInt(a) / BigInt(b);
-    return overflowsOrUnderflows(quotient, ELM_LONG_TYPE) ? null : quotient;
+    return overflowsOrUnderflows(quotient) ? null : quotient;
   }
   if (typeof a === 'number' && typeof b === 'number') {
     if (b === 0) {
@@ -225,7 +225,7 @@ export function divide(a: any, b: any, type?: string) {
     }
     // here we need to truncate manually to ensure the value is an integer
     const quotient = Math.trunc(a / b);
-    return overflowsOrUnderflows(quotient, ELM_INTEGER_TYPE) ? null : quotient;
+    return overflowsOrUnderflows(quotient) ? null : quotient;
   }
 
   throw new Error('Unsupported argument types.');
@@ -254,7 +254,7 @@ export function limitDecimalPrecision<
 
 export class OverFlowException extends Exception {}
 
-export function successor(val: any, type?: string, precision?: string): any {
+export function successor(val: any, _type?: string, precision?: string): any {
   if (typeof val === 'number') {
     if (val >= MAX_INT_VALUE) {
       throw new OverFlowException();
@@ -295,12 +295,12 @@ export function successor(val: any, type?: string, precision?: string): any {
     // For uncertainties, if the high is the max val, don't increment it
     const high = (() => {
       try {
-        return successor(val.high, type, precision);
+        return successor(val.high, undefined, precision);
       } catch {
         return val.high;
       }
     })();
-    return new Uncertainty(successor(val.low, type, precision), high);
+    return new Uncertainty(successor(val.low, undefined, precision), high);
   } else if (val && val.isQuantity) {
     const succ = val.clone();
     succ.value = successor(val.value, ELM_DECIMAL_TYPE);
@@ -310,7 +310,7 @@ export function successor(val: any, type?: string, precision?: string): any {
   }
 }
 
-export function predecessor(val: any, type?: string, precision?: string): any {
+export function predecessor(val: any, _type?: string, precision?: string): any {
   if (typeof val === 'number') {
     if (val <= MIN_INT_VALUE) {
       throw new OverFlowException();
@@ -351,12 +351,12 @@ export function predecessor(val: any, type?: string, precision?: string): any {
     // For uncertainties, if the low is the min val, don't decrement it
     const low = ((): any => {
       try {
-        return predecessor(val.low, type, precision);
+        return predecessor(val.low, undefined, precision);
       } catch {
         return val.low;
       }
     })();
-    return new Uncertainty(low, predecessor(val.high, type, precision));
+    return new Uncertainty(low, predecessor(val.high, undefined, precision));
   } else if (val && val.isQuantity) {
     const pred = val.clone();
     pred.value = predecessor(val.value, ELM_DECIMAL_TYPE);
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 1671c64c5..b05c6b580 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -345,9 +345,8 @@ describe('Power', () => {
     should(await this.twoLongExpMaxLong.exec(this.ctx)).be.null();
   });
 
-  // TODO: Unskip this test when we properly handle negative Long exponents that can't be safely converted to Number
-  it.skip('should return an infinitesimally small number when the exponent is the minimum Long value', async function () {
-    (await this.twoLongExpMinLong.exec(this.ctx)).should.be(0.0);
+  it('should return an infinitesimally small number when the exponent is the minimum Long value', async function () {
+    (await this.twoLongExpMinLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.0));
   });
 });
 

From d66fad57286a42ae8935c99c4f4171d9353ee101 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 11:57:21 -0400
Subject: [PATCH 09/62] remove now-unnecessary param in successor/predecessor

---
 src/datatypes/interval.ts | 21 +++++++++------------
 src/elm/arithmetic.ts     |  4 ++--
 src/util/math.ts          | 16 ++++++++--------
 test/util/math-test.ts    | 19 ++++++-------------
 4 files changed, 25 insertions(+), 35 deletions(-)

diff --git a/src/datatypes/interval.ts b/src/datatypes/interval.ts
index 2ec03243e..120b0b31d 100644
--- a/src/datatypes/interval.ts
+++ b/src/datatypes/interval.ts
@@ -518,10 +518,10 @@ export class Interval {
         this.pointType === ELM_DATETIME_TYPE ||
         this.pointType === ELM_TIME_TYPE
       ) {
-        return this.start()?.sameAs(successor(other.end(), other.pointType, precision), precision);
+        return this.start()?.sameAs(successor(other.end(), precision), precision);
       }
 
-      return cmp.equals(this.start(), successor(other.end(), other.pointType));
+      return cmp.equals(this.start(), successor(other.end()));
     } catch {
       return false;
     }
@@ -543,13 +543,10 @@ export class Interval {
         this.pointType === ELM_DATETIME_TYPE ||
         this.pointType === ELM_TIME_TYPE
       ) {
-        return this.end()?.sameAs(
-          predecessor(other.start(), other.pointType, precision),
-          precision
-        );
+        return this.end()?.sameAs(predecessor(other.start(), precision), precision);
       }
 
-      return cmp.equals(this.end(), predecessor(other.start(), other.pointType));
+      return cmp.equals(this.end(), predecessor(other.start()));
     } catch {
       return false;
     }
@@ -577,7 +574,7 @@ export class Interval {
     // "If the low boundary of the interval is closed and non-null, this operator returns the low
     // value of the interval... If the low boundary of the interval is open and non-null, this
     // operator returns the successor of the low value of the interval."
-    return this.lowClosed ? this.low : successor(this.low, this.pointType);
+    return this.lowClosed ? this.low : successor(this.low);
   }
 
   // https://cql.hl7.org/R2/09-b-cqlreference.html#end
@@ -602,7 +599,7 @@ export class Interval {
     // "If the high boundary of the interval is closed and non-null, this operator returns the high
     // value of the interval... If the high boundary of the interval is open and non-null, this
     // operator returns the predecessor of the high value of the interval."
-    return this.highClosed ? this.high : predecessor(this.high, this.pointType);
+    return this.highClosed ? this.high : predecessor(this.high);
   }
 
   // https://cql.hl7.org/R2/09-b-cqlreference.html#starts
@@ -712,7 +709,7 @@ export class Interval {
         // E.g., point size of Interval[@2012-01, @2012-12] is 1 month, not 1 ms.
         return new Quantity(1, (this.low ?? this.high).getPrecision());
       }
-      return subtract(successor(minValue, this.pointType), minValue, this.pointType);
+      return subtract(successor(minValue), minValue, this.pointType);
     }
 
     throw new Error('Point type of interval cannot be determined.');
@@ -743,7 +740,7 @@ export class Interval {
       if (this.lowClosed && this.low == null) {
         low = minValueForType(this.pointType, quantityInstance);
       } else if (!this.lowClosed && this.low != null) {
-        low = successor(this.low, this.pointType);
+        low = successor(this.low);
       } else {
         low = this.low;
       }
@@ -751,7 +748,7 @@ export class Interval {
       if (this.highClosed && this.high == null) {
         high = maxValueForType(this.pointType, quantityInstance);
       } else if (!this.highClosed && this.high != null) {
-        high = predecessor(this.high, this.pointType);
+        high = predecessor(this.high);
       } else {
         high = this.high;
       }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index 72f00c8be..2c3b85e9b 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -507,7 +507,7 @@ export class Successor extends Expression {
     try {
       // MathUtil.successor throws on overflow, and the exception is used in
       // the logic for evaluating `meets`, so it can't be changed to just return null
-      successor = MathUtil.successor(arg, this.resultTypeName);
+      successor = MathUtil.successor(arg);
     } catch (e) {
       if (e instanceof MathUtil.OverFlowException) {
         return null;
@@ -536,7 +536,7 @@ export class Predecessor extends Expression {
     try {
       // MathUtil.predecessor throws on underflow, and the exception is used in
       // the logic for evaluating `meets`, so it can't be changed to just return null
-      predecessor = MathUtil.predecessor(arg, this.resultTypeName);
+      predecessor = MathUtil.predecessor(arg);
     } catch (e) {
       if (e instanceof MathUtil.OverFlowException) {
         return null;
diff --git a/src/util/math.ts b/src/util/math.ts
index 06d9dcb4f..365a749b8 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -254,7 +254,7 @@ export function limitDecimalPrecision<
 
 export class OverFlowException extends Exception {}
 
-export function successor(val: any, _type?: string, precision?: string): any {
+export function successor(val: any, precision?: string): any {
   if (typeof val === 'number') {
     if (val >= MAX_INT_VALUE) {
       throw new OverFlowException();
@@ -295,22 +295,22 @@ export function successor(val: any, _type?: string, precision?: string): any {
     // For uncertainties, if the high is the max val, don't increment it
     const high = (() => {
       try {
-        return successor(val.high, undefined, precision);
+        return successor(val.high, precision);
       } catch {
         return val.high;
       }
     })();
-    return new Uncertainty(successor(val.low, undefined, precision), high);
+    return new Uncertainty(successor(val.low, precision), high);
   } else if (val && val.isQuantity) {
     const succ = val.clone();
-    succ.value = successor(val.value, ELM_DECIMAL_TYPE);
+    succ.value = successor(val.value);
     return succ;
   } else if (val == null) {
     return null;
   }
 }
 
-export function predecessor(val: any, _type?: string, precision?: string): any {
+export function predecessor(val: any, precision?: string): any {
   if (typeof val === 'number') {
     if (val <= MIN_INT_VALUE) {
       throw new OverFlowException();
@@ -351,15 +351,15 @@ export function predecessor(val: any, _type?: string, precision?: string): any {
     // For uncertainties, if the low is the min val, don't decrement it
     const low = ((): any => {
       try {
-        return predecessor(val.low, undefined, precision);
+        return predecessor(val.low, precision);
       } catch {
         return val.low;
       }
     })();
-    return new Uncertainty(low, predecessor(val.high, undefined, precision));
+    return new Uncertainty(low, predecessor(val.high, precision));
   } else if (val && val.isQuantity) {
     const pred = val.clone();
-    pred.value = predecessor(val.value, ELM_DECIMAL_TYPE);
+    pred.value = predecessor(val.value);
     return pred;
   } else if (val == null) {
     return null;
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index 5071fd60d..a6e6d3629 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -2,48 +2,41 @@ import { Uncertainty } from '../../src/datatypes/uncertainty';
 import { MAX_FLOAT_VALUE, MIN_FLOAT_VALUE } from '../../src/util/limits';
 import { Decimal } from '../../src/datatypes/decimal';
 import { predecessor, successor } from '../../src/util/math';
-import { ELM_DECIMAL_TYPE, ELM_INTEGER_TYPE } from '../../src/util/elmTypes';
 
 describe('successor', () => {
   it('should preserve integers in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0), ELM_INTEGER_TYPE);
+    const result = successor(new Uncertainty(1.0, 2.0));
     result.low.should.equal(2);
     result.high.should.equal(3);
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(
-      new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)),
-      ELM_DECIMAL_TYPE
-    );
+    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
     result.low.should.equalDecimal(Decimal.from(1.00000001));
     result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
-    const result = successor(new Uncertainty(Decimal.from(1), MAX_FLOAT_VALUE), ELM_DECIMAL_TYPE);
+    const result = successor(new Uncertainty(Decimal.from(1), MAX_FLOAT_VALUE));
     result.should.eql(new Uncertainty(Decimal.from(1.00000001), MAX_FLOAT_VALUE));
   });
 });
 
 describe('predecessor', () => {
   it('should preserve integers in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0), ELM_INTEGER_TYPE);
+    const result = successor(new Uncertainty(1.0, 2.0));
     result.low.should.equal(2);
     result.high.should.equal(3);
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(
-      new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)),
-      ELM_DECIMAL_TYPE
-    );
+    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
     result.low.should.equalDecimal(Decimal.from(1.00000001));
     result.high.should.equalDecimal(Decimal.from(2.00000001));
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
-    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(2)), ELM_DECIMAL_TYPE);
+    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(2)));
     result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(1.99999999)));
   });
 });

From cb3c83f7602b8dacbda696b076e7cfc30ca056ea Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 15:15:26 -0400
Subject: [PATCH 10/62] additional cleanup and fixes

---
 src/datatypes/decimal.ts                      |  28 ++--
 src/elm/aggregate.ts                          | 120 +++++++++---------
 src/elm/arithmetic.ts                         |  89 ++++++-------
 src/elm/interval.ts                           |  45 ++-----
 src/elm/type.ts                               |  30 +++++
 src/util/math.ts                              |  25 ++--
 test/datatypes/decimal-test.ts                |   6 +-
 test/elm/convert/convert-test.ts              |  10 +-
 test/elm/convert/data.cql                     |   2 +-
 test/elm/convert/data.js                      |   6 +-
 test/elm/instance/instance-test.ts            |   4 +-
 test/elm/interval/interval-test.ts            |  46 +++----
 .../spec-tests/cql/CqlStringOperatorsTest.cql |   4 +-
 .../cql/CqlStringOperatorsTest.json           |  53 +-------
 test/spec-tests/skip-list.txt                 |   1 +
 15 files changed, 201 insertions(+), 268 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 53c6b66e5..5d0a99ec0 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -64,15 +64,14 @@ export class Decimal {
   }
 
   divideBy(other: DecimalInput): Decimal {
-    if (toNumber(other) === 0) {
+    if (Decimal.from(other).equals(0)) {
       throw new RangeError('Cannot divide a decimal by zero');
     }
     return this.applyWrapper(this.value.dividedBy, other);
   }
 
   modulo(other: DecimalInput) {
-    const divisor = toNumber(other);
-    if (divisor === 0) {
+    if (Decimal.from(other).equals(0)) {
       throw new RangeError('Cannot calculate decimal modulo by zero');
     }
     return this.applyWrapper(this.value.mod, other);
@@ -180,6 +179,7 @@ export class Decimal {
   }
 
   toInteger() {
+    // note that this is permissive and converts non-integral values
     return this.truncate();
   }
 
@@ -193,7 +193,16 @@ export class Decimal {
   }
 
   toString() {
-    return this.value.toString();
+    // decimal.js toString can return exponential notation,
+    // toFixed always returns normal notation
+    // CQL spec expects format (-)?#0.0#
+    // https://cql.hl7.org/R2/09-b-cqlreference.html#tostring
+    // meaning, optional minus sign, at least one digit, decimal point, at least one digit
+    // (# means any number of digits, including none; 0 means a digit must appear)
+    // a regex for this is -?\d+\.\d+
+    // so Decimal.from(1).toString() --> "1.0"
+    const places = Math.max(1, this.value.decimalPlaces());
+    return this.value.toFixed(places);
   }
 
   toJSON() {
@@ -206,14 +215,3 @@ export const MIN_DECIMAL_STRING = '-99999999999999999999.99999999';
 
 export const MAX_DECIMAL_VALUE = Decimal.from(MAX_DECIMAL_STRING);
 export const MIN_DECIMAL_VALUE = Decimal.from(MIN_DECIMAL_STRING);
-
-function toNumber(value: DecimalInput) {
-  if (value instanceof Decimal) {
-    return value.toNumber();
-  }
-  if (typeof value === 'string' && value.trim() === '') {
-    // Number() and Number('') return 0 instead of NaN, so catch that case
-    return NaN;
-  }
-  return Number(value);
-}
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 7d233f2ed..fe72381f7 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -1,12 +1,25 @@
 import { Expression } from './expression';
-import { typeIsArray, allTrue, anyTrue, removeNulls, numerical_sort } from '../util/util';
-import { Quantity } from '../datatypes/datatypes';
+import { typeIsArray, allTrue, anyTrue, removeNulls } from '../util/util';
+import { doAddition, Quantity } from '../datatypes/datatypes';
 import { Decimal } from '../datatypes/decimal';
 import { Context } from '../runtime/context';
 import { Exception } from '../datatypes/exception';
 import { greaterThan, lessThan } from '../util/comparison';
 import { build } from './builder';
-import { overflowsOrUnderflows, finalizeNumericResult } from '../util/math';
+import * as MathUtil from '../util/math';
+
+function finalizeAggregateResult(result: any, firstItem: any) {
+  if (result == null) {
+    return null;
+  }
+  const finalized = MathUtil.finalizeNumericResult(result);
+  const bounded = MathUtil.overflowsOrUnderflows(finalized) ? null : finalized;
+  if (bounded && firstItem instanceof Quantity && !(bounded instanceof Quantity)) {
+    return new Quantity(bounded, firstItem.unit);
+  } else {
+    return bounded;
+  }
+}
 
 class AggregateExpression extends Expression {
   source: any;
@@ -52,19 +65,18 @@ export class Sum extends AggregateExpression {
       return null;
     }
 
+    let sum;
     if (hasOnlyQuantities(items)) {
-      const sum = sumOfDecimals(getValuesFromQuantities(items));
-      return overflowsOrUnderflows(sum) ? null : new Quantity(sum, items[0].unit);
+      // note doAddition is Quantity addition
+      sum = items.reduce(doAddition);
     } else {
-      let sum;
       if (hasDecimals(items)) {
         sum = sumOfDecimals(items.map(Decimal.from));
       } else {
         sum = items.reduce((x: any, y: any) => x + y);
       }
-      sum = finalizeNumericResult(sum);
-      return overflowsOrUnderflows(sum) ? null : sum;
     }
+    return finalizeAggregateResult(sum, items[0]);
   }
 }
 
@@ -157,13 +169,17 @@ export class Avg extends AggregateExpression {
       return null;
     }
 
+    let decimals;
     if (hasOnlyQuantities(items)) {
-      const sum = sumOfDecimals(getValuesFromQuantities(items));
-      return new Quantity(sum.divideBy(items.length), items[0].unit);
+      decimals = getValuesFromQuantities(items);
     } else {
       // return type is always Decimal, so just map everything to Decimals
-      return sumOfDecimals(items.map(Decimal.from)).divideBy(items.length).normalized();
+      decimals = items.map(Decimal.from);
     }
+    const sum = sumOfDecimals(decimals);
+    const avg = finalizeAggregateResult(sum.divideBy(items.length), items[0]);
+
+    return finalizeAggregateResult(avg, items[0]);
   }
 }
 
@@ -187,17 +203,22 @@ export class Median extends AggregateExpression {
       return null;
     }
 
+    let decimals;
     if (hasOnlyQuantities(items)) {
-      const median = medianOfDecimals(getValuesFromQuantities(items));
-      return new Quantity(median, items[0].unit);
+      decimals = getValuesFromQuantities(items);
+    } else {
+      // Note that the Median signature is Median(argument List<Decimal>) Decimal
+      // because median on a list of even number of items takes the average of the 2 middle items
+      // so we can treat all the input as decimals
+      decimals = items.map(Decimal.from);
     }
 
-    if (hasDecimals(items)) {
-      const decimals = items.map(Decimal.from);
-      return finalizeNumericResult(medianOfDecimals(decimals));
-    }
+    const sorted = [...decimals].sort((a, b) => a.compareTo(b));
+    const middle = Math.floor(items.length / 2);
+    const median =
+      items.length % 2 === 1 ? sorted[middle] : sorted[middle - 1].add(sorted[middle]).divideBy(2);
 
-    return medianOfNumbers(items);
+    return finalizeAggregateResult(median, items[0]);
   }
 }
 
@@ -285,18 +306,15 @@ export class StdDev extends AggregateExpression {
     if (items.length === 0) {
       return null;
     }
-
+    let values;
     if (hasOnlyQuantities(items)) {
-      const values = getValuesFromQuantities(items);
-      const stdDev = this.standardDeviation(values);
-      if (stdDev === null) {
-        return null;
-      }
-      return new Quantity(stdDev, items[0].unit);
+      values = getValuesFromQuantities(items);
     } else {
-      const standardDeviation = this.standardDeviation(items.map(Decimal.from));
-      return standardDeviation?.normalized();
+      values = items.map(Decimal.from);
     }
+
+    const stdDev = this.standardDeviation(values);
+    return finalizeAggregateResult(stdDev, items[0]);
   }
 
   standardDeviation(list: Decimal[]) {
@@ -356,20 +374,16 @@ export class Product extends AggregateExpression {
       return null;
     }
 
+    let product;
     if (hasOnlyQuantities(items)) {
-      const product = productOfDecimals(getValuesFromQuantities(items));
-      // Units are not multiplied for the geometric product
-      return overflowsOrUnderflows(product) ? null : new Quantity(product, items[0].unit);
+      product = productOfDecimals(getValuesFromQuantities(items));
+    } else if (hasDecimals(items)) {
+      product = productOfDecimals(items.map(Decimal.from));
     } else {
-      let result;
-      if (hasDecimals(items)) {
-        result = productOfDecimals(items.map(Decimal.from));
-      } else {
-        result = items.reduce((x: number, y: number) => x * y);
-      }
-      result = finalizeNumericResult(result);
-      return overflowsOrUnderflows(result) ? null : result;
+      product = items.reduce((x: number, y: number) => x * y);
     }
+
+    return finalizeAggregateResult(product, items[0]);
   }
 }
 
@@ -394,15 +408,16 @@ export class GeometricMean extends AggregateExpression {
       return null;
     }
 
+    let decimals;
     if (hasOnlyQuantities(items)) {
-      const product = productOfDecimals(getValuesFromQuantities(items));
-      const geoMean = product.power(1.0 / items.length);
-      return new Quantity(geoMean, items[0].unit);
+      decimals = getValuesFromQuantities(items);
     } else {
-      return productOfDecimals(items.map(Decimal.from))
-        .power(1.0 / items.length)
-        .normalized();
+      decimals = items.map(Decimal.from);
     }
+    const product = productOfDecimals(decimals);
+    const oneOverLength = Decimal.from(1).divideBy(items.length);
+    const geoMean = product.power(oneOverLength);
+    return finalizeAggregateResult(geoMean, items[0]);
   }
 }
 
@@ -489,23 +504,6 @@ function convertAllUnits(arr: any[]) {
   return arr.map(q => q.convertUnit(arr[0].unit));
 }
 
-function medianOfNumbers(numbers: number[]) {
-  const items = numerical_sort(numbers, 'asc');
-  if (items.length % 2 === 1) {
-    // Odd number of items
-    return items[(items.length - 1) / 2];
-  } else {
-    // Even number of items
-    return (items[items.length / 2 - 1] + items[items.length / 2]) / 2;
-  }
-}
-
-function medianOfDecimals(decimals: Decimal[]) {
-  const items = [...decimals].sort((a, b) => a.compareTo(b));
-  const middle = Math.floor(items.length / 2);
-  return items.length % 2 === 1 ? items[middle] : items[middle - 1].add(items[middle]).divideBy(2);
-}
-
 function sumOfDecimals(values: Decimal[]) {
   return values.reduce((sum, value) => sum.add(value));
 }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index 2c3b85e9b..9f37e676a 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -24,6 +24,14 @@ import {
 } from '../util/elmTypes';
 import { MAX_INT_VALUE, MAX_LONG_VALUE, MIN_INT_VALUE, MIN_LONG_VALUE } from '../util/limits';
 
+function finalizeArithmeticResult<T>(result: T): T | null {
+  if (result == null) {
+    return null;
+  }
+  const finalized = MathUtil.finalizeNumericResult(result);
+  return MathUtil.overflowsOrUnderflows(finalized) ? null : finalized;
+}
+
 export class Add extends Expression {
   constructor(json: any) {
     super(json);
@@ -36,7 +44,7 @@ export class Add extends Expression {
     }
 
     const sum = MathUtil.add(args[0], args[1], this.resultTypeName);
-    return MathUtil.finalizeNumericResult(sum, this.resultTypeName);
+    return finalizeArithmeticResult(sum);
   }
 }
 
@@ -52,7 +60,7 @@ export class Subtract extends Expression {
     }
 
     const difference = MathUtil.subtract(args[0], args[1], this.resultTypeName);
-    return MathUtil.finalizeNumericResult(difference, this.resultTypeName);
+    return finalizeArithmeticResult(difference);
   }
 }
 
@@ -91,11 +99,7 @@ export class Multiply extends Expression {
       product = MathUtil.multiply(x, y);
     }
 
-    if (MathUtil.overflowsOrUnderflows(product)) {
-      return null;
-    }
-
-    return MathUtil.finalizeNumericResult(product, this.resultTypeName);
+    return finalizeArithmeticResult(product);
   }
 }
 
@@ -139,10 +143,7 @@ export class Divide extends Expression {
       return null;
     }
 
-    if (MathUtil.overflowsOrUnderflows(quotient)) {
-      return null;
-    }
-    return MathUtil.finalizeNumericResult(quotient, this.resultTypeName);
+    return finalizeArithmeticResult(quotient);
   }
 }
 
@@ -176,10 +177,7 @@ export class TruncatedDivide extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(quotient)) {
-      return null;
-    }
-    return quotient;
+    return finalizeArithmeticResult(quotient);
   }
 }
 
@@ -203,7 +201,7 @@ export class Modulo extends Expression {
       return null;
     }
 
-    return MathUtil.decimalLongOrNull(MathUtil.finalizeNumericResult(modulo, this.resultTypeName));
+    return finalizeArithmeticResult(modulo);
   }
 }
 
@@ -260,18 +258,18 @@ export class Abs extends Expression {
     const arg = await this.execArgs(ctx);
     if (arg == null) {
       return null;
-    } else if (arg.isQuantity) {
-      return new Quantity(arg.value.abs(), arg.unit);
+    }
+    let absoluteValue;
+    if (arg.isQuantity) {
+      absoluteValue = new Quantity(arg.value.abs(), arg.unit);
     } else if (typeof arg === 'bigint') {
-      const absoluteValue = arg < 0n ? -arg : arg;
-      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
+      absoluteValue = arg < 0n ? -arg : arg;
     } else if (arg.isDecimal) {
-      const absoluteValue = arg.abs();
-      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
+      absoluteValue = arg.abs();
     } else {
-      const absoluteValue = Math.abs(arg);
-      return MathUtil.overflowsOrUnderflows(absoluteValue) ? null : absoluteValue;
+      absoluteValue = Math.abs(arg);
     }
+    return finalizeArithmeticResult(absoluteValue);
   }
 }
 
@@ -284,18 +282,18 @@ export class Negate extends Expression {
     const arg = await this.execArgs(ctx);
     if (arg == null) {
       return null;
-    } else if (arg.isQuantity) {
-      return new Quantity(arg.value.negate(), arg.unit);
+    }
+    let negatedValue;
+    if (arg.isQuantity) {
+      negatedValue = new Quantity(arg.value.negate(), arg.unit);
     } else if (typeof arg === 'bigint') {
-      const negatedValue = arg * -1n;
-      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
+      negatedValue = arg * -1n;
     } else if (arg.isDecimal) {
-      const negatedValue = arg.negate();
-      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
+      negatedValue = arg.negate();
     } else {
-      const negatedValue = arg * -1;
-      return MathUtil.overflowsOrUnderflows(negatedValue) ? null : negatedValue;
+      negatedValue = arg * -1;
     }
+    return finalizeArithmeticResult(negatedValue);
   }
 }
 
@@ -331,10 +329,7 @@ export class Ln extends Expression {
 
     try {
       const ln = Decimal.from(arg).ln();
-      if (MathUtil.overflowsOrUnderflows(ln)) {
-        return null;
-      }
-      return MathUtil.finalizeNumericResult(ln);
+      return finalizeArithmeticResult(ln);
     } catch {
       return null;
     }
@@ -359,10 +354,7 @@ export class Exp extends Expression {
       return null;
     }
 
-    if (MathUtil.overflowsOrUnderflows(power)) {
-      return null;
-    }
-    return MathUtil.finalizeNumericResult(power);
+    return finalizeArithmeticResult(power);
   }
 }
 
@@ -379,7 +371,7 @@ export class Log extends Expression {
 
     try {
       const log = Decimal.from(args[0]).log(args[1]);
-      return MathUtil.finalizeNumericResult(log);
+      return finalizeArithmeticResult(log);
     } catch {
       return null;
     }
@@ -402,10 +394,7 @@ export class Power extends Expression {
     // doPower handles this scenario
     const power = doPower(args[0], args[1]);
 
-    if (MathUtil.overflowsOrUnderflows(power)) {
-      return null;
-    }
-    return power;
+    return finalizeArithmeticResult(power);
   }
 }
 
@@ -514,10 +503,7 @@ export class Successor extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(successor)) {
-      return null;
-    }
-    return successor;
+    return finalizeArithmeticResult(successor);
   }
 }
 
@@ -543,9 +529,6 @@ export class Predecessor extends Expression {
       }
     }
 
-    if (MathUtil.overflowsOrUnderflows(predecessor)) {
-      return null;
-    }
-    return predecessor;
+    return finalizeArithmeticResult(predecessor);
   }
 }
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index b48b26775..cea2cf1a7 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -474,18 +474,12 @@ export class Expand extends Expression {
     if (['time', 'date', 'datetime'].includes(type)) {
       expandFunction = this.expandDTishInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.getPrecision());
-    } else if (type === 'quantity') {
+    } else if (['integer', 'long', 'decimal'].includes(type)) {
+      expandFunction = this.expandNumericInterval;
+      defaultPer = (_interval: any) => new Quantity(1, '1');
+    } else if (['quantity'].includes(type)) {
       expandFunction = this.expandQuantityInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.unit);
-    } else if (type === 'integer') {
-      expandFunction = this.expandIntegerInterval;
-      defaultPer = (_interval: any) => new Quantity(1, '1');
-    } else if (type === 'long') {
-      expandFunction = this.expandLongInterval;
-      defaultPer = (_interval: any) => new Quantity(1, '1');
-    } else if (type === 'decimal') {
-      expandFunction = this.expandDecimalInterval;
-      defaultPer = (_interval: any) => new Quantity(1, '1');
     } else {
       throw new Error('Interval list type not yet supported.');
     }
@@ -624,7 +618,7 @@ export class Expand extends Expression {
       return null;
     }
 
-    const results = this.makeDecimalIntervalList(low_value, high_value, per_value);
+    const results = this.makeNumericIntervalList(low_value, high_value, per_value);
 
     for (const itvl of results) {
       itvl.low = new Quantity(itvl.low, result_units);
@@ -633,38 +627,17 @@ export class Expand extends Expression {
     return results;
   }
 
-  expandIntegerInterval(interval: any, per: any) {
+  expandNumericInterval(interval: any, per: any) {
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
     const low = interval.lowClosed ? interval.low : successor(interval.low);
     const high = interval.highClosed ? interval.high : predecessor(interval.high);
 
-    return this.makeDecimalIntervalList(low, high, per.value);
-  }
-
-  expandDecimalInterval(interval: any, per: any) {
-    if (per.unit !== '1' && per.unit !== '') {
-      return null;
-    }
-    const low = interval.lowClosed ? interval.low : successor(interval.low);
-    const high = interval.highClosed ? interval.high : predecessor(interval.high);
-
-    return this.makeDecimalIntervalList(low, high, per.value);
-  }
-
-  expandLongInterval(interval: any, per: any) {
-    if (per.unit !== '1' && per.unit !== '') {
-      return null;
-    }
-
-    const low = interval.lowClosed ? interval.low : successor(interval.low);
-    const high = interval.highClosed ? interval.high : predecessor(interval.high);
-
-    return this.makeDecimalIntervalList(low, high, per.value);
+    return this.makeNumericIntervalList(low, high, per.value);
   }
 
-  makeDecimalIntervalList(low: any, high: any, perValue: any) {
+  makeNumericIntervalList(low: any, high: any, perValue: any) {
     // If the per value is a decimal, 8 decimal places are appropriate
     // Integers should have 0 Decimal places
     const perIsIntegral = perValue.isInteger();
@@ -678,7 +651,7 @@ export class Expand extends Expression {
     low = Decimal.from(low);
     high = Decimal.from(high);
 
-    let convertBound: (d: Decimal) => Decimal | number | bigint = d => d.toInteger();
+    let convertBound: (d: Decimal) => Decimal | number | bigint;
     if (!perIsIntegral) {
       // If per is not an integer value, then regardless of the original point types, the values will be Decimals
       convertBound = d => d;
diff --git a/src/elm/type.ts b/src/elm/type.ts
index c68982d1c..e7184691d 100644
--- a/src/elm/type.ts
+++ b/src/elm/type.ts
@@ -96,6 +96,21 @@ export class ToBoolean extends Expression {
   async exec(ctx: Context) {
     const arg = await this.execArgs(ctx);
     if (arg != null) {
+      if (typeof arg === 'boolean') {
+        return arg;
+      } else if (typeof arg === 'number' || typeof arg === 'bigint') {
+        if (arg == 1) {
+          return true;
+        } else if (arg == 0) {
+          return false;
+        }
+      } else if (arg instanceof Decimal) {
+        if (arg.equals('1.0')) {
+          return true;
+        } else if (arg.equals('0.0')) {
+          return false;
+        }
+      }
       const strArg = arg.toString().toLowerCase();
       if (['true', 't', 'yes', 'y', '1'].includes(strArg)) {
         return true;
@@ -157,6 +172,14 @@ export class ToDateTime extends Expression {
   }
 }
 
+// Described in the CQL spec as (+|-)?#0(.0#)?
+// Meaning an optional polarity indicator,
+// followed by any number of digits (including none),
+// followed by at least one digit,
+// followed optionally by a decimal point,
+// at least one digit, and any number of additional digits (including none).
+const CQL_DECIMAL_STRING = /^[+-]?\d+(\.\d+)?$/;
+
 export class ToDecimal extends Expression {
   constructor(json: any) {
     super(json);
@@ -170,6 +193,13 @@ export class ToDecimal extends Expression {
         const high = Decimal.from(arg.high).normalized();
         return new Uncertainty(low, high);
       } else {
+        if (typeof arg === 'string' && !CQL_DECIMAL_STRING.test(arg)) {
+          // reject anything that doesn't match the CQL Decimal format
+          // In particular, our Decimal.from could be more permissive
+          // and allow things like "1e8", which is not allowed by the spec
+          return null;
+        }
+
         try {
           const decimal = Decimal.from(arg.toString());
           if (isValidDecimal(decimal)) {
diff --git a/src/util/math.ts b/src/util/math.ts
index 365a749b8..76b090a12 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -439,30 +439,21 @@ export function decimalAdjust(type: MathFn, value: any, exp: any) {
   return +(value[0] + 'e' + v);
 }
 
-export function decimalOrNull(value: any) {
-  return isValidDecimal(value) ? value : null;
-}
-
-export function decimalLongOrNull(value: any) {
-  return (typeof value === 'number' && Number.isFinite(value)) ||
-    (value && value.isDecimal && isValidDecimal(value)) ||
-    (typeof value === 'bigint' && isValidLong(value))
-    ? value
-    : null;
-}
-
-export function finalizeNumericResult(result: any, _type?: string) {
+export function finalizeNumericResult(result: any) {
   if (result instanceof Decimal) {
     return result.normalized();
   } else if (result instanceof Quantity) {
     return new Quantity(result.value.normalized(), result.unit);
   } else if (result instanceof Uncertainty) {
-    if (result.low instanceof Quantity || result.low instanceof Decimal) {
-      result.low = finalizeNumericResult(result.low);
+    let low = result.low;
+    if (low instanceof Quantity || low instanceof Decimal) {
+      low = finalizeNumericResult(low);
     }
-    if (result.high instanceof Quantity || result.high instanceof Decimal) {
-      result.high = finalizeNumericResult(result.high);
+    let high = result.high;
+    if (high instanceof Quantity || high instanceof Decimal) {
+      high = finalizeNumericResult(high);
     }
+    return new Uncertainty(low, high);
   }
 
   return result;
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 54e693207..1622b5034 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -13,10 +13,10 @@ describe('Decimal', () => {
     const value = Decimal.from('1.5').subtract('0.5');
 
     value.compareTo('1').should.equal(0);
-    value.add(2).toString().should.equal('3');
-    value.multiplyBy(2).toString().should.equal('2');
+    value.add(2).toString().should.equal('3.0');
+    value.multiplyBy(2).toString().should.equal('2.0');
     value.divideBy(2).toString().should.equal('0.5');
-    Decimal.from(3).modulo(2).toString().should.equal('1');
+    Decimal.from(3).modulo(2).toString().should.equal('1.0');
   });
 
   it('should provide an explicit scale and JSON representation', () => {
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index 7e0ac943a..a5f7cc01d 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -173,15 +173,15 @@ describe('FromQuantity', () => {
   });
 
   it('should convert "10 \'A\'" to "10 \'A\'"', async function () {
-    (await this.quantityStr.exec(this.ctx)).should.equal("10 'A'");
+    (await this.quantityStr.exec(this.ctx)).should.equal("10.0 'A'");
   });
 
   it('should convert "+10 \'A\'" to "10 \'A\'"', async function () {
-    (await this.posQuantityStr.exec(this.ctx)).should.equal("10 'A'");
+    (await this.posQuantityStr.exec(this.ctx)).should.equal("10.0 'A'");
   });
 
   it('should convert "-10 \'A\'" to "10 \'A\'"', async function () {
-    (await this.negQuantityStr.exec(this.ctx)).should.equal("-10 'A'");
+    (await this.negQuantityStr.exec(this.ctx)).should.equal("-10.0 'A'");
   });
 
   it('should convert "10 \'A\'" to "10 \'A\'"', async function () {
@@ -357,7 +357,7 @@ describe('ToDecimal', () => {
   });
 
   it('should truncate decimal to 8 digits after decimal point', async function () {
-    (await this.tooPrecise.exec(this.ctx)).should.equalDecimal(Decimal.from(0.44444444));
+    (await this.tooPrecise.exec(this.ctx)).should.equalDecimal(Decimal.from('0.44444444'));
   });
 
   it('should be null for decimal that is above max decimal value', async function () {
@@ -372,7 +372,7 @@ describe('ToDecimal', () => {
     should.not.exist(await this.nullDecimal.exec(this.ctx));
   });
 
-  it.skip('should be null if wrong format (+.1)', async function () {
+  it('should be null if wrong format (+.1)', async function () {
     // TODO: parseFloat is more forgiving than the CQL spec, so this does get converted
     should(await this.wrongFormat.exec(this.ctx)).be.null();
   });
diff --git a/test/elm/convert/data.cql b/test/elm/convert/data.cql
index eb64cd79f..35c249ba4 100644
--- a/test/elm/convert/data.cql
+++ b/test/elm/convert/data.cql
@@ -76,7 +76,7 @@ define foo: 'bar'
 define NoSign: ToDecimal('0.0')
 define PositiveSign: ToDecimal('+1.1')
 define NegativeSign: ToDecimal('-1.1')
-define TooPrecise: ToDecimal('.444444444')
+define TooPrecise: ToDecimal('0.444444444')
 define TooLargeDec: ToDecimal('444444444444444444444444444444')
 define TooSmallDec: ToDecimal('-444444444444444444444444444444')
 define NullDecimal: ToDecimal((null as String))
diff --git a/test/elm/convert/data.js b/test/elm/convert/data.js
index 4c259f550..bc8abadd2 100644
--- a/test/elm/convert/data.js
+++ b/test/elm/convert/data.js
@@ -3849,7 +3849,7 @@ context Patient
 define NoSign: ToDecimal('0.0')
 define PositiveSign: ToDecimal('+1.1')
 define NegativeSign: ToDecimal('-1.1')
-define TooPrecise: ToDecimal('.444444444')
+define TooPrecise: ToDecimal('0.444444444')
 define TooLargeDec: ToDecimal('444444444444444444444444444444')
 define TooSmallDec: ToDecimal('-444444444444444444444444444444')
 define NullDecimal: ToDecimal((null as String))
@@ -4104,7 +4104,7 @@ module.exports['ToDecimal'] = {
               }, {
                 "r" : "245",
                 "s" : [ {
-                  "value" : [ "'.444444444'" ]
+                  "value" : [ "'0.444444444'" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -4128,7 +4128,7 @@ module.exports['ToDecimal'] = {
             "localId" : "245",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
             "valueType" : "{urn:hl7-org:elm-types:r1}String",
-            "value" : ".444444444",
+            "value" : "0.444444444",
             "annotation" : [ ]
           }
         }
diff --git a/test/elm/instance/instance-test.ts b/test/elm/instance/instance-test.ts
index 722e7ca05..7197a395e 100644
--- a/test/elm/instance/instance-test.ts
+++ b/test/elm/instance/instance-test.ts
@@ -16,8 +16,8 @@ describe('Instance', () => {
     q.unit.should.eql('a');
     const decimal12 = Decimal.from(12);
     q.value.should.eql(decimal12);
-    q.toString().should.equal("12 'a'");
-    (await this.val.exec(this.ctx)).should.eql(decimal12);
+    q.toString().should.equal("12.0 'a'");
+    (await this.val.exec(this.ctx)).should.equalDecimal(decimal12);
   });
 
   it('should be able to construct a Code', async function () {
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 4a1660041..20bceedd0 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -3394,83 +3394,83 @@ describe('QuantityIntervalExpand', () => {
   it('expands single intervals', async function () {
     // define ClosedSingleGPerG: expand { Interval[2 'g', 4 'g'] } per 1 'g'
     let a = await this.closedSingleGPerG.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
 
     // define ClosedSingleGPerGDecimal: expand { Interval[2.1 'g', 4.1 'g'] } per 1 'g'
     a = await this.closedSingleGPerGDecimal.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
 
     // define ClosedSingleGPerMG: expand { Interval[2 'g', 2.003 'g'] } per 1 'mg'
     a = await this.closedSingleGPerMG.exec(this.ctx);
     prettyList(a).should.equal(
-      "{ [2000 'mg', 2000 'mg'], [2001 'mg', 2001 'mg'], [2002 'mg', 2002 'mg'], [2003 'mg', 2003 'mg'] }"
+      "{ [2000.0 'mg', 2000.0 'mg'], [2001.0 'mg', 2001.0 'mg'], [2002.0 'mg', 2002.0 'mg'], [2003.0 'mg', 2003.0 'mg'] }"
     );
 
     // define ClosedSingleMGPerGTrunc: expand { Interval[2999 'mg', 4200 'mg'] } per 1 'g'
     a = await this.closedSingleMGPerGTrunc.exec(this.ctx);
-    prettyList(a).should.equal("{ [2999 'mg', 3998 'mg'] }");
+    prettyList(a).should.equal("{ [2999.0 'mg', 3998.0 'mg'] }");
 
     // define ClosedSingleMGPerMGTrunc: expand { Interval[2000 'mg', 4500 'mg'] } per 800 'mg'
     a = await this.closedSingleMGPerMGTrunc.exec(this.ctx);
     prettyList(a).should.equal(
-      "{ [2000 'mg', 2799 'mg'], [2800 'mg', 3599 'mg'], [3600 'mg', 4399 'mg'] }"
+      "{ [2000.0 'mg', 2799.0 'mg'], [2800.0 'mg', 3599.0 'mg'], [3600.0 'mg', 4399.0 'mg'] }"
     );
 
     // define ClosedSingleMGPerMGDecimal: expand { Interval[2000.01 'mg', 4500 'mg'] } per 800 'mg'
     a = await this.closedSingleMGPerMGDecimal.exec(this.ctx);
     prettyList(a).should.equal(
-      "{ [2000 'mg', 2799 'mg'], [2800 'mg', 3599 'mg'], [3600 'mg', 4399 'mg'] }"
+      "{ [2000.0 'mg', 2799.0 'mg'], [2800.0 'mg', 3599.0 'mg'], [3600.0 'mg', 4399.0 'mg'] }"
     );
   });
 
   it('expands lists of multiple intervals', async function () {
     // define NullInList: expand { Interval[2 'g', 4 'g'], null } per 1 'g'
     let a = await this.nullInList.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
 
     // define Overlapping: expand { Interval[2 'g', 4 'g'], Interval[3 'g', 5 'g'] } per 1 'g'
     a = await this.overlapping.exec(this.ctx);
     prettyList(a).should.equal(
-      "{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'], [5 'g', 5 'g'] }"
+      "{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'], [5.0 'g', 5.0 'g'] }"
     );
 
     // define NonOverlapping: expand { Interval[2 'g', 4 'g'], Interval[6 'g', 6 'g'] } per 1 'g'
     a = await this.nonOverlapping.exec(this.ctx);
     prettyList(a).should.equal(
-      "{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'], [6 'g', 6 'g'] }"
+      "{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'], [6.0 'g', 6.0 'g'] }"
     );
   });
 
   it('expands interval using the first items units if no per provided', async function () {
     // define NoPerDefaultM: expand { Interval[2 'm', 400 'cm'] }
     let a = await this.noPerDefaultM.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'm', 2 'm'], [3 'm', 3 'm'], [4 'm', 4 'm'] }");
+    prettyList(a).should.equal("{ [2.0 'm', 2.0 'm'], [3.0 'm', 3.0 'm'], [4.0 'm', 4.0 'm'] }");
 
     // define NoPerDefaultG: expand { Interval[2 'g', 4 'g'] }
     a = await this.noPerDefaultG.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
   });
 
   it('expands interval with open ends', async function () {
     // define OpenStart: expand { Interval(2 'g', 4 'g'] } per 1 'g'
     let a = await this.openStart.exec(this.ctx);
-    prettyList(a).should.equal("{ [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
 
     // define OpenEnd: expand { Interval[2 'g', 4 'g') } per 1 'g'
     a = await this.openEnd.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'] }");
 
     // define OpenBoth: expand { Interval(2 'g', 4 'g') } per 1 'g'
     a = await this.openBoth.exec(this.ctx);
-    prettyList(a).should.equal("{ [3 'g', 3 'g'] }");
+    prettyList(a).should.equal("{ [3.0 'g', 3.0 'g'] }");
 
     // define OpenBothDecimal: expand { Interval(2.1 'g', 4.1 'g') } per 1 'g'
     a = await this.openBothDecimal.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
 
     // define OpenBothDecimalTrunc: expand { Interval(2.1 'g', 4.101 'g') } per 1 'g'
     a = await this.openBothDecimalTrunc.exec(this.ctx);
-    prettyList(a).should.equal("{ [2 'g', 2 'g'], [3 'g', 3 'g'], [4 'g', 4 'g'] }");
+    prettyList(a).should.equal("{ [2.0 'g', 2.0 'g'], [3.0 'g', 3.0 'g'], [4.0 'g', 4.0 'g'] }");
   });
 
   it('returns an empty list if we get an empty list or if there are no results', async function () {
@@ -3705,7 +3705,7 @@ describe('DecimalIntervalExpand', () => {
   it('expands single intervals', async function () {
     // define ClosedSingle: expand { Interval[2, 5] } per 1.5 '1'
     let a = await this.closedSingle.exec(this.ctx);
-    prettyList(a).should.equal('{ [2, 3.49999999], [3.5, 4.99999999] }');
+    prettyList(a).should.equal('{ [2.0, 3.49999999], [3.5, 4.99999999] }');
 
     // define ClosedSingle1: expand { Interval[2.5, 10] } per 2 '1'
     a = await this.closedSingle1.exec(this.ctx);
@@ -3714,22 +3714,22 @@ describe('DecimalIntervalExpand', () => {
     // define ClosedSingle2: expand { Interval[2, 4.5] } per 0.5 '1'
     a = await this.closedSingle2.exec(this.ctx);
     prettyList(a).should.equal(
-      '{ [2, 2.49999999], [2.5, 2.99999999], [3, 3.49999999], [3.5, 3.99999999], [4, 4.49999999] }'
+      '{ [2.0, 2.49999999], [2.5, 2.99999999], [3.0, 3.49999999], [3.5, 3.99999999], [4.0, 4.49999999] }'
     );
   });
 
   it('expands lists of multiple intervals', async function () {
     // define NullInList: expand { Interval[2, 5], null } per 1.5 '1'
     let a = await this.nullInList.exec(this.ctx);
-    prettyList(a).should.equal('{ [2, 3.49999999], [3.5, 4.99999999] }');
+    prettyList(a).should.equal('{ [2.0, 3.49999999], [3.5, 4.99999999] }');
 
     // define Overlapping: expand { Interval[2, 5], Interval[4, 7] } per 1.5 '1'
     a = await this.overlapping.exec(this.ctx);
-    prettyList(a).should.equal('{ [2, 3.49999999], [3.5, 4.99999999], [5, 6.49999999] }');
+    prettyList(a).should.equal('{ [2.0, 3.49999999], [3.5, 4.99999999], [5.0, 6.49999999] }');
 
     // define NonOverlapping: expand { Interval[2, 4], Interval[6, 8] } per 1.5 '1'
     a = await this.nonOverlapping.exec(this.ctx);
-    prettyList(a).should.equal('{ [2, 3.49999999], [6, 7.49999999] }');
+    prettyList(a).should.equal('{ [2.0, 3.49999999], [6.0, 7.49999999] }');
   });
 
   it('expands interval using default per of 1', async function () {
@@ -3741,11 +3741,11 @@ describe('DecimalIntervalExpand', () => {
   it('expands interval with open ends', async function () {
     // define OpenStart: expand { Interval(2, 5] } per 1.5 '1'
     let a = await this.openStart.exec(this.ctx);
-    prettyList(a).should.equal('{ [3, 4.49999999] }');
+    prettyList(a).should.equal('{ [3.0, 4.49999999] }');
 
     // define OpenEnd: expand { Interval[2, 5) } per 1.5 '1'
     a = await this.openEnd.exec(this.ctx);
-    prettyList(a).should.equal('{ [2, 3.49999999] }');
+    prettyList(a).should.equal('{ [2.0, 3.49999999] }');
 
     // define OpenBoth: expand { Interval(2, 5) } per 1.5 '1'
     (await this.openBoth.exec(this.ctx)).should.be.empty();
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.cql b/test/spec-tests/cql/CqlStringOperatorsTest.cql
index fbc62f47d..12054e0e6 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.cql
@@ -350,9 +350,11 @@ define "Upper": Tuple{
 
 define "toString tests": Tuple{
   "QuantityToString": Tuple{
+    skipped: 'Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side'
+    /*
     expression: ToString(125 'cm'),
     output: '125 \'cm\''
-  },
+    */  },
   "DateTimeToString1": Tuple{
     expression: ToString(DateTime(2000, 1, 1)),
     output: '2000-01-01'
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.json b/test/spec-tests/cql/CqlStringOperatorsTest.json
index 430bcf316..1fd5e49e9 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.json
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.json
@@ -10087,16 +10087,7 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
@@ -10227,16 +10218,7 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
@@ -10363,16 +10345,7 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
@@ -10384,28 +10357,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "ToString",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Quantity",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "value": 125,
-                          "unit": "cm",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "125 'cm'",
+                        "value": "Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index a939904b0..6e8072e7b 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -16,6 +16,7 @@ CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: In
 "CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See test Divide1Q1Q which is correct
 "CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10By5DQuantity"           Wrong output: The resulting Quantity should have an appropriate unit
 "CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide414By206DQuantity"        Wrong output: The resulting Quantity should have an appropriate unit
+"CqlStringOperatorsTest.toString tests.QuantityToString"        Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side
 
 # Potentially Incorrect Expected Output
 "CqlStringOperatorsTest.toString tests.DateTimeToString2"         Answer does not include timezone offset, but default offset depends on test environment

From 8993bf88f6f56f2b20a1019e86e3feeee39c8b5e Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 15:31:58 -0400
Subject: [PATCH 11/62] additional cleanup

---
 src/elm/aggregate.ts      | 16 ++++++++++------
 src/elm/arithmetic.ts     |  7 ++++++-
 src/util/immutableUtil.ts |  6 ++----
 src/util/math.ts          | 23 -----------------------
 4 files changed, 18 insertions(+), 34 deletions(-)

diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index fe72381f7..6d9e91536 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -177,8 +177,7 @@ export class Avg extends AggregateExpression {
       decimals = items.map(Decimal.from);
     }
     const sum = sumOfDecimals(decimals);
-    const avg = finalizeAggregateResult(sum.divideBy(items.length), items[0]);
-
+    const avg = sum.divideBy(items.length);
     return finalizeAggregateResult(avg, items[0]);
   }
 }
@@ -414,10 +413,15 @@ export class GeometricMean extends AggregateExpression {
     } else {
       decimals = items.map(Decimal.from);
     }
-    const product = productOfDecimals(decimals);
-    const oneOverLength = Decimal.from(1).divideBy(items.length);
-    const geoMean = product.power(oneOverLength);
-    return finalizeAggregateResult(geoMean, items[0]);
+
+    try {
+      const product = productOfDecimals(decimals);
+      const oneOverLength = Decimal.from(1).divideBy(items.length);
+      const geoMean = product.power(oneOverLength);
+      return finalizeAggregateResult(geoMean, items[0]);
+    } catch {
+      return null;
+    }
   }
 }
 
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index 9f37e676a..c0d7f796a 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -392,7 +392,12 @@ export class Power extends Expression {
     // Note: The resultTypeName may be wrong if the exponent is a negative number.
     // E.g., CQL-to-ELM says 10^-1 is an Integer result type, but the correct result is a 0.1 (a Decimal)
     // doPower handles this scenario
-    const power = doPower(args[0], args[1]);
+    let power;
+    try {
+      power = doPower(args[0], args[1]);
+    } catch {
+      return null;
+    }
 
     return finalizeArithmeticResult(power);
   }
diff --git a/src/util/immutableUtil.ts b/src/util/immutableUtil.ts
index 14d6c7d01..adeada848 100644
--- a/src/util/immutableUtil.ts
+++ b/src/util/immutableUtil.ts
@@ -9,7 +9,6 @@ import {
   Ratio,
   Uncertainty
 } from '../datatypes/datatypes';
-import { decimalAdjust } from './math';
 import { convertUnit } from './units';
 
 const ucumUtilInstance = ucum.UcumLhcUtils.getInstance();
@@ -108,12 +107,11 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
           __instance: js.constructor
         });
       } else {
-        // Unit was found - convert to baseUnit and normalize
+        // Unit was found - convert to baseUnit
         const baseUnitKeyCode = baseUnitKey[0].csCode_;
         const conversionValue = convertUnit(js.value, js.unit, baseUnitKeyCode);
-        const finalValue = conversionValue ? decimalAdjust('round', conversionValue, -8) : null;
         return ImmutableMap({
-          value: finalValue ? toNormalizedKey(finalValue) : null,
+          value: conversionValue ? toNormalizedKey(conversionValue) : null,
           unit: baseUnitKeyCode ?? null,
           __instance: js.constructor
         });
diff --git a/src/util/math.ts b/src/util/math.ts
index 76b090a12..48d913c00 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -416,29 +416,6 @@ export function minValueForType(type: string, quantityInstance?: Quantity) {
   return null;
 }
 
-type MathFn = keyof typeof Math;
-
-export function decimalAdjust(type: MathFn, value: any, exp: any) {
-  //If the exp is undefined or zero...
-  if (typeof exp === 'undefined' || +exp === 0) {
-    return (Math[type] as (x: number) => number)(value);
-  }
-  value = +value;
-  exp = +exp;
-  //If the value is not a number or the exp is not an integer...
-  if (isNaN(value) || !(typeof exp === 'number' && exp % 1 === 0)) {
-    return NaN;
-  }
-  //Shift
-  value = value.toString().split('e');
-  let v = value[1] ? +value[1] - exp : -exp;
-  value = (Math[type] as (x: number) => number)(+(value[0] + 'e' + v));
-  //Shift back
-  value = value.toString().split('e');
-  v = value[1] ? +value[1] + exp : exp;
-  return +(value[0] + 'e' + v);
-}
-
 export function finalizeNumericResult(result: any) {
   if (result instanceof Decimal) {
     return result.normalized();

From b7cb9e6c33ca2a400b2aa5be9c5428c43ee84932 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 15:51:37 -0400
Subject: [PATCH 12/62] new tests added by codex

---
 test/datatypes/decimal-test.ts         |  11 +
 test/elm/aggregate/aggregate-test.ts   |  26 +
 test/elm/aggregate/data.cql            |   8 +
 test/elm/aggregate/data.js             | 853 +++++++++++++++++++++----
 test/elm/arithmetic/arithmetic-test.ts |  16 +
 test/elm/arithmetic/data.cql           |   5 +
 test/elm/arithmetic/data.js            | 336 +++++++++-
 test/elm/convert/convert-test.ts       |  21 +
 test/elm/convert/data.cql              |   9 +
 test/elm/convert/data.js               | 433 ++++++++++++-
 test/util/immutableUtil-test.ts        |   8 +
 test/util/math-test.ts                 |  21 +-
 12 files changed, 1626 insertions(+), 121 deletions(-)

diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 1622b5034..053584fd3 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -24,6 +24,13 @@ describe('Decimal', () => {
     JSON.stringify({ value: Decimal.from('1.25') }).should.equal('{"value":"1.25"}');
   });
 
+  it('should serialize using fixed-point CQL Decimal notation', () => {
+    Decimal.from(1).toString().should.equal('1.0');
+    Decimal.from('-12.5').toString().should.equal('-12.5');
+    Decimal.from('0.00000001').toString().should.equal('0.00000001');
+    JSON.stringify({ value: Decimal.from(1) }).should.equal('{"value":"1.0"}');
+  });
+
   it('should provide CQL arithmetic helpers without exposing a number', () => {
     Decimal.from('-1.9').truncate().should.equal(-1);
     Decimal.from('1.1').ceil().should.equal(2);
@@ -38,4 +45,8 @@ describe('Decimal', () => {
     (() => Decimal.from('not a number')).should.throw();
     (() => Decimal.from(1).divideBy(0)).should.throw();
   });
+
+  it('should not coerce a nonzero Decimal divisor through a JavaScript number', () => {
+    (() => Decimal.from(1).divideBy('1e-1000')).should.not.throw();
+  });
 });
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 22292ffdb..5f946e4cc 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -309,6 +309,10 @@ describe('Avg', () => {
     (await this.has_null.exec(this.ctx)).should.equalDecimal(Decimal.from(1.5));
   });
 
+  it('should normalize repeating Decimal averages at the aggregate boundary', async function () {
+    (await this.repeating_decimal.exec(this.ctx)).should.equalDecimal(Decimal.from('1.66666667'));
+  });
+
   it('should return null for empty list', async function () {
     should(await this.empty.exec(this.ctx)).be.null();
   });
@@ -444,6 +448,11 @@ describe('PopulationVariance', () => {
   it('should be null if quantity units are not compatible', async function () {
     should(await this.incompatibleUnitsNull.exec(this.ctx)).be.null();
   });
+
+  it('should return zero for a single-item population variance', async function () {
+    (await this.single_value.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    validateQuantity(await this.single_value_q.exec(this.ctx), 0, 'ml');
+  });
 });
 
 describe('Variance', () => {
@@ -465,6 +474,10 @@ describe('Variance', () => {
   it('should be null if quantity units are not compatible', async function () {
     should(await this.incompatibleUnitsNull.exec(this.ctx)).be.null();
   });
+
+  it('should return null for a single-item sample variance', async function () {
+    should(await this.single_value.exec(this.ctx)).be.null();
+  });
 });
 
 describe('StdDev', () => {
@@ -486,6 +499,10 @@ describe('StdDev', () => {
   it('should be null if quantity units are not compatible', async function () {
     should(await this.incompatibleUnitsNull.exec(this.ctx)).be.null();
   });
+
+  it('should return null for a single-item sample standard deviation', async function () {
+    should(await this.single_value.exec(this.ctx)).be.null();
+  });
 });
 
 describe('PopulationStdDev', () => {
@@ -507,6 +524,11 @@ describe('PopulationStdDev', () => {
   it('should be null if quantity units are not compatible', async function () {
     should(await this.incompatibleUnitsNull.exec(this.ctx)).be.null();
   });
+
+  it('should return zero for a single-item population standard deviation', async function () {
+    (await this.single_value.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    validateQuantity(await this.single_value_q.exec(this.ctx), 0, 'ml');
+  });
 });
 
 describe('Product', () => {
@@ -660,6 +682,10 @@ describe('GeometricMean', () => {
   it('should return null when pass in list as null', async function () {
     should(await this.also_null_geometric_mean.exec(this.ctx)).be.null();
   });
+
+  it('should return null when the geometric mean cannot be represented', async function () {
+    should(await this.negative_geometric_mean.exec(this.ctx)).be.null();
+  });
 });
 
 describe('AllTrue', () => {
diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index c82e2527e..61eeffe92 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -84,6 +84,7 @@ define not_null_q: Avg({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define has_null_q: Avg({1 'ml',null,null,2 'ml'})
 define empty: Avg(List<Integer>{})
 define q_diff_units: Avg({1 'ml',0.002 'l',0.03 'dl',4 'ml',5 'ml'})
+define repeating_decimal: Avg({1.0, 2.0, 2.0})
 define NumbersAndQuantities: Avg({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Avg({1 'mg/d', 0.002 '/d'})
 
@@ -120,6 +121,7 @@ define v_q: Variance({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define q_diff_units: Variance({1.0 'ml',0.002 'l',0.003 'l',0.04 'dl',5.0 'ml'})
 define NumbersAndQuantities: Variance({1.0 ,2.0 ,3.0 ,4.0 'ml',5.0 'ml'})
 define IncompatibleUnitsNull: Variance({1 'mg/d', 0.002 '/d'})
+define single_value: Variance({2.0})
 
 // @Test: PopulationVariance
 define v: PopulationVariance({1.0,2.0,3.0,4.0,5.0})
@@ -127,6 +129,8 @@ define v_q: PopulationVariance({1.0 'ml',2.0 'ml',3.0 'ml',4.0 'ml',5.0 'ml'})
 define q_diff_units: PopulationVariance({1.0 'ml',0.002 'l',0.003 'l',0.04 'dl',5.0 'ml'})
 define NumbersAndQuantities: PopulationVariance({1.0 ,2.0 ,3.0 ,4.0 'ml',5.0 'ml'})
 define IncompatibleUnitsNull: PopulationVariance({1 'mg/d', 0.002 '/d'})
+define single_value: PopulationVariance({2.0})
+define single_value_q: PopulationVariance({2.0 'ml'})
 
 // @Test: StdDev
 define std: StdDev({1,2,3,4,5})
@@ -135,6 +139,7 @@ define q_diff_units: StdDev({1 'ml', 0.002 'l',3 'ml',4 'ml', 0.05 'dl'})
 define sq_throw1: StdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'm'})
 define NumbersAndQuantities: StdDev({1 ,2 ,3 ,4 'ml',5 })
 define IncompatibleUnitsNull: StdDev({1 'mg/d', 0.002 '/d'})
+define single_value: StdDev({2.0})
 
 // @Test: PopulationStdDev
 define dev: PopulationStdDev({1,2,3,4,5})
@@ -142,6 +147,8 @@ define dev_q: PopulationStdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define q_diff_units: PopulationStdDev({1 'ml', 0.002 'l',3 'ml',4 'ml', 0.05 'dl'})
 define NumbersAndQuantities: PopulationStdDev({1 ,2 ,3 ,4 'ml',5 })
 define IncompatibleUnitsNull: PopulationStdDev({1 'mg/d', 0.002 '/d'})
+define single_value: PopulationStdDev({2.0})
+define single_value_q: PopulationStdDev({2.0 'ml'})
 
 // @Test: Product
 define integer_product: Product({5, 4, 5})
@@ -183,6 +190,7 @@ define zero_geometric_mean: GeometricMean({2.0, 8.0, 0})
 define null_geometric_mean: GeometricMean({1, 2, null})
 define all_nulls: GeometricMean({null, null, null})
 define also_null_geometric_mean: GeometricMean(null as List<Decimal>)
+define negative_geometric_mean: GeometricMean({-1.0, 4.0})
 
 // @Test: AllTrue
 define at: AllTrue({true,true,true,true})
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index 9199f9626..5f063253c 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -8157,6 +8157,7 @@ define not_null_q: Avg({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define has_null_q: Avg({1 'ml',null,null,2 'ml'})
 define empty: Avg(List<Integer>{})
 define q_diff_units: Avg({1 'ml',0.002 'l',0.03 'dl',4 'ml',5 'ml'})
+define repeating_decimal: Avg({1.0, 2.0, 2.0})
 define NumbersAndQuantities: Avg({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Avg({1 'mg/d', 0.002 '/d'})
 */
@@ -8173,7 +8174,7 @@ module.exports['Avg'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "385",
+        "r" : "401",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8996,8 +8997,8 @@ module.exports['Avg'] = {
         }
       }, {
         "localId" : "363",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "NumbersAndQuantities",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "repeating_decimal",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -9006,46 +9007,130 @@ module.exports['Avg'] = {
           "s" : {
             "r" : "363",
             "s" : [ {
-              "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
+              "value" : [ "", "define ", "repeating_decimal", ": " ]
             }, {
-              "r" : "380",
+              "r" : "374",
               "s" : [ {
                 "value" : [ "Avg", "(" ]
               }, {
                 "r" : "364",
                 "s" : [ {
                   "r" : "365",
+                  "value" : [ "{", "1.0", ", ", "2.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Avg",
+          "localId" : "374",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "375",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "376",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "364",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "368",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "369",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "365",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "366",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "367",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "379",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "NumbersAndQuantities",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "379",
+            "s" : [ {
+              "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
+            }, {
+              "r" : "396",
+              "s" : [ {
+                "value" : [ "Avg", "(" ]
+              }, {
+                "r" : "380",
+                "s" : [ {
+                  "r" : "381",
                   "value" : [ "{", "1", " ," ]
                 }, {
-                  "r" : "366",
+                  "r" : "382",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "367",
+                  "r" : "383",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "368",
+                  "r" : "384",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "369",
+                  "r" : "385",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "370",
+                  "r" : "386",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -9060,48 +9145,48 @@ module.exports['Avg'] = {
         } ],
         "expression" : {
           "type" : "Avg",
-          "localId" : "380",
+          "localId" : "396",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "381",
+            "localId" : "397",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "382",
+              "localId" : "398",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "364",
+            "localId" : "380",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "374",
+              "localId" : "390",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "375",
+                "localId" : "391",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "ToQuantity",
-              "localId" : "372",
+              "localId" : "388",
               "annotation" : [ ],
               "signature" : [ {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "373",
+                "localId" : "389",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               } ],
               "operand" : {
                 "type" : "Literal",
-                "localId" : "365",
+                "localId" : "381",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
                 "value" : "1",
@@ -9109,35 +9194,35 @@ module.exports['Avg'] = {
               }
             }, {
               "type" : "Quantity",
-              "localId" : "366",
+              "localId" : "382",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "367",
+              "localId" : "383",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "368",
+              "localId" : "384",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "369",
+              "localId" : "385",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "370",
+              "localId" : "386",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -9146,7 +9231,7 @@ module.exports['Avg'] = {
           }
         }
       }, {
-        "localId" : "385",
+        "localId" : "401",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "IncompatibleUnitsNull",
         "context" : "Patient",
@@ -9155,26 +9240,26 @@ module.exports['Avg'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "385",
+            "r" : "401",
             "s" : [ {
               "value" : [ "", "define ", "IncompatibleUnitsNull", ": " ]
             }, {
-              "r" : "395",
+              "r" : "411",
               "s" : [ {
                 "value" : [ "Avg", "(" ]
               }, {
-                "r" : "386",
+                "r" : "402",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "387",
+                  "r" : "403",
                   "s" : [ {
                     "value" : [ "1 ", "'mg/d'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "388",
+                  "r" : "404",
                   "s" : [ {
                     "value" : [ "0.002 ", "'/d'" ]
                   } ]
@@ -9189,45 +9274,45 @@ module.exports['Avg'] = {
         } ],
         "expression" : {
           "type" : "Avg",
-          "localId" : "395",
+          "localId" : "411",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "396",
+            "localId" : "412",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "397",
+              "localId" : "413",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "386",
+            "localId" : "402",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "389",
+              "localId" : "405",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "390",
+                "localId" : "406",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "387",
+              "localId" : "403",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "mg/d",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "388",
+              "localId" : "404",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "/d",
@@ -12193,6 +12278,7 @@ define v_q: Variance({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define q_diff_units: Variance({1.0 'ml',0.002 'l',0.003 'l',0.04 'dl',5.0 'ml'})
 define NumbersAndQuantities: Variance({1.0 ,2.0 ,3.0 ,4.0 'ml',5.0 'ml'})
 define IncompatibleUnitsNull: Variance({1 'mg/d', 0.002 '/d'})
+define single_value: Variance({2.0})
 */
 
 module.exports['Variance'] = {
@@ -12207,7 +12293,7 @@ module.exports['Variance'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "309",
+        "r" : "324",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -12910,6 +12996,76 @@ module.exports['Variance'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "324",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "single_value",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "324",
+            "s" : [ {
+              "value" : [ "", "define ", "single_value", ": " ]
+            }, {
+              "r" : "333",
+              "s" : [ {
+                "value" : [ "Variance", "(" ]
+              }, {
+                "r" : "325",
+                "s" : [ {
+                  "r" : "326",
+                  "value" : [ "{", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Variance",
+          "localId" : "333",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "334",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "335",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "325",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "327",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "328",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "326",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
@@ -12924,6 +13080,8 @@ define v_q: PopulationVariance({1.0 'ml',2.0 'ml',3.0 'ml',4.0 'ml',5.0 'ml'})
 define q_diff_units: PopulationVariance({1.0 'ml',0.002 'l',0.003 'l',0.04 'dl',5.0 'ml'})
 define NumbersAndQuantities: PopulationVariance({1.0 ,2.0 ,3.0 ,4.0 'ml',5.0 'ml'})
 define IncompatibleUnitsNull: PopulationVariance({1 'mg/d', 0.002 '/d'})
+define single_value: PopulationVariance({2.0})
+define single_value_q: PopulationVariance({2.0 'ml'})
 */
 
 module.exports['PopulationVariance'] = {
@@ -12938,7 +13096,7 @@ module.exports['PopulationVariance'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "295",
+        "r" : "324",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -13607,91 +13765,238 @@ module.exports['PopulationVariance'] = {
             } ]
           }
         }
-      } ]
-    }
-  }
-}
-
-/* StdDev
-library TestSnippet version '1'
-using Simple version '1.0.0'
-context Patient
-define std: StdDev({1,2,3,4,5})
-define std_q: StdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
-define q_diff_units: StdDev({1 'ml', 0.002 'l',3 'ml',4 'ml', 0.05 'dl'})
-define sq_throw1: StdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'm'})
-define NumbersAndQuantities: StdDev({1 ,2 ,3 ,4 'ml',5 })
-define IncompatibleUnitsNull: StdDev({1 'mg/d', 0.002 '/d'})
-*/
-
-module.exports['StdDev'] = {
-  "library" : {
-    "localId" : "0",
-    "annotation" : [ {
-      "type" : "CqlToElmInfo",
-      "translatorVersion" : "4.2.0",
-      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
-      "signatureLevel" : "All"
-    }, {
-      "type" : "Annotation",
-      "t" : [ ],
-      "s" : {
-        "r" : "330",
-        "s" : [ {
-          "value" : [ "", "library TestSnippet version '1'" ]
-        } ]
-      }
-    } ],
-    "identifier" : {
-      "id" : "TestSnippet",
-      "version" : "1"
-    },
-    "schemaIdentifier" : {
-      "id" : "urn:hl7-org:elm",
-      "version" : "r1"
-    },
-    "usings" : {
-      "def" : [ {
-        "localId" : "1",
-        "localIdentifier" : "System",
-        "uri" : "urn:hl7-org:elm-types:r1",
-        "annotation" : [ ]
       }, {
-        "localId" : "206",
-        "localIdentifier" : "Simple",
-        "uri" : "https://github.com/cqframework/cql-execution/simple",
-        "version" : "1.0.0",
+        "localId" : "310",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "single_value",
+        "context" : "Patient",
+        "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "206",
+            "r" : "310",
             "s" : [ {
-              "value" : [ "", "using " ]
+              "value" : [ "", "define ", "single_value", ": " ]
             }, {
+              "r" : "319",
               "s" : [ {
-                "value" : [ "Simple" ]
+                "value" : [ "PopulationVariance", "(" ]
+              }, {
+                "r" : "311",
+                "s" : [ {
+                  "r" : "312",
+                  "value" : [ "{", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
-            }, {
-              "value" : [ " version '1.0.0'" ]
             } ]
           }
-        } ]
-      } ]
-    },
-    "contexts" : {
-      "def" : [ {
-        "localId" : "211",
-        "name" : "Patient",
-        "annotation" : [ ]
-      } ]
-    },
-    "statements" : {
-      "def" : [ {
-        "localId" : "209",
-        "name" : "Patient",
-        "context" : "Patient",
-        "annotation" : [ ],
+        } ],
+        "expression" : {
+          "type" : "PopulationVariance",
+          "localId" : "319",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "320",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "321",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "311",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "313",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "314",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "312",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "324",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "single_value_q",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "324",
+            "s" : [ {
+              "value" : [ "", "define ", "single_value_q", ": " ]
+            }, {
+              "r" : "333",
+              "s" : [ {
+                "value" : [ "PopulationVariance", "(" ]
+              }, {
+                "r" : "325",
+                "s" : [ {
+                  "value" : [ "{" ]
+                }, {
+                  "r" : "326",
+                  "s" : [ {
+                    "value" : [ "2.0 ", "'ml'" ]
+                  } ]
+                }, {
+                  "value" : [ "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "PopulationVariance",
+          "localId" : "333",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "334",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "335",
+              "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "325",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "327",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "328",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Quantity",
+              "localId" : "326",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 2.0,
+              "unit" : "ml",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      } ]
+    }
+  }
+}
+
+/* StdDev
+library TestSnippet version '1'
+using Simple version '1.0.0'
+context Patient
+define std: StdDev({1,2,3,4,5})
+define std_q: StdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
+define q_diff_units: StdDev({1 'ml', 0.002 'l',3 'ml',4 'ml', 0.05 'dl'})
+define sq_throw1: StdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'm'})
+define NumbersAndQuantities: StdDev({1 ,2 ,3 ,4 'ml',5 })
+define IncompatibleUnitsNull: StdDev({1 'mg/d', 0.002 '/d'})
+define single_value: StdDev({2.0})
+*/
+
+module.exports['StdDev'] = {
+  "library" : {
+    "localId" : "0",
+    "annotation" : [ {
+      "type" : "CqlToElmInfo",
+      "translatorVersion" : "4.2.0",
+      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
+      "signatureLevel" : "All"
+    }, {
+      "type" : "Annotation",
+      "t" : [ ],
+      "s" : {
+        "r" : "345",
+        "s" : [ {
+          "value" : [ "", "library TestSnippet version '1'" ]
+        } ]
+      }
+    } ],
+    "identifier" : {
+      "id" : "TestSnippet",
+      "version" : "1"
+    },
+    "schemaIdentifier" : {
+      "id" : "urn:hl7-org:elm",
+      "version" : "r1"
+    },
+    "usings" : {
+      "def" : [ {
+        "localId" : "1",
+        "localIdentifier" : "System",
+        "uri" : "urn:hl7-org:elm-types:r1",
+        "annotation" : [ ]
+      }, {
+        "localId" : "206",
+        "localIdentifier" : "Simple",
+        "uri" : "https://github.com/cqframework/cql-execution/simple",
+        "version" : "1.0.0",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "206",
+            "s" : [ {
+              "value" : [ "", "using " ]
+            }, {
+              "s" : [ {
+                "value" : [ "Simple" ]
+              } ]
+            }, {
+              "value" : [ " version '1.0.0'" ]
+            } ]
+          }
+        } ]
+      } ]
+    },
+    "contexts" : {
+      "def" : [ {
+        "localId" : "211",
+        "name" : "Patient",
+        "annotation" : [ ]
+      } ]
+    },
+    "statements" : {
+      "def" : [ {
+        "localId" : "209",
+        "name" : "Patient",
+        "context" : "Patient",
+        "annotation" : [ ],
         "expression" : {
           "type" : "SingletonFrom",
           "localId" : "210",
@@ -14476,6 +14781,76 @@ module.exports['StdDev'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "345",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "single_value",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "345",
+            "s" : [ {
+              "value" : [ "", "define ", "single_value", ": " ]
+            }, {
+              "r" : "354",
+              "s" : [ {
+                "value" : [ "StdDev", "(" ]
+              }, {
+                "r" : "346",
+                "s" : [ {
+                  "r" : "347",
+                  "value" : [ "{", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "StdDev",
+          "localId" : "354",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "355",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "356",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "346",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "348",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "349",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "347",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
@@ -14490,6 +14865,8 @@ define dev_q: PopulationStdDev({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 define q_diff_units: PopulationStdDev({1 'ml', 0.002 'l',3 'ml',4 'ml', 0.05 'dl'})
 define NumbersAndQuantities: PopulationStdDev({1 ,2 ,3 ,4 'ml',5 })
 define IncompatibleUnitsNull: PopulationStdDev({1 'mg/d', 0.002 '/d'})
+define single_value: PopulationStdDev({2.0})
+define single_value_q: PopulationStdDev({2.0 'ml'})
 */
 
 module.exports['PopulationStdDev'] = {
@@ -14504,7 +14881,7 @@ module.exports['PopulationStdDev'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "312",
+        "r" : "341",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -15212,6 +15589,152 @@ module.exports['PopulationStdDev'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "327",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "single_value",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "327",
+            "s" : [ {
+              "value" : [ "", "define ", "single_value", ": " ]
+            }, {
+              "r" : "336",
+              "s" : [ {
+                "value" : [ "PopulationStdDev", "(" ]
+              }, {
+                "r" : "328",
+                "s" : [ {
+                  "r" : "329",
+                  "value" : [ "{", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "PopulationStdDev",
+          "localId" : "336",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "337",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "338",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "328",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "330",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "331",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "329",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "341",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "single_value_q",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "341",
+            "s" : [ {
+              "value" : [ "", "define ", "single_value_q", ": " ]
+            }, {
+              "r" : "350",
+              "s" : [ {
+                "value" : [ "PopulationStdDev", "(" ]
+              }, {
+                "r" : "342",
+                "s" : [ {
+                  "value" : [ "{" ]
+                }, {
+                  "r" : "343",
+                  "s" : [ {
+                    "value" : [ "2.0 ", "'ml'" ]
+                  } ]
+                }, {
+                  "value" : [ "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "PopulationStdDev",
+          "localId" : "350",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "351",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "352",
+              "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "342",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "344",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "345",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Quantity",
+              "localId" : "343",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 2.0,
+              "unit" : "ml",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
@@ -18205,6 +18728,7 @@ define zero_geometric_mean: GeometricMean({2.0, 8.0, 0})
 define null_geometric_mean: GeometricMean({1, 2, null})
 define all_nulls: GeometricMean({null, null, null})
 define also_null_geometric_mean: GeometricMean(null as List<Decimal>)
+define negative_geometric_mean: GeometricMean({-1.0, 4.0})
 */
 
 module.exports['GeometricMean'] = {
@@ -18219,7 +18743,7 @@ module.exports['GeometricMean'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "307",
+        "r" : "325",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -18811,6 +19335,103 @@ module.exports['GeometricMean'] = {
             }
           }
         }
+      }, {
+        "localId" : "325",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "negative_geometric_mean",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "325",
+            "s" : [ {
+              "value" : [ "", "define ", "negative_geometric_mean", ": " ]
+            }, {
+              "r" : "337",
+              "s" : [ {
+                "value" : [ "GeometricMean", "(" ]
+              }, {
+                "r" : "326",
+                "s" : [ {
+                  "value" : [ "{" ]
+                }, {
+                  "r" : "327",
+                  "s" : [ {
+                    "r" : "328",
+                    "value" : [ "-", "1.0" ]
+                  } ]
+                }, {
+                  "r" : "330",
+                  "value" : [ ", ", "4.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "GeometricMean",
+          "localId" : "337",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "338",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "339",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "326",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "331",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "332",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Negate",
+              "localId" : "327",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ],
+              "signature" : [ {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "329",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              } ],
+              "operand" : {
+                "type" : "Literal",
+                "localId" : "328",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "value" : "1.0",
+                "annotation" : [ ]
+              }
+            }, {
+              "type" : "Literal",
+              "localId" : "330",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "4.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index b05c6b580..67c861761 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -348,6 +348,17 @@ describe('Power', () => {
   it('should return an infinitesimally small number when the exponent is the minimum Long value', async function () {
     (await this.twoLongExpMinLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.0));
   });
+
+  it('should normalize Decimal power results at the ELM boundary', async function () {
+    (await this.decimalPowerNeedsNormalization.exec(this.ctx)).should.equalDecimal(
+      Decimal.from('1.52415788')
+    );
+  });
+
+  it('should return null for Decimal powers that cannot be represented', async function () {
+    should(await this.negativeFractionalPower.exec(this.ctx)).be.null();
+    should(await this.zeroNegativePower.exec(this.ctx)).be.null();
+  });
 });
 
 describe('MinValue', () => {
@@ -636,6 +647,11 @@ describe('Round', () => {
     (await this.up_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.6));
     (await this.down_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.4));
   });
+
+  it('should round negative exact-half values toward positive infinity', async function () {
+    (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(Decimal.from(-1));
+  });
 });
 
 describe('Successor', () => {
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 5f621470a..8907b069a 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -82,6 +82,9 @@ define ThreeExpFourReverseMixed: 3L ^ 4
 define TenLongExpNegativeOneLong: 10L ^ -1L
 define TwoLongExpMaxLong: 2L ^ maximum Long
 define TwoLongExpMinLong: 2L ^ minimum Long
+define DecimalPowerNeedsNormalization: 1.23456789 ^ 2.0
+define NegativeFractionalPower: (-1.0) ^ 0.5
+define ZeroNegativePower: 0.0 ^ -1.0
 
 // @Test: MinValue
 define MinInteger: minimum Integer
@@ -144,6 +147,8 @@ define Up: Round(4.56)
 define Up_percent: Round(4.56,1)
 define Down: Round(4.49)
 define Down_percent: Round(4.43,1)
+define NegativeHalf: Round(-0.5)
+define NegativeOnePointFive: Round(-1.5)
 
 // @Test: Ln
 define ln: Ln(4)
diff --git a/test/elm/arithmetic/data.js b/test/elm/arithmetic/data.js
index fd1503036..c87f24008 100644
--- a/test/elm/arithmetic/data.js
+++ b/test/elm/arithmetic/data.js
@@ -5394,6 +5394,9 @@ define ThreeExpFourReverseMixed: 3L ^ 4
 define TenLongExpNegativeOneLong: 10L ^ -1L
 define TwoLongExpMaxLong: 2L ^ maximum Long
 define TwoLongExpMinLong: 2L ^ minimum Long
+define DecimalPowerNeedsNormalization: 1.23456789 ^ 2.0
+define NegativeFractionalPower: (-1.0) ^ 0.5
+define ZeroNegativePower: 0.0 ^ -1.0
 */
 
 module.exports['Power'] = {
@@ -5408,7 +5411,7 @@ module.exports['Power'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "281",
+        "r" : "308",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -5988,6 +5991,211 @@ module.exports['Power'] = {
             "annotation" : [ ]
           } ]
         }
+      }, {
+        "localId" : "290",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "DecimalPowerNeedsNormalization",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "290",
+            "s" : [ {
+              "value" : [ "", "define ", "DecimalPowerNeedsNormalization", ": " ]
+            }, {
+              "r" : "291",
+              "s" : [ {
+                "r" : "292",
+                "value" : [ "1.23456789", " ^ ", "2.0" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Power",
+          "localId" : "291",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "294",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "295",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "292",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "1.23456789",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "293",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2.0",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "298",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "NegativeFractionalPower",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "298",
+            "s" : [ {
+              "value" : [ "", "define ", "NegativeFractionalPower", ": " ]
+            }, {
+              "r" : "299",
+              "s" : [ {
+                "r" : "300",
+                "s" : [ {
+                  "value" : [ "(" ]
+                }, {
+                  "r" : "300",
+                  "s" : [ {
+                    "r" : "301",
+                    "value" : [ "-", "1.0" ]
+                  } ]
+                }, {
+                  "value" : [ ")" ]
+                } ]
+              }, {
+                "r" : "303",
+                "value" : [ " ^ ", "0.5" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Power",
+          "localId" : "299",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "304",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "305",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Negate",
+            "localId" : "300",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "302",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "301",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "Literal",
+            "localId" : "303",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "0.5",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "308",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "ZeroNegativePower",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "308",
+            "s" : [ {
+              "value" : [ "", "define ", "ZeroNegativePower", ": " ]
+            }, {
+              "r" : "309",
+              "s" : [ {
+                "r" : "310",
+                "value" : [ "0.0", " ^ " ]
+              }, {
+                "r" : "311",
+                "s" : [ {
+                  "r" : "312",
+                  "value" : [ "-", "1.0" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Power",
+          "localId" : "309",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "314",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "315",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "310",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "0.0",
+            "annotation" : [ ]
+          }, {
+            "type" : "Negate",
+            "localId" : "311",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "313",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "312",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }
+          } ]
+        }
       } ]
     }
   }
@@ -8642,6 +8850,8 @@ define Up: Round(4.56)
 define Up_percent: Round(4.56,1)
 define Down: Round(4.49)
 define Down_percent: Round(4.43,1)
+define NegativeHalf: Round(-0.5)
+define NegativeOnePointFive: Round(-1.5)
 */
 
 module.exports['Round'] = {
@@ -8656,7 +8866,7 @@ module.exports['Round'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "244",
+        "r" : "267",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8922,6 +9132,128 @@ module.exports['Round'] = {
             "annotation" : [ ]
           }
         }
+      }, {
+        "localId" : "256",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "NegativeHalf",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "256",
+            "s" : [ {
+              "value" : [ "", "define ", "NegativeHalf", ": " ]
+            }, {
+              "r" : "263",
+              "s" : [ {
+                "value" : [ "Round", "(" ]
+              }, {
+                "r" : "257",
+                "s" : [ {
+                  "r" : "258",
+                  "value" : [ "-", "0.5" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Round",
+          "localId" : "263",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "264",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Negate",
+            "localId" : "257",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "259",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "258",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "0.5",
+              "annotation" : [ ]
+            }
+          }
+        }
+      }, {
+        "localId" : "267",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "NegativeOnePointFive",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "267",
+            "s" : [ {
+              "value" : [ "", "define ", "NegativeOnePointFive", ": " ]
+            }, {
+              "r" : "274",
+              "s" : [ {
+                "value" : [ "Round", "(" ]
+              }, {
+                "r" : "268",
+                "s" : [ {
+                  "r" : "269",
+                  "value" : [ "-", "1.5" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Round",
+          "localId" : "274",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "275",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Negate",
+            "localId" : "268",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "270",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "269",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.5",
+              "annotation" : [ ]
+            }
+          }
+        }
       } ]
     }
   }
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index a5f7cc01d..92a83bad6 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -376,6 +376,22 @@ describe('ToDecimal', () => {
     // TODO: parseFloat is more forgiving than the CQL spec, so this does get converted
     should(await this.wrongFormat.exec(this.ctx)).be.null();
   });
+
+  it('should reject exponent notation and malformed Decimal strings', async function () {
+    should(await this.exponentNotation.exec(this.ctx)).be.null();
+    should(await this.exponentNotationUpper.exec(this.ctx)).be.null();
+    should(await this.trailingDecimalPoint.exec(this.ctx)).be.null();
+    should(await this.leadingDecimalPoint.exec(this.ctx)).be.null();
+  });
+
+  it('should accept an integer-form Decimal string', async function () {
+    (await this.integerFormat.exec(this.ctx)).should.equalDecimal(Decimal.from(1));
+  });
+
+  it('should format Decimals in fixed-point notation', async function () {
+    (await this.decimalToString.exec(this.ctx)).should.equal('1.0');
+    (await this.smallDecimalToString.exec(this.ctx)).should.equal('0.00000001');
+  });
 });
 
 describe('ToInteger', () => {
@@ -860,6 +876,11 @@ describe('ConvertsToDecimal', () => {
     (await this.isFalse.exec(this.ctx)).should.equal(false);
   });
 
+  it('should reject exponent notation and accept fixed-point Decimal notation', async function () {
+    (await this.exponentNotation.exec(this.ctx)).should.equal(false);
+    (await this.decimalFormat.exec(this.ctx)).should.equal(true);
+  });
+
   it('should return null for null input', async function () {
     should(await this.isNull.exec(this.ctx)).be.null();
   });
diff --git a/test/elm/convert/data.cql b/test/elm/convert/data.cql
index 35c249ba4..68c1742c6 100644
--- a/test/elm/convert/data.cql
+++ b/test/elm/convert/data.cql
@@ -81,6 +81,13 @@ define TooLargeDec: ToDecimal('444444444444444444444444444444')
 define TooSmallDec: ToDecimal('-444444444444444444444444444444')
 define NullDecimal: ToDecimal((null as String))
 define WrongFormat: ToDecimal('+.1')
+define ExponentNotation: ToDecimal('1e3')
+define ExponentNotationUpper: ToDecimal('1E-8')
+define TrailingDecimalPoint: ToDecimal('1.')
+define LeadingDecimalPoint: ToDecimal('.1')
+define IntegerFormat: ToDecimal('+1')
+define DecimalToString: ToString(1.0)
+define SmallDecimalToString: ToString(0.00000001)
 
 // @Test: ToInteger
 define NoSign: ToInteger('12345')
@@ -206,6 +213,8 @@ define IsNull: ConvertsToDateTime(null as DateTime)
 define IsTrue: ConvertsToDecimal('0.1')
 define IsFalse: ConvertsToDecimal('foo')
 define IsNull: ConvertsToDecimal(null as Decimal)
+define ExponentNotation: ConvertsToDecimal('1e3')
+define DecimalFormat: ConvertsToDecimal('1.0')
 
 // @Test: ConvertsToInteger
 define IsTrue: ConvertsToInteger('101')
diff --git a/test/elm/convert/data.js b/test/elm/convert/data.js
index bc8abadd2..764975694 100644
--- a/test/elm/convert/data.js
+++ b/test/elm/convert/data.js
@@ -3854,6 +3854,13 @@ define TooLargeDec: ToDecimal('444444444444444444444444444444')
 define TooSmallDec: ToDecimal('-444444444444444444444444444444')
 define NullDecimal: ToDecimal((null as String))
 define WrongFormat: ToDecimal('+.1')
+define ExponentNotation: ToDecimal('1e3')
+define ExponentNotationUpper: ToDecimal('1E-8')
+define TrailingDecimalPoint: ToDecimal('1.')
+define LeadingDecimalPoint: ToDecimal('.1')
+define IntegerFormat: ToDecimal('+1')
+define DecimalToString: ToString(1.0)
+define SmallDecimalToString: ToString(0.00000001)
 */
 
 module.exports['ToDecimal'] = {
@@ -3868,7 +3875,7 @@ module.exports['ToDecimal'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "285",
+        "r" : "354",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -4350,6 +4357,330 @@ module.exports['ToDecimal'] = {
             "annotation" : [ ]
           }
         }
+      }, {
+        "localId" : "295",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "ExponentNotation",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "295",
+            "s" : [ {
+              "value" : [ "", "define ", "ExponentNotation", ": " ]
+            }, {
+              "r" : "301",
+              "s" : [ {
+                "value" : [ "ToDecimal", "(" ]
+              }, {
+                "r" : "296",
+                "s" : [ {
+                  "value" : [ "'1e3'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToDecimal",
+          "localId" : "301",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "302",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "296",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "1e3",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "305",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "ExponentNotationUpper",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "305",
+            "s" : [ {
+              "value" : [ "", "define ", "ExponentNotationUpper", ": " ]
+            }, {
+              "r" : "311",
+              "s" : [ {
+                "value" : [ "ToDecimal", "(" ]
+              }, {
+                "r" : "306",
+                "s" : [ {
+                  "value" : [ "'1E-8'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToDecimal",
+          "localId" : "311",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "312",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "306",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "1E-8",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "315",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "TrailingDecimalPoint",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "315",
+            "s" : [ {
+              "value" : [ "", "define ", "TrailingDecimalPoint", ": " ]
+            }, {
+              "r" : "321",
+              "s" : [ {
+                "value" : [ "ToDecimal", "(" ]
+              }, {
+                "r" : "316",
+                "s" : [ {
+                  "value" : [ "'1.'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToDecimal",
+          "localId" : "321",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "322",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "316",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "1.",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "325",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "LeadingDecimalPoint",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "325",
+            "s" : [ {
+              "value" : [ "", "define ", "LeadingDecimalPoint", ": " ]
+            }, {
+              "r" : "331",
+              "s" : [ {
+                "value" : [ "ToDecimal", "(" ]
+              }, {
+                "r" : "326",
+                "s" : [ {
+                  "value" : [ "'.1'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToDecimal",
+          "localId" : "331",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "332",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "326",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : ".1",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "335",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "IntegerFormat",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "335",
+            "s" : [ {
+              "value" : [ "", "define ", "IntegerFormat", ": " ]
+            }, {
+              "r" : "341",
+              "s" : [ {
+                "value" : [ "ToDecimal", "(" ]
+              }, {
+                "r" : "336",
+                "s" : [ {
+                  "value" : [ "'+1'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToDecimal",
+          "localId" : "341",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "342",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "336",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "+1",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "345",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+        "name" : "DecimalToString",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "345",
+            "s" : [ {
+              "value" : [ "", "define ", "DecimalToString", ": " ]
+            }, {
+              "r" : "350",
+              "s" : [ {
+                "r" : "346",
+                "value" : [ "ToString", "(", "1.0", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToString",
+          "localId" : "350",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "351",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "346",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "1.0",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "354",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+        "name" : "SmallDecimalToString",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "354",
+            "s" : [ {
+              "value" : [ "", "define ", "SmallDecimalToString", ": " ]
+            }, {
+              "r" : "359",
+              "s" : [ {
+                "r" : "355",
+                "value" : [ "ToString", "(", "0.00000001", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ToString",
+          "localId" : "359",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "360",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "355",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "0.00000001",
+            "annotation" : [ ]
+          }
+        }
       } ]
     }
   }
@@ -10503,6 +10834,8 @@ context Patient
 define IsTrue: ConvertsToDecimal('0.1')
 define IsFalse: ConvertsToDecimal('foo')
 define IsNull: ConvertsToDecimal(null as Decimal)
+define ExponentNotation: ConvertsToDecimal('1e3')
+define DecimalFormat: ConvertsToDecimal('1.0')
 */
 
 module.exports['ConvertsToDecimal'] = {
@@ -10517,7 +10850,7 @@ module.exports['ConvertsToDecimal'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "234",
+        "r" : "255",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -10752,6 +11085,102 @@ module.exports['ConvertsToDecimal'] = {
             }
           }
         }
+      }, {
+        "localId" : "245",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Boolean",
+        "name" : "ExponentNotation",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "245",
+            "s" : [ {
+              "value" : [ "", "define ", "ExponentNotation", ": " ]
+            }, {
+              "r" : "251",
+              "s" : [ {
+                "value" : [ "ConvertsToDecimal", "(" ]
+              }, {
+                "r" : "246",
+                "s" : [ {
+                  "value" : [ "'1e3'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ConvertsToDecimal",
+          "localId" : "251",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Boolean",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "252",
+            "name" : "{urn:hl7-org:elm-types:r1}Any",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "246",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "1e3",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "255",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Boolean",
+        "name" : "DecimalFormat",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "255",
+            "s" : [ {
+              "value" : [ "", "define ", "DecimalFormat", ": " ]
+            }, {
+              "r" : "261",
+              "s" : [ {
+                "value" : [ "ConvertsToDecimal", "(" ]
+              }, {
+                "r" : "256",
+                "s" : [ {
+                  "value" : [ "'1.0'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ConvertsToDecimal",
+          "localId" : "261",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Boolean",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "262",
+            "name" : "{urn:hl7-org:elm-types:r1}Any",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "256",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "1.0",
+            "annotation" : [ ]
+          }
+        }
       } ]
     }
   }
diff --git a/test/util/immutableUtil-test.ts b/test/util/immutableUtil-test.ts
index f7463ce5c..be3adfb50 100644
--- a/test/util/immutableUtil-test.ts
+++ b/test/util/immutableUtil-test.ts
@@ -37,6 +37,14 @@ describe('ImmutableUtil Tests', () => {
     immutableIs(iq2, iq3).should.be.false();
   });
 
+  it('should normalize fractional unit conversions without JavaScript-number rounding', () => {
+    const inches = new Quantity(1, '[in_i]');
+    const centimeters = new Quantity('2.54', 'cm');
+
+    equals(inches, centimeters).should.be.true();
+    immutableIs(toNormalizedKey(inches), toNormalizedKey(centimeters)).should.be.true();
+  });
+
   it('should properly match ratios', () => {
     const r1 = new Ratio(new Quantity(1, 'km'), new Quantity(1, 'h'));
     const r2 = new Ratio(new Quantity(1000, 'm'), new Quantity(60, 'min'));
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index a6e6d3629..56305f115 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -1,7 +1,7 @@
 import { Uncertainty } from '../../src/datatypes/uncertainty';
 import { MAX_FLOAT_VALUE, MIN_FLOAT_VALUE } from '../../src/util/limits';
 import { Decimal } from '../../src/datatypes/decimal';
-import { predecessor, successor } from '../../src/util/math';
+import { finalizeNumericResult, predecessor, successor } from '../../src/util/math';
 
 describe('successor', () => {
   it('should preserve integers in an Uncertainty', () => {
@@ -40,3 +40,22 @@ describe('predecessor', () => {
     result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(1.99999999)));
   });
 });
+
+describe('finalizeNumericResult', () => {
+  it('should normalize Decimal results to eight places using the implicit rounding mode', () => {
+    const result = finalizeNumericResult(Decimal.from('1.234567895'));
+
+    result.should.equalDecimal(Decimal.from('1.23456790'));
+  });
+
+  it('should return a new normalized Uncertainty without modifying the input', () => {
+    const input = new Uncertainty(Decimal.from('1.234567895'), Decimal.from('2.345678995'));
+    const result = finalizeNumericResult(input);
+
+    result.should.not.equal(input);
+    input.low.should.equalDecimal(Decimal.from('1.234567895'));
+    input.high.should.equalDecimal(Decimal.from('2.345678995'));
+    result.low.should.equalDecimal(Decimal.from('1.23456790'));
+    result.high.should.equalDecimal(Decimal.from('2.34567900'));
+  });
+});

From 1c075ff9e2896882b88dde82b0e57bee718eaf4a Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 26 Aug 2026 16:36:48 -0400
Subject: [PATCH 13/62] one more round of cleanup

---
 src/datatypes/decimal.ts               |  20 ++--
 src/elm/arithmetic.ts                  |  18 ++-
 src/elm/literal.ts                     |   2 +-
 test/datatypes/decimal-test.ts         |  15 +++
 test/elm/arithmetic/arithmetic-test.ts |  12 ++
 test/elm/arithmetic/data.cql           |   3 +
 test/elm/arithmetic/data.js            | 154 ++++++++++++++++++++++++-
 7 files changed, 207 insertions(+), 17 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 5d0a99ec0..e72e6eeb9 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -1,24 +1,26 @@
 import { Decimal as DecimalJS } from 'decimal.js';
 
-// Default precision is set to 30 significant figures. (Not decimal places)
-// MAX_DECIMAL_VALUE = 99999999999999999999.99999999 is 28 significant figures,
-// 30 is just a cleaner number.
-DecimalJS.set({ precision: 30 });
+// Use a clone rather than DecimalJS.set because decimal.js configuration is otherwise global.
+// This keeps our settings from changing the behavior of other decimal.js instances in
+// the same process.
+// Precision is significant figures (not decimal places);
+// CQL's maximum Decimal value has 28 significant figures, 30 is just a cleaner number.
+const CQLDecimalJS = DecimalJS.clone({ precision: 30 });
 
 export type DecimalInput = Decimal | string | number | bigint;
 
 export type DecimalRoundingMode = DecimalJS.Rounding;
 
-const MIN_PRECISION_VALUE = DecimalJS.pow(10, -8);
+const MIN_PRECISION_VALUE = CQLDecimalJS.pow(10, -8);
 
 const CQL_IMPLICIT_SCALE = 8;
-const CQL_IMPLICIT_ROUNDING = DecimalJS.ROUND_HALF_UP;
+const CQL_IMPLICIT_ROUNDING = CQLDecimalJS.ROUND_HALF_UP;
 
 export class Decimal {
   private value: DecimalJS;
 
   private constructor(value: string | number | bigint | DecimalJS) {
-    this.value = new DecimalJS(value);
+    this.value = new CQLDecimalJS(value);
     if (!this.value.isFinite()) {
       throw new Error('Cannot create a decimal with a non-finite value');
     }
@@ -167,10 +169,10 @@ export class Decimal {
     // ROUND_HALF_CEIL "Rounds towards nearest neighbour. If equidistant, rounds towards Infinity"
     // rounds 0.5 -> 1.0, -0.5 -> 0.0
     // https://mikemcl.github.io/decimal.js/#modes
-    return this.setScale(scale, DecimalJS.ROUND_HALF_CEIL);
+    return this.setScale(scale, CQLDecimalJS.ROUND_HALF_CEIL);
   }
 
-  setScale(scale: number, roundingMode: DecimalRoundingMode = DecimalJS.ROUND_DOWN) {
+  setScale(scale: number, roundingMode: DecimalRoundingMode = CQLDecimalJS.ROUND_DOWN) {
     if (!Number.isInteger(scale) || scale < 0) {
       throw new RangeError('Decimal scale must be a non-negative integer');
     }
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index c0d7f796a..ffff1a73f 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -216,7 +216,8 @@ export class Ceiling extends Expression {
       return null;
     }
 
-    return arg.isDecimal ? arg.ceil() : Math.ceil(arg);
+    const ceiling = arg.isDecimal ? arg.ceil() : Math.ceil(arg);
+    return MathUtil.isValidInteger(ceiling) ? ceiling : null;
   }
 }
 
@@ -231,7 +232,8 @@ export class Floor extends Expression {
       return null;
     }
 
-    return arg.isDecimal ? arg.floor() : Math.floor(arg);
+    const floor = arg.isDecimal ? arg.floor() : Math.floor(arg);
+    return MathUtil.isValidInteger(floor) ? floor : null;
   }
 }
 
@@ -246,7 +248,15 @@ export class Truncate extends Expression {
       return null;
     }
 
-    return arg.isDecimal ? arg.truncate() : arg >= 0 ? Math.floor(arg) : Math.ceil(arg);
+    let truncated;
+    if (arg.isDecimal) {
+      truncated = arg.truncate();
+    } else if (arg >= 0) {
+      truncated = Math.floor(arg);
+    } else {
+      truncated = Math.ceil(arg);
+    }
+    return MathUtil.isValidInteger(truncated) ? truncated : null;
   }
 }
 export class Abs extends Expression {
@@ -349,7 +359,7 @@ export class Exp extends Expression {
 
     let power;
     try {
-      power = Decimal.from(arg).exp().normalized();
+      power = Decimal.from(arg).exp();
     } catch {
       return null;
     }
diff --git a/src/elm/literal.ts b/src/elm/literal.ts
index dea41feb3..68d0a448c 100644
--- a/src/elm/literal.ts
+++ b/src/elm/literal.ts
@@ -97,7 +97,7 @@ export class LongLiteral extends Literal {
 export class DecimalLiteral extends Literal {
   constructor(json: any) {
     super(json);
-    this.value = Decimal.from(this.value);
+    this.value = Decimal.from(this.value).normalized();
   }
 
   // Define a simple getter to allow type-checking of this class without instanceof
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 053584fd3..e2682a5ae 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -1,3 +1,4 @@
+import { Decimal as DecimalJS } from 'decimal.js';
 import { Decimal } from '../../src/datatypes/decimal';
 
 describe('Decimal', () => {
@@ -49,4 +50,18 @@ describe('Decimal', () => {
   it('should not coerce a nonzero Decimal divisor through a JavaScript number', () => {
     (() => Decimal.from(1).divideBy('1e-1000')).should.not.throw();
   });
+
+  it('should keep CQL Decimal precision independent from the base decimal.js constructor', () => {
+    const basePrecision = DecimalJS.precision;
+    try {
+      DecimalJS.set({ precision: 5 });
+
+      const oneThird = Decimal.from(1).divideBy(3);
+      oneThird.toString().should.equal('0.333333333333333333333333333333'); // we specify precision of 30 = significant figures
+
+      oneThird.normalized().toString().should.equal('0.33333333');
+    } finally {
+      DecimalJS.set({ precision: basePrecision });
+    }
+  });
 });
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 67c861761..092a36c7d 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -517,6 +517,10 @@ describe('Truncate', () => {
     // NOTE: Truncate returns an integer (not specified to return a Long)
     (await this.truncTenLong.exec(this.ctx)).should.equal(10);
   });
+
+  it('should return null when the result is outside the Integer range', async function () {
+    should(await this.truncateOverflow.exec(this.ctx)).be.null();
+  });
 });
 
 describe('Floor', () => {
@@ -530,6 +534,10 @@ describe('Floor', () => {
     // NOTE: Floor returns an Integer (not specified to return a Long)
     (await this.floorTenLong.exec(this.ctx)).should.equal(10);
   });
+
+  it('should return null when the result is outside the Integer range', async function () {
+    should(await this.floorUnderflow.exec(this.ctx)).be.null();
+  });
 });
 
 describe('Ceiling', () => {
@@ -543,6 +551,10 @@ describe('Ceiling', () => {
     // Note: Ceiling returns an Integer (not specified to return a Long)
     (await this.ceilTenLong.exec(this.ctx)).should.equal(10);
   });
+
+  it('should return null when the result is outside the Integer range', async function () {
+    should(await this.ceilingOverflow.exec(this.ctx)).be.null();
+  });
 });
 
 describe('Ln', () => {
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 8907b069a..7d5e49457 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -123,16 +123,19 @@ define ThreeModZeroDecimal: 3.0 mod 0.0
 define Ceil: Ceiling(10.1)
 define Even: Ceiling(10)
 define CeilTenLong: Ceiling(10L)
+define CeilingOverflow: Ceiling(2147483647.1)
 
 // @Test: Floor
 define flr: Floor(10.1)
 define Even: Floor(10)
 define FloorTenLong: Floor(10L)
+define FloorUnderflow: Floor(-2147483648.1)
 
 // @Test: Truncate
 define Trunc: Truncate(10.1)
 define Even: Truncate(10)
 define TruncTenLong: Truncate(10L)
+define TruncateOverflow: Truncate(2147483648.0)
 
 // @Test: Abs
 define Pos: Abs(10)
diff --git a/test/elm/arithmetic/data.js b/test/elm/arithmetic/data.js
index c87f24008..ccfe850d1 100644
--- a/test/elm/arithmetic/data.js
+++ b/test/elm/arithmetic/data.js
@@ -7700,6 +7700,7 @@ context Patient
 define Ceil: Ceiling(10.1)
 define Even: Ceiling(10)
 define CeilTenLong: Ceiling(10L)
+define CeilingOverflow: Ceiling(2147483647.1)
 */
 
 module.exports['Ceiling'] = {
@@ -7714,7 +7715,7 @@ module.exports['Ceiling'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "238",
+        "r" : "253",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -7934,6 +7935,48 @@ module.exports['Ceiling'] = {
             }
           }
         }
+      }, {
+        "localId" : "253",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "CeilingOverflow",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "253",
+            "s" : [ {
+              "value" : [ "", "define ", "CeilingOverflow", ": " ]
+            }, {
+              "r" : "258",
+              "s" : [ {
+                "r" : "254",
+                "value" : [ "Ceiling", "(", "2147483647.1", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Ceiling",
+          "localId" : "258",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "259",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "254",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2147483647.1",
+            "annotation" : [ ]
+          }
+        }
       } ]
     }
   }
@@ -7946,6 +7989,7 @@ context Patient
 define flr: Floor(10.1)
 define Even: Floor(10)
 define FloorTenLong: Floor(10L)
+define FloorUnderflow: Floor(-2147483648.1)
 */
 
 module.exports['Floor'] = {
@@ -7960,7 +8004,7 @@ module.exports['Floor'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "238",
+        "r" : "253",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8180,6 +8224,67 @@ module.exports['Floor'] = {
             }
           }
         }
+      }, {
+        "localId" : "253",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "FloorUnderflow",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "253",
+            "s" : [ {
+              "value" : [ "", "define ", "FloorUnderflow", ": " ]
+            }, {
+              "r" : "260",
+              "s" : [ {
+                "value" : [ "Floor", "(" ]
+              }, {
+                "r" : "254",
+                "s" : [ {
+                  "r" : "255",
+                  "value" : [ "-", "2147483648.1" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Floor",
+          "localId" : "260",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "261",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Negate",
+            "localId" : "254",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "256",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "255",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2147483648.1",
+              "annotation" : [ ]
+            }
+          }
+        }
       } ]
     }
   }
@@ -8192,6 +8297,7 @@ context Patient
 define Trunc: Truncate(10.1)
 define Even: Truncate(10)
 define TruncTenLong: Truncate(10L)
+define TruncateOverflow: Truncate(2147483648.0)
 */
 
 module.exports['Truncate'] = {
@@ -8206,7 +8312,7 @@ module.exports['Truncate'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "238",
+        "r" : "253",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8426,6 +8532,48 @@ module.exports['Truncate'] = {
             }
           }
         }
+      }, {
+        "localId" : "253",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "TruncateOverflow",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "253",
+            "s" : [ {
+              "value" : [ "", "define ", "TruncateOverflow", ": " ]
+            }, {
+              "r" : "258",
+              "s" : [ {
+                "r" : "254",
+                "value" : [ "Truncate", "(", "2147483648.0", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Truncate",
+          "localId" : "258",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "259",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "254",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2147483648.0",
+            "annotation" : [ ]
+          }
+        }
       } ]
     }
   }

From 95ad9ed34e037660c625da3ceb4bf7d23d1c83bb Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 08:40:15 -0400
Subject: [PATCH 14/62] Low-hanging fruit to get interval tests passing

---
 src/elm/interval.ts                           |   19 +-
 .../cql/CqlIntervalOperatorsTest.cql          |   48 +-
 .../cql/CqlIntervalOperatorsTest.json         | 2656 ++++++++++++++---
 test/spec-tests/skip-list.txt                 |   25 +-
 4 files changed, 2291 insertions(+), 457 deletions(-)

diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index cea2cf1a7..c7f53a91d 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -453,10 +453,17 @@ export class Expand extends Expression {
       return null;
     }
 
-    // CQL 1.5 introduced an overload to allow singular intervals; make it a list so we can use the same logic for either overload
-    if (!Array.isArray(intervals)) {
+    const isSingleInterval = !Array.isArray(intervals);
+    // CQL 1.5 introduced an overload to allow singular intervals; make it a list so we can use the same logic for either overload.
+    if (isSingleInterval) {
       intervals = [intervals];
     }
+
+    // If the list of intervals is empty, the result is empty.
+    if (intervals.length === 0) {
+      return [];
+    }
+
     const type = intervalListType(intervals);
     if (type === 'mismatch') {
       throw new Error('List of intervals contains mismatched types.');
@@ -508,6 +515,14 @@ export class Expand extends Expression {
       results.push(...(items || []));
     }
 
+    // If the input argument is an interval, rather than a list of intervals,
+    // the result is a list of points, rather than a list of intervals.
+    // In this case, the calculation is performed the same way,
+    // but the starting point of each resulting interval is returned, rather than the interval.
+    if (isSingleInterval) {
+      return results.map(i => i.start());
+    }
+
     return results;
   }
 
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
index 1f15520ab..eb465ed41 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
@@ -247,11 +247,9 @@ define "Expand": Tuple{
     output: null
   },
   "ExpandEmptyList": Tuple{
-    skipped: 'Wrong answer (should be empty list)'
-    /*
     expression: expand { },
     output: { }
-    */  },
+  },
   "ExpandListWithNull": Tuple{
     skipped: 'Wrong answer (should be empty list due to removing nulls)'
     /*
@@ -263,61 +261,49 @@ define "Expand": Tuple{
     output: { Interval[@2018-01-01, @2018-01-01], Interval[@2018-01-02, @2018-01-02], Interval[@2018-01-03, @2018-01-03], Interval[@2018-01-04, @2018-01-04] }
   },
   "ExpandPerDayIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[@2018-01-01, @2018-01-04] per day,
     output: { @2018-01-01, @2018-01-02, @2018-01-03, @2018-01-04 }
-    */  },
+  },
   "ExpandPer2Days": Tuple{
     expression: expand { Interval[@2018-01-01, @2018-01-04] } per 2 days,
     output: { Interval[@2018-01-01, @2018-01-02], Interval[@2018-01-03, @2018-01-04] }
   },
   "ExpandPer2DaysIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[@2018-01-01, @2018-01-04] per 2 days,
     output: { @2018-01-01, @2018-01-03 }
-    */  },
+  },
   "ExpandPerHour": Tuple{
     expression: expand { Interval[@T10:00, @T12:30] } per hour,
     output: { Interval[@T10, @T10], Interval[@T11, @T11], Interval[@T12, @T12] }
   },
   "ExpandPerHourIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[@T10:00, @T12:30] per hour,
     output: { @T10, @T11, @T12 }
-    */  },
+  },
   "ExpandPerHourOpen": Tuple{
     expression: expand { Interval[@T10:00, @T12:30) } per hour,
     output: { Interval[@T10, @T10], Interval[@T11, @T11], Interval[@T12, @T12] }
   },
   "ExpandPerHourOpenIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[@T10:00, @T12:30) per hour,
     output: { @T10, @T11, @T12 }
-    */  },
+  },
   "ExpandPer1": Tuple{
     expression: expand { Interval[10.0, 12.5] } per 1,
     output: { Interval[10, 10], Interval[11, 11], Interval[12, 12] }
   },
   "ExpandPer1IntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[10.0, 12.5] per 1,
     output: { 10, 11, 12 }
-    */  },
+  },
   "ExpandPer1Open": Tuple{
     expression: expand { Interval[10.0, 12.5) } per 1,
     output: { Interval[10, 10], Interval[11, 11], Interval[12, 12] }
   },
   "ExpandPer1OpenIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[10.0, 12.5) per 1,
     output: { 10, 11, 12 }
-    */  },
+  },
   "ExpandPerMinute": Tuple{
     expression: expand { Interval[@T10, @T10] } per minute,
     output: { }
@@ -327,13 +313,13 @@ define "Expand": Tuple{
     output: { }
   },
   "ExpandPer0D1": Tuple{
-    skipped: 'Wrong answer (interval elements\'s decimals do not match expected output)'
+    skipped: 'Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705'
     /*
     expression: expand { Interval[10, 10] } per 0.1,
     output: { Interval[10.0, 10.0], Interval[10.1, 10.1], Interval[10.2, 10.2], Interval[10.3, 10.3], Interval[10.4, 10.4], Interval[10.5, 10.5], Interval[10.6, 10.6], Interval[10.7, 10.7], Interval[10.8, 10.8], Interval[10.9, 10.9] }
     */  },
   "ExpandPer0D1IntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
+    skipped: 'Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705'
     /*
     expression: expand Interval[10, 10] per 0.1,
     output: { 10.0, 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8, 10.9 }
@@ -343,41 +329,33 @@ define "Expand": Tuple{
     output: { Interval[1, 1], Interval[2, 2], Interval[3, 3], Interval[4, 4], Interval[5, 5], Interval[6, 6], Interval[7, 7], Interval[8, 8], Interval[9, 9], Interval[10, 10] }
   },
   "ExpandIntegerIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[1, 10],
     output: { 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 }
-    */  },
+  },
   "ExpandIntervalOpen": Tuple{
     expression: expand { Interval[1, 10) },
     output: { Interval[1, 1], Interval[2, 2], Interval[3, 3], Interval[4, 4], Interval[5, 5], Interval[6, 6], Interval[7, 7], Interval[8, 8], Interval[9, 9] }
   },
   "ExpandIntegerOpenIntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[1, 10),
     output: { 1, 2, 3, 4, 5, 6, 7, 8, 9 }
-    */  },
+  },
   "ExpandIntervalPer2": Tuple{
     expression: expand { Interval[1, 10] } per 2,
     output: { Interval[1, 2], Interval[3, 4], Interval[5, 6], Interval[7, 8], Interval[9, 10] }
   },
   "ExpandIntervalPer2IntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[1, 10] per 2,
     output: { 1, 3, 5, 7, 9 }
-    */  },
+  },
   "ExpandIntervalOpenPer2": Tuple{
     expression: expand { Interval[1, 10) } per 2,
     output: { Interval[1, 2], Interval[3, 4], Interval[5, 6], Interval[7, 8] }
   },
   "ExpandIntervalOpenPer2IntervalOverload": Tuple{
-    skipped: 'Wrong answer (single interval overload should return list of points)'
-    /*
     expression: expand Interval[1, 10) per 2,
     output: { 1, 3, 5, 7 }
-    */  }
+  }
 }
 
 define "Contains": Tuple{
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.json b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
index b229a9370..8fc6eda5e 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.json
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
@@ -13763,12 +13763,33 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -13845,12 +13866,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -13908,12 +13946,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -13971,12 +14026,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14034,12 +14106,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14097,12 +14186,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14160,12 +14266,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14337,12 +14460,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14395,25 +14535,6 @@
               {
                 "name": "ExpandIntegerOpenIntervalOverload",
                 "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "ExpandIntervalPer2",
-                "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
                   "annotation": [],
@@ -14425,13 +14546,9 @@
                         "type": "ListTypeSpecifier",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
                         }
                       }
                     },
@@ -14442,13 +14559,9 @@
                         "type": "ListTypeSpecifier",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
                         }
                       }
                     }
@@ -14456,26 +14569,87 @@
                 }
               },
               {
-                "name": "ExpandIntervalPer2IntervalOverload",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "ExpandIntervalOpenPer2",
+                "name": "ExpandIntervalPer2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "ExpandIntervalPer2IntervalOverload",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "ExpandIntervalOpenPer2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14526,12 +14700,29 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -14586,12 +14777,33 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Any",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14668,12 +14880,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14731,12 +14960,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14794,12 +15040,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14857,12 +15120,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14920,12 +15200,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -14983,12 +15280,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -15160,12 +15474,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -15223,12 +15554,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -15286,12 +15634,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -15349,12 +15714,29 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
@@ -15461,25 +15843,130 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Any",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (should be empty list)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Any",
+                              "annotation": []
+                            }
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Query",
+                            "annotation": [],
+                            "source": [
+                              {
+                                "alias": "X",
+                                "annotation": [],
+                                "expression": {
+                                  "type": "List",
+                                  "annotation": [],
+                                  "resultTypeSpecifier": {
+                                    "type": "ListTypeSpecifier",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "annotation": []
+                                    }
+                                  },
+                                  "element": []
+                                }
+                              }
+                            ],
+                            "let": [],
+                            "relationship": [],
+                            "return": {
+                              "distinct": false,
+                              "annotation": [],
+                              "expression": {
+                                "type": "As",
+                                "annotation": [],
+                                "signature": [],
+                                "operand": {
+                                  "type": "AliasRef",
+                                  "name": "X",
+                                  "annotation": []
+                                },
+                                "asTypeSpecifier": {
+                                  "type": "IntervalTypeSpecifier",
+                                  "annotation": [],
+                                  "pointType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}Any",
+                                    "annotation": []
+                                  }
+                                }
+                              }
+                            }
+                          },
+                          {
+                            "type": "Null",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          }
+                        },
+                        "element": []
                       }
                     }
                   ]
@@ -15955,40 +16442,6 @@
               },
               {
                 "name": "ExpandPerDayIntervalOverload",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "skipped",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "ExpandPer2Days",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -16003,13 +16456,9 @@
                           "type": "ListTypeSpecifier",
                           "annotation": [],
                           "elementType": {
-                            "type": "IntervalTypeSpecifier",
-                            "annotation": [],
-                            "pointType": {
-                              "type": "NamedTypeSpecifier",
-                              "name": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": []
-                            }
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
                           }
                         }
                       },
@@ -16020,13 +16469,9 @@
                           "type": "ListTypeSpecifier",
                           "annotation": [],
                           "elementType": {
-                            "type": "IntervalTypeSpecifier",
-                            "annotation": [],
-                            "pointType": {
-                              "type": "NamedTypeSpecifier",
-                              "name": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": []
-                            }
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
                           }
                         }
                       }
@@ -16042,128 +16487,379 @@
                           "type": "ListTypeSpecifier",
                           "annotation": [],
                           "elementType": {
-                            "type": "IntervalTypeSpecifier",
-                            "annotation": [],
-                            "pointType": {
-                              "type": "NamedTypeSpecifier",
-                              "name": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": []
-                            }
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
                           }
                         },
                         "signature": [],
                         "operand": [
-                          {
-                            "type": "List",
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "ListTypeSpecifier",
-                              "annotation": [],
-                              "elementType": {
-                                "type": "IntervalTypeSpecifier",
-                                "annotation": [],
-                                "pointType": {
-                                  "type": "NamedTypeSpecifier",
-                                  "name": "{urn:hl7-org:elm-types:r1}Date",
-                                  "annotation": []
-                                }
-                              }
-                            },
-                            "element": [
-                              {
-                                "type": "Interval",
-                                "lowClosed": true,
-                                "highClosed": true,
-                                "annotation": [],
-                                "resultTypeSpecifier": {
-                                  "type": "IntervalTypeSpecifier",
-                                  "annotation": [],
-                                  "pointType": {
-                                    "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}Date",
-                                    "annotation": []
-                                  }
-                                },
-                                "low": {
-                                  "type": "Date",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                                  "annotation": [],
-                                  "signature": [],
-                                  "year": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "2018",
-                                    "annotation": []
-                                  },
-                                  "month": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
-                                    "annotation": []
-                                  },
-                                  "day": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
-                                    "annotation": []
-                                  }
-                                },
-                                "high": {
-                                  "type": "Date",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                                  "annotation": [],
-                                  "signature": [],
-                                  "year": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "2018",
-                                    "annotation": []
-                                  },
-                                  "month": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
-                                    "annotation": []
-                                  },
-                                  "day": {
-                                    "type": "Literal",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "4",
-                                    "annotation": []
-                                  }
-                                }
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 2,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "List",
-                        "annotation": [],
-                        "resultTypeSpecifier": {
-                          "type": "ListTypeSpecifier",
-                          "annotation": [],
-                          "elementType": {
-                            "type": "IntervalTypeSpecifier",
-                            "annotation": [],
-                            "pointType": {
-                              "type": "NamedTypeSpecifier",
-                              "name": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": []
-                            }
-                          }
-                        },
-                        "element": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Date",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Date",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2018",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              }
+                            },
+                            "high": {
+                              "type": "Date",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2018",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "4",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 1,
+                            "unit": "day",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "4",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "ExpandPer2Days",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": []
+                            }
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "List",
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "ListTypeSpecifier",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "IntervalTypeSpecifier",
+                                "annotation": [],
+                                "pointType": {
+                                  "type": "NamedTypeSpecifier",
+                                  "name": "{urn:hl7-org:elm-types:r1}Date",
+                                  "annotation": []
+                                }
+                              }
+                            },
+                            "element": [
+                              {
+                                "type": "Interval",
+                                "lowClosed": true,
+                                "highClosed": true,
+                                "annotation": [],
+                                "resultTypeSpecifier": {
+                                  "type": "IntervalTypeSpecifier",
+                                  "annotation": [],
+                                  "pointType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}Date",
+                                    "annotation": []
+                                  }
+                                },
+                                "low": {
+                                  "type": "Date",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                                  "annotation": [],
+                                  "signature": [],
+                                  "year": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "2018",
+                                    "annotation": []
+                                  },
+                                  "month": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  },
+                                  "day": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                },
+                                "high": {
+                                  "type": "Date",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                                  "annotation": [],
+                                  "signature": [],
+                                  "year": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "2018",
+                                    "annotation": []
+                                  },
+                                  "month": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  },
+                                  "day": {
+                                    "type": "Literal",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "4",
+                                    "annotation": []
+                                  }
+                                }
+                              }
+                            ]
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 2,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "IntervalTypeSpecifier",
+                            "annotation": [],
+                            "pointType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": []
+                            }
+                          }
+                        },
+                        "element": [
                           {
                             "type": "Interval",
                             "lowClosed": true,
@@ -16306,25 +17002,187 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Date",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Date",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2018",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              }
+                            },
+                            "high": {
+                              "type": "Date",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2018",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "4",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 2,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2018",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     }
                   ]
@@ -16627,25 +17485,162 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Time",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Time",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                              "annotation": [],
+                              "signature": [],
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "0",
+                                "annotation": []
+                              }
+                            },
+                            "high": {
+                              "type": "Time",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                              "annotation": [],
+                              "signature": [],
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "12",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "30",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 1,
+                            "unit": "hour",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     }
                   ]
@@ -16948,25 +17943,162 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": false,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Time",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Time",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                              "annotation": [],
+                              "signature": [],
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "0",
+                                "annotation": []
+                              }
+                            },
+                            "high": {
+                              "type": "Time",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                              "annotation": [],
+                              "signature": [],
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "12",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "30",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 1,
+                            "unit": "hour",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     }
                   ]
@@ -17217,25 +18349,125 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "10.0",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "12.5",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 1,
+                            "unit": "1",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "11",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "12",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -17486,25 +18718,125 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": false,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "10.0",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "12.5",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 1,
+                            "unit": "1",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "11",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "12",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -17808,7 +19140,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (interval elements's decimals do not match expected output)",
+                        "value": "Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705",
                         "annotation": []
                       }
                     }
@@ -17842,7 +19174,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
+                        "value": "Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705",
                         "annotation": []
                       }
                     }
@@ -18296,25 +19628,173 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Null",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "4",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "6",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "7",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "8",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "9",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -18738,25 +20218,166 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": false,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Null",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "4",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "6",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "7",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "8",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "9",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -19065,25 +20686,139 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": true,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 2,
+                            "unit": "1",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "7",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "9",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -19363,25 +21098,132 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (single interval overload should return list of points)",
-                        "annotation": []
+                        "type": "Expand",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Interval",
+                            "lowClosed": true,
+                            "highClosed": false,
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            "low": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "high": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "value": 2,
+                            "unit": "1",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "List",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "7",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
@@ -53485,11 +55327,11 @@
                               "annotation": [],
                               "resultTypeSpecifier": {
                                 "type": "IntervalTypeSpecifier",
-                                "localId": "9912",
+                                "localId": "10275",
                                 "annotation": [],
                                 "pointType": {
                                   "type": "NamedTypeSpecifier",
-                                  "localId": "9913",
+                                  "localId": "10276",
                                   "name": "{urn:hl7-org:elm-types:r1}Date",
                                   "annotation": []
                                 }
@@ -55355,11 +57197,11 @@
                               "annotation": [],
                               "resultTypeSpecifier": {
                                 "type": "IntervalTypeSpecifier",
-                                "localId": "10237",
+                                "localId": "10600",
                                 "annotation": [],
                                 "pointType": {
                                   "type": "NamedTypeSpecifier",
-                                  "localId": "10238",
+                                  "localId": "10601",
                                   "name": "{urn:hl7-org:elm-types:r1}Date",
                                   "annotation": []
                                 }
@@ -81779,11 +83621,11 @@
                             "annotation": [],
                             "resultTypeSpecifier": {
                               "type": "IntervalTypeSpecifier",
-                              "localId": "15175",
+                              "localId": "15538",
                               "annotation": [],
                               "pointType": {
                                 "type": "NamedTypeSpecifier",
-                                "localId": "15176",
+                                "localId": "15539",
                                 "name": "{urn:hl7-org:elm-types:r1}Any",
                                 "annotation": []
                               }
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index 6e8072e7b..ee19feabc 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -9,6 +9,8 @@ CqlIntervalOperatorsTest.ProperContains.TimeProperContainsPrecisionFalse  Wrong
 CqlIntervalOperatorsTest.ProperContains.TimeProperContainsFalse Wrong output: According to spec, a contained point is properly contained as long as the interval is not a unit interval
 CqlIntervalOperatorsTest.ProperIn.TimeProperInPrecisionFalse    Wrong output: According to spec, a contained point is properly in as long as the interval is not a unit interval
 CqlIntervalOperatorsTest.ProperIn.TimeProperInFalse             Wrong output: According to spec, a contained point is properly in as long as the interval is not a unit interval
+CqlIntervalOperatorsTest.Expand.ExpandPer0D1                    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
+CqlIntervalOperatorsTest.Expand.ExpandPer0D1IntervalOverload    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
 CqlListOperatorsTest.Equal.EqualNullNull                        Wrong output: According to spec, if either list contains a null, the result is null
 CqlListOperatorsTest.Sort.simpleSortAsc                         Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlListOperatorsTest.Sort.simpleSortDesc                        Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
@@ -27,20 +29,17 @@ CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: In
 CqlComparisonOperatorsTest.Equal.DateTimeEqNull                 Wrong answer (true vs null - due to not evaluating DateTime(null) as null)
 CqlIntervalOperatorsTest.Collapse.TestCollapseNull              Wrong answer (Interval(null, null) vs null)
 CqlIntervalOperatorsTest.Except.NullInterval                    Wrong answer (Interval(null, null) vs null)
-CqlIntervalOperatorsTest.Expand.ExpandEmptyList                           Wrong answer (should be empty list)
-CqlIntervalOperatorsTest.Expand.ExpandIntegerIntervalOverload             Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandIntegerOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandIntervalOpenPer2IntervalOverload    Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandIntervalPer2IntervalOverload        Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandIntegerIntervalOverload             Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandIntegerOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandIntervalOpenPer2IntervalOverload    Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandIntervalPer2IntervalOverload        Wrong answer (single interval overload should return list of points)
 CqlIntervalOperatorsTest.Expand.ExpandListWithNull                        Wrong answer (should be empty list due to removing nulls)
-CqlIntervalOperatorsTest.Expand.ExpandPerDayIntervalOverload              Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPerHourIntervalOverload             Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPerHourOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPer0D1                              Wrong answer (interval elements's decimals do not match expected output)
-CqlIntervalOperatorsTest.Expand.ExpandPer0D1IntervalOverload              Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPer1IntervalOverload                Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPer1OpenIntervalOverload            Wrong answer (single interval overload should return list of points)
-CqlIntervalOperatorsTest.Expand.ExpandPer2DaysIntervalOverload            Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPerDayIntervalOverload              Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPerHourIntervalOverload             Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPerHourOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPer1IntervalOverload                Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPer1OpenIntervalOverload            Wrong answer (single interval overload should return list of points)
+# CqlIntervalOperatorsTest.Expand.ExpandPer2DaysIntervalOverload            Wrong answer (single interval overload should return list of points)
 CqlIntervalOperatorsTest.Intersect.TestIntersectNull            Wrong answer (Interval[5, 10] vs Interval[5, null))
 CqlTypeOperatorsTest.Convert.StringToDateTime                   Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime1                     Wrong answer (different offsets)

From 8c25d28db39b370a5d624244406024258a3910c6 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 09:49:13 -0400
Subject: [PATCH 15/62] just a couple more tests

---
 test/datatypes/datetime-test.ts        |   4 +
 test/datatypes/decimal-test.ts         |   5 +
 test/elm/aggregate/aggregate-test.ts   |   9 +
 test/elm/aggregate/data.cql            |   2 +
 test/elm/aggregate/data.js             | 298 ++++++++++++++++++++++---
 test/elm/arithmetic/arithmetic-test.ts |   4 +
 test/elm/arithmetic/data.cql           |   1 +
 test/elm/arithmetic/data.js            |  66 +++++-
 8 files changed, 351 insertions(+), 38 deletions(-)

diff --git a/test/datatypes/datetime-test.ts b/test/datatypes/datetime-test.ts
index e771a8aca..cc3105cb3 100644
--- a/test/datatypes/datetime-test.ts
+++ b/test/datatypes/datetime-test.ts
@@ -219,6 +219,10 @@ describe('DateTime', () => {
     DateTime.fromJSDate(new Date(Date.UTC(1999, 1, 16, 13, 56, 24, 123)), +4.5).should.eql(
       DateTime.parse('1999-02-16T18:26:24.123+04:30')
     );
+    DateTime.fromJSDate(
+      new Date(Date.UTC(1999, 1, 16, 13, 56, 24, 123)),
+      Decimal.from(-5)
+    ).should.eql(DateTime.parse('1999-02-16T08:56:24.123-05:00'));
   });
 
   it('should construct from a Luxon DateTime', () =>
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index e2682a5ae..171ca129d 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -42,6 +42,11 @@ describe('Decimal', () => {
     Decimal.from('8').log(2).should.equalDecimal(Decimal.from(3));
   });
 
+  it('should reject an invalid scale', () => {
+    (() => Decimal.from(1).setScale(-1)).should.throw(RangeError);
+    (() => Decimal.from(1).setScale(1.5)).should.throw(RangeError);
+  });
+
   it('should reject non-finite and divide-by-zero values', () => {
     (() => Decimal.from('not a number')).should.throw();
     (() => Decimal.from(1).divideBy(0)).should.throw();
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 5f946e4cc..f9300bc0c 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -420,6 +420,15 @@ describe('Mode', () => {
     (await this.bi_modal.exec(this.ctx)).should.eql([2, 3]);
   });
 
+  it('should preserve units for single and tied quantity modes', async function () {
+    validateQuantity(await this.quantitySingleMode.exec(this.ctx), 1, 'g');
+
+    const modes = await this.quantityBiModal.exec(this.ctx);
+    modes.should.have.length(2);
+    validateQuantity(modes[0], 1, 'g');
+    validateQuantity(modes[1], 2, 'g');
+  });
+
   it('should be null if some are numbers and some are quantities', async function () {
     should(await this.numbersAndQuantities.exec(this.ctx)).be.null();
   });
diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index 61eeffe92..48c754ae4 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -112,6 +112,8 @@ define has_null: Mode({1,null,null,2,2})
 define empty: Mode({})
 
 define bi_modal: Mode({1,2,2,2,3,3,3,4,5})
+define QuantitySingleMode: Mode({1.0 'g', 1.0 'g', 2.0 'g'})
+define QuantityBiModal: Mode({1.0 'g', 1.0 'g', 2.0 'g', 2.0 'g'})
 define NumbersAndQuantities: Mode({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Mode({1 'mg/d', 0.002 '/d'})
 
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index 5f063253c..f3ef86c20 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -11421,6 +11421,8 @@ define has_null: Mode({1,null,null,2,2})
 define empty: Mode({})
 
 define bi_modal: Mode({1,2,2,2,3,3,3,4,5})
+define QuantitySingleMode: Mode({1.0 'g', 1.0 'g', 2.0 'g'})
+define QuantityBiModal: Mode({1.0 'g', 1.0 'g', 2.0 'g', 2.0 'g'})
 define NumbersAndQuantities: Mode({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Mode({1 'mg/d', 0.002 '/d'})
 */
@@ -11437,7 +11439,7 @@ module.exports['Mode'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "331",
+        "r" : "364",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -12026,7 +12028,7 @@ module.exports['Mode'] = {
       }, {
         "localId" : "309",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "NumbersAndQuantities",
+        "name" : "QuantitySingleMode",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -12035,46 +12037,268 @@ module.exports['Mode'] = {
           "s" : {
             "r" : "309",
             "s" : [ {
-              "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
+              "value" : [ "", "define ", "QuantitySingleMode", ": " ]
             }, {
-              "r" : "326",
+              "r" : "320",
               "s" : [ {
                 "value" : [ "Mode", "(" ]
               }, {
                 "r" : "310",
                 "s" : [ {
+                  "value" : [ "{" ]
+                }, {
                   "r" : "311",
-                  "value" : [ "{", "1", " ," ]
+                  "s" : [ {
+                    "value" : [ "1.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
                 }, {
                   "r" : "312",
+                  "s" : [ {
+                    "value" : [ "1.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "313",
+                  "s" : [ {
+                    "value" : [ "2.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Mode",
+          "localId" : "320",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "321",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "322",
+              "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "310",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "314",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "315",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Quantity",
+              "localId" : "311",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 1.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            }, {
+              "type" : "Quantity",
+              "localId" : "312",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 1.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            }, {
+              "type" : "Quantity",
+              "localId" : "313",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 2.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "325",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "QuantityBiModal",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "325",
+            "s" : [ {
+              "value" : [ "", "define ", "QuantityBiModal", ": " ]
+            }, {
+              "r" : "337",
+              "s" : [ {
+                "value" : [ "Mode", "(" ]
+              }, {
+                "r" : "326",
+                "s" : [ {
+                  "value" : [ "{" ]
+                }, {
+                  "r" : "327",
+                  "s" : [ {
+                    "value" : [ "1.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "328",
+                  "s" : [ {
+                    "value" : [ "1.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "329",
+                  "s" : [ {
+                    "value" : [ "2.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "330",
+                  "s" : [ {
+                    "value" : [ "2.0 ", "'g'" ]
+                  } ]
+                }, {
+                  "value" : [ "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Mode",
+          "localId" : "337",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "338",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "339",
+              "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "326",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "331",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "332",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Quantity",
+              "localId" : "327",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 1.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            }, {
+              "type" : "Quantity",
+              "localId" : "328",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 1.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            }, {
+              "type" : "Quantity",
+              "localId" : "329",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 2.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            }, {
+              "type" : "Quantity",
+              "localId" : "330",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "value" : 2.0,
+              "unit" : "g",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "342",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "NumbersAndQuantities",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "342",
+            "s" : [ {
+              "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
+            }, {
+              "r" : "359",
+              "s" : [ {
+                "value" : [ "Mode", "(" ]
+              }, {
+                "r" : "343",
+                "s" : [ {
+                  "r" : "344",
+                  "value" : [ "{", "1", " ," ]
+                }, {
+                  "r" : "345",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "313",
+                  "r" : "346",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "314",
+                  "r" : "347",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "315",
+                  "r" : "348",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "316",
+                  "r" : "349",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -12089,48 +12313,48 @@ module.exports['Mode'] = {
         } ],
         "expression" : {
           "type" : "Mode",
-          "localId" : "326",
+          "localId" : "359",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "327",
+            "localId" : "360",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "328",
+              "localId" : "361",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "310",
+            "localId" : "343",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "320",
+              "localId" : "353",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "321",
+                "localId" : "354",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "ToQuantity",
-              "localId" : "318",
+              "localId" : "351",
               "annotation" : [ ],
               "signature" : [ {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "319",
+                "localId" : "352",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               } ],
               "operand" : {
                 "type" : "Literal",
-                "localId" : "311",
+                "localId" : "344",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
                 "value" : "1",
@@ -12138,35 +12362,35 @@ module.exports['Mode'] = {
               }
             }, {
               "type" : "Quantity",
-              "localId" : "312",
+              "localId" : "345",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "313",
+              "localId" : "346",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "314",
+              "localId" : "347",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "315",
+              "localId" : "348",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "316",
+              "localId" : "349",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -12175,7 +12399,7 @@ module.exports['Mode'] = {
           }
         }
       }, {
-        "localId" : "331",
+        "localId" : "364",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "IncompatibleUnitsNull",
         "context" : "Patient",
@@ -12184,26 +12408,26 @@ module.exports['Mode'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "331",
+            "r" : "364",
             "s" : [ {
               "value" : [ "", "define ", "IncompatibleUnitsNull", ": " ]
             }, {
-              "r" : "341",
+              "r" : "374",
               "s" : [ {
                 "value" : [ "Mode", "(" ]
               }, {
-                "r" : "332",
+                "r" : "365",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "333",
+                  "r" : "366",
                   "s" : [ {
                     "value" : [ "1 ", "'mg/d'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "334",
+                  "r" : "367",
                   "s" : [ {
                     "value" : [ "0.002 ", "'/d'" ]
                   } ]
@@ -12218,45 +12442,45 @@ module.exports['Mode'] = {
         } ],
         "expression" : {
           "type" : "Mode",
-          "localId" : "341",
+          "localId" : "374",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "342",
+            "localId" : "375",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "343",
+              "localId" : "376",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "332",
+            "localId" : "365",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "335",
+              "localId" : "368",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "336",
+                "localId" : "369",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "333",
+              "localId" : "366",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "mg/d",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "334",
+              "localId" : "367",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "/d",
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 092a36c7d..f3475e0c1 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -501,6 +501,10 @@ describe('TruncatedDivide', () => {
   it('should be able to return just the long portion of a dividing a long by an integer', async function () {
     (await this.tenDivThreeReverseMixed.exec(this.ctx)).should.equal(3n);
   });
+
+  it('should truncate quantity division results', async function () {
+    validateQuantity(await this.quantityTruncatedDivide.exec(this.ctx), 5, '1');
+  });
 });
 
 describe('Truncate', () => {
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 7d5e49457..6812f7c04 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -108,6 +108,7 @@ define Even: 9 div 3
 define TenDivThreeLong: 10L div 3L
 define TenDivThreeMixed: 10 div 3L
 define TenDivThreeReverseMixed: 10L div 3
+define QuantityTruncatedDivide: 10.5 'g' div 2.0 'g'
 
 // @Test: Modulo
 define Mod: 3 mod 2
diff --git a/test/elm/arithmetic/data.js b/test/elm/arithmetic/data.js
index ccfe850d1..b94eb9583 100644
--- a/test/elm/arithmetic/data.js
+++ b/test/elm/arithmetic/data.js
@@ -6808,6 +6808,7 @@ define Even: 9 div 3
 define TenDivThreeLong: 10L div 3L
 define TenDivThreeMixed: 10 div 3L
 define TenDivThreeReverseMixed: 10L div 3
+define QuantityTruncatedDivide: 10.5 'g' div 2.0 'g'
 */
 
 module.exports['TruncatedDivide'] = {
@@ -6822,7 +6823,7 @@ module.exports['TruncatedDivide'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "249",
+        "r" : "260",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -7186,6 +7187,69 @@ module.exports['TruncatedDivide'] = {
             }
           } ]
         }
+      }, {
+        "localId" : "260",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "QuantityTruncatedDivide",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "260",
+            "s" : [ {
+              "value" : [ "", "define ", "QuantityTruncatedDivide", ": " ]
+            }, {
+              "r" : "261",
+              "s" : [ {
+                "r" : "262",
+                "s" : [ {
+                  "value" : [ "10.5 ", "'g'" ]
+                } ]
+              }, {
+                "value" : [ " div " ]
+              }, {
+                "r" : "263",
+                "s" : [ {
+                  "value" : [ "2.0 ", "'g'" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "TruncatedDivide",
+          "localId" : "261",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "264",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "265",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Quantity",
+            "localId" : "262",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "value" : 10.5,
+            "unit" : "g",
+            "annotation" : [ ]
+          }, {
+            "type" : "Quantity",
+            "localId" : "263",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "value" : 2.0,
+            "unit" : "g",
+            "annotation" : [ ]
+          } ]
+        }
       } ]
     }
   }

From b3eb56d9096e460c41fb6421e8f4eb7dc6dd8ce7 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 11:26:30 -0400
Subject: [PATCH 16/62] more cleanup on manual review

---
 src/elm/interval.ts              |  6 +++---
 test/elm/convert/convert-test.ts |  1 -
 test/util/math-test.ts           | 16 ++++++++--------
 test/util/units-test.ts          |  7 -------
 4 files changed, 11 insertions(+), 19 deletions(-)

diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index c7f53a91d..a60f7f080 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -481,12 +481,12 @@ export class Expand extends Expression {
     if (['time', 'date', 'datetime'].includes(type)) {
       expandFunction = this.expandDTishInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.getPrecision());
-    } else if (['integer', 'long', 'decimal'].includes(type)) {
-      expandFunction = this.expandNumericInterval;
-      defaultPer = (_interval: any) => new Quantity(1, '1');
     } else if (['quantity'].includes(type)) {
       expandFunction = this.expandQuantityInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.unit);
+    } else if (['integer', 'long', 'decimal'].includes(type)) {
+      expandFunction = this.expandNumericInterval;
+      defaultPer = (_interval: any) => new Quantity(1, '1');
     } else {
       throw new Error('Interval list type not yet supported.');
     }
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index 92a83bad6..f8986052c 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -373,7 +373,6 @@ describe('ToDecimal', () => {
   });
 
   it('should be null if wrong format (+.1)', async function () {
-    // TODO: parseFloat is more forgiving than the CQL spec, so this does get converted
     should(await this.wrongFormat.exec(this.ctx)).be.null();
   });
 
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index 56305f115..ac82ebe3e 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -5,39 +5,39 @@ import { finalizeNumericResult, predecessor, successor } from '../../src/util/ma
 
 describe('successor', () => {
   it('should preserve integers in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0));
+    const result = successor(new Uncertainty(1, 2));
     result.low.should.equal(2);
     result.high.should.equal(3);
   });
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
-    result.low.should.equalDecimal(Decimal.from(1.00000001));
-    result.high.should.equalDecimal(Decimal.from(2.00000001));
+    result.low.should.equalDecimal(Decimal.from('1.00000001'));
+    result.high.should.equalDecimal(Decimal.from('2.00000001'));
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
     const result = successor(new Uncertainty(Decimal.from(1), MAX_FLOAT_VALUE));
-    result.should.eql(new Uncertainty(Decimal.from(1.00000001), MAX_FLOAT_VALUE));
+    result.should.eql(new Uncertainty(Decimal.from('1.00000001'), MAX_FLOAT_VALUE));
   });
 });
 
 describe('predecessor', () => {
   it('should preserve integers in an Uncertainty', () => {
-    const result = successor(new Uncertainty(1.0, 2.0));
+    const result = successor(new Uncertainty(1, 2));
     result.low.should.equal(2);
     result.high.should.equal(3);
   });
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
-    result.low.should.equalDecimal(Decimal.from(1.00000001));
-    result.high.should.equalDecimal(Decimal.from(2.00000001));
+    result.low.should.equalDecimal(Decimal.from('1.00000001'));
+    result.high.should.equalDecimal(Decimal.from('2.00000001'));
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
     const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(2)));
-    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(1.99999999)));
+    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from('1.99999999')));
   });
 });
 
diff --git a/test/util/units-test.ts b/test/util/units-test.ts
index 3550a6f25..21c8771c9 100644
--- a/test/util/units-test.ts
+++ b/test/util/units-test.ts
@@ -135,13 +135,6 @@ describe('convertUnit', () => {
     result.should.equalDecimal(Decimal.from('0.00018939'));
   });
 
-  // it('should not truncate precision to 8 decimals when adjustPrecision is false', () => {
-  //   const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]', false);
-  //   result.should.not.equalDecimal(Decimal.from("0.00018939"));
-  //   result.toString().length.should.be.greaterThan(10);
-  //   result.toString().should.startWith('0.000189393939393');
-  // });
-
   it('should return undefined for incompatible units', () => {
     should(convertUnit(Decimal.from(18), '[in_i]', '[in_i]2')).be.undefined();
   });

From a887e94972562841fc930d964f10cabb4f845e0b Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 11:30:53 -0400
Subject: [PATCH 17/62] one more

---
 src/elm/interval.ts | 2 +-
 1 file changed, 1 insertion(+), 1 deletion(-)

diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index a60f7f080..d4288fb70 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -484,7 +484,7 @@ export class Expand extends Expression {
     } else if (['quantity'].includes(type)) {
       expandFunction = this.expandQuantityInterval;
       defaultPer = (interval: any) => new Quantity(1, interval.low.unit);
-    } else if (['integer', 'long', 'decimal'].includes(type)) {
+    } else if (['long', 'integer', 'decimal'].includes(type)) {
       expandFunction = this.expandNumericInterval;
       defaultPer = (_interval: any) => new Quantity(1, '1');
     } else {

From 15252124ef196f17f50e14663f5e1f3f0c15b793 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 11:36:15 -0400
Subject: [PATCH 18/62] forgot to save this file

---
 test/spec-tests/skip-list.txt | 10 ----------
 1 file changed, 10 deletions(-)

diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index ee19feabc..642e4f220 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -29,17 +29,7 @@ CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: In
 CqlComparisonOperatorsTest.Equal.DateTimeEqNull                 Wrong answer (true vs null - due to not evaluating DateTime(null) as null)
 CqlIntervalOperatorsTest.Collapse.TestCollapseNull              Wrong answer (Interval(null, null) vs null)
 CqlIntervalOperatorsTest.Except.NullInterval                    Wrong answer (Interval(null, null) vs null)
-# CqlIntervalOperatorsTest.Expand.ExpandIntegerIntervalOverload             Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandIntegerOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandIntervalOpenPer2IntervalOverload    Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandIntervalPer2IntervalOverload        Wrong answer (single interval overload should return list of points)
 CqlIntervalOperatorsTest.Expand.ExpandListWithNull                        Wrong answer (should be empty list due to removing nulls)
-# CqlIntervalOperatorsTest.Expand.ExpandPerDayIntervalOverload              Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandPerHourIntervalOverload             Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandPerHourOpenIntervalOverload         Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandPer1IntervalOverload                Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandPer1OpenIntervalOverload            Wrong answer (single interval overload should return list of points)
-# CqlIntervalOperatorsTest.Expand.ExpandPer2DaysIntervalOverload            Wrong answer (single interval overload should return list of points)
 CqlIntervalOperatorsTest.Intersect.TestIntersectNull            Wrong answer (Interval[5, 10] vs Interval[5, null))
 CqlTypeOperatorsTest.Convert.StringToDateTime                   Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime1                     Wrong answer (different offsets)

From 240f95bf6459ff5074cb1c2f519c63d452adecf0 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 27 Aug 2026 12:06:57 -0400
Subject: [PATCH 19/62] update some comments

---
 src/datatypes/decimal.ts           | 4 ++++
 test/elm/interval/interval-test.ts | 4 ++--
 2 files changed, 6 insertions(+), 2 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index e72e6eeb9..3a04017c5 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -107,10 +107,14 @@ export class Decimal {
   }
 
   successor() {
+    // TODO: successor should be based on current precision
+    // For Decimal, successor is equivalent to adding 1 * the precision of the argument.
     return new Decimal(this.value.add(MIN_PRECISION_VALUE));
   }
 
   predecessor() {
+    // TODO: predecessor should be based on current precision
+    // For Decimal, predecessor is equivalent to subtracting 1 * the precision of the argument.
     return new Decimal(this.value.minus(MIN_PRECISION_VALUE));
   }
 
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 20bceedd0..77dc2c701 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -3605,8 +3605,8 @@ describe('IntegerIntervalExpand', () => {
     // https://jira.hl7.org/browse/FHIR-58705 and
     // https://chat.fhir.org/#narrow/channel/179220-cql/topic/Interval.20Expand.20example/with/619051021
     // Note that as of this writing the produced result is { } (empty list)
-    // which I believe is the correct result.
-    // But an empty list doesn't clearly show the intent of the test.
+    // but I believe the correct answer is either { } or { [ Interval[10.0, 10.0 ] }
+    // depending on whether the size of the interval is based on the precision of the decimals (not currently supported)
 
     // define PerDecimalMorePrecise: expand { Interval[10, 10] } per 0.1
     const a = await this.perDecimalMorePrecise.exec(this.ctx);

From ae241c0629b0f4881851e99d7b8dc9c87dfca2ca Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 3 Sep 2026 17:33:52 -0400
Subject: [PATCH 20/62] Update spec-tests to the latest, plus some minor
 supporting changes to get a couple more passing

---
 src/datatypes/datetime.ts                     |     6 +-
 src/datatypes/quantity.ts                     |     4 +
 test/spec-tests/cql/CqlAggregateTest.cql      |     2 +-
 .../cql/CqlArithmeticFunctionsTest.cql        |   130 +-
 .../cql/CqlArithmeticFunctionsTest.json       |  6233 +-
 .../cql/CqlComparisonOperatorsTest.cql        |   291 +-
 .../cql/CqlComparisonOperatorsTest.json       |  9235 ++-
 .../cql/CqlDateTimeOperatorsTest.cql          |    28 +-
 .../cql/CqlDateTimeOperatorsTest.json         | 58068 ++++++++++++----
 .../cql/CqlIntervalOperatorsTest.cql          |    16 +-
 .../cql/CqlIntervalOperatorsTest.json         |   478 +-
 .../spec-tests/cql/CqlStringOperatorsTest.cql |     6 +
 .../cql/CqlStringOperatorsTest.json           |    72 +
 test/spec-tests/cql/CqlTypesTest.cql          |    28 +-
 test/spec-tests/cql/CqlTypesTest.json         |  4129 +-
 test/spec-tests/skip-list.txt                 |    39 +-
 test/spec-tests/spec-test.ts                  |     7 +
 .../xml/CqlAggregateFunctionsTest.xml         |    79 +
 test/spec-tests/xml/CqlAggregateTest.xml      |    23 +-
 .../xml/CqlArithmeticFunctionsTest.xml        |   221 +-
 .../xml/CqlComparisonOperatorsTest.xml        |   318 +-
 .../xml/CqlConditionalOperatorsTest.xml       |    39 +
 .../xml/CqlDateTimeOperatorsTest.xml          |   444 +-
 .../CqlErrorsAndMessagingOperatorsTest.xml    |     6 +
 .../xml/CqlIntervalOperatorsTest.xml          |   453 +-
 .../xml/CqlLogicalOperatorsTest.xml           |    45 +
 .../xml/CqlNullologicalOperatorsTest.xml      |    27 +
 test/spec-tests/xml/CqlQueryTests.xml         |    16 +
 .../spec-tests/xml/CqlStringOperatorsTest.xml |   102 +
 test/spec-tests/xml/CqlTypeOperatorsTest.xml  |    47 +
 test/spec-tests/xml/CqlTypesTest.xml          |    48 +-
 .../xml/ValueLiteralsAndSelectors.xml         |    81 +
 32 files changed, 61751 insertions(+), 18970 deletions(-)

diff --git a/src/datatypes/datetime.ts b/src/datatypes/datetime.ts
index b8f288895..5b30779cb 100644
--- a/src/datatypes/datetime.ts
+++ b/src/datatypes/datetime.ts
@@ -20,6 +20,7 @@ import {
   MIN_TIME_VALUE_STRING
 } from '../util/limits';
 import { Decimal } from './decimal';
+import { equals } from '../util/comparison';
 
 // It's easiest and most performant to organize formats by length of the supported strings.
 // This way we can test strings only against the formats that have a chance of working.
@@ -1274,7 +1275,8 @@ function compareWithDefaultResult(a: any, b: any, defaultResult: any) {
   }
 
   // make a copy of other in the correct timezone offset if they don't match.
-  if (a.timezoneOffset !== b.timezoneOffset) {
+  const differentTZ = (a.timeZoneOffset == null) ? (b.timezoneOffset != null) : !(a.timezoneOffset.equals(b.timezoneOffset));
+  if (differentTZ) {
     b = b.convertToTimezoneOffset(a.timezoneOffset);
   }
 
@@ -1296,7 +1298,7 @@ function compareWithDefaultResult(a: any, b: any, defaultResult: any) {
       }
 
       // if they are different then return with false
-      if (a[field] !== b[field]) {
+      if (!equals(a[field], b[field])) {
         return false;
       }
 
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index 190cc1e4e..77eab93db 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -96,6 +96,10 @@ export class Quantity {
         // same unit, or both are null
         return this.value.equals(other.value);
       } else {
+        // TODO: time-based Quantities are defined to have separate calendar duration semantics,
+        //  not implemented here.
+        // eg, 1 year == 365 days. (Per UCUM unit conversion, 1 year is 365.25 days)
+        // https://cql.hl7.org/09-b-cqlreference.html#equal
         const otherVal = convertUnit(other.value, other.unit, this.unit);
         if (otherVal == null) {
           return null;
diff --git a/test/spec-tests/cql/CqlAggregateTest.cql b/test/spec-tests/cql/CqlAggregateTest.cql
index 62812517e..a4d5d5375 100644
--- a/test/spec-tests/cql/CqlAggregateTest.cql
+++ b/test/spec-tests/cql/CqlAggregateTest.cql
@@ -18,7 +18,7 @@ define "AggregateTests": Tuple{
 				  aggregate R starting (null as List<Interval<DateTime>>): R union ({
 				    M X
 				      let S: Max({ end of Last(R) + 1 day, start of X }),
-				        E: S + duration in days of X
+				        E: S + Quantity{ value: duration in days of X, unit: 'days' }
 				      return Interval[S, E]
 				  }),
     output: {
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
index cc94b950e..10d8a19ca 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
@@ -92,6 +92,46 @@ define "Ceiling": Tuple{
   "Ceiling1I": Tuple{
     expression: Ceiling(1),
     output: 1
+  },
+  "CeilingMaxInteger": Tuple{
+    expression: Ceiling(2147483647),
+    output: 2147483647
+  },
+  "CeilingMaxIntegerAsDecimal": Tuple{
+    expression: Ceiling(2147483647.0),
+    output: 2147483647
+  },
+  "CeilingMaxIntegerAsDecimalWhereDecimalIsNonZero": Tuple{
+    expression: Ceiling(2147483647.2),
+    output: null
+  },
+  "CeilingIntegerGreaterThanMaxInteger": Tuple{
+    expression: Ceiling(2147483648),
+    output: null
+  },
+  "CeilingDecimalGreaterThanMaxInteger": Tuple{
+    expression: Ceiling(2147483648.2),
+    output: null
+  },
+  "CeilingMinInteger": Tuple{
+    expression: Ceiling(-2147483648),
+    output: -2147483648
+  },
+  "CeilingMinIntegerAsDecimal": Tuple{
+    expression: Ceiling(-2147483648.0),
+    output: -2147483648
+  },
+  "CeilingMinIntegerAsDecimalWhereDecimalIsNonZero": Tuple{
+    expression: Ceiling(-2147483648.2),
+    output: -2147483648
+  },
+  "CeilingIntegerLessThanMinInteger": Tuple{
+    expression: Ceiling(-2147483649),
+    output: null
+  },
+  "CeilingDecimalLessThanMinInteger": Tuple{
+    expression: Ceiling(-2147483649.2),
+    output: null
   }
 }
 
@@ -178,6 +218,46 @@ define "Floor": Tuple{
   "Floor2I": Tuple{
     expression: Floor(2),
     output: 2
+  },
+  "FloorMaxInteger": Tuple{
+    expression: Floor(2147483647),
+    output: 2147483647
+  },
+  "FloorMaxIntegerAsDecimal": Tuple{
+    expression: Floor(2147483647.0),
+    output: 2147483647
+  },
+  "FloorMaxIntegerAsDecimalWhereDecimalIsNonZero": Tuple{
+    expression: Floor(2147483647.2),
+    output: 2147483647
+  },
+  "FloorIntegerGreaterThanMaxInteger": Tuple{
+    expression: Floor(2147483648),
+    output: null
+  },
+  "FloorDecimalGreaterThanMaxInteger": Tuple{
+    expression: Floor(2147483648.2),
+    output: null
+  },
+  "FloorMinInteger": Tuple{
+    expression: Floor(-2147483648),
+    output: -2147483648
+  },
+  "FloorMinIntegerAsDecimal": Tuple{
+    expression: Floor(-2147483648.0),
+    output: -2147483648
+  },
+  "FloorMinIntegerAsDecimalWhereDecimalIsNonZero": Tuple{
+    expression: Floor(-2147483648.2),
+    output: null
+  },
+  "FloorIntegerLessThanMinInteger": Tuple{
+    expression: Floor(-2147483649),
+    output: null
+  },
+  "FloorDecimalLessThanMinInteger": Tuple{
+    expression: Floor(-2147483649.2),
+    output: null
   }
 }
 
@@ -240,6 +320,18 @@ define "HighBoundary": Tuple{
     /*
     expression: HighBoundary(@T10:30, 9),
     output: @T10:30:59.999
+    */  },
+  "HighBoundaryNull": Tuple{
+    skipped: 'HighBoundary not implemented'
+    /*
+    expression: HighBoundary(null as Decimal, 8),
+    output: null
+    */  },
+  "HighBoundaryNullPrecision": Tuple{
+    skipped: 'HighBoundary not implemented'
+    /*
+    expression: HighBoundary(1.58888, null),
+    output: 1.58888999
     */  }
 }
 
@@ -306,6 +398,18 @@ define "LowBoundary": Tuple{
     /*
     expression: LowBoundary(@T10:30, 9),
     output: @T10:30:00.000
+    */  },
+  "LowBoundaryNull": Tuple{
+    skipped: 'LowBoundary not implemented'
+    /*
+    expression: LowBoundary(null as Decimal, 8),
+    output: null
+    */  },
+  "LowBoundaryNullPrecision": Tuple{
+    skipped: 'LowBoundary not implemented'
+    /*
+    expression: LowBoundary(1.58888, null),
+    output: 1.58888000
     */  }
 }
 
@@ -590,17 +694,23 @@ define "Predecessor": Tuple{
     output: 0L
   },
   "PredecessorOf1D": Tuple{
+    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147'
+    /*
     expression: predecessor of 1.0,
     output: 0.99999999
-  },
+    */  },
   "PredecessorOf101D": Tuple{
+    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    /*
     expression: predecessor of 1.01,
     output: 1.00999999
-  },
+    */  },
   "PredecessorOf1QCM": Tuple{
+    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    /*
     expression: predecessor of 1.0 'cm',
     output: 0.99999999'cm'
-  },
+    */  },
   "PredecessorOfJan12000": Tuple{
     expression: predecessor of DateTime(2000,1,1),
     output: @1999-12-31T
@@ -705,7 +815,7 @@ define "Round": Tuple{
   },
   "RoundNeg0D5": Tuple{
     expression: Round(-0.5),
-    output: 0.0
+    output: -1.0
   },
   "RoundNeg0D4": Tuple{
     expression: Round(-0.4),
@@ -721,7 +831,7 @@ define "Round": Tuple{
   },
   "RoundNeg1D5": Tuple{
     expression: Round(-1.5),
-    output: -1.0
+    output: -2.0
   },
   "RoundNeg1D6": Tuple{
     expression: Round(-1.6),
@@ -774,13 +884,17 @@ define "Successor": Tuple{
     output: 2L
   },
   "SuccessorOf1D": Tuple{
+    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    /*
     expression: successor of 1.0,
     output: 1.00000001
-  },
+    */  },
   "SuccessorOf101D": Tuple{
+    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    /*
     expression: successor of 1.01,
     output: 1.01000001
-  },
+    */  },
   "SuccessorOfJan12000": Tuple{
     expression: successor of DateTime(2000,1,1),
     output: @2000-01-02T
@@ -924,7 +1038,7 @@ define "Truncated Divide": Tuple{
     output: 2.0
   },
   "TruncatedDivide10d1ByNeg3D1Quantity": Tuple{
-    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit; \'g\' / \'g\' should be \'1\', not \'g\'. See test Divide1Q1Q which is correct'
+    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit; \'g\' / \'g\' should be \'1\', not \'g\'. See https://github.com/cqframework/cql-tests/pull/148'
     /*
     expression: 10.1 'cm' div -3.1 'cm',
     output: -3.0 'cm'
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
index d09ab84b4..a0552b7d3 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
@@ -2026,6 +2026,2227 @@
                     }
                   ]
                 }
+              },
+              {
+                "name": "CeilingMaxInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMaxIntegerAsDecimal",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMaxIntegerAsDecimalWhereDecimalIsNonZero",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingIntegerGreaterThanMaxInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingDecimalGreaterThanMaxInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinIntegerAsDecimal",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinIntegerAsDecimalWhereDecimalIsNonZero",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingIntegerLessThanMinInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingDecimalLessThanMinInteger",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "CeilingNull",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Ceiling1D",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Ceiling1D1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingNegD1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingNeg1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingNeg1D1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Ceiling1I",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMaxInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMaxIntegerAsDecimal",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMaxIntegerAsDecimalWhereDecimalIsNonZero",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingIntegerGreaterThanMaxInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingDecimalGreaterThanMaxInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMinInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMinIntegerAsDecimal",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingMinIntegerAsDecimalWhereDecimalIsNonZero",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingIntegerLessThanMinInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "CeilingDecimalLessThanMinInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "CeilingNull",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "As",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "strict": false,
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Null",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          },
+                          "asTypeSpecifier": {
+                            "type": "NamedTypeSpecifier",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Ceiling1D",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Ceiling1D1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.1",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingNegD1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "0.1",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingNeg1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingNeg1D1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.1",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Ceiling1I",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
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+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMaxInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2147483647",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2147483647",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMaxIntegerAsDecimal",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "2147483647.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2147483647",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMaxIntegerAsDecimalWhereDecimalIsNonZero",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "2147483647.2",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingIntegerGreaterThanMaxInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2147483648",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingDecimalGreaterThanMaxInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "2147483648.2",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2147483648",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2147483648",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinIntegerAsDecimal",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "2147483648.0",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2147483648",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingMinIntegerAsDecimalWhereDecimalIsNonZero",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "2147483648.2",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2147483648",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingIntegerLessThanMinInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2147483649",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "CeilingDecimalLessThanMinInteger",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Ceiling",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "2147483649.2",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Divide",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DivideNull",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide10",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide01",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide11",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1L1L",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1d1d",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide103",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1Q1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1Q1Q",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide10I5D",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide10I5I",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide10Q5I",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
               }
             ]
           },
@@ -2037,9 +4258,425 @@
               "annotation": [],
               "element": [
                 {
-                  "name": "CeilingNull",
+                  "name": "DivideNull",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide10",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide01",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide11",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide1L1L",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide1d1d",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide103",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide1Q1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide1Q1Q",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide10I5D",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide10I5I",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Divide10Q5I",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DivideNull",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "As",
+                            "asType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Null",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide10",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2048,7 +4685,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2062,12 +4699,60 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Ceiling1D",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide01",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2076,7 +4761,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2085,17 +4770,145 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Ceiling1D1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "0.0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide11",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1L1L",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2104,7 +4917,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2113,17 +4926,67 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "CeilingNegD1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1d1d",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2132,7 +4995,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2141,17 +5004,57 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "CeilingNeg1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide103",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2160,7 +5063,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2169,45 +5072,80 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "CeilingNeg1D1",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Round",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                         "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "signature": [],
+                        "operand": {
+                          "type": "Divide",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": [
+                            {
+                              "type": "ToDecimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "type": "ToDecimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "3",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        },
+                        "precision": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "8",
                           "annotation": []
                         }
                       }
-                    ]
-                  }
-                },
-                {
-                  "name": "Ceiling1I",
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "3.33333333",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Divide1Q1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -2216,7 +5154,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       },
@@ -2225,18 +5163,58 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
-                    ]
-                  }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "g/cm3",
+                            "annotation": []
+                          },
+                          {
+                            "type": "ToQuantity",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 1,
+                        "unit": "g/cm3",
+                        "annotation": []
+                      }
+                    }
+                  ]
                 }
-              ]
-            },
-            "element": [
+              },
               {
-                "name": "CeilingNull",
+                "name": "Divide1Q1Q",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -2249,7 +5227,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       },
@@ -2258,7 +5236,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -2268,35 +5246,35 @@
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "As",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "strict": false,
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Null",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "g/cm3",
                             "annotation": []
                           },
-                          "asTypeSpecifier": {
-                            "type": "NamedTypeSpecifier",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "g/cm3",
                             "annotation": []
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 1,
+                        "unit": "1",
                         "annotation": []
                       }
                     }
@@ -2304,7 +5282,7 @@
                 }
               },
               {
-                "name": "Ceiling1D",
+                "name": "Divide10I5D",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -2317,7 +5295,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2326,7 +5304,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
@@ -2336,26 +5314,40 @@
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "5.0",
+                            "annotation": []
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "2.0",
                         "annotation": []
                       }
                     }
@@ -2363,7 +5355,7 @@
                 }
               },
               {
-                "name": "Ceiling1D1",
+                "name": "Divide10I5I",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -2376,7 +5368,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       },
@@ -2385,7 +5377,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
@@ -2395,26 +5387,45 @@
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.1",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "2.0",
                         "annotation": []
                       }
                     }
@@ -2422,7 +5433,7 @@
                 }
               },
               {
-                "name": "CeilingNegD1",
+                "name": "Divide10Q5I",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -2435,7 +5446,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       },
@@ -2444,42 +5455,146 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
-                    ]
-                  },
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Divide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 10,
+                            "unit": "g",
+                            "annotation": []
+                          },
+                          {
+                            "type": "ToQuantity",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 2,
+                        "unit": "g",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Floor",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "FloorNull",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Floor1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Floor1D",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Negate",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "0.1",
-                            "annotation": []
-                          }
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "0",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2487,225 +5602,91 @@
                 }
               },
               {
-                "name": "CeilingNeg1",
-                "value": {
-                  "type": "Tuple",
+                "name": "Floor1D1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Negate",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
-                            "annotation": []
-                          }
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "CeilingNeg1D1",
-                "value": {
-                  "type": "Tuple",
+                "name": "FloorNegD1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Negate",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.1",
-                            "annotation": []
-                          }
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "Ceiling1I",
-                "value": {
-                  "type": "Tuple",
+                "name": "FloorNeg1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Ceiling",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "ToDecimal",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "1",
-                            "annotation": []
-                          }
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Divide",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "resultTypeSpecifier": {
-            "type": "TupleTypeSpecifier",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DivideNull",
+                "name": "FloorNeg1D1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2716,7 +5697,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2725,7 +5706,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2733,7 +5714,7 @@
                 }
               },
               {
-                "name": "Divide10",
+                "name": "Floor2I",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2744,7 +5725,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2753,7 +5734,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2761,7 +5742,7 @@
                 }
               },
               {
-                "name": "Divide01",
+                "name": "FloorMaxInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2772,7 +5753,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2781,7 +5762,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2789,7 +5770,7 @@
                 }
               },
               {
-                "name": "Divide11",
+                "name": "FloorMaxIntegerAsDecimal",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2800,7 +5781,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2809,7 +5790,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2817,7 +5798,7 @@
                 }
               },
               {
-                "name": "Divide1L1L",
+                "name": "FloorMaxIntegerAsDecimalWhereDecimalIsNonZero",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2828,7 +5809,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2837,7 +5818,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2845,7 +5826,7 @@
                 }
               },
               {
-                "name": "Divide1d1d",
+                "name": "FloorIntegerGreaterThanMaxInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2856,7 +5837,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2865,7 +5846,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -2873,7 +5854,7 @@
                 }
               },
               {
-                "name": "Divide103",
+                "name": "FloorDecimalGreaterThanMaxInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2884,7 +5865,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2893,7 +5874,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -2901,7 +5882,7 @@
                 }
               },
               {
-                "name": "Divide1Q1",
+                "name": "FloorMinInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2912,7 +5893,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2921,7 +5902,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2929,7 +5910,7 @@
                 }
               },
               {
-                "name": "Divide1Q1Q",
+                "name": "FloorMinIntegerAsDecimal",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2940,7 +5921,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2949,7 +5930,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -2957,7 +5938,7 @@
                 }
               },
               {
-                "name": "Divide10I5D",
+                "name": "FloorMinIntegerAsDecimalWhereDecimalIsNonZero",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2968,7 +5949,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -2977,7 +5958,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -2985,7 +5966,7 @@
                 }
               },
               {
-                "name": "Divide10I5I",
+                "name": "FloorIntegerLessThanMinInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -2996,7 +5977,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -3005,7 +5986,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -3013,7 +5994,7 @@
                 }
               },
               {
-                "name": "Divide10Q5I",
+                "name": "FloorDecimalLessThanMinInteger",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -3024,7 +6005,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     },
@@ -3033,7 +6014,7 @@
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -3041,184 +6022,16 @@
                 }
               }
             ]
-          },
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "resultTypeSpecifier": {
-              "type": "TupleTypeSpecifier",
-              "annotation": [],
-              "element": [
-                {
-                  "name": "DivideNull",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
-                {
-                  "name": "Divide10",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
-                {
-                  "name": "Divide01",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
-                {
-                  "name": "Divide11",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
-                {
-                  "name": "Divide1L1L",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
-                {
-                  "name": "Divide1d1d",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
                 {
-                  "name": "Divide103",
+                  "name": "FloorNull",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3229,7 +6042,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3238,7 +6051,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -3246,7 +6059,7 @@
                   }
                 },
                 {
-                  "name": "Divide1Q1",
+                  "name": "Floor1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3257,7 +6070,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3266,7 +6079,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -3274,7 +6087,7 @@
                   }
                 },
                 {
-                  "name": "Divide1Q1Q",
+                  "name": "Floor1D",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3285,7 +6098,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3294,7 +6107,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -3302,7 +6115,7 @@
                   }
                 },
                 {
-                  "name": "Divide10I5D",
+                  "name": "Floor1D1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3313,7 +6126,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3322,7 +6135,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -3330,7 +6143,7 @@
                   }
                 },
                 {
-                  "name": "Divide10I5I",
+                  "name": "FloorNegD1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3341,7 +6154,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3350,7 +6163,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -3358,7 +6171,7 @@
                   }
                 },
                 {
-                  "name": "Divide10Q5I",
+                  "name": "FloorNeg1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -3369,7 +6182,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3378,97 +6191,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
                   }
-                }
-              ]
-            },
-            "element": [
-              {
-                "name": "DivideNull",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "As",
-                            "asType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Null",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Null",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide10",
-                "value": {
-                  "type": "Tuple",
+                },
+                {
+                  "name": "FloorNeg1D1",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3477,7 +6210,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3486,65 +6219,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Null",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide01",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "Floor2I",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3553,7 +6238,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3561,68 +6246,18 @@
                         "name": "output",
                         "annotation": [],
                         "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "0.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide11",
-                "value": {
-                  "type": "Tuple",
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "FloorMaxInteger",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3631,7 +6266,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3640,67 +6275,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide1L1L",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorMaxIntegerAsDecimal",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3709,7 +6294,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3718,67 +6303,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide1d1d",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorMaxIntegerAsDecimalWhereDecimalIsNonZero",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3787,7 +6322,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3796,57 +6331,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide103",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorIntegerGreaterThanMaxInteger",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3855,7 +6350,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3864,80 +6359,45 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Round",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                  }
+                },
+                {
+                  "name": "FloorDecimalGreaterThanMaxInteger",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Divide",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
-                            {
-                              "type": "ToDecimal",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "10",
-                                "annotation": []
-                              }
-                            },
-                            {
-                              "type": "ToDecimal",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "3",
-                                "annotation": []
-                              }
-                            }
-                          ]
-                        },
-                        "precision": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "8",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "3.33333333",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide1Q1",
-                "value": {
-                  "type": "Tuple",
+                    ]
+                  }
+                },
+                {
+                  "name": "FloorMinInteger",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -3946,7 +6406,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -3955,62 +6415,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "g/cm3",
-                            "annotation": []
-                          },
-                          {
-                            "type": "ToQuantity",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "value": 1,
-                        "unit": "g/cm3",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide1Q1Q",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorMinIntegerAsDecimal",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4019,7 +6434,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -4028,57 +6443,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "g/cm3",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "g/cm3",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "value": 1,
-                        "unit": "1",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide10I5D",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorMinIntegerAsDecimalWhereDecimalIsNonZero",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4087,7 +6462,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -4096,62 +6471,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "5.0",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "2.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide10I5I",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorIntegerLessThanMinInteger",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4160,7 +6490,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -4169,67 +6499,17 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "2.0",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Divide10Q5I",
-                "value": {
-                  "type": "Tuple",
+                  }
+                },
+                {
+                  "name": "FloorDecimalLessThanMinInteger",
                   "annotation": [],
-                  "resultTypeSpecifier": {
+                  "elementType": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4238,7 +6518,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       },
@@ -4247,258 +6527,78 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
                     ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Divide",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 10,
-                            "unit": "g",
-                            "annotation": []
-                          },
-                          {
-                            "type": "ToQuantity",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "value": 2,
-                        "unit": "g",
-                        "annotation": []
-                      }
-                    }
-                  ]
+                  }
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Floor",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "resultTypeSpecifier": {
-            "type": "TupleTypeSpecifier",
-            "annotation": [],
+              ]
+            },
             "element": [
               {
                 "name": "FloorNull",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Any",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Floor1",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Floor1D",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "Floor1D1",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "FloorNegD1",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "FloorNeg1",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "FloorNeg1D1",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "As",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "strict": false,
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Null",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                            "annotation": []
+                          },
+                          "asTypeSpecifier": {
+                            "type": "NamedTypeSpecifier",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "annotation": []
+                          }
+                        }
                       }
                     },
                     {
                       "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -4506,46 +6606,75 @@
                 }
               },
               {
-                "name": "Floor2I",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
+                "name": "Floor1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          }
+                        }
                       }
                     },
                     {
                       "name": "output",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          },
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "resultTypeSpecifier": {
-              "type": "TupleTypeSpecifier",
-              "annotation": [],
-              "element": [
-                {
-                  "name": "FloorNull",
+              },
+              {
+                "name": "Floor1D",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4563,17 +6692,48 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Floor1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Floor1D1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4596,12 +6756,43 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Floor1D",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.1",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "FloorNegD1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4624,12 +6815,55 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Floor1D1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "0.1",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "FloorNeg1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4652,12 +6886,55 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "FloorNegD1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "FloorNeg1D1",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4680,12 +6957,55 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "FloorNeg1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.1",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Floor2I",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4708,12 +7028,48 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "FloorNeg1D1",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "FloorMaxInteger",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4736,12 +7092,48 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "Floor2I",
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2147483647",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2147483647",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "FloorMaxIntegerAsDecimal",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -4764,13 +7156,39 @@
                         }
                       }
                     ]
-                  }
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Floor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "2147483647.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2147483647",
+                        "annotation": []
+                      }
+                    }
+                  ]
                 }
-              ]
-            },
-            "element": [
+              },
               {
-                "name": "FloorNull",
+                "name": "FloorMaxIntegerAsDecimalWhereDecimalIsNonZero",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4792,7 +7210,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -4803,34 +7221,25 @@
                       "name": "expression",
                       "value": {
                         "type": "Floor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "As",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "strict": false,
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "Null",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
-                            "annotation": []
-                          },
-                          "asTypeSpecifier": {
-                            "type": "NamedTypeSpecifier",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "2147483647.2",
+                          "annotation": []
                         }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2147483647",
                         "annotation": []
                       }
                     }
@@ -4838,7 +7247,7 @@
                 }
               },
               {
-                "name": "Floor1",
+                "name": "FloorIntegerGreaterThanMaxInteger",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4860,7 +7269,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -4882,7 +7291,7 @@
                             "type": "Literal",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                             "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "1",
+                            "value": "2147483648",
                             "annotation": []
                           }
                         }
@@ -4891,10 +7300,8 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -4902,7 +7309,7 @@
                 }
               },
               {
-                "name": "Floor1D",
+                "name": "FloorDecimalGreaterThanMaxInteger",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4924,7 +7331,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -4942,7 +7349,7 @@
                           "type": "Literal",
                           "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
+                          "value": "2147483648.2",
                           "annotation": []
                         }
                       }
@@ -4950,10 +7357,8 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -4961,7 +7366,7 @@
                 }
               },
               {
-                "name": "Floor1D1",
+                "name": "FloorMinInteger",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4998,29 +7403,46 @@
                         "annotation": [],
                         "signature": [],
                         "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.1",
-                          "annotation": []
+                          "type": "ToDecimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2147483648",
+                              "annotation": []
+                            }
+                          }
                         }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
+                        "type": "Negate",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
-                        "annotation": []
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2147483648",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "FloorNegD1",
+                "name": "FloorMinIntegerAsDecimal",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -5065,7 +7487,7 @@
                             "type": "Literal",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                             "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "0.1",
+                            "value": "2147483648.0",
                             "annotation": []
                           }
                         }
@@ -5082,7 +7504,7 @@
                           "type": "Literal",
                           "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
+                          "value": "2147483648",
                           "annotation": []
                         }
                       }
@@ -5091,7 +7513,7 @@
                 }
               },
               {
-                "name": "FloorNeg1",
+                "name": "FloorMinIntegerAsDecimalWhereDecimalIsNonZero",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -5113,7 +7535,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -5136,7 +7558,7 @@
                             "type": "Literal",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                             "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
+                            "value": "2147483648.2",
                             "annotation": []
                           }
                         }
@@ -5145,24 +7567,16 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        }
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "FloorNeg1D1",
+                "name": "FloorIntegerLessThanMinInteger",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -5184,7 +7598,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -5199,16 +7613,21 @@
                         "annotation": [],
                         "signature": [],
                         "operand": {
-                          "type": "Negate",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "type": "ToDecimal",
                           "annotation": [],
                           "signature": [],
                           "operand": {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.1",
-                            "annotation": []
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2147483649",
+                              "annotation": []
+                            }
                           }
                         }
                       }
@@ -5216,24 +7635,16 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
-                        }
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "Floor2I",
+                "name": "FloorDecimalLessThanMinInteger",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -5255,7 +7666,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -5270,14 +7681,15 @@
                         "annotation": [],
                         "signature": [],
                         "operand": {
-                          "type": "ToDecimal",
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": [],
                           "signature": [],
                           "operand": {
                             "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "2147483649.2",
                             "annotation": []
                           }
                         }
@@ -5286,10 +7698,8 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -6417,6 +8827,44 @@
                     }
                   ]
                 }
+              },
+              {
+                "name": "HighBoundaryNull",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "HighBoundaryNullPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
               }
             ]
           },
@@ -6468,7 +8916,88 @@
                 {
                   "name": "HighBoundaryDateTimeMillisecond",
                   "annotation": [],
-                  "elementType": {
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "HighBoundaryTimeMillisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "HighBoundaryNull",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "HighBoundaryNullPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "HighBoundaryDecimal",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -6482,12 +9011,27 @@
                         }
                       }
                     ]
-                  }
-                },
-                {
-                  "name": "HighBoundaryTimeMillisecond",
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "HighBoundary not implemented",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "HighBoundaryDateMonth",
+                "value": {
+                  "type": "Tuple",
                   "annotation": [],
-                  "elementType": {
+                  "resultTypeSpecifier": {
                     "type": "TupleTypeSpecifier",
                     "annotation": [],
                     "element": [
@@ -6501,13 +9045,23 @@
                         }
                       }
                     ]
-                  }
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "HighBoundary not implemented",
+                        "annotation": []
+                      }
+                    }
+                  ]
                 }
-              ]
-            },
-            "element": [
+              },
               {
-                "name": "HighBoundaryDecimal",
+                "name": "HighBoundaryDateTimeMillisecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -6541,7 +9095,7 @@
                 }
               },
               {
-                "name": "HighBoundaryDateMonth",
+                "name": "HighBoundaryTimeMillisecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -6575,7 +9129,7 @@
                 }
               },
               {
-                "name": "HighBoundaryDateTimeMillisecond",
+                "name": "HighBoundaryNull",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -6609,7 +9163,7 @@
                 }
               },
               {
-                "name": "HighBoundaryTimeMillisecond",
+                "name": "HighBoundaryNullPrecision",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -7949,6 +10503,44 @@
                     }
                   ]
                 }
+              },
+              {
+                "name": "LowBoundaryNull",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LowBoundaryNullPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
               }
             ]
           },
@@ -8034,6 +10626,44 @@
                       }
                     ]
                   }
+                },
+                {
+                  "name": "LowBoundaryNull",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "LowBoundaryNullPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
                 }
               ]
             },
@@ -8173,6 +10803,74 @@
                     }
                   ]
                 }
+              },
+              {
+                "name": "LowBoundaryNull",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "LowBoundary not implemented",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LowBoundaryNullPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "LowBoundary not implemented",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
               }
             ]
           }
@@ -15614,20 +18312,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -15642,20 +18331,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -15670,20 +18350,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -15931,20 +18602,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -15959,20 +18621,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -15987,20 +18640,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -16383,20 +19027,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -16404,28 +19039,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Predecessor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "0.99999999",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147",
                         "annotation": []
                       }
                     }
@@ -16442,20 +19061,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -16463,28 +19073,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Predecessor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.01",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.00999999",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
                         "annotation": []
                       }
                     }
@@ -16501,20 +19095,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -16522,28 +19107,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Predecessor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Quantity",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "value": 1,
-                          "unit": "cm",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Quantity",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                        "value": 0.99999999,
-                        "unit": "cm",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
                         "annotation": []
                       }
                     }
@@ -19915,11 +22484,17 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
+                        "type": "Negate",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "0.0",
-                        "annotation": []
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.0",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -20195,7 +22770,7 @@
                           "type": "Literal",
                           "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
+                          "value": "2.0",
                           "annotation": []
                         }
                       }
@@ -21193,20 +23768,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -21221,20 +23787,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -21482,20 +24039,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21510,20 +24058,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21900,20 +24439,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21921,28 +24451,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Successor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.00000001",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
                         "annotation": []
                       }
                     }
@@ -21959,20 +24473,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21980,28 +24485,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Successor",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.01",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.01000001",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
                         "annotation": []
                       }
                     }
@@ -26454,7 +28943,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See test Divide1Q1Q which is correct",
+                        "value": "Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See https://github.com/cqframework/cql-tests/pull/148",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/CqlComparisonOperatorsTest.cql b/test/spec-tests/cql/CqlComparisonOperatorsTest.cql
index 31737de72..d19c842f2 100644
--- a/test/spec-tests/cql/CqlComparisonOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlComparisonOperatorsTest.cql
@@ -46,6 +46,10 @@ define "Equal": Tuple{
     expression: 1 = 2,
     output: false
   },
+  "SimpleEqLong1Long2": Tuple{
+    expression: 1L = 2L,
+    output: false
+  },
   "SimpleEqStringAStringA": Tuple{
     expression: 'a' = 'a',
     output: true
@@ -62,6 +66,14 @@ define "Equal": Tuple{
     expression: 1.0 = 2.0,
     output: false
   },
+  "SimpleEqFloat1Float1WithZ": Tuple{
+    expression: 1.0 = 1.00,
+    output: true
+  },
+  "SimpleEqFloat1Float1WithPrecisionAndZ": Tuple{
+    expression: 1.50 = 1.55,
+    output: false
+  },
   "SimpleEqFloat1Int1": Tuple{
     expression: 1.0 = 1,
     output: true
@@ -82,6 +94,18 @@ define "Equal": Tuple{
     expression: 2.0'cm' = 2.00'cm',
     output: true
   },
+  "RatioEqual": Tuple{
+    expression: 1'cm':2'cm' = 1'cm':2'cm',
+    output: true
+  },
+  "RatioNotEqualDiffNumerator": Tuple{
+    expression: 1'cm':2'cm' = 1.1'cm':2'cm',
+    output: false
+  },
+  "RatioNotEqualDiffDenominator": Tuple{
+    expression: 1'cm':2'cm' = 1'cm':2.1'cm',
+    output: false
+  },
   "TupleEqJohnJohn": Tuple{
     expression: Tuple { Id : 1, Name : 'John' } = Tuple { Id : 1, Name : 'John' },
     output: true
@@ -99,9 +123,11 @@ define "Equal": Tuple{
     output: false
   },
   "TupleEqDifferentNamesWithOneNullId": Tuple{
+    skipped: 'Wrong output: Tuple equality with a known-unequal element should return false'
+    /*
     expression: Tuple { Id : null, Name : 'John' } = Tuple { Id : 1, Name : 'James' },
-    output: false
-  },
+    output: null
+    */  },
   "TupleEqJohn1John1WithBothNamesNull": Tuple{
     expression: Tuple { Id : 1, Name : null } = Tuple { Id : 1, Name : null },
     output: true
@@ -122,6 +148,10 @@ define "Equal": Tuple{
     expression: Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 0, 0, 0, 0) } = Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 5, 0, 0, 0) },
     output: false
   },
+  "TupleEqDateTimeTrue2": Tuple{
+    expression: Tuple { dateId: 12, Date: DateTime(2012, 1, 1) } = Tuple { dateId: 12, Date: DateTime(2012, 1, 1) },
+    output: true
+  },
   "TupleEqTimeTrue": Tuple{
     expression: Tuple { timeId: 55, TheTime: @T05:15:15.541 } = Tuple { timeId: 55, TheTime: @T05:15:15.541 },
     output: true
@@ -146,12 +176,20 @@ define "Equal": Tuple{
     expression: DateTime(2014, 1, 5, 5, 0, 0, 0, 0) = DateTime(2014, 7, 5, 5, 0, 0, 0, 0),
     output: false
   },
+  "DateTimeEqMissingArg": Tuple{
+    expression: DateTime(2015, 1, 5, 5, 0, 0) = DateTime(2015, 1, 5, 5, 0, 0),
+    output: true
+  },
   "DateTimeEqNull": Tuple{
     skipped: 'Wrong answer (true vs null - due to not evaluating DateTime(null) as null)'
     /*
     expression: DateTime(null) = DateTime(null),
     output: null
     */  },
+  "DateTimeEqTrue": Tuple{
+    expression: DateTime(2001, 1, 1, null) = DateTime(2001, 1, 1, null, null),
+    output: true
+  },
   "DateTimeUTC": Tuple{
     expression: @2014-01-25T14:30:14.559+01:00 = @2014-01-25T14:30:14.559+01:00,
     output: true
@@ -179,6 +217,10 @@ define "Greater": Tuple{
     expression: 0 > 1,
     output: false
   },
+  "GreaterLong": Tuple{
+    expression: 0L > 10L,
+    output: false
+  },
   "GreaterZNeg1": Tuple{
     expression: 0 > -1,
     output: true
@@ -282,6 +324,10 @@ define "Greater Or Equal": Tuple{
     expression: 0 >= 1,
     output: false
   },
+  "GreaterOrEqualZ1Long": Tuple{
+    expression: 0L >= 10L,
+    output: false
+  },
   "GreaterOrEqualZNeg1": Tuple{
     expression: 0 >= -1,
     output: true
@@ -393,6 +439,14 @@ define "Less": Tuple{
     expression: 0 < 1,
     output: true
   },
+  "LessLong": Tuple{
+    expression: 0L < 10L,
+    output: true
+  },
+  "LessLongNeg": Tuple{
+    expression: -30L < -20L,
+    output: true
+  },
   "LessZNeg1": Tuple{
     expression: 0 < -1,
     output: false
@@ -496,6 +550,10 @@ define "Less Or Equal": Tuple{
     expression: 0 <= 1,
     output: true
   },
+  "LessOrEqualZ1Long": Tuple{
+    expression: 0L <= 10L,
+    output: true
+  },
   "LessOrEqualZNeg1": Tuple{
     expression: 0 <= -1,
     output: false
@@ -643,6 +701,10 @@ define "Equivalent": Tuple{
     expression: 'a' ~ 'b',
     output: false
   },
+  "EquivStringIgnoreCase": Tuple{
+    expression: 'Abel' ~ 'abel',
+    output: true
+  },
   "EquivFloat1Float1": Tuple{
     expression: 1.0 ~ 1.0,
     output: true
@@ -651,6 +713,22 @@ define "Equivalent": Tuple{
     expression: 1.0 ~ 2.0,
     output: false
   },
+  "EquivFloat1Float1WithZ": Tuple{
+    expression: 1.0 ~ 1.00,
+    output: true
+  },
+  "EquivFloat1Float1WithPrecision": Tuple{
+    expression: 1.5 ~ 1.55,
+    output: false
+  },
+  "EquivFloat1Float1WithPrecisionAndZ": Tuple{
+    expression: 1.50 ~ 1.55,
+    output: false
+  },
+  "EquivFloatTrailingZero": Tuple{
+    expression: 1.001 ~ 1.000,
+    output: true
+  },
   "EquivFloat1Int1": Tuple{
     expression: 1.0 ~ 1,
     output: true
@@ -667,6 +745,18 @@ define "Equivalent": Tuple{
     expression: 1'cm' ~ 0.01'm',
     output: true
   },
+  "RatioEquivalent": Tuple{
+    expression: 1'cm':2'cm' ~ 1'cm':2'cm',
+    output: true
+  },
+  "RatioNotEquivalentDiffNumerator": Tuple{
+    expression: 1'cm':2'cm' ~ 3'cm':2'cm',
+    output: false
+  },
+  "RatioNotEquivalentDiffDenominator": Tuple{
+    expression: 1'cm':2'cm' ~ 1'cm':3'cm',
+    output: false
+  },
   "EquivTupleJohnJohn": Tuple{
     expression: Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 1, Name : 'John' },
     output: true
@@ -675,6 +765,14 @@ define "Equivalent": Tuple{
     expression: Tuple { Id : 1, Name : 'John', Position: null } ~ Tuple { Id : 1, Name : 'John', Position: null },
     output: true
   },
+  "EquivTupleJohnJohnFalse": Tuple{
+    expression: Tuple { Id : 1, Name : 'John', Position: 'Shift Manager' } ~ Tuple { Id : 1, Name : 'John' },
+    invalid: true
+  },
+  "EquivTupleJohnJohnFalse2": Tuple{
+    expression: Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 1, Name : 'John', Position: 'Shift Manager' },
+    invalid: true
+  },
   "EquivTupleJohnJane": Tuple{
     expression: Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 2, Name : 'Jane' },
     output: false
@@ -738,6 +836,10 @@ define "Not Equal": Tuple{
     expression: 1 != 2,
     output: true
   },
+  "SimpleNotEqLong1Long2": Tuple{
+    expression: 1L != 2L,
+    output: true
+  },
   "SimpleNotEqStringAStringA": Tuple{
     expression: 'a' != 'a',
     output: false
@@ -787,9 +889,11 @@ define "Not Equal": Tuple{
     output: true
   },
   "TupleNotEqDifferingNamesWithOneNullId": Tuple{
+    skipped: 'Wrong output: Tuple inequality with a known-unequal element should return true'
+    /*
     expression: Tuple{ Id : null, Name : 'John' } != Tuple{ Id : 1, Name : 'Joe' },
-    output: true
-  },
+    output: null
+    */  },
   "TupleNotEqJohn1John1WithBothNamesNull": Tuple{
     expression: Tuple{ Id : 1, Name : null } != Tuple{ Id : 1, Name : null },
     output: false
@@ -819,3 +923,182 @@ define "Not Equal": Tuple{
     output: true
   }
 }
+
+define "Unit Comparison": Tuple{
+  "TestQuantityMillisecondEqualMs": Tuple{
+    expression: 1 millisecond = 1 'ms',
+    output: true
+  },
+  "TestQuantityMillisecondEqualMilliseconds": Tuple{
+    expression: 1 millisecond = 1 milliseconds,
+    output: true
+  },
+  "TestQuantityMillisecondsEqualMs": Tuple{
+    expression: 1 milliseconds = 1 'ms',
+    output: true
+  },
+  "TestQuantitySecondEqualS": Tuple{
+    expression: 1 second = 1 's',
+    output: true
+  },
+  "TestQuantitySecondEqualSeconds": Tuple{
+    expression: 1 second = 1 seconds,
+    output: true
+  },
+  "TestQuantitySecondsEqualS": Tuple{
+    expression: 1 seconds = 1 's',
+    output: true
+  },
+  "TestQuantityMinuteEqualMin": Tuple{
+    expression: 1 minute = 1 'min',
+    output: true
+  },
+  "TestQuantityMinuteEqualMinutes": Tuple{
+    expression: 1 minute = 1 minutes,
+    output: true
+  },
+  "TestQuantityMinutesEqualMin": Tuple{
+    expression: 1 minutes = 1 'min',
+    output: true
+  },
+  "TestQuantityHourEqualH": Tuple{
+    expression: 1 hour = 1 'h',
+    output: true
+  },
+  "TestQuantityHourEqualHours": Tuple{
+    expression: 1 hour = 1 hours,
+    output: true
+  },
+  "TestQuantityHoursEqualH": Tuple{
+    expression: 1 hours = 1 'h',
+    output: true
+  },
+  "TestQuantityDayEqualD": Tuple{
+    expression: 1 day = 1 'd',
+    output: true
+  },
+  "TestQuantityDayEqualDays": Tuple{
+    expression: 1 day = 1 days,
+    output: true
+  },
+  "TestQuantityDaysEqualD": Tuple{
+    expression: 1 days = 1 'd',
+    output: true
+  },
+  "TestQuantityWeekEqualWk": Tuple{
+    expression: 1 week = 1 'wk',
+    output: true
+  },
+  "TestQuantityWeekEqualWeeks": Tuple{
+    expression: 1 week = 1 weeks,
+    output: true
+  },
+  "TestQuantityWeeksEqualWk": Tuple{
+    expression: 1 weeks = 1 'wk',
+    output: true
+  },
+  "TestQuantityMonthEqualMo": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 month = 1 'mo',
+    output: null
+    */  },
+  "TestQuantityMonthNotEqualMo": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 month != 1 'mo',
+    output: null
+    */  },
+  "TestQuantityMonthEquivalentMo": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 month ~ 1 'mo',
+    output: true
+    */  },
+  "TestQuantityMonthEqualMonths": Tuple{
+    expression: 1 month = 1 months,
+    output: true
+  },
+  "TestQuantityMonthsNotEqualMo": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 months != 1 'mo',
+    output: null
+    */  },
+  "TestQuantityMonthsEquivalentMo": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 months ~ 1 'mo',
+    output: true
+    */  },
+  "TestQuantityYearEqualA": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 year = 1 'a',
+    output: null
+    */  },
+  "TestQuantityYearNotEqualA": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 year != 1 'a',
+    output: null
+    */  },
+  "TestQuantityYearEquivalentA": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 year ~ 1 'a',
+    output: true
+    */  },
+  "TestQuantityYearsEqualYear": Tuple{
+    expression: 1 years = 1 year,
+    output: true
+  },
+  "TestQuantityYearsNotEqualA": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 years != 1 'a',
+    output: null
+    */  },
+  "TestQuantityYearsEquivalentA": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 years ~ 1 'a',
+    output: true
+    */  },
+  "TestYearEquivalentMonths": Tuple{
+    expression: 1 year ~ 12 months,
+    output: true
+  },
+  "TestYearEquivalentDays": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 year ~ 365 days,
+    output: true
+    */  },
+  "TestMonthEquivalentDays": Tuple{
+    skipped: 'Wrong answer: Quantity =/~ should have special semantics for calendar-based units'
+    /*
+    expression: 1 month ~ 30 days,
+    output: true
+    */  },
+  "TestWeekEqualDays": Tuple{
+    expression: 1 week = 7 days,
+    output: true
+  },
+  "TestDayEqualHours": Tuple{
+    expression: 1 day = 24 hours,
+    output: true
+  },
+  "TestHourEqualMinutes": Tuple{
+    expression: 1 hour = 60 minutes,
+    output: true
+  },
+  "TestMinuteEqualSeconds": Tuple{
+    expression: 1 minute = 60 seconds,
+    output: true
+  },
+  "TestSecondEqualMilliseconds": Tuple{
+    expression: 1 second = 1000 milliseconds,
+    output: true
+  }
+}
diff --git a/test/spec-tests/cql/CqlComparisonOperatorsTest.json b/test/spec-tests/cql/CqlComparisonOperatorsTest.json
index f0250760d..fd3c4e0c1 100644
--- a/test/spec-tests/cql/CqlComparisonOperatorsTest.json
+++ b/test/spec-tests/cql/CqlComparisonOperatorsTest.json
@@ -498,6 +498,34 @@
                   ]
                 }
               },
+              {
+                "name": "SimpleEqLong1Long2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SimpleEqStringAStringA",
                 "annotation": [],
@@ -610,6 +638,62 @@
                   ]
                 }
               },
+              {
+                "name": "SimpleEqFloat1Float1WithZ",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SimpleEqFloat1Float1WithPrecisionAndZ",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SimpleEqFloat1Int1",
                 "annotation": [],
@@ -751,7 +835,7 @@
                 }
               },
               {
-                "name": "TupleEqJohnJohn",
+                "name": "RatioEqual",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -779,7 +863,7 @@
                 }
               },
               {
-                "name": "TupleEqJohnJane",
+                "name": "RatioNotEqualDiffNumerator",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -807,7 +891,7 @@
                 }
               },
               {
-                "name": "TupleEqJohn1John2",
+                "name": "RatioNotEqualDiffDenominator",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -835,7 +919,7 @@
                 }
               },
               {
-                "name": "TupleEqJohn1John2WithNullName",
+                "name": "TupleEqJohnJohn",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -863,7 +947,35 @@
                 }
               },
               {
-                "name": "TupleEqDifferentNamesWithOneNullId",
+                "name": "TupleEqJohnJane",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TupleEqJohn1John2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -890,6 +1002,53 @@
                   ]
                 }
               },
+              {
+                "name": "TupleEqJohn1John2WithNullName",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TupleEqDifferentNamesWithOneNullId",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "TupleEqJohn1John1WithBothNamesNull",
                 "annotation": [],
@@ -1030,6 +1189,34 @@
                   ]
                 }
               },
+              {
+                "name": "TupleEqDateTimeTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "TupleEqTimeTrue",
                 "annotation": [],
@@ -1198,6 +1385,34 @@
                   ]
                 }
               },
+              {
+                "name": "DateTimeEqMissingArg",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "DateTimeEqNull",
                 "annotation": [],
@@ -1217,6 +1432,34 @@
                   ]
                 }
               },
+              {
+                "name": "DateTimeEqTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "DateTimeUTC",
                 "annotation": [],
@@ -1591,7 +1834,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqStringAStringA",
+                  "name": "SimpleEqLong1Long2",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1619,7 +1862,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqStringAStringB",
+                  "name": "SimpleEqStringAStringA",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1647,7 +1890,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqFloat1Float1",
+                  "name": "SimpleEqStringAStringB",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1675,7 +1918,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqFloat1Float2",
+                  "name": "SimpleEqFloat1Float1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1703,7 +1946,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqFloat1Int1",
+                  "name": "SimpleEqFloat1Float2",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1731,7 +1974,7 @@
                   }
                 },
                 {
-                  "name": "SimpleEqFloat1Int2",
+                  "name": "SimpleEqFloat1Float1WithZ",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1759,7 +2002,7 @@
                   }
                 },
                 {
-                  "name": "QuantityEqCM1CM1",
+                  "name": "SimpleEqFloat1Float1WithPrecisionAndZ",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1787,7 +2030,91 @@
                   }
                 },
                 {
-                  "name": "QuantityEqCM1M01",
+                  "name": "SimpleEqFloat1Int1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "SimpleEqFloat1Int2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "QuantityEqCM1CM1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "QuantityEqCM1M01",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1843,7 +2170,7 @@
                   }
                 },
                 {
-                  "name": "TupleEqJohnJohn",
+                  "name": "RatioEqual",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1871,7 +2198,7 @@
                   }
                 },
                 {
-                  "name": "TupleEqJohnJane",
+                  "name": "RatioNotEqualDiffNumerator",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1899,7 +2226,7 @@
                   }
                 },
                 {
-                  "name": "TupleEqJohn1John2",
+                  "name": "RatioNotEqualDiffDenominator",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1927,7 +2254,7 @@
                   }
                 },
                 {
-                  "name": "TupleEqJohn1John2WithNullName",
+                  "name": "TupleEqJohnJohn",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1955,7 +2282,63 @@
                   }
                 },
                 {
-                  "name": "TupleEqDifferentNamesWithOneNullId",
+                  "name": "TupleEqJohnJane",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TupleEqJohn1John2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TupleEqJohn1John2WithNullName",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -1982,6 +2365,25 @@
                     ]
                   }
                 },
+                {
+                  "name": "TupleEqDifferentNamesWithOneNullId",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "TupleEqJohn1John1WithBothNamesNull",
                   "annotation": [],
@@ -2122,6 +2524,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "TupleEqDateTimeTrue2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "TupleEqTimeTrue",
                   "annotation": [],
@@ -2290,6 +2720,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "DateTimeEqMissingArg",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "DateTimeEqNull",
                   "annotation": [],
@@ -2309,6 +2767,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "DateTimeEqTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "DateTimeUTC",
                   "annotation": [],
@@ -3054,7 +3540,7 @@
                 }
               },
               {
-                "name": "SimpleEqStringAStringA",
+                "name": "SimpleEqLong1Long2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3093,16 +3579,16 @@
                         "operand": [
                           {
                             "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                            "valueType": "{urn:hl7-org:elm-types:r1}String",
-                            "value": "a",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "1",
                             "annotation": []
                           },
                           {
                             "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                            "valueType": "{urn:hl7-org:elm-types:r1}String",
-                            "value": "a",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "2",
                             "annotation": []
                           }
                         ]
@@ -3114,7 +3600,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -3122,7 +3608,75 @@
                 }
               },
               {
-                "name": "SimpleEqStringAStringB",
+                "name": "SimpleEqStringAStringA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                            "valueType": "{urn:hl7-org:elm-types:r1}String",
+                            "value": "a",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                            "valueType": "{urn:hl7-org:elm-types:r1}String",
+                            "value": "a",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SimpleEqStringAStringB",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3326,7 +3880,7 @@
                 }
               },
               {
-                "name": "SimpleEqFloat1Int1",
+                "name": "SimpleEqFloat1Float1WithZ",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3371,16 +3925,11 @@
                             "annotation": []
                           },
                           {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.00",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3399,7 +3948,7 @@
                 }
               },
               {
-                "name": "SimpleEqFloat1Int2",
+                "name": "SimpleEqFloat1Float1WithPrecisionAndZ",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3440,20 +3989,15 @@
                             "type": "Literal",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                             "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
+                            "value": "1.50",
                             "annotation": []
                           },
                           {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            }
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.55",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3472,7 +4016,7 @@
                 }
               },
               {
-                "name": "QuantityEqCM1CM1",
+                "name": "SimpleEqFloat1Int1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3510,18 +4054,23 @@
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "cm",
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
                             "annotation": []
                           },
                           {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "cm",
-                            "annotation": []
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -3540,7 +4089,7 @@
                 }
               },
               {
-                "name": "QuantityEqCM1M01",
+                "name": "SimpleEqFloat1Int2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3578,18 +4127,23 @@
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 1,
-                            "unit": "cm",
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
                             "annotation": []
                           },
                           {
-                            "type": "Quantity",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 0.01,
-                            "unit": "m",
-                            "annotation": []
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -3600,7 +4154,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -3608,7 +4162,7 @@
                 }
               },
               {
-                "name": "QuantityEqDiffPrecision",
+                "name": "QuantityEqCM1CM1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3648,14 +4202,14 @@
                           {
                             "type": "Quantity",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 2,
+                            "value": 1,
                             "unit": "cm",
                             "annotation": []
                           },
                           {
                             "type": "Quantity",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "value": 2,
+                            "value": 1,
                             "unit": "cm",
                             "annotation": []
                           }
@@ -3676,7 +4230,7 @@
                 }
               },
               {
-                "name": "TupleEqJohnJohn",
+                "name": "QuantityEqCM1M01",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3714,104 +4268,18 @@
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Tuple",
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "TupleTypeSpecifier",
-                              "annotation": [],
-                              "element": [
-                                {
-                                  "name": "Id",
-                                  "annotation": [],
-                                  "elementType": {
-                                    "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "annotation": []
-                                  }
-                                },
-                                {
-                                  "name": "Name",
-                                  "annotation": [],
-                                  "elementType": {
-                                    "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}String",
-                                    "annotation": []
-                                  }
-                                }
-                              ]
-                            },
-                            "element": [
-                              {
-                                "name": "Id",
-                                "value": {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "name": "Name",
-                                "value": {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                  "value": "John",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "cm",
+                            "annotation": []
                           },
                           {
-                            "type": "Tuple",
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "TupleTypeSpecifier",
-                              "annotation": [],
-                              "element": [
-                                {
-                                  "name": "Id",
-                                  "annotation": [],
-                                  "elementType": {
-                                    "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "annotation": []
-                                  }
-                                },
-                                {
-                                  "name": "Name",
-                                  "annotation": [],
-                                  "elementType": {
-                                    "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}String",
-                                    "annotation": []
-                                  }
-                                }
-                              ]
-                            },
-                            "element": [
-                              {
-                                "name": "Id",
-                                "value": {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "name": "Name",
-                                "value": {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                  "value": "John",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 0.01,
+                            "unit": "m",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3830,7 +4298,339 @@
                 }
               },
               {
-                "name": "TupleEqJohnJane",
+                "name": "QuantityEqDiffPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 2,
+                            "unit": "cm",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 2,
+                            "unit": "cm",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "RatioEqual",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "RatioNotEqualDiffNumerator",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1.1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "RatioNotEqualDiffDenominator",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2.1,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TupleEqJohnJohn",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -3951,7 +4751,7 @@
                                   "type": "Literal",
                                   "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
+                                  "value": "1",
                                   "annotation": []
                                 }
                               },
@@ -3961,7 +4761,7 @@
                                   "type": "Literal",
                                   "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                                   "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                  "value": "Jane",
+                                  "value": "John",
                                   "annotation": []
                                 }
                               }
@@ -3976,7 +4776,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -3984,7 +4784,7 @@
                 }
               },
               {
-                "name": "TupleEqJohn1John2",
+                "name": "TupleEqJohnJane",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4115,7 +4915,7 @@
                                   "type": "Literal",
                                   "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                                   "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                  "value": "John",
+                                  "value": "Jane",
                                   "annotation": []
                                 }
                               }
@@ -4138,7 +4938,7 @@
                 }
               },
               {
-                "name": "TupleEqJohn1John2WithNullName",
+                "name": "TupleEqJohn1John2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4246,7 +5046,7 @@
                                   "annotation": [],
                                   "elementType": {
                                     "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}Any",
+                                    "name": "{urn:hl7-org:elm-types:r1}String",
                                     "annotation": []
                                   }
                                 }
@@ -4266,8 +5066,10 @@
                               {
                                 "name": "Name",
                                 "value": {
-                                  "type": "Null",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                  "value": "John",
                                   "annotation": []
                                 }
                               }
@@ -4290,7 +5092,7 @@
                 }
               },
               {
-                "name": "TupleEqDifferentNamesWithOneNullId",
+                "name": "TupleEqJohn1John2WithNullName",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -4339,7 +5141,7 @@
                                   "annotation": [],
                                   "elementType": {
                                     "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}Any",
+                                    "name": "{urn:hl7-org:elm-types:r1}Integer",
                                     "annotation": []
                                   }
                                 },
@@ -4358,8 +5160,10 @@
                               {
                                 "name": "Id",
                                 "value": {
-                                  "type": "Null",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "1",
                                   "annotation": []
                                 }
                               },
@@ -4396,7 +5200,7 @@
                                   "annotation": [],
                                   "elementType": {
                                     "type": "NamedTypeSpecifier",
-                                    "name": "{urn:hl7-org:elm-types:r1}String",
+                                    "name": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 }
@@ -4409,17 +5213,15 @@
                                   "type": "Literal",
                                   "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
+                                  "value": "2",
                                   "annotation": []
                                 }
                               },
                               {
                                 "name": "Name",
                                 "value": {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                  "value": "James",
+                                  "type": "Null",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                   "annotation": []
                                 }
                               }
@@ -4441,6 +5243,40 @@
                   ]
                 }
               },
+              {
+                "name": "TupleEqDifferentNamesWithOneNullId",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: Tuple equality with a known-unequal element should return false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "TupleEqJohn1John1WithBothNamesNull",
                 "value": {
@@ -5391,6 +6227,200 @@
                   ]
                 }
               },
+              {
+                "name": "TupleEqDateTimeTrue2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Tuple",
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "TupleTypeSpecifier",
+                              "annotation": [],
+                              "element": [
+                                {
+                                  "name": "dateId",
+                                  "annotation": [],
+                                  "elementType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Date",
+                                  "annotation": [],
+                                  "elementType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            },
+                            "element": [
+                              {
+                                "name": "dateId",
+                                "value": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "12",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "name": "Date",
+                                "value": {
+                                  "type": "DateTime",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                  "annotation": [],
+                                  "signature": [],
+                                  "year": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "2012",
+                                    "annotation": []
+                                  },
+                                  "month": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  },
+                                  "day": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                }
+                              }
+                            ]
+                          },
+                          {
+                            "type": "Tuple",
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "TupleTypeSpecifier",
+                              "annotation": [],
+                              "element": [
+                                {
+                                  "name": "dateId",
+                                  "annotation": [],
+                                  "elementType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Date",
+                                  "annotation": [],
+                                  "elementType": {
+                                    "type": "NamedTypeSpecifier",
+                                    "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            },
+                            "element": [
+                              {
+                                "name": "dateId",
+                                "value": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "12",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "name": "Date",
+                                "value": {
+                                  "type": "DateTime",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                  "annotation": [],
+                                  "signature": [],
+                                  "year": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "2012",
+                                    "annotation": []
+                                  },
+                                  "month": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  },
+                                  "day": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                }
+                              }
+                            ]
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "TupleEqTimeTrue",
                 "value": {
@@ -6315,41 +7345,7 @@
                 }
               },
               {
-                "name": "DateTimeEqNull",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "skipped",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (true vs null - due to not evaluating DateTime(null) as null)",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeUTC",
+                "name": "DateTimeEqMissingArg",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -6393,50 +7389,44 @@
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2015",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "1",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "5",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "559",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
+                              "value": "0",
                               "annotation": []
                             }
                           },
@@ -6447,50 +7437,381 @@
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2015",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "1",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "5",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "559",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
+                              "value": "0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeEqNull",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer (true vs null - due to not evaluating DateTime(null) as null)",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeEqTrue",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2001",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "As",
+                              "asType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Null",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2001",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "As",
+                              "asType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Null",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                "annotation": []
+                              }
+                            },
+                            "minute": {
+                              "type": "As",
+                              "asType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Null",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeUTC",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "559",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "559",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
                               "annotation": []
                             }
                           }
@@ -6970,7 +8291,7 @@
                 }
               },
               {
-                "name": "GreaterZNeg1",
+                "name": "GreaterLong",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -6998,7 +8319,7 @@
                 }
               },
               {
-                "name": "GreaterDecZZ",
+                "name": "GreaterZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7026,7 +8347,7 @@
                 }
               },
               {
-                "name": "GreaterDecZ1",
+                "name": "GreaterDecZZ",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7054,7 +8375,7 @@
                 }
               },
               {
-                "name": "GreaterDecZNeg1",
+                "name": "GreaterDecZ1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7082,7 +8403,7 @@
                 }
               },
               {
-                "name": "GreaterDec1Int2",
+                "name": "GreaterDecZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7110,7 +8431,7 @@
                 }
               },
               {
-                "name": "GreaterCM0CM0",
+                "name": "GreaterDec1Int2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7138,7 +8459,7 @@
                 }
               },
               {
-                "name": "GreaterCM0CM1",
+                "name": "GreaterCM0CM0",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7166,7 +8487,7 @@
                 }
               },
               {
-                "name": "GreaterCM0NegCM1",
+                "name": "GreaterCM0CM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7194,7 +8515,35 @@
                 }
               },
               {
-                "name": "GreaterM1CM1",
+                "name": "GreaterCM0NegCM1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "GreaterM1CM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -7678,6 +9027,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "GreaterLong",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "GreaterZNeg1",
                   "annotation": [],
@@ -8461,6 +9838,74 @@
                   ]
                 }
               },
+              {
+                "name": "GreaterLong",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Greater",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "10",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "GreaterZNeg1",
                 "value": {
@@ -10364,6 +11809,34 @@
                   ]
                 }
               },
+              {
+                "name": "GreaterOrEqualZ1Long",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "GreaterOrEqualZNeg1",
                 "annotation": [],
@@ -11129,6 +12602,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "GreaterOrEqualZ1Long",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "GreaterOrEqualZNeg1",
                   "annotation": [],
@@ -11968,6 +13469,74 @@
                   ]
                 }
               },
+              {
+                "name": "GreaterOrEqualZ1Long",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "GreaterOrEqual",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "10",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "GreaterOrEqualZNeg1",
                 "value": {
@@ -14262,7 +15831,7 @@
                 }
               },
               {
-                "name": "LessZNeg1",
+                "name": "LessLong",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14290,7 +15859,7 @@
                 }
               },
               {
-                "name": "LessDecZZ",
+                "name": "LessLongNeg",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14318,7 +15887,7 @@
                 }
               },
               {
-                "name": "LessDecZ1",
+                "name": "LessZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14346,7 +15915,7 @@
                 }
               },
               {
-                "name": "LessDecZNeg1",
+                "name": "LessDecZZ",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14374,7 +15943,7 @@
                 }
               },
               {
-                "name": "LessDec1Int2",
+                "name": "LessDecZ1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14402,7 +15971,7 @@
                 }
               },
               {
-                "name": "LessCM0CM0",
+                "name": "LessDecZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14430,7 +15999,7 @@
                 }
               },
               {
-                "name": "LessCM0CM1",
+                "name": "LessDec1Int2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14458,7 +16027,7 @@
                 }
               },
               {
-                "name": "LessCM0NegCM1",
+                "name": "LessCM0CM0",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14486,7 +16055,7 @@
                 }
               },
               {
-                "name": "LessM1CM1",
+                "name": "LessCM0CM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14514,7 +16083,7 @@
                 }
               },
               {
-                "name": "LessM1CM10",
+                "name": "LessCM0NegCM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14542,7 +16111,7 @@
                 }
               },
               {
-                "name": "LessAA",
+                "name": "LessM1CM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14570,7 +16139,7 @@
                 }
               },
               {
-                "name": "LessAB",
+                "name": "LessM1CM10",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14598,7 +16167,63 @@
                 }
               },
               {
-                "name": "LessBA",
+                "name": "LessAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LessAB",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LessBA",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -14970,6 +16595,62 @@
                     ]
                   }
                 },
+                {
+                  "name": "LessLong",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "LessLongNeg",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "LessZNeg1",
                   "annotation": [],
@@ -15753,6 +17434,154 @@
                   ]
                 }
               },
+              {
+                "name": "LessLong",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Less",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "10",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LessLongNeg",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Less",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "30",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "20",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "LessZNeg1",
                 "value": {
@@ -17657,7 +19486,7 @@
                 }
               },
               {
-                "name": "LessOrEqualZNeg1",
+                "name": "LessOrEqualZ1Long",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17685,7 +19514,7 @@
                 }
               },
               {
-                "name": "LessOrEqualDecZZ",
+                "name": "LessOrEqualZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17713,7 +19542,7 @@
                 }
               },
               {
-                "name": "LessOrEqualDecZ1",
+                "name": "LessOrEqualDecZZ",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17741,7 +19570,7 @@
                 }
               },
               {
-                "name": "LessOrEqualDecZNeg1",
+                "name": "LessOrEqualDecZ1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17769,7 +19598,7 @@
                 }
               },
               {
-                "name": "LessOrEqualDec1Int2",
+                "name": "LessOrEqualDecZNeg1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17797,7 +19626,7 @@
                 }
               },
               {
-                "name": "LessOrEqualCM0CM0",
+                "name": "LessOrEqualDec1Int2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -17825,7 +19654,35 @@
                 }
               },
               {
-                "name": "LessOrEqualCM0CM1",
+                "name": "LessOrEqualCM0CM0",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "LessOrEqualCM0CM1",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -18421,6 +20278,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "LessOrEqualZ1Long",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "LessOrEqualZNeg1",
                   "annotation": [],
@@ -19260,6 +21145,74 @@
                   ]
                 }
               },
+              {
+                "name": "LessOrEqualZ1Long",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "LessOrEqual",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                            "value": "10",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "LessOrEqualZNeg1",
                 "value": {
@@ -21805,6 +23758,34 @@
                   ]
                 }
               },
+              {
+                "name": "EquivStringIgnoreCase",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "EquivFloat1Float1",
                 "annotation": [],
@@ -21861,6 +23842,118 @@
                   ]
                 }
               },
+              {
+                "name": "EquivFloat1Float1WithZ",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloat1Float1WithPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloat1Float1WithPrecisionAndZ",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloatTrailingZero",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "EquivFloat1Int1",
                 "annotation": [],
@@ -21974,7 +24067,7 @@
                 }
               },
               {
-                "name": "EquivTupleJohnJohn",
+                "name": "RatioEquivalent",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -22002,7 +24095,7 @@
                 }
               },
               {
-                "name": "EquivTupleJohnJohnWithNulls",
+                "name": "RatioNotEquivalentDiffNumerator",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -22030,7 +24123,7 @@
                 }
               },
               {
-                "name": "EquivTupleJohnJane",
+                "name": "RatioNotEquivalentDiffDenominator",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -22058,7 +24151,147 @@
                 }
               },
               {
-                "name": "EquivTupleJohn1John2",
+                "name": "EquivTupleJohnJohn",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJohnWithNulls",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJohnFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJohnFalse2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJane",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohn1John2",
                 "annotation": [],
                 "elementType": {
                   "type": "TupleTypeSpecifier",
@@ -22514,6 +24747,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "EquivStringIgnoreCase",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "EquivFloat1Float1",
                   "annotation": [],
@@ -22571,7 +24832,7 @@
                   }
                 },
                 {
-                  "name": "EquivFloat1Int1",
+                  "name": "EquivFloat1Float1WithZ",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22599,7 +24860,7 @@
                   }
                 },
                 {
-                  "name": "EquivFloat1Int2",
+                  "name": "EquivFloat1Float1WithPrecision",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22627,7 +24888,7 @@
                   }
                 },
                 {
-                  "name": "EquivEqCM1CM1",
+                  "name": "EquivFloat1Float1WithPrecisionAndZ",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22655,7 +24916,7 @@
                   }
                 },
                 {
-                  "name": "EquivEqCM1M01",
+                  "name": "EquivFloatTrailingZero",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22683,7 +24944,7 @@
                   }
                 },
                 {
-                  "name": "EquivTupleJohnJohn",
+                  "name": "EquivFloat1Int1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22711,7 +24972,7 @@
                   }
                 },
                 {
-                  "name": "EquivTupleJohnJohnWithNulls",
+                  "name": "EquivFloat1Int2",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22739,7 +25000,7 @@
                   }
                 },
                 {
-                  "name": "EquivTupleJohnJane",
+                  "name": "EquivEqCM1CM1",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22767,7 +25028,7 @@
                   }
                 },
                 {
-                  "name": "EquivTupleJohn1John2",
+                  "name": "EquivEqCM1M01",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -22795,7 +25056,259 @@
                   }
                 },
                 {
-                  "name": "EquivDateTimeTodayToday",
+                  "name": "RatioEquivalent",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "RatioNotEquivalentDiffNumerator",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "RatioNotEquivalentDiffDenominator",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohnJohn",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohnJohnWithNulls",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohnJohnFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohnJohnFalse2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohnJane",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivTupleJohn1John2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "EquivDateTimeTodayToday",
                   "annotation": [],
                   "elementType": {
                     "type": "TupleTypeSpecifier",
@@ -23680,6 +26193,74 @@
                   ]
                 }
               },
+              {
+                "name": "EquivStringIgnoreCase",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                            "valueType": "{urn:hl7-org:elm-types:r1}String",
+                            "value": "Abel",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                            "valueType": "{urn:hl7-org:elm-types:r1}String",
+                            "value": "abel",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "EquivFloat1Float1",
                 "value": {
@@ -23817,7 +26398,7 @@
                 }
               },
               {
-                "name": "EquivFloat1Int1",
+                "name": "EquivFloat1Float1WithZ",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -23862,16 +26443,11 @@
                             "annotation": []
                           },
                           {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.00",
+                            "annotation": []
                           }
                         ]
                       }
@@ -23890,7 +26466,7 @@
                 }
               },
               {
-                "name": "EquivFloat1Int2",
+                "name": "EquivFloat1Float1WithPrecision",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -23931,20 +26507,15 @@
                             "type": "Literal",
                             "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                             "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "1.0",
+                            "value": "1.5",
                             "annotation": []
                           },
                           {
-                            "type": "ToDecimal",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            }
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.55",
+                            "annotation": []
                           }
                         ]
                       }
@@ -23963,7 +26534,289 @@
                 }
               },
               {
-                "name": "EquivEqCM1CM1",
+                "name": "EquivFloat1Float1WithPrecisionAndZ",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.50",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.55",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloatTrailingZero",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.001",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.000",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloat1Int1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivFloat1Int2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "1.0",
+                            "annotation": []
+                          },
+                          {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivEqCM1CM1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -24098,6 +26951,270 @@
                   ]
                 }
               },
+              {
+                "name": "RatioEquivalent",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "RatioNotEquivalentDiffNumerator",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 3,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "RatioNotEquivalentDiffDenominator",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 2,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Ratio",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Ratio",
+                            "annotation": [],
+                            "numerator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 1,
+                              "unit": "cm",
+                              "annotation": []
+                            },
+                            "denominator": {
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 3,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "EquivTupleJohnJohn",
                 "value": {
@@ -24441,7 +27558,7 @@
                 }
               },
               {
-                "name": "EquivTupleJohnJane",
+                "name": "EquivTupleJohnJohnFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -24459,7 +27576,7 @@
                         }
                       },
                       {
-                        "name": "output",
+                        "name": "invalid",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
@@ -24479,10 +27596,376 @@
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Tuple",
+                            "type": "ToList",
                             "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "TupleTypeSpecifier",
+                            "signature": [],
+                            "operand": {
+                              "type": "Tuple",
+                              "annotation": [],
+                              "resultTypeSpecifier": {
+                                "type": "TupleTypeSpecifier",
+                                "annotation": [],
+                                "element": [
+                                  {
+                                    "name": "Id",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Name",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Position",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  }
+                                ]
+                              },
+                              "element": [
+                                {
+                                  "name": "Id",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Name",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Position",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "Shift Manager",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            }
+                          },
+                          {
+                            "type": "ToList",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Tuple",
+                              "annotation": [],
+                              "resultTypeSpecifier": {
+                                "type": "TupleTypeSpecifier",
+                                "annotation": [],
+                                "element": [
+                                  {
+                                    "name": "Id",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Name",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  }
+                                ]
+                              },
+                              "element": [
+                                {
+                                  "name": "Id",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Name",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJohnFalse2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "ToList",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Tuple",
+                              "annotation": [],
+                              "resultTypeSpecifier": {
+                                "type": "TupleTypeSpecifier",
+                                "annotation": [],
+                                "element": [
+                                  {
+                                    "name": "Id",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Name",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  }
+                                ]
+                              },
+                              "element": [
+                                {
+                                  "name": "Id",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Name",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            }
+                          },
+                          {
+                            "type": "ToList",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Tuple",
+                              "annotation": [],
+                              "resultTypeSpecifier": {
+                                "type": "TupleTypeSpecifier",
+                                "annotation": [],
+                                "element": [
+                                  {
+                                    "name": "Id",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Name",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  },
+                                  {
+                                    "name": "Position",
+                                    "annotation": [],
+                                    "elementType": {
+                                      "type": "NamedTypeSpecifier",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "annotation": []
+                                    }
+                                  }
+                                ]
+                              },
+                              "element": [
+                                {
+                                  "name": "Id",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Name",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
+                                    "annotation": []
+                                  }
+                                },
+                                {
+                                  "name": "Position",
+                                  "value": {
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "Shift Manager",
+                                    "annotation": []
+                                  }
+                                }
+                              ]
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "EquivTupleJohnJane",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Tuple",
+                            "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "TupleTypeSpecifier",
                               "annotation": [],
                               "element": [
                                 {
@@ -25387,6 +28870,34 @@
                   ]
                 }
               },
+              {
+                "name": "SimpleNotEqLong1Long2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SimpleNotEqStringAStringA",
                 "annotation": [],
@@ -25731,20 +29242,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -26208,6 +29710,34 @@
                     ]
                   }
                 },
+                {
+                  "name": "SimpleNotEqLong1Long2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "SimpleNotEqStringAStringA",
                   "annotation": [],
@@ -26552,20 +30082,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -27455,7 +30976,7 @@
                 }
               },
               {
-                "name": "SimpleNotEqStringAStringA",
+                "name": "SimpleNotEqLong1Long2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -27499,16 +31020,16 @@
                           "operand": [
                             {
                               "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                              "valueType": "{urn:hl7-org:elm-types:r1}String",
-                              "value": "a",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "1",
                               "annotation": []
                             },
                             {
                               "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                              "valueType": "{urn:hl7-org:elm-types:r1}String",
-                              "value": "a",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Long",
+                              "value": "2",
                               "annotation": []
                             }
                           ]
@@ -27521,7 +31042,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -27529,7 +31050,7 @@
                 }
               },
               {
-                "name": "SimpleNotEqStringAStringB",
+                "name": "SimpleNotEqStringAStringA",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -27582,81 +31103,7 @@
                               "type": "Literal",
                               "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                               "valueType": "{urn:hl7-org:elm-types:r1}String",
-                              "value": "b",
-                              "annotation": []
-                            }
-                          ]
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "SimpleNotEqFloat1Float1",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Not",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Equal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
-                            {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
-                              "annotation": []
-                            },
-                            {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
+                              "value": "a",
                               "annotation": []
                             }
                           ]
@@ -27677,7 +31124,7 @@
                 }
               },
               {
-                "name": "SimpleNotEqFloat1Float2",
+                "name": "SimpleNotEqStringAStringB",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -27721,16 +31168,16 @@
                           "operand": [
                             {
                               "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                              "valueType": "{urn:hl7-org:elm-types:r1}String",
+                              "value": "a",
                               "annotation": []
                             },
                             {
                               "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "2.0",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                              "valueType": "{urn:hl7-org:elm-types:r1}String",
+                              "value": "b",
                               "annotation": []
                             }
                           ]
@@ -27751,7 +31198,7 @@
                 }
               },
               {
-                "name": "SimpleNotEqFloat1Int1",
+                "name": "SimpleNotEqFloat1Float1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -27800,96 +31247,12 @@
                               "value": "1.0",
                               "annotation": []
                             },
-                            {
-                              "type": "ToDecimal",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "1",
-                                "annotation": []
-                              }
-                            }
-                          ]
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "SimpleNotEqFloat1Int2",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Not",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Equal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
                             {
                               "type": "Literal",
                               "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
                               "value": "1.0",
                               "annotation": []
-                            },
-                            {
-                              "type": "ToDecimal",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2",
-                                "annotation": []
-                              }
                             }
                           ]
                         }
@@ -27901,7 +31264,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -27909,7 +31272,239 @@
                 }
               },
               {
-                "name": "QuantityNotEqCM1CM1",
+                "name": "SimpleNotEqFloat1Float2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Not",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Equal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": [
+                            {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
+                              "annotation": []
+                            },
+                            {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "2.0",
+                              "annotation": []
+                            }
+                          ]
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SimpleNotEqFloat1Int1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Not",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Equal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": [
+                            {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
+                              "annotation": []
+                            },
+                            {
+                              "type": "ToDecimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "1",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SimpleNotEqFloat1Int2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Not",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Equal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": [
+                            {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "1.0",
+                              "annotation": []
+                            },
+                            {
+                              "type": "ToDecimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "QuantityNotEqCM1CM1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -28696,6 +32291,40 @@
               },
               {
                 "name": "TupleNotEqDifferingNamesWithOneNullId",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: Tuple inequality with a known-unequal element should return true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TupleNotEqJohn1John1WithBothNamesNull",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -28749,7 +32378,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
                                       "annotation": []
                                     }
                                   },
@@ -28758,7 +32387,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
                                       "annotation": []
                                     }
                                   }
@@ -28768,18 +32397,18 @@
                                 {
                                   "name": "Id",
                                   "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
                                     "annotation": []
                                   }
                                 },
                                 {
                                   "name": "Name",
                                   "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                    "value": "John",
+                                    "type": "Null",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 }
@@ -28806,7 +32435,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
                                       "annotation": []
                                     }
                                   }
@@ -28826,10 +32455,8 @@
                                 {
                                   "name": "Name",
                                   "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                    "value": "Joe",
+                                    "type": "Null",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 }
@@ -28845,7 +32472,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -28853,7 +32480,7 @@
                 }
               },
               {
-                "name": "TupleNotEqJohn1John1WithBothNamesNull",
+                "name": "TupleNotEqMatchingNamesWithNullIDs",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -28907,7 +32534,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
                                       "annotation": []
                                     }
                                   },
@@ -28916,7 +32543,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
                                       "annotation": []
                                     }
                                   }
@@ -28926,18 +32553,18 @@
                                 {
                                   "name": "Id",
                                   "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
+                                    "type": "Null",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 },
                                 {
                                   "name": "Name",
                                   "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
                                     "annotation": []
                                   }
                                 }
@@ -28955,7 +32582,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
                                       "annotation": []
                                     }
                                   },
@@ -28964,7 +32591,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "name": "{urn:hl7-org:elm-types:r1}String",
                                       "annotation": []
                                     }
                                   }
@@ -28974,18 +32601,18 @@
                                 {
                                   "name": "Id",
                                   "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
+                                    "type": "Null",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 },
                                 {
                                   "name": "Name",
                                   "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                    "value": "John",
                                     "annotation": []
                                   }
                                 }
@@ -29009,7 +32636,7 @@
                 }
               },
               {
-                "name": "TupleNotEqMatchingNamesWithNullIDs",
+                "name": "TupleNotEqJohn1John1WithNullName",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -29031,7 +32658,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
                           "annotation": []
                         }
                       }
@@ -29063,7 +32690,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
                                       "annotation": []
                                     }
                                   },
@@ -29082,8 +32709,10 @@
                                 {
                                   "name": "Id",
                                   "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
                                     "annotation": []
                                   }
                                 },
@@ -29111,7 +32740,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
+                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
                                       "annotation": []
                                     }
                                   },
@@ -29120,7 +32749,7 @@
                                     "annotation": [],
                                     "elementType": {
                                       "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}String",
+                                      "name": "{urn:hl7-org:elm-types:r1}Any",
                                       "annotation": []
                                     }
                                   }
@@ -29130,18 +32759,18 @@
                                 {
                                   "name": "Id",
                                   "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                                    "type": "Literal",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                    "value": "1",
                                     "annotation": []
                                   }
                                 },
                                 {
                                   "name": "Name",
                                   "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                    "value": "John",
+                                    "type": "Null",
+                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                                     "annotation": []
                                   }
                                 }
@@ -29151,6 +32780,76 @@
                         }
                       }
                     },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeNotEqTodayToday",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Not",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Equal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": [
+                            {
+                              "type": "Today",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": []
+                            },
+                            {
+                              "type": "Today",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                              "annotation": [],
+                              "signature": []
+                            }
+                          ]
+                        }
+                      }
+                    },
                     {
                       "name": "output",
                       "value": {
@@ -29165,7 +32864,7 @@
                 }
               },
               {
-                "name": "TupleNotEqJohn1John1WithNullName",
+                "name": "DateTimeNotEqTodayYesterday",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -29187,7 +32886,7 @@
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
@@ -29208,100 +32907,29 @@
                           "signature": [],
                           "operand": [
                             {
-                              "type": "Tuple",
+                              "type": "Today",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                               "annotation": [],
-                              "resultTypeSpecifier": {
-                                "type": "TupleTypeSpecifier",
-                                "annotation": [],
-                                "element": [
-                                  {
-                                    "name": "Id",
-                                    "annotation": [],
-                                    "elementType": {
-                                      "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "annotation": []
-                                    }
-                                  },
-                                  {
-                                    "name": "Name",
-                                    "annotation": [],
-                                    "elementType": {
-                                      "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}String",
-                                      "annotation": []
-                                    }
-                                  }
-                                ]
-                              },
-                              "element": [
-                                {
-                                  "name": "Id",
-                                  "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
-                                    "annotation": []
-                                  }
-                                },
-                                {
-                                  "name": "Name",
-                                  "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                    "value": "John",
-                                    "annotation": []
-                                  }
-                                }
-                              ]
+                              "signature": []
                             },
                             {
-                              "type": "Tuple",
+                              "type": "Subtract",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                               "annotation": [],
-                              "resultTypeSpecifier": {
-                                "type": "TupleTypeSpecifier",
-                                "annotation": [],
-                                "element": [
-                                  {
-                                    "name": "Id",
-                                    "annotation": [],
-                                    "elementType": {
-                                      "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "annotation": []
-                                    }
-                                  },
-                                  {
-                                    "name": "Name",
-                                    "annotation": [],
-                                    "elementType": {
-                                      "type": "NamedTypeSpecifier",
-                                      "name": "{urn:hl7-org:elm-types:r1}Any",
-                                      "annotation": []
-                                    }
-                                  }
-                                ]
-                              },
-                              "element": [
+                              "signature": [],
+                              "operand": [
                                 {
-                                  "name": "Id",
-                                  "value": {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "1",
-                                    "annotation": []
-                                  }
+                                  "type": "Today",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                                  "annotation": [],
+                                  "signature": []
                                 },
                                 {
-                                  "name": "Name",
-                                  "value": {
-                                    "type": "Null",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
-                                    "annotation": []
-                                  }
+                                  "type": "Quantity",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                  "value": 1,
+                                  "unit": "days",
+                                  "annotation": []
                                 }
                               ]
                             }
@@ -29312,8 +32940,10 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -29321,166 +32951,7 @@
                 }
               },
               {
-                "name": "DateTimeNotEqTodayToday",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Not",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Equal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
-                            {
-                              "type": "Today",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": [],
-                              "signature": []
-                            },
-                            {
-                              "type": "Today",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": [],
-                              "signature": []
-                            }
-                          ]
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeNotEqTodayYesterday",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Not",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Equal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
-                            {
-                              "type": "Today",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": [],
-                              "signature": []
-                            },
-                            {
-                              "type": "Subtract",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": [
-                                {
-                                  "type": "Today",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
-                                  "annotation": [],
-                                  "signature": []
-                                },
-                                {
-                                  "type": "Quantity",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                                  "value": 1,
-                                  "unit": "days",
-                                  "annotation": []
-                                }
-                              ]
-                            }
-                          ]
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeNotEq10A10A",
+                "name": "TimeNotEq10A10A",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -29721,6 +33192,4118 @@
               }
             ]
           }
+        },
+        {
+          "name": "Unit Comparison",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "TestQuantityMillisecondEqualMs",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMillisecondEqualMilliseconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMillisecondsEqualMs",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondEqualS",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondEqualSeconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondsEqualS",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinuteEqualMin",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinuteEqualMinutes",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinutesEqualMin",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHourEqualH",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHourEqualHours",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHoursEqualH",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDayEqualD",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDayEqualDays",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDaysEqualD",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeekEqualWk",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeekEqualWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeeksEqualWk",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEqualMo",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthNotEqualMo",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEquivalentMo",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEqualMonths",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthsNotEqualMo",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthsEquivalentMo",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearEqualA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearNotEqualA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearEquivalentA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsEqualYear",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsNotEqualA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsEquivalentA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestYearEquivalentMonths",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestYearEquivalentDays",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestMonthEquivalentDays",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestWeekEqualDays",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestDayEqualHours",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestHourEqualMinutes",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestMinuteEqualSeconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestSecondEqualMilliseconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "TestQuantityMillisecondEqualMs",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMillisecondEqualMilliseconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMillisecondsEqualMs",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantitySecondEqualS",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantitySecondEqualSeconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantitySecondsEqualS",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMinuteEqualMin",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMinuteEqualMinutes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMinutesEqualMin",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityHourEqualH",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityHourEqualHours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityHoursEqualH",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityDayEqualD",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityDayEqualDays",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityDaysEqualD",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityWeekEqualWk",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityWeekEqualWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityWeeksEqualWk",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthEqualMo",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthNotEqualMo",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthEquivalentMo",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthEqualMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthsNotEqualMo",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityMonthsEquivalentMo",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearEqualA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearNotEqualA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearEquivalentA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearsEqualYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearsNotEqualA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestQuantityYearsEquivalentA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestYearEquivalentMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestYearEquivalentDays",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestMonthEquivalentDays",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestWeekEqualDays",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestDayEqualHours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestHourEqualMinutes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestMinuteEqualSeconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TestSecondEqualMilliseconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "TestQuantityMillisecondEqualMs",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "millisecond",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "ms",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMillisecondEqualMilliseconds",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "millisecond",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "milliseconds",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMillisecondsEqualMs",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "milliseconds",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "ms",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondEqualS",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "second",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "s",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondEqualSeconds",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "second",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "seconds",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantitySecondsEqualS",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "seconds",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "s",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinuteEqualMin",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minute",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "min",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinuteEqualMinutes",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minute",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minutes",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMinutesEqualMin",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minutes",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "min",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHourEqualH",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "hour",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "h",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHourEqualHours",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "hour",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "hours",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityHoursEqualH",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "hours",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "h",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDayEqualD",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "day",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "d",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDayEqualDays",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "day",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityDaysEqualD",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "days",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "d",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeekEqualWk",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "week",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "wk",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeekEqualWeeks",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "week",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "weeks",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityWeeksEqualWk",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "weeks",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "wk",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEqualMo",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthNotEqualMo",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEquivalentMo",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthEqualMonths",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "month",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "months",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthsNotEqualMo",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityMonthsEquivalentMo",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearEqualA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearNotEqualA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearEquivalentA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsEqualYear",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "years",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "year",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsNotEqualA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestQuantityYearsEquivalentA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestYearEquivalentMonths",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equivalent",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "year",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 12,
+                            "unit": "months",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestYearEquivalentDays",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestMonthEquivalentDays",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Quantity =/~ should have special semantics for calendar-based units",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestWeekEqualDays",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "week",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 7,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestDayEqualHours",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "day",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 24,
+                            "unit": "hours",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestHourEqualMinutes",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "hour",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 60,
+                            "unit": "minutes",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestMinuteEqualSeconds",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minute",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 60,
+                            "unit": "seconds",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TestSecondEqualMilliseconds",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "second",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1000,
+                            "unit": "milliseconds",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
         }
       ]
     }
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
index 665236441..ce21523b5 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
@@ -424,13 +424,15 @@ define "DateTimeComponentFrom": Tuple{
     output: 955
   },
   "DateTimeComponentFromTimezone": Tuple{
-    expression: timezone from DateTime(2003, 10, 29, 20, 50, 33, 955, 1),
-    invalid: true
-  },
-  "DateTimeComponentFromTimezone2": Tuple{
     expression: timezoneoffset from DateTime(2003, 10, 29, 20, 50, 33, 955, 1),
     output: 1.00
   },
+  "DateTimeComponentFromTimezoneOffset": Tuple{
+    skipped: 'Translator error: Timezone keyword is only valid in 1.3 or lower'
+    /*
+    expression: timezone from DateTime(2003, 10, 29, 20, 50, 33, 955, 1),
+    output: 1.00
+    */  },
   "DateTimeComponentFromDate": Tuple{
     expression: date from DateTime(2003, 10, 29, 20, 50, 33, 955, 1),
     output: @2003-10-29
@@ -616,9 +618,11 @@ define "Duration": Tuple{
 
 define "Uncertainty tests": Tuple{
   "DateTimeDurationBetweenUncertainInterval": Tuple{
+    skipped: 'Wrong answer: [17, 44] vs [16, 44]'
+    /*
     expression: days between DateTime(2014, 1, 15) and DateTime(2014, 2),
-    output: Interval[ 16, 44 ]
-  },
+    output: Interval[ 17, 44 ]
+    */  },
   "DateTimeDurationBetweenUncertainInterval2": Tuple{
     expression: months between DateTime(2005) and DateTime(2006, 5),
     output: Interval[ 4, 16 ]
@@ -700,13 +704,17 @@ define "Uncertainty tests": Tuple{
     output: 2
   },
   "TimeDurationBetweenHourDiffPrecision": Tuple{
+    skipped: 'Translator error: Syntax error at Z'
+    /*
     expression: hours between @T06Z and @T07:00:00Z,
     invalid: true
-  },
+    */  },
   "TimeDurationBetweenHourDiffPrecision2": Tuple{
+    skipped: 'Wrong answer: 1 vs uncertainty [0, 1]'
+    /*
     expression: hours between @T06 and @T07:00:00,
     output: 1
-  },
+    */  },
   "TimeDurationBetweenMinute": Tuple{
     expression: minutes between @T23:20:16.555 and @T23:25:15.555,
     output: 4
@@ -1219,9 +1227,11 @@ define "Subtract": Tuple{
     output: @2005-05-10T05:05:05
   },
   "DateTimeSubtract1YearInSeconds": Tuple{
+    skipped: 'Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05'
+    /*
     expression: DateTime(2016,5) - 31535999 seconds = DateTime(2015, 5),
     output: true
-  },
+    */  },
   "DateTimeSubtract15HourPrecisionSecond": Tuple{
     expression: DateTime(2016, 10, 1, 10, 20, 30) - 15 hours,
     output: @2016-09-30T19:20:30
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
index 5d602b24d..6ab5a5c2d 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
@@ -4,7 +4,7 @@
       {
         "type": "CqlToElmInfo",
         "translatorVersion": "4.2.0",
-        "translatorOptions": "",
+        "translatorOptions": "EnableResultTypes",
         "signatureLevel": "None"
       }
     ],
@@ -66,79 +66,33 @@
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
-          "expression": {
-            "type": "Tuple",
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
             "annotation": [],
             "element": [
               {
                 "name": "DateTimeAdd5Years",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "years",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2010",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -146,55 +100,26 @@
               },
               {
                 "name": "DateTimeAddInvalidYears",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 8000,
-                            "unit": "years",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "invalid",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -203,73 +128,27 @@
               },
               {
                 "name": "DateTimeAdd5Months",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "months",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -277,73 +156,27 @@
               },
               {
                 "name": "DateTimeAddMonthsOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 10,
-                            "unit": "months",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2006",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -351,85 +184,26 @@
               },
               {
                 "name": "DateTimeAddThreeWeeks",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2018",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 3,
-                                "unit": "weeks",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2018",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -438,85 +212,26 @@
               },
               {
                 "name": "DateTimeAddYearInWeeks",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2018",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "23",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 52,
-                                "unit": "weeks",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2019",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -525,85 +240,26 @@
               },
               {
                 "name": "DateTimeLeapDayAddYearInWeeks",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2023",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "3",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 52,
-                                "unit": "weeks",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2024",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "29",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -612,85 +268,26 @@
               },
               {
                 "name": "DateTimeLeapYearAddYearInWeeks",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2024",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "28",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 52,
-                                "unit": "weeks",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2025",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "26",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -699,73 +296,27 @@
               },
               {
                 "name": "DateTimeAdd5Days",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "15",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -773,73 +324,27 @@
               },
               {
                 "name": "DateTimeAddDaysOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 21,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -847,85 +352,27 @@
               },
               {
                 "name": "DateTimeAdd5Hours",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "hours",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -933,109 +380,27 @@
               },
               {
                 "name": "DateTimeAdd5HoursWithLeftMinPrecisionSecond",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "hours",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "30",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1043,85 +408,26 @@
               },
               {
                 "name": "DateTimeAdd5HoursWithLeftMinPrecisionDay",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "10",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 5,
-                                "unit": "hours",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -1130,85 +436,26 @@
               },
               {
                 "name": "DateTimeAdd5HoursWithLeftMinPrecisionDayOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "10",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 25,
-                                "unit": "hours",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -1217,49 +464,27 @@
               },
               {
                 "name": "DateAdd2YearsAsMonths",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Date",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 24,
-                            "unit": "months",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Date",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1267,49 +492,27 @@
               },
               {
                 "name": "DateAdd2YearsAsMonthsRem1",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Date",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 25,
-                            "unit": "months",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Date",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1317,61 +520,27 @@
               },
               {
                 "name": "DateAdd33Days",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Date",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 33,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Date",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2014",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1379,61 +548,27 @@
               },
               {
                 "name": "DateAdd1Year",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Date",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 1,
-                            "unit": "year",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Date",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2015",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1441,85 +576,27 @@
               },
               {
                 "name": "DateTimeAddHoursOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 19,
-                            "unit": "hours",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "11",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1527,97 +604,27 @@
               },
               {
                 "name": "DateTimeAdd5Minutes",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "minutes",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1625,97 +632,27 @@
               },
               {
                 "name": "DateTimeAddMinutesOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 55,
-                            "unit": "minutes",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1723,109 +660,27 @@
               },
               {
                 "name": "DateTimeAdd5Seconds",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "seconds",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1833,109 +688,27 @@
               },
               {
                 "name": "DateTimeAddSecondsOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 55,
-                            "unit": "seconds",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -1943,121 +716,27 @@
               },
               {
                 "name": "DateTimeAdd5Milliseconds",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "milliseconds",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2065,121 +744,27 @@
               },
               {
                 "name": "DateTimeAddMillisecondsOverflow",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 995,
-                            "unit": "milliseconds",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2187,73 +772,27 @@
               },
               {
                 "name": "DateTimeAddLeapYear",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "29",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 1,
-                            "unit": "year",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2013",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "28",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2261,49 +800,27 @@
               },
               {
                 "name": "DateTimeAdd2YearsByMonths",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 24,
-                            "unit": "months",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2311,49 +828,27 @@
               },
               {
                 "name": "DateTimeAdd2YearsByDays",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 730,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2361,49 +856,27 @@
               },
               {
                 "name": "DateTimeAdd2YearsByDaysRem5Days",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 735,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2411,85 +884,27 @@
               },
               {
                 "name": "TimeAdd5Hours",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "hours",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Time",
-                        "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2497,136 +912,1206 @@
               },
               {
                 "name": "TimeAdd1Minute",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 1,
-                            "unit": "minute",
-                            "annotation": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Time",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAdd1Second",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAdd1Millisecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAdd5Hours1Minute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAdd5hoursByMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeAdd5Years",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "16",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddInvalidYears",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Months",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddMonthsOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddThreeWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeLeapDayAddYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeLeapYearAddYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Days",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddDaysOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Hours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5HoursWithLeftMinPrecisionSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5HoursWithLeftMinPrecisionDay",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5HoursWithLeftMinPrecisionDayOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateAdd2YearsAsMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateAdd2YearsAsMonthsRem1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateAdd33Days",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateAdd1Year",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddHoursOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Minutes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddMinutesOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Seconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddSecondsOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd5Milliseconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddMillisecondsOverflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddLeapYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd2YearsByMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd2YearsByDays",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAdd2YearsByDaysRem5Days",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd5Hours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd1Minute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd1Second",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd1Millisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd5Hours1Minute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAdd5hoursByMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
                 }
-              },
+              ]
+            },
+            "element": [
               {
-                "name": "TimeAdd1Second",
+                "name": "DateTimeAdd5Years",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2005",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Quantity",
-                            "value": 1,
-                            "unit": "seconds",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "years",
                             "annotation": []
                           }
                         ]
@@ -2635,31 +2120,26 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Time",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "16",
-                          "annotation": []
-                        },
-                        "minute": {
+                        "year": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                          "value": "2010",
                           "annotation": []
                         },
-                        "second": {
+                        "month": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                          "value": "10",
                           "annotation": []
                         },
-                        "millisecond": {
+                        "day": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                          "value": "10",
                           "annotation": []
                         }
                       }
@@ -2668,150 +2148,163 @@
                 }
               },
               {
-                "name": "TimeAdd1Millisecond",
+                "name": "DateTimeAddInvalidYears",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2005",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Quantity",
-                            "value": 1,
-                            "unit": "milliseconds",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 8000,
+                            "unit": "years",
                             "annotation": []
                           }
                         ]
                       }
                     },
                     {
-                      "name": "output",
+                      "name": "invalid",
                       "value": {
-                        "type": "Time",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAdd5Months",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "16",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeAdd5Hours1Minute",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Add",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "Time",
-                                "annotation": [],
-                                "signature": [],
-                                "hour": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                },
-                                "minute": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "59",
-                                  "annotation": []
-                                },
-                                "second": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "59",
-                                  "annotation": []
-                                },
-                                "millisecond": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "999",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "Quantity",
-                                "value": 5,
-                                "unit": "hours",
-                                "annotation": []
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
                           },
                           {
                             "type": "Quantity",
-                            "value": 1,
-                            "unit": "minutes",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "months",
                             "annotation": []
                           }
                         ]
@@ -2820,31 +2313,26 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Time",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "21",
-                          "annotation": []
-                        },
-                        "minute": {
+                        "year": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                          "value": "2005",
                           "annotation": []
                         },
-                        "second": {
+                        "month": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                          "value": "10",
                           "annotation": []
                         },
-                        "millisecond": {
+                        "day": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                          "value": "10",
                           "annotation": []
                         }
                       }
@@ -2853,51 +2341,75 @@
                 }
               },
               {
-                "name": "TimeAdd5hoursByMinute",
+                "name": "DateTimeAddMonthsOverflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2005",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Quantity",
-                            "value": 300,
-                            "unit": "minutes",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 10,
+                            "unit": "months",
                             "annotation": []
                           }
                         ]
@@ -2906,107 +2418,137 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Time",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
+                        "year": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                          "value": "2006",
                           "annotation": []
                         },
-                        "second": {
+                        "month": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                          "value": "3",
                           "annotation": []
                         },
-                        "millisecond": {
+                        "day": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                          "value": "10",
                           "annotation": []
                         }
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "After",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeAfterYearTrue",
+                "name": "DateTimeAddThreeWeeks",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Year",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2018",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "5",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 3,
+                                "unit": "weeks",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2018",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             }
                           }
@@ -3017,6 +2559,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -3026,62 +2569,109 @@
                 }
               },
               {
-                "name": "DateTimeAfterYearFalse",
+                "name": "DateTimeAddYearInWeeks",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Year",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2018",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "5",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "23",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 52,
+                                "unit": "weeks",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2019",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "22",
                               "annotation": []
                             }
                           }
@@ -3092,8 +2682,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -3101,62 +2692,109 @@
                 }
               },
               {
-                "name": "DateTimeAfterMonthTrue",
+                "name": "DateTimeLeapDayAddYearInWeeks",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Month",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2023",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "3",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 52,
+                                "unit": "weeks",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2024",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "2",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "29",
                               "annotation": []
                             }
                           }
@@ -3167,6 +2805,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -3176,62 +2815,109 @@
                 }
               },
               {
-                "name": "DateTimeAfterMonthFalse",
+                "name": "DateTimeLeapYearAddYearInWeeks",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Month",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2024",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "28",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 52,
+                                "unit": "weeks",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2025",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "2",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "26",
                               "annotation": []
                             }
                           }
@@ -3242,8 +2928,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -3251,64 +2938,76 @@
                 }
               },
               {
-                "name": "DateTimeAfterDayTrue",
+                "name": "DateTimeAdd5Days",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Day",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "days",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3316,149 +3015,104 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeAfterDayTrue2",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "After",
-                        "precision": "Day",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "09",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2003",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "15",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterDayFalse",
+                "name": "DateTimeAddDaysOverflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Day",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 21,
+                            "unit": "days",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3466,86 +3120,111 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterHourTrue",
+                "name": "DateTimeAdd5Hours",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "hours",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3553,86 +3232,131 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterHourFalse",
+                "name": "DateTimeAdd5HoursWithLeftMinPrecisionSecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "20",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
+                              "value": "30",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "hours",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3640,97 +3364,156 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "30",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterMinuteTrue",
+                "name": "DateTimeAdd5HoursWithLeftMinPrecisionDay",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Minute",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2005",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "5",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "10",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 5,
+                                "unit": "hours",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "29",
-                              "annotation": []
                             }
                           }
                         ]
@@ -3740,6 +3523,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -3749,86 +3533,109 @@
                 }
               },
               {
-                "name": "DateTimeAfterMinuteFalse",
+                "name": "DateTimeAdd5HoursWithLeftMinPrecisionDayOverflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Minute",
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2005",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "5",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "10",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 25,
+                                "unit": "hours",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "31",
+                              "value": "11",
                               "annotation": []
                             }
                           }
@@ -3839,8 +3646,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -3848,100 +3656,62 @@
                 }
               },
               {
-                "name": "DateTimeAfterSecondTrue",
+                "name": "DateAdd2YearsAsMonths",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Second",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "2014",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 24,
+                            "unit": "months",
+                            "annotation": []
                           }
                         ]
                       }
@@ -3949,110 +3719,78 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterSecondFalse",
+                "name": "DateAdd2YearsAsMonthsRem1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Second",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "2014",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 25,
+                            "unit": "months",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4060,122 +3798,85 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterMillisecondTrue",
+                "name": "DateAdd33Days",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Millisecond",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "512",
+                              "value": "6",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "510",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 33,
+                            "unit": "days",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4183,122 +3884,91 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2014",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterMillisecondFalse",
+                "name": "DateAdd1Year",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Millisecond",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "512",
+                              "value": "6",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "513",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "year",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4306,68 +3976,105 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2015",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeAfterUncertain",
+                "name": "DateTimeAddHoursOverflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Day",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
+                              "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
                             },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "5",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 19,
+                            "unit": "hours",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4375,134 +4082,255 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "11",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "AfterTimezoneTrue",
+                "name": "DateTimeAdd5Minutes",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "5",
                               "annotation": []
                             }
                           },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "minutes",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAddMinutesOverflow",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "8",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "5",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 55,
+                            "unit": "minutes",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4510,134 +4338,281 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "AfterTimezoneFalse",
+                "name": "DateTimeAdd5Seconds",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "5",
                               "annotation": []
                             }
                           },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "seconds",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAddSecondsOverflow",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "5",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 55,
+                            "unit": "seconds",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4645,86 +4620,150 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterHourTrue",
+                "name": "DateTimeAdd5Milliseconds",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "2005",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "5",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "milliseconds",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4732,86 +4771,156 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterHourFalse",
+                "name": "DateTimeAddMillisecondsOverflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "2016",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "6",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
+                              "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "5",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "5",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 995,
+                            "unit": "milliseconds",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4819,86 +4928,128 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeAfterMinuteTrue",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "After",
-                        "precision": "Minute",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAddLeapYear",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2012",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "29",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "year",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4906,86 +5057,90 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2013",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "28",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterMinuteFalse",
+                "name": "DateTimeAdd2YearsByMonths",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Minute",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "2014",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 24,
+                            "unit": "months",
+                            "annotation": []
                           }
                         ]
                       }
@@ -4993,86 +5148,78 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterSecondTrue",
+                "name": "DateTimeAdd2YearsByDays",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Second",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "2014",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 730,
+                            "unit": "days",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5080,60 +5227,141 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterSecondFalse",
+                "name": "DateTimeAdd2YearsByDaysRem5Days",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Second",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "2014",
                               "annotation": []
                             }
                           },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 735,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAdd5Hours",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -5160,6 +5388,13 @@
                               "value": "999",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "hours",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5167,31 +5402,80 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterMillisecondTrue",
+                "name": "TimeAdd1Minute",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Millisecond",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -5220,33 +5504,11 @@
                             }
                           },
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "998",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minute",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5254,31 +5516,80 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "16",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterMillisecondFalse",
+                "name": "TimeAdd1Second",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Millisecond",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -5302,38 +5613,16 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "998",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "seconds",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5341,62 +5630,113 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "16",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeAfterTimeCstor",
+                "name": "TimeAdd1Millisecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "After",
-                        "precision": "Hour",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "59",
                               "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
+                            },
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "999",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "milliseconds",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5404,74 +5744,128 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "16",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Before",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeBeforeYearTrue",
+                "name": "TimeAdd5Hours1Minute",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Before",
-                        "precision": "Year",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2003",
-                              "annotation": []
-                            }
+                            "operand": [
+                              {
+                                "type": "Time",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                                "annotation": [],
+                                "signature": [],
+                                "hour": {
+                                  "type": "Literal",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "15",
+                                  "annotation": []
+                                },
+                                "minute": {
+                                  "type": "Literal",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "59",
+                                  "annotation": []
+                                },
+                                "second": {
+                                  "type": "Literal",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "59",
+                                  "annotation": []
+                                },
+                                "millisecond": {
+                                  "type": "Literal",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "999",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                                "value": 5,
+                                "unit": "hours",
+                                "annotation": []
+                              }
+                            ]
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 1,
+                            "unit": "minutes",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5479,74 +5873,113 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "21",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeBeforeYearFalse",
+                "name": "TimeAdd5hoursByMinute",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Before",
-                        "precision": "Year",
+                        "type": "Add",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "15",
                               "annotation": []
                             },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2003",
+                              "value": "59",
                               "annotation": []
                             },
-                            "month": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "999",
                               "annotation": []
                             }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 300,
+                            "unit": "minutes",
+                            "annotation": []
                           }
                         ]
                       }
@@ -5554,9 +5987,73 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "After",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeAfterYearTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5564,74 +6061,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMonthTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterYearFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Month",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5639,74 +6089,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMonthFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMonthTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Month",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5714,74 +6117,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeDayTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMonthFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Day",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5789,74 +6145,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeDayTrue2",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterDayTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Day",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2003",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5864,74 +6173,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeDayFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterDayTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Day",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -5939,86 +6201,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeHourTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterDayFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6026,86 +6229,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeHourFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterHourTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6113,98 +6257,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMinuteTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "28",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "29",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6212,98 +6285,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMinuteFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMinuteTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "31",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6311,110 +6313,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeSecondTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMinuteFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6422,110 +6341,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeSecondFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterSecondTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6533,122 +6369,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMillisecondTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterSecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "508",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "510",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6656,122 +6397,27 @@
                 }
               },
               {
-                "name": "DateTimeBeforeMillisecondFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMillisecondTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "599",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2004",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "513",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6779,134 +6425,27 @@
                 }
               },
               {
-                "name": "BeforeTimezoneTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterMillisecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -6914,134 +6453,27 @@
                 }
               },
               {
-                "name": "BeforeTimezoneFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeAfterUncertain",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7049,86 +6481,27 @@
                 }
               },
               {
-                "name": "TimeBeforeHourTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "AfterTimezoneTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "13",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "14",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7136,86 +6509,27 @@
                 }
               },
               {
-                "name": "TimeBeforeHourFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "AfterTimezoneFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7223,86 +6537,27 @@
                 }
               },
               {
-                "name": "TimeBeforeMinuteTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAfterHourTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "57",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7310,86 +6565,27 @@
                 }
               },
               {
-                "name": "TimeBeforeMinuteFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAfterHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7397,86 +6593,27 @@
                 }
               },
               {
-                "name": "TimeBeforeSecondTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAfterMinuteTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "57",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "58",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -7484,74 +6621,1031 @@
                 }
               },
               {
-                "name": "TimeBeforeSecondFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAfterMinuteFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Before",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
-                              "annotation": []
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAfterSecondTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAfterSecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAfterMillisecondTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAfterMillisecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeAfterTimeCstor",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeAfterYearTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterYearFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMonthTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMonthFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterDayTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterDayTrue2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterDayFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterHourTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterHourFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMinuteTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMinuteFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterSecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterSecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMillisecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterMillisecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAfterUncertain",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AfterTimezoneTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AfterTimezoneFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterHourTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterHourFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterMinuteTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterMinuteFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterSecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterSecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterMillisecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterMillisecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAfterTimeCstor",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeAfterYearTrue",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "56",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2004",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -7562,8 +7656,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -7571,74 +7666,95 @@
                 }
               },
               {
-                "name": "TimeBeforeMillisecondTrue",
+                "name": "DateTimeAfterYearFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Before",
-                        "precision": "Millisecond",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2004",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "11",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "997",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2004",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "998",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -7649,8 +7765,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -7658,74 +7775,95 @@
                 }
               },
               {
-                "name": "TimeBeforeMillisecondFalse",
+                "name": "DateTimeAfterMonthTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Before",
-                        "precision": "Millisecond",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2004",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "12",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "998",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "2004",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "59",
+                              "value": "11",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "997",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -7736,617 +7874,691 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "DateTime",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeYear",
+                "name": "DateTimeAfterMonthFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeMonth",
+                "name": "DateTimeAfterDayTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "DateTime",
+                      },
+                      {
+                        "name": "output",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeDay",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeHour",
+                "name": "DateTimeAfterDayTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "09",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2003",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeMinute",
+                "name": "DateTimeAfterDayFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeSecond",
+                "name": "DateTimeAfterHourTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    },
+                    ]
+                  },
+                  "element": [
                     {
-                      "name": "output",
+                      "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeMillisecond",
+                "name": "DateTimeAfterHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "955",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "DateTime",
+                      },
+                      {
+                        "name": "output",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "50",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "955",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              }
-            ]
-          }
-        },
-        {
-          "name": "DateTimeComponentFrom",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
-              {
-                "name": "DateTimeComponentFromYear",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Year",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            }
                           },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "21",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2003",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -8354,73 +8566,136 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromMonth",
+                "name": "DateTimeAfterMinuteTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Month",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            }
                           },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "29",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "10",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -8428,73 +8703,136 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromMonthMinBoundary",
+                "name": "DateTimeAfterMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Month",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            }
                           },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "01",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "31",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -8502,147 +8840,150 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromDay",
+                "name": "DateTimeAfterSecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Day",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
-                          }
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "29",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeComponentFromHour",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Hour",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            }
                           },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "20",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -8650,147 +8991,150 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromMinute",
+                "name": "DateTimeAfterSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Minute",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
-                          }
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "50",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeComponentFromSecond",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Second",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            }
                           },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "16",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "33",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -8798,73 +9142,164 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromMillisecond",
+                "name": "DateTimeAfterMillisecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "512",
+                              "annotation": []
+                            }
                           },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "510",
+                              "annotation": []
+                            }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "955",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -8872,101 +9307,164 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromTimezone",
+                "name": "DateTimeAfterMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Translation Error: Timezone keyword is only valid in 1.3 or lower",
-                        "annotation": []
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeComponentFromTimezone2",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "TimezoneOffsetFrom",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "512",
+                              "annotation": []
+                            }
                           },
-                          "timezoneOffset": {
-                            "type": "ToDecimal",
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "513",
                               "annotation": []
                             }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                        "value": "1.00",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -8974,445 +9472,252 @@
                 }
               },
               {
-                "name": "DateTimeComponentFromDate",
+                "name": "DateTimeAfterUncertain",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateFrom",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
-                        "operand": {
-                          "type": "DateTime",
-                          "annotation": [],
-                          "signature": [],
-                          "year": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2003",
-                            "annotation": []
-                          },
-                          "month": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          "day": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "29",
-                            "annotation": []
-                          },
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "50",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "33",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "955",
-                            "annotation": []
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
                           },
-                          "timezoneOffset": {
-                            "type": "ToDecimal",
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
                               "annotation": []
                             }
                           }
-                        }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Date",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2003",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "29",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeComponentFromHour",
+                "name": "AfterTimezoneTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Hour",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Time",
-                          "annotation": [],
-                          "signature": [],
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "23",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "15",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "555",
-                            "annotation": []
-                          }
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "23",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeComponentFromMinute",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Time",
-                          "annotation": [],
-                          "signature": [],
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "23",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "15",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "555",
-                            "annotation": []
-                          }
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "20",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeComponentFromSecond",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Time",
-                          "annotation": [],
-                          "signature": [],
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "23",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "15",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "555",
-                            "annotation": []
-                          }
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "15",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "TimeComponentFromMilli",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTimeComponentFrom",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Time",
-                          "annotation": [],
-                          "signature": [],
-                          "hour": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "23",
-                            "annotation": []
-                          },
-                          "minute": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "20",
-                            "annotation": []
-                          },
-                          "second": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "15",
-                            "annotation": []
-                          },
-                          "millisecond": {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "555",
-                            "annotation": []
-                          }
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "555",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Difference",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
-              {
-                "name": "DateTimeDifferenceYear",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Year",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "2012",
                               "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
+                            },
+                            "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
+                              "value": "3",
                               "annotation": []
                             },
-                            "month": {
+                            "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "5",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeDifferenceMonth",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Month",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
+                            },
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "10",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "8",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
                             }
                           }
                         ]
@@ -9422,8 +9727,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "8",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -9431,39 +9737,65 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceDay",
+                "name": "AfterTimezoneFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Day",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
@@ -9475,30 +9807,49 @@
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
@@ -9508,10 +9859,28 @@
                               "annotation": []
                             },
                             "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "0",
                               "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
                             }
                           }
                         ]
@@ -9521,8 +9890,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "10",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -9530,74 +9900,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceHour",
+                "name": "TimeAfterHourTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "4",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "59",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "14",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "4",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "59",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "999",
                               "annotation": []
                             }
                           }
@@ -9608,8 +10005,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "8",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -9617,86 +10015,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceMinute",
+                "name": "TimeAfterHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Minute",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "15",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "16",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "999",
                               "annotation": []
                             }
                           }
@@ -9707,8 +10120,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "9",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -9716,98 +10130,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceSecond",
+                "name": "TimeAfterMinuteTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Second",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "58",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "50",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           }
@@ -9818,8 +10235,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "5",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -9827,133 +10245,102 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceMillisecond",
+                "name": "TimeAfterMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Millisecond",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "58",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "59",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
+                              "value": "999",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "59",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "999",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
                             }
                           }
                         ]
@@ -9963,8 +10350,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "3600400",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -9972,62 +10360,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceWeeks",
+                "name": "TimeAfterSecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Week",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "28",
+                              "value": "58",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           }
@@ -10038,8 +10465,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -10047,62 +10475,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceWeeks2",
+                "name": "TimeAfterSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Week",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "58",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2000",
+                              "value": "15",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "59",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "29",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           }
@@ -10113,8 +10580,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -10122,98 +10590,101 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceWeeks3",
+                "name": "TimeAfterMillisecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Week",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "999",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "24",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "7",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "19",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "33",
+                              "value": "998",
                               "annotation": []
                             }
                           }
@@ -10224,8 +10695,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -10233,125 +10705,114 @@
                 }
               },
               {
-                "name": "DateTimeDifferenceNegative",
+                "name": "TimeAfterMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Year",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "998",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1998",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
                               "annotation": []
                             }
                           }
                         ]
                       }
                     },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Negate",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "18",
-                          "annotation": []
-                        }
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeDifferenceUncertain",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Greater",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DifferenceBetween",
-                            "precision": "Month",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "5",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -10359,56 +10820,81 @@
                 }
               },
               {
-                "name": "TimeDifferenceHour",
+                "name": "TimeAfterTimeCstor",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
+                        "type": "After",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "11",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "55",
                               "annotation": []
                             }
                           }
@@ -10419,95 +10905,49 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "3",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              },
-              {
-                "name": "TimeDifferenceMinute",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+              }
+            ]
+          }
+        },
+        {
+          "name": "Before",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeBeforeYearTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "5",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -10515,86 +10955,27 @@
                 }
               },
               {
-                "name": "TimeDifferenceSecond",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeBeforeYearFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "5",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -10602,1624 +10983,1437 @@
                 }
               },
               {
-                "name": "TimeDifferenceMillis",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeBeforeMonthTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "550",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Negate",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "From Github issue #29",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
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               {
-                "name": "DateTimeA",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeBeforeMonthFalse",
+                "annotation": [],
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-7.0",
-                          "annotation": []
-                        }
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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                       "name": "output",
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-7.0",
-                          "annotation": []
-                        }
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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                   ]
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               },
               {
-                "name": "DateTimeAA",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeBeforeDayTrue",
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                        },
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-                            "value": "7.0",
-                            "annotation": []
-                          }
-                        }
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-7.0",
-                          "annotation": []
-                        }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
                     }
                   ]
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               },
               {
-                "name": "DateTimeB",
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+                "name": "DateTimeBeforeDayTrue2",
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
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-                        }
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                       }
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
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-                        }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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                   ]
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               },
               {
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                            "value": "6.0",
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
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-                        }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
                     }
                   ]
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               },
               {
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+                "name": "DateTimeBeforeHourTrue",
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
-                          "annotation": []
-                        }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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                       }
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-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
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-                        }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeCC",
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-                  "type": "Tuple",
+                "name": "DateTimeBeforeHourFalse",
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                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
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-                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "value": "6.0",
-                            "annotation": []
-                          }
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2017",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "13",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "timezoneOffset": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "-6.0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DifferenceInHoursA",
-                "value": {
-                  "type": "Tuple",
+                "name": "BeforeTimezoneTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Hour",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "BeforeTimezoneFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeBeforeHourTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeBeforeHourFalse",
+                "annotation": [],
+                "elementType": {
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+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeBeforeMinuteTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeBeforeMinuteFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeBeforeSecondTrue",
+                "annotation": [],
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+                  "annotation": [],
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+                      "name": "expression",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeBeforeSecondFalse",
+                "annotation": [],
+                "elementType": {
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+                  "annotation": [],
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeBeforeMillisecondTrue",
+                "annotation": [],
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
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+                "name": "TimeBeforeMillisecondFalse",
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                      }
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
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+              "annotation": [],
+              "element": [
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+                        "name": "expression",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
+                      }
+                    ]
+                  }
+                },
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+                  "annotation": [],
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
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+                {
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+                  "annotation": [],
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+                        "name": "expression",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
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+                {
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeDayTrue",
+                  "annotation": [],
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+                    "annotation": [],
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
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+                      },
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+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
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+                  "name": "DateTimeBeforeDayTrue2",
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeDayFalse",
+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeHourTrue",
+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
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+                  }
+                },
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
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+                  "annotation": [],
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeMinuteFalse",
+                  "annotation": [],
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+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeSecondTrue",
+                  "annotation": [],
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeSecondFalse",
+                  "annotation": [],
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+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeMillisecondTrue",
+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
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+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBeforeMillisecondFalse",
+                  "annotation": [],
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+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
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+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
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+                  "name": "BeforeTimezoneTrue",
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
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+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "elementType": {
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        "elementType": {
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+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeMinuteTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeMinuteFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeSecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeSecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeMillisecondTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeBeforeMillisecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeBeforeYearTrue",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
+                              "value": "2003",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -12230,8 +12424,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -12239,110 +12434,95 @@
                 }
               },
               {
-                "name": "DifferenceInMinutesA",
+                "name": "DateTimeBeforeYearFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Minute",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "11",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2003",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -12353,8 +12533,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "45",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -12362,110 +12543,95 @@
                 }
               },
               {
-                "name": "DifferenceInDaysA",
+                "name": "DateTimeBeforeMonthTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Day",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
+                              "value": "10",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "11",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "13",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -12476,8 +12642,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -12485,133 +12652,96 @@
                 }
               },
               {
-                "name": "DifferenceInHoursAA",
+                "name": "DateTimeBeforeMonthFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Hour",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "11",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "10",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "10",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
                             }
                           }
                         ]
@@ -12621,8 +12751,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -12630,133 +12761,96 @@
                 }
               },
               {
-                "name": "DifferenceInMinutesAA",
+                "name": "DateTimeBeforeDayTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
-                        "precision": "Minute",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "1",
                               "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "10",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
                             }
                           }
                         ]
@@ -12766,8 +12860,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "45",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -12775,133 +12870,96 @@
                 }
               },
               {
-                "name": "DifferenceInDaysAA",
+                "name": "DateTimeBeforeDayTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DifferenceBetween",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2003",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "11",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "13",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "10",
                               "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
                             }
                           }
                         ]
@@ -12911,59 +12969,105 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Duration",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeDurationBetweenYear",
+                "name": "DateTimeBeforeDayFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Year",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2010",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -12973,84 +13077,133 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeDurationBetweenYearOffset",
+                "name": "DateTimeBeforeHourTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Year",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2010",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "4",
+                              "value": "10",
                               "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "4",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -13058,62 +13211,109 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonth",
+                "name": "DateTimeBeforeHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Month",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Date",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "31",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Date",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "21",
                               "annotation": []
                             }
                           }
@@ -13124,8 +13324,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "0",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -13133,86 +13334,123 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenDaysDiffYears",
+                "name": "DateTimeBeforeMinuteTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Day",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2010",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "20",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "28",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2008",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "8",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "8",
+                              "value": "20",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "8",
+                              "value": "29",
                               "annotation": []
                             }
                           }
@@ -13222,83 +13460,134 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Negate",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "788",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "Uncertainty tests",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeDurationBetweenUncertainInterval",
+                "name": "DateTimeBeforeMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Day",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "35",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "31",
                               "annotation": []
                             }
                           }
@@ -13308,66 +13597,148 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "16",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "44",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeDurationBetweenUncertainInterval2",
+                "name": "DateTimeBeforeSecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Month",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2006",
+                              "value": "2004",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
                               "annotation": []
                             }
                           }
@@ -13377,135 +13748,150 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "16",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeDurationBetweenUncertainAdd",
+                "name": "DateTimeBeforeSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Add",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Day",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "DurationBetween",
-                            "precision": "Day",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "16",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -13513,123 +13899,164 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "32",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "88",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeDurationBetweenUncertainSubtract",
+                "name": "DateTimeBeforeMillisecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Subtract",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Day",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "508",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "510",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -13637,269 +14064,175 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "40",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeDurationBetweenUncertainMultiply",
+                "name": "DateTimeBeforeMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Multiply",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DurationBetween",
-                            "precision": "Day",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
-                          },
-                          {
-                            "type": "DurationBetween",
-                            "precision": "Day",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "256",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1936",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeDurationBetweenUncertainDiv",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "TruncatedDivide",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Day",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "1",
-                                  "annotation": []
-                                },
-                                "day": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "15",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2014",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "599",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "5",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2004",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "513",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
                     },
                     {
-                      "name": "invalid",
+                      "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -13907,59 +14240,151 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain",
+                "name": "BeforeTimezoneTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Greater",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "5",
-                            "annotation": []
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -13968,6 +14393,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -13977,59 +14403,151 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain2",
+                "name": "BeforeTimezoneFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Greater",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "5",
-                            "annotation": []
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14037,7 +14555,10 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -14045,59 +14566,103 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain3",
+                "name": "TimeBeforeHourTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Greater",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "13",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "25",
-                            "annotation": []
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "14",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14106,8 +14671,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -14115,59 +14681,103 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain4",
+                "name": "TimeBeforeHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Less",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "16",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "24",
-                            "annotation": []
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14176,8 +14786,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -14185,59 +14796,103 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain5",
+                "name": "TimeBeforeMinuteTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "Equal",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "24",
-                            "annotation": []
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "57",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "58",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14246,8 +14901,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -14255,59 +14911,103 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain6",
+                "name": "TimeBeforeMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "GreaterOrEqual",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "5",
-                            "annotation": []
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14316,8 +15016,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -14325,59 +15026,103 @@
                 }
               },
               {
-                "name": "DateTimeDurationBetweenMonthUncertain7",
+                "name": "TimeBeforeSecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "LessOrEqual",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DurationBetween",
-                            "precision": "Month",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": [
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2005",
-                                  "annotation": []
-                                }
-                              },
-                              {
-                                "type": "DateTime",
-                                "annotation": [],
-                                "signature": [],
-                                "year": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2006",
-                                  "annotation": []
-                                },
-                                "month": {
-                                  "type": "Literal",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "7",
-                                  "annotation": []
-                                }
-                              }
-                            ]
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "57",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           },
                           {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "24",
-                            "annotation": []
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "58",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
                           }
                         ]
                       }
@@ -14386,6 +15131,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -14395,413 +15141,216 @@
                 }
               },
               {
-                "name": "DateTime1",
+                "name": "TimeBeforeSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2012",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "DateTime",
+                      },
+                      {
+                        "name": "output",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2012",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTime2",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2013",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "56",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "59",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            }
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2013",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "3",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "20",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInYears",
+                "name": "TimeBeforeMillisecondTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Year",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateFrom",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "operand": {
-                              "type": "DateTime",
-                              "annotation": [],
-                              "signature": [],
-                              "year": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2012",
-                                "annotation": []
-                              },
-                              "month": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "3",
-                                "annotation": []
-                              },
-                              "day": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "10",
-                                "annotation": []
-                              },
-                              "hour": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "10",
-                                "annotation": []
-                              },
-                              "minute": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "20",
-                                "annotation": []
-                              },
-                              "second": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "0",
-                                "annotation": []
-                              }
-                            }
-                          },
-                          {
-                            "type": "DateFrom",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "DateTime",
-                              "annotation": [],
-                              "signature": [],
-                              "year": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2013",
-                                "annotation": []
-                              },
-                              "month": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "3",
-                                "annotation": []
-                              },
-                              "day": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "10",
-                                "annotation": []
-                              },
-                              "hour": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "9",
-                                "annotation": []
-                              },
-                              "minute": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "20",
-                                "annotation": []
-                              },
-                              "second": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "0",
-                                "annotation": []
-                              }
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DurationInWeeks",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DurationBetween",
-                        "precision": "Week",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "997",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "7",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "19",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "33",
+                              "value": "998",
                               "annotation": []
                             }
                           }
@@ -14812,8 +15361,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -14821,98 +15371,101 @@
                 }
               },
               {
-                "name": "DurationInWeeks2",
+                "name": "TimeBeforeMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Week",
+                        "type": "Before",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "998",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "24",
+                              "value": "15",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "7",
+                              "value": "59",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "19",
+                              "value": "59",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "33",
+                              "value": "997",
                               "annotation": []
                             }
                           }
@@ -14923,8 +15476,49 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "DateTime",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeYear",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -14932,110 +15526,27 @@
                 }
               },
               {
-                "name": "DurationInWeeks3",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeMonth",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DurationBetween",
-                        "precision": "Week",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "24",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "7",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "19",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "33",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -15043,86 +15554,27 @@
                 }
               },
               {
-                "name": "TimeDurationBetweenHour",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeDay",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DurationBetween",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "26",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -15130,17 +15582,27 @@
                 }
               },
               {
-                "name": "TimeDurationBetweenHourDiffPrecision",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Translation Error: Syntax error at Z",
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -15148,17 +15610,27 @@
                 }
               },
               {
-                "name": "TimeDurationBetweenHourDiffPrecision2",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: Duration in hours between T06 and T07:00:00 should be Uncertainty[0, 1]",
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -15166,86 +15638,27 @@
                 }
               },
               {
-                "name": "TimeDurationBetweenMinute",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DurationBetween",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "16",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "4",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": []
                       }
                     }
@@ -15253,978 +15666,957 @@
                 }
               },
               {
-                "name": "TimeDurationBetweenSecond",
+                "name": "DateTimeMillisecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeMonth",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDay",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeMillisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeYear",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Second",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "556",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "4",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "TimeDurationBetweenMillis",
+                "name": "DateTimeMonth",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Millisecond",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "560",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "5",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInHoursA",
+                "name": "DateTimeDay",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Hour",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInMinutesA",
+                "name": "DateTimeHour",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Minute",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "45",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInDaysA",
+                "name": "DateTimeMinute",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Day",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-7.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "13",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "-6.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "0",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInHoursAA",
+                "name": "DateTimeSecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Hour",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DurationInMinutesAA",
+                "name": "DateTimeMillisecond",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DurationBetween",
-                        "precision": "Minute",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "1",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "45",
-                        "annotation": []
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DurationInDaysAA",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Day",
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "7.0",
-                                "annotation": []
-                              }
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "13",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Negate",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "value": "6.0",
-                                "annotation": []
-                              }
-                            }
-                          }
-                        ]
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "955",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "0",
-                        "annotation": []
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "50",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "955",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -16234,109 +16626,64 @@
           }
         },
         {
-          "name": "Now",
+          "name": "DateTimeComponentFrom",
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
-          "expression": {
-            "type": "Tuple",
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
             "annotation": [],
             "element": [
               {
-                "name": "DateTimeNow",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromYear",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Equal",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Now",
-                            "annotation": [],
-                            "signature": []
-                          },
-                          {
-                            "type": "Now",
-                            "annotation": [],
-                            "signature": []
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "SameAs",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeSameAsYearTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromMonth",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Year",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16344,50 +16691,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsYearFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromMonthMinBoundary",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Year",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2013",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16395,62 +16719,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsMonthTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromDay",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Month",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16458,62 +16747,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsMonthFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Month",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16521,74 +16775,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsDayTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Day",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16596,74 +16803,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsDayFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Day",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16671,86 +16831,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsHourTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromMillisecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
                         "annotation": []
                       }
                     }
@@ -16758,86 +16859,27 @@
                 }
               },
               {
-                "name": "DateTimeSameAsHourFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromTimezone",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
                         "annotation": []
                       }
                     }
@@ -16845,408 +16887,21987 @@
                 }
               },
               {
-                "name": "DateTimeSameAsMinuteTrue",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeComponentFromTimezoneOffset",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromDate",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Minute",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromMilli",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeComponentFromYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromMonth",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromMonthMinBoundary",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromDay",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromMillisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromTimezone",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromTimezoneOffset",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeComponentFromDate",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeComponentFromHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeComponentFromMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeComponentFromSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeComponentFromMilli",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeComponentFromYear",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2003",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromMonth",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Month",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "10",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromMonthMinBoundary",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Month",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "01",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromDay",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "29",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromHour",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "20",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromMinute",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "50",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromSecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "33",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromMillisecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "955",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromTimezone",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "TimezoneOffsetFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          },
+                          "timezoneOffset": {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.00",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromTimezoneOffset",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Translator error: Timezone keyword is only valid in 1.3 or lower",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeComponentFromDate",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTime",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": [],
+                          "signature": [],
+                          "year": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2003",
+                            "annotation": []
+                          },
+                          "month": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "10",
+                            "annotation": []
+                          },
+                          "day": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "29",
+                            "annotation": []
+                          },
+                          "hour": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "50",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "33",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "955",
+                            "annotation": []
+                          },
+                          "timezoneOffset": {
+                            "type": "ToDecimal",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2003",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "29",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromHour",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Time",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": [],
+                          "signature": [],
+                          "hour": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "23",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "15",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "555",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "23",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromMinute",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Time",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": [],
+                          "signature": [],
+                          "hour": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "23",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "15",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "555",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "20",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromSecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Time",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": [],
+                          "signature": [],
+                          "hour": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "23",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "15",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "555",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "15",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeComponentFromMilli",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTimeComponentFrom",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Time",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": [],
+                          "signature": [],
+                          "hour": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "23",
+                            "annotation": []
+                          },
+                          "minute": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "20",
+                            "annotation": []
+                          },
+                          "second": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "15",
+                            "annotation": []
+                          },
+                          "millisecond": {
+                            "type": "Literal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "555",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "555",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Difference",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeDifferenceYear",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMonth",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceDay",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMillisecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks3",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceNegative",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceUncertain",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceMillis",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeDifferenceYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceMonth",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceDay",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceMillisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceWeeks2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceWeeks3",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceNegative",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDifferenceUncertain",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDifferenceHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDifferenceMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDifferenceSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDifferenceMillis",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeDifferenceYear",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "5",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMonth",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Month",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "8",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceDay",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "10",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceHour",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "4",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "4",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "8",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMinute",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "16",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "9",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceSecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "50",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "5",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceMillisecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "500",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "900",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "3600400",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "28",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2000",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "29",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceWeeks3",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "22",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "24",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "7",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "19",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "33",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceNegative",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2016",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1998",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "18",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDifferenceUncertain",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Greater",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DifferenceBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Month",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2005",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2006",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "7",
+                                  "annotation": []
+                                }
+                              }
+                            ]
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceHour",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "3",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceMinute",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "5",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceSecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "5",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDifferenceMillis",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "550",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "From Github issue #29",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeB",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeBB",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeC",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeCC",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeD",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDD",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeE",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeEE",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeF",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeFF",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInHoursA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInMinutesA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInDaysA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInHoursAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInMinutesAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInDaysAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
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+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeA",
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+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
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+                  "name": "DateTimeAA",
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+                    "annotation": [],
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+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
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+                  "name": "DateTimeB",
+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeBB",
+                  "annotation": [],
+                  "elementType": {
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+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeC",
+                  "annotation": [],
+                  "elementType": {
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+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeCC",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeD",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDD",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeE",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeEE",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeF",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeFF",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInHoursA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInMinutesA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInDaysA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInHoursAA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInMinutesAA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DifferenceInDaysAA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-7.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-7.0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "7.0",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-7.0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeB",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-6.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-6.0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeBB",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "6.0",
+                            "annotation": []
+                          }
+                        }
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+                    },
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+                        "type": "DateTime",
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+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
+                        "month": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
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+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                        },
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+                          "annotation": []
+                        },
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+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-6.0",
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+                        }
+                      }
+                    }
+                  ]
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+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        }
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+                        "signature": [],
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+                        },
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+                          "value": "5",
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+                        },
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+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                        "second": {
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+                        }
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+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "30",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-6.0",
+                          "annotation": []
+                        }
+                      }
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+                        }
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2017",
+                          "annotation": []
+                        },
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "11",
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+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
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+                        },
+                        "hour": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "30",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "timezoneOffset": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                            "value": "6.0",
+                            "annotation": []
+                          }
+                        }
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
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+                        }
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+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                        },
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+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "-7.0",
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+                          "value": "-7.0",
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+                        }
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+                          "value": "2017",
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+                          "value": "0",
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+                        },
+                        "timezoneOffset": {
+                          "type": "Negate",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
+                            "type": "Literal",
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+                            "value": "7.0",
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+                        }
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+                        "month": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                          "signature": [],
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+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-6.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-7.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "45",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInDaysA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-7.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "13",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-6.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInHoursAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInMinutesAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "45",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DifferenceInDaysAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DifferenceBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "13",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Duration",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeDurationBetweenYear",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenYearOffset",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonth",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenDaysDiffYears",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeDurationBetweenYear",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenYearOffset",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonth",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenDaysDiffYears",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeDurationBetweenYear",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2010",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Interval",
+                        "lowClosed": true,
+                        "highClosed": true,
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "low": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "4",
+                          "annotation": []
+                        },
+                        "high": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenYearOffset",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2010",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "4",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "4",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonth",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Month",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "31",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenDaysDiffYears",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2010",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2008",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "8",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "8",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "8",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "788",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Uncertainty tests",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeDurationBetweenUncertainInterval",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenUncertainInterval2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenUncertainAdd",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenUncertainSubtract",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenUncertainMultiply",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenUncertainDiv",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain3",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain4",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain5",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain6",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain7",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTime1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTime2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInYears",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks3",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHour",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHourDiffPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "skipped",
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHourDiffPrecision2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "skipped",
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
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+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
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+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenMillis",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInHoursA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInMinutesA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInDaysA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInHoursAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInMinutesAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInDaysAA",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeDurationBetweenUncertainInterval",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenUncertainInterval2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenUncertainAdd",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenUncertainSubtract",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenUncertainMultiply",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenUncertainDiv",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain3",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain4",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain5",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain6",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeDurationBetweenMonthUncertain7",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTime1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTime2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInYears",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInWeeks2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInWeeks3",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenHour",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenHourDiffPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenHourDiffPrecision2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeDurationBetweenMillis",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInHoursA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInMinutesA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInDaysA",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
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+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInMinutesAA",
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+                    "annotation": [],
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+                        "name": "expression",
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
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+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DurationInDaysAA",
+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
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+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
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+                "name": "DateTimeDurationBetweenUncertainInterval",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
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+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
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+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: [17, 44] vs [16, 44]",
+                        "annotation": []
+                      }
+                    }
+                  ]
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+                "name": "DateTimeDurationBetweenUncertainInterval2",
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+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
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+                        "name": "output",
+                        "annotation": [],
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+                          "type": "IntervalTypeSpecifier",
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+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
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+                        "precision": "Month",
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+                        "signature": [],
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+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
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+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2006",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          }
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+                      }
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+                        "highClosed": true,
+                        "annotation": [],
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+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
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+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "4",
+                          "annotation": []
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+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "16",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
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+                "name": "DateTimeDurationBetweenUncertainAdd",
+                "value": {
+                  "type": "Tuple",
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+                    "annotation": [],
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+                        "name": "expression",
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
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+                        "name": "output",
+                        "annotation": [],
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+                          "type": "IntervalTypeSpecifier",
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+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
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+                            "type": "DurationBetween",
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+                            "signature": [],
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+                                "type": "DateTime",
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "1",
+                                  "annotation": []
+                                },
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "15",
+                                  "annotation": []
+                                }
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+                                "type": "DateTime",
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+                                "signature": [],
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+                                  "type": "Literal",
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+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2",
+                                  "annotation": []
+                                }
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+                            "type": "DurationBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Day",
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+                            "signature": [],
+                            "operand": [
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+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
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+                                "signature": [],
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+                                  "type": "Literal",
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+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "1",
+                                  "annotation": []
+                                },
+                                "day": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "15",
+                                  "annotation": []
+                                }
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+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2",
+                                  "annotation": []
+                                }
+                              }
+                            ]
+                          }
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+                      "name": "output",
+                      "value": {
+                        "type": "Interval",
+                        "lowClosed": true,
+                        "highClosed": true,
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
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+                            "annotation": []
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "32",
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+                          "value": "88",
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+                "name": "DateTimeDurationBetweenUncertainSubtract",
+                "value": {
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+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
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+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
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+                          }
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+                            "type": "DurationBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Day",
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+                            "signature": [],
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+                                "type": "DateTime",
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+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
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+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "1",
+                                  "annotation": []
+                                },
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
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+                                  "value": "15",
+                                  "annotation": []
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+                                "type": "DateTime",
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+                                "signature": [],
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+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2014",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
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+                                  "annotation": []
+                                }
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+                            "type": "DurationBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Month",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": [
+                              {
+                                "type": "DateTime",
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+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
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+                                  "annotation": []
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+                                "signature": [],
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+                            "type": "DurationBetween",
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+                                "type": "DateTime",
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+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain6",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "GreaterOrEqual",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DurationBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Month",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2005",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2006",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "7",
+                                  "annotation": []
+                                }
+                              }
+                            ]
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "5",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeDurationBetweenMonthUncertain7",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "LessOrEqual",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DurationBetween",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "precision": "Month",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": [
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2005",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                                "annotation": [],
+                                "signature": [],
+                                "year": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "2006",
+                                  "annotation": []
+                                },
+                                "month": {
+                                  "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "value": "7",
+                                  "annotation": []
+                                }
+                              }
+                            ]
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "24",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTime1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2012",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2012",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTime2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2013",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "9",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2013",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "3",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "9",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "20",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInYears",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateFrom",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "DateTime",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2012",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "3",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              },
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "20",
+                                "annotation": []
+                              },
+                              "second": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateFrom",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "DateTime",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                              "annotation": [],
+                              "signature": [],
+                              "year": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "2013",
+                                "annotation": []
+                              },
+                              "month": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "3",
+                                "annotation": []
+                              },
+                              "day": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "10",
+                                "annotation": []
+                              },
+                              "hour": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "9",
+                                "annotation": []
+                              },
+                              "minute": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "20",
+                                "annotation": []
+                              },
+                              "second": {
+                                "type": "Literal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "22",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "7",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "19",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "33",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "22",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "24",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "7",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "19",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "33",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInWeeks3",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Week",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "6",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "24",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "7",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "19",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "33",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHour",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "26",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHourDiffPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Translator error: Syntax error at Z",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenHourDiffPrecision2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: 1 vs uncertainty [0, 1]",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenMinute",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "16",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "4",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenSecond",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "556",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "4",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeDurationBetweenMillis",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "560",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "5",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInHoursA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-7.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-6.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInMinutesA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-6.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-7.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "45",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInDaysA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-7.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "13",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "-6.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInHoursAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "1",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInMinutesAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "1",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "45",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DurationInDaysAA",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "7.0",
+                                "annotation": []
+                              }
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2017",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "13",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Negate",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "annotation": [],
+                              "signature": [],
+                              "operand": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                                "value": "6.0",
+                                "annotation": []
+                              }
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "0",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Now",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeNow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeNow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeNow",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Now",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": []
+                          },
+                          {
+                            "type": "Now",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "SameAs",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeSameAsYearTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsYearFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsMonthTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsMonthFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsDayTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsDayFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsHourTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameAsMinuteTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
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+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "11",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
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+                      }
+                    }
+                  ]
+                }
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+                "name": "DateTimeSameAsHourTrue",
+                "value": {
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
+                      }
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+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
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+                            "signature": [],
+                            "year": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
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+                              "value": "20",
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+                            }
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+                            "annotation": [],
+                            "signature": [],
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            }
+                          }
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+                        "value": "true",
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
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+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
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+                            "signature": [],
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
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+                              "value": "10",
+                              "annotation": []
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "value": "21",
+                              "annotation": []
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+                        "value": "false",
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+                      }
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+                        }
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+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
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+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
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+                            }
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+                            "signature": [],
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
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+                              "value": "12",
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+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
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+                            },
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+                              "value": "55",
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+                            }
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+                        "precision": "Minute",
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+                        "signature": [],
+                        "operand": [
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+                            "signature": [],
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                        "precision": "Second",
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+                        "signature": [],
+                        "operand": [
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+                            "signature": [],
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                              "value": "20",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
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+                            "signature": [],
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
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+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
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+                            },
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+                              "value": "20",
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+                            },
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
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+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
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+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
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+                            }
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+                            "signature": [],
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+                              "value": "2014",
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+                            },
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+                              "value": "21",
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+                              "value": "55",
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+                        "operand": [
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SameAsTimezoneFalse",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameAsHourTrue",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "900",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "value": {
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+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "22",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeSameAsMinuteTrue",
+                "value": {
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+                  "annotation": [],
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "22",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "900",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeSameAsMinuteFalse",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
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+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
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+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "26",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
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+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameAsSecondTrue",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "900",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameAsSecondFalse",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "35",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeSameAsMillisTrue",
+                "value": {
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
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+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "TimeSameAsMillisFalse",
+                "value": {
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+                    "annotation": [],
+                    "element": [
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+                        "name": "expression",
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+                        "elementType": {
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
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+                      "name": "expression",
+                      "value": {
+                        "type": "SameAs",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "23",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "554",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "SameOrAfter",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
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+                "name": "DateTimeSameOrAfterYearTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "elementType": {
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterYearTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterYearFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterMonthTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                      }
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+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
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+                "name": "DateTimeSameOrAfterMonthTrue2",
+                "annotation": [],
+                "elementType": {
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+                  "element": [
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterMonthFalse",
+                "annotation": [],
+                "elementType": {
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+                  "annotation": [],
+                  "element": [
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterDayTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterDayTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterDayFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterHourTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
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+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterHourTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
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+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
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+                      "name": "expression",
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+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrAfterMinuteTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
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+                        "name": "expression",
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
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-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "56",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
-                        "annotation": []
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrAfterMillisTrue2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeSameAsSecondTrue",
-                "value": {
-                  "type": "Tuple",
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrAfterMillisFalse",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Second",
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
+                    ]
+                  }
+                },
+                {
+                  "name": "OnOrAfterTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
                       }
-                    }
-                  ]
+                    ]
+                  }
+                },
+                {
+                  "name": "Issue32DateTime",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
                 }
-              },
+              ]
+            },
+            "element": [
               {
-                "name": "DateTimeSameAsSecondFalse",
+                "name": "DateTimeSameOrAfterYearTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Second",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "44",
-                              "annotation": []
                             }
                           }
                         ]
@@ -17256,8 +38877,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -17265,111 +38887,68 @@
                 }
               },
               {
-                "name": "DateTimeSameAsMillisecondTrue",
+                "name": "DateTimeSameOrAfterYearTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Millisecond",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
+                              "value": "2016",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
-                              "annotation": []
                             }
                           }
                         ]
@@ -17379,6 +38958,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -17388,110 +38968,67 @@
                 }
               },
               {
-                "name": "DateTimeSameAsMillisecondFalse",
+                "name": "DateTimeSameOrAfterYearFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "SameAs",
-                        "precision": "Millisecond",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "2013",
                               "annotation": []
-                            },
-                            "millisecond": {
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "501",
+                              "value": "2014",
                               "annotation": []
                             }
                           }
@@ -17502,6 +39039,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -17511,54 +39049,79 @@
                 }
               },
               {
-                "name": "DateTimeSameAsNull",
+                "name": "DateTimeSameOrAfterMonthTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Day",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
@@ -17570,7 +39133,10 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -17578,123 +39144,82 @@
                 }
               },
               {
-                "name": "SameAsTimezoneTrue",
+                "name": "DateTimeSameOrAfterMonthTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
-                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "9",
                               "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
-                              "annotation": []
                             }
                           }
                         ]
@@ -17704,6 +39229,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -17713,122 +39239,81 @@
                 }
               },
               {
-                "name": "SameAsTimezoneFalse",
+                "name": "DateTimeSameOrAfterMonthFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
-                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "11",
                               "annotation": []
                             }
                           }
@@ -17839,6 +39324,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -17848,74 +39334,95 @@
                 }
               },
               {
-                "name": "TimeSameAsHourTrue",
+                "name": "DateTimeSameOrAfterDayTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "12",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "12",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "20",
                               "annotation": []
                             }
                           }
@@ -17926,6 +39433,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -17935,74 +39443,95 @@
                 }
               },
               {
-                "name": "TimeSameAsHourFalse",
+                "name": "DateTimeSameOrAfterDayTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Hour",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "20",
                               "annotation": []
                             }
                           }
@@ -18013,8 +39542,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -18022,75 +39552,96 @@
                 }
               },
               {
-                "name": "TimeSameAsMinuteTrue",
+                "name": "DateTimeSameOrAfterDayFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Minute",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "second": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "10",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
                             }
                           }
                         ]
@@ -18100,8 +39651,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -18109,74 +39661,109 @@
                 }
               },
               {
-                "name": "TimeSameAsMinuteFalse",
+                "name": "DateTimeSameOrAfterHourTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Minute",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "26",
+                              "value": "12",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "12",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
                               "annotation": []
                             }
                           }
@@ -18187,8 +39774,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -18196,74 +39784,109 @@
                 }
               },
               {
-                "name": "TimeSameAsSecondTrue",
+                "name": "DateTimeSameOrAfterHourTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Second",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -18274,6 +39897,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -18283,74 +39907,109 @@
                 }
               },
               {
-                "name": "TimeSameAsSecondFalse",
+                "name": "DateTimeSameOrAfterHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Second",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
+                              "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "15",
                               "annotation": []
                             }
                           }
@@ -18361,6 +40020,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -18370,74 +40030,123 @@
                 }
               },
               {
-                "name": "TimeSameAsMillisTrue",
+                "name": "DateTimeSameOrAfterMinuteTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Millisecond",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "12",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "12",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
                               "annotation": []
                             }
                           }
@@ -18448,6 +40157,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -18457,74 +40167,123 @@
                 }
               },
               {
-                "name": "TimeSameAsMillisFalse",
+                "name": "DateTimeSameOrAfterMinuteTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameAs",
-                        "precision": "Millisecond",
+                        "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "minute": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
-                            "second": {
+                            "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "554",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
                               "annotation": []
                             }
                           }
@@ -18535,60 +40294,134 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "SameOrAfter",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeSameOrAfterYearTrue1",
+                "name": "DateTimeSameOrAfterMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
                             }
                           }
                         ]
@@ -18598,8 +40431,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -18607,39 +40441,138 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterYearTrue2",
+                "name": "DateTimeSameOrAfterSecondTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
                             }
                           }
                         ]
@@ -18649,6 +40582,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -18658,39 +40592,138 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterYearFalse",
+                "name": "DateTimeSameOrAfterSecondTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2013",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
                             }
                           }
                         ]
@@ -18700,8 +40733,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -18709,50 +40743,137 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMonthTrue1",
+                "name": "DateTimeSameOrAfterSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "21",
                               "annotation": []
                             }
                           }
@@ -18763,8 +40884,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -18772,50 +40894,151 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMonthTrue2",
+                "name": "DateTimeSameOrAfterMillisecondTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "250",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "250",
                               "annotation": []
                             }
                           }
@@ -18826,6 +41049,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -18835,50 +41059,151 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMonthFalse",
+                "name": "DateTimeSameOrAfterMillisecondTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "500",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "499",
                               "annotation": []
                             }
                           }
@@ -18889,8 +41214,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -18898,63 +41224,152 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterDayTrue1",
+                "name": "DateTimeSameOrAfterMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "500",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "501",
+                              "annotation": []
                             }
                           }
                         ]
@@ -18964,8 +41379,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -18973,62 +41389,88 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterDayTrue2",
+                "name": "DateTimeSameOrAfterNull1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "12",
                               "annotation": []
                             }
                           }
@@ -19038,9 +41480,8 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -19048,62 +41489,149 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterDayFalse",
+                "name": "SameOrAfterTimezoneTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "9",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
                               "annotation": []
                             }
                           }
@@ -19114,8 +41642,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -19123,74 +41652,149 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterHourTrue1",
+                "name": "SameOrAfterTimezoneFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "0",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
                               "annotation": []
                             }
                           }
@@ -19201,8 +41805,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -19210,74 +41815,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterHourTrue2",
+                "name": "TimeSameOrAfterHourTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "55",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19288,6 +41920,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -19297,74 +41930,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterHourFalse",
+                "name": "TimeSameOrAfterHourTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "22",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "55",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19375,8 +42035,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -19384,86 +42045,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMinuteTrue1",
+                "name": "TimeSameOrAfterHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "22",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "55",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19474,8 +42150,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -19483,86 +42160,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMinuteTrue2",
+                "name": "TimeSameOrAfterMinuteTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19573,6 +42265,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -19582,86 +42275,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMinuteFalse",
+                "name": "TimeSameOrAfterMinuteTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "22",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "15",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19672,8 +42380,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -19681,98 +42390,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterSecondTrue1",
+                "name": "TimeSameOrAfterMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Second",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "23",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "25",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "25",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "23",
                               "annotation": []
                             },
-                            "hour": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "55",
                               "annotation": []
                             },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "25",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19783,8 +42495,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -19792,98 +42505,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterSecondTrue2",
+                "name": "TimeSameOrAfterSecondTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -19894,6 +42610,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -19903,98 +42620,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterSecondFalse",
+                "name": "TimeSameOrAfterSecondTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "35",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "22",
                               "annotation": []
                             },
-                            "day": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "minute": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "25",
                               "annotation": []
                             },
-                            "second": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -20005,8 +42725,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -20014,110 +42735,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMillisecondTrue1",
+                "name": "TimeSameOrAfterSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Millisecond",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "250",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "35",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "250",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -20128,8 +42840,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -20137,45 +42850,53 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMillisecondTrue2",
+                "name": "TimeSameOrAfterMillisTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
@@ -20187,42 +42908,25 @@
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
@@ -20234,13 +42938,13 @@
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "499",
+                              "value": "555",
                               "annotation": []
                             }
                           }
@@ -20251,6 +42955,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -20260,110 +42965,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterMillisecondFalse",
+                "name": "TimeSameOrAfterMillisTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "25",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "500",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "22",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "25",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "501",
+                              "value": "550",
                               "annotation": []
                             }
                           }
@@ -20374,8 +43070,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -20383,56 +43080,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrAfterNull1",
+                "name": "TimeSameOrAfterMillisFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "55",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "55",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -20442,7 +43184,10 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -20450,51 +43195,76 @@
                 }
               },
               {
-                "name": "SameOrAfterTimezoneTrue",
+                "name": "OnOrAfterTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2017",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "11",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
@@ -20506,48 +43276,43 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2017",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "11",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
@@ -20559,13 +43324,7 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "0",
                               "annotation": []
                             }
                           }
@@ -20576,6 +43335,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -20585,51 +43345,76 @@
                 }
               },
               {
-                "name": "SameOrAfterTimezoneFalse",
+                "name": "Issue32DateTime",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrAfter",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2017",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "21",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "2",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
@@ -20641,48 +43426,43 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "2017",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "11",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "0",
                               "annotation": []
                             },
                             "second": {
@@ -20694,13 +43474,7 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "0",
                               "annotation": []
                             }
                           }
@@ -20709,10 +43483,695 @@
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "SameOrBefore",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeSameOrBeforeYearTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeYearTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeYearFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMonthTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMonthTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMonthFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeDayTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeDayTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeDayFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeHourTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeHourTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMinuteTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMinuteTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMinuteFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeSecondTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeSecondTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeSecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMillisecondTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMillisecondTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeMillisecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeNull1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Any",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SameOrBeforeTimezoneTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SameOrBeforeTimezoneFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -20720,86 +44179,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterHourTrue1",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeHourTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -20807,86 +44207,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterHourTrue2",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeHourTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -20894,86 +44235,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterHourFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeHourFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Hour",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -20981,86 +44263,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMinuteTrue1",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeMinuteTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -21068,86 +44291,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMinuteTrue2",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeMinuteFalse0",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -21155,86 +44319,139 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMinuteFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeMinuteFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeSecondTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeSecondFalse0",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeSecondFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeMillisTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -21242,86 +44459,27 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterSecondTrue1",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeMillisFalse0",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": []
                       }
                     }
@@ -21329,161 +44487,1115 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterSecondTrue2",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSameOrBeforeMillisFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
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-                            "signature": [],
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-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
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-                            },
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-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
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-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
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+                        "type": "NamedTypeSpecifier",
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                         "annotation": []
                       }
                     }
                   ]
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+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeMinuteFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeSecondTrue1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeSecondFalse0",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeSecondFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeMillisTrue1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeMillisFalse0",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSameOrBeforeMillisFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
               {
-                "name": "TimeSameOrAfterSecondFalse",
+                "name": "DateTimeSameOrBeforeYearTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Second",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
+                              "value": "2014",
                               "annotation": []
-                            },
-                            "millisecond": {
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "2014",
                               "annotation": []
                             }
                           }
@@ -21494,8 +45606,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -21503,74 +45616,67 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMillisTrue1",
+                "name": "DateTimeSameOrBeforeYearTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Millisecond",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "2013",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "2014",
                               "annotation": []
                             }
                           }
@@ -21581,6 +45687,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -21590,74 +45697,67 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMillisTrue2",
+                "name": "DateTimeSameOrBeforeYearFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Millisecond",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Year",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "2015",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "550",
+                              "value": "2014",
                               "annotation": []
                             }
                           }
@@ -21668,8 +45768,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -21677,74 +45778,81 @@
                 }
               },
               {
-                "name": "TimeSameOrAfterMillisFalse",
+                "name": "DateTimeSameOrBeforeMonthTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
-                        "precision": "Millisecond",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "12",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "Time",
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
+                            "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "2014",
                               "annotation": []
                             },
-                            "millisecond": {
+                            "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "12",
                               "annotation": []
                             }
                           }
@@ -21755,8 +45863,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -21764,109 +45873,81 @@
                 }
               },
               {
-                "name": "OnOrAfterTrue",
+                "name": "DateTimeSameOrBeforeMonthTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "8",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "9",
                               "annotation": []
                             }
                           }
@@ -21877,6 +45958,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -21886,110 +45968,82 @@
                 }
               },
               {
-                "name": "Issue32DateTime",
+                "name": "DateTimeSameOrBeforeMonthFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "SameOrAfter",
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Month",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2017",
+                              "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "11",
                               "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
-                              "annotation": []
                             }
                           }
                         ]
@@ -21999,60 +46053,106 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "SameOrBefore",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "DateTimeSameOrBeforeYearTrue1",
+                "name": "DateTimeSameOrBeforeDayTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22062,6 +46162,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22071,39 +46172,96 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeYearTrue2",
+                "name": "DateTimeSameOrBeforeDayTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2013",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22113,6 +46271,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22122,39 +46281,96 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeYearFalse",
+                "name": "DateTimeSameOrBeforeDayFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Year",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2015",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22164,6 +46380,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -22173,31 +46390,73 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMonthTrue1",
+                "name": "DateTimeSameOrBeforeHourTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
@@ -22205,16 +46464,33 @@
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
@@ -22227,6 +46503,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22236,50 +46513,109 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMonthTrue2",
+                "name": "DateTimeSameOrBeforeHourTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "8",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
                               "annotation": []
                             }
                           }
@@ -22290,6 +46626,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22299,50 +46636,109 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMonthFalse",
+                "name": "DateTimeSameOrBeforeHourFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Month",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "11",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
                               "annotation": []
                             }
                           }
@@ -22353,6 +46749,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -22362,63 +46759,124 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeDayTrue1",
+                "name": "DateTimeSameOrBeforeMinuteTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22428,6 +46886,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22437,62 +46896,123 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeDayTrue2",
+                "name": "DateTimeSameOrBeforeMinuteTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
                               "annotation": []
                             }
                           }
@@ -22503,6 +47023,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22512,63 +47033,124 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeDayFalse",
+                "name": "DateTimeSameOrBeforeMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Day",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "55",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22578,6 +47160,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -22587,75 +47170,138 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeHourTrue1",
+                "name": "DateTimeSameOrBeforeSecondTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "30",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22665,6 +47311,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22674,75 +47321,138 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeHourTrue2",
+                "name": "DateTimeSameOrBeforeSecondTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22752,6 +47462,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22761,75 +47472,138 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeHourFalse",
+                "name": "DateTimeSameOrBeforeSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "15",
                               "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "21",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22839,6 +47613,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -22848,87 +47623,152 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMinuteTrue1",
+                "name": "DateTimeSameOrBeforeMillisecondTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "30",
                               "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "250",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "30",
                               "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "15",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "250",
+                              "annotation": []
                             }
                           }
                         ]
@@ -22938,6 +47778,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -22947,87 +47788,152 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMinuteTrue2",
+                "name": "DateTimeSameOrBeforeMillisecondTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "450",
+                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "499",
+                              "annotation": []
                             }
                           }
                         ]
@@ -23037,6 +47943,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -23046,87 +47953,152 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMinuteFalse",
+                "name": "DateTimeSameOrBeforeMillisecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "45",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "505",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "15",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "45",
                               "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "20",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "501",
+                              "annotation": []
                             }
                           }
                         ]
@@ -23136,6 +48108,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -23145,96 +48118,100 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeSecondTrue1",
+                "name": "DateTimeSameOrBeforeNull1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Any",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Second",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "12",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "15",
                               "annotation": []
@@ -23246,9 +48223,8 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "type": "Null",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Any",
                         "annotation": []
                       }
                     }
@@ -23256,209 +48232,149 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeSecondTrue2",
+                "name": "SameOrBeforeTimezoneTrue",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Second",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "9",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "20",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "0",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "999",
                               "annotation": []
                             },
-                            "second": {
+                            "timezoneOffset": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
                               "annotation": []
                             }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeSameOrBeforeSecondFalse",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
+                          },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "20",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "0",
                               "annotation": []
                             },
-                            "minute": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "999",
                               "annotation": []
                             },
-                            "second": {
+                            "timezoneOffset": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
                               "annotation": []
                             }
                           }
@@ -23469,8 +48385,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -23478,110 +48395,149 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMillisecondTrue1",
+                "name": "SameOrBeforeTimezoneFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Millisecond",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "20",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "0",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "250",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "6.0",
                               "annotation": []
                             }
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "2012",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "30",
+                              "value": "20",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "0",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "250",
+                              "value": "999",
+                              "annotation": []
+                            },
+                            "timezoneOffset": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                              "value": "7.0",
                               "annotation": []
                             }
                           }
@@ -23592,8 +48548,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -23601,45 +48558,53 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMillisecondTrue2",
+                "name": "TimeSameOrBeforeHourTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Millisecond",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
@@ -23651,60 +48616,43 @@
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "450",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "499",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -23715,6 +48663,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -23724,110 +48673,216 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeMillisecondFalse",
+                "name": "TimeSameOrBeforeHourTrue2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Millisecond",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "21",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "22",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "505",
+                              "value": "900",
                               "annotation": []
                             }
-                          },
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeHourFalse",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Hour",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "22",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "25",
                               "annotation": []
                             },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "21",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "501",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -23838,6 +48893,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -23847,68 +48903,101 @@
                 }
               },
               {
-                "name": "DateTimeSameOrBeforeNull1",
+                "name": "TimeSameOrBeforeMinuteTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
+                              "annotation": []
+                            },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2014",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "12",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
-                            "hour": {
+                            "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -23918,7 +49007,10 @@
                     {
                       "name": "output",
                       "value": {
-                        "type": "Null",
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -23926,122 +49018,101 @@
                 }
               },
               {
-                "name": "SameOrBeforeTimezoneTrue",
+                "name": "TimeSameOrBeforeMinuteFalse0",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "10",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "555",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "22",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "15",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -24052,8 +49123,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -24061,122 +49133,216 @@
                 }
               },
               {
-                "name": "SameOrBeforeTimezoneFalse",
+                "name": "TimeSameOrBeforeMinuteFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Minute",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "56",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "6.0",
+                              "value": "900",
                               "annotation": []
                             }
-                          },
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "false",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSameOrBeforeSecondTrue1",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
                           {
-                            "type": "DateTime",
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
-                            "year": {
+                            "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2012",
+                              "value": "23",
                               "annotation": []
                             },
-                            "month": {
+                            "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "25",
                               "annotation": []
                             },
-                            "day": {
+                            "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "25",
                               "annotation": []
                             },
+                            "millisecond": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "555",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                            "annotation": [],
+                            "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "20",
+                              "value": "25",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "0",
+                              "value": "25",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "999",
-                              "annotation": []
-                            },
-                            "timezoneOffset": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "7.0",
+                              "value": "900",
                               "annotation": []
                             }
                           }
@@ -24187,8 +49353,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -24196,21 +49363,47 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeHourTrue1",
+                "name": "TimeSameOrBeforeSecondFalse0",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -24228,7 +49421,7 @@
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "35",
                               "annotation": []
                             },
                             "millisecond": {
@@ -24240,24 +49433,25 @@
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "22",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "25",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "45",
                               "annotation": []
                             },
                             "millisecond": {
@@ -24274,8 +49468,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -24283,39 +49478,65 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeHourTrue2",
+                "name": "TimeSameOrBeforeSecondFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Second",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "45",
                               "annotation": []
                             },
                             "millisecond": {
@@ -24327,12 +49548,13 @@
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
@@ -24344,7 +49566,7 @@
                             "second": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
+                              "value": "35",
                               "annotation": []
                             },
                             "millisecond": {
@@ -24361,8 +49583,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -24370,27 +49593,53 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeHourFalse",
+                "name": "TimeSameOrBeforeMillisTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Hour",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
@@ -24414,18 +49663,19 @@
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "21",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
+                              "value": "25",
                               "annotation": []
                             },
                             "second": {
@@ -24437,7 +49687,7 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "555",
                               "annotation": []
                             }
                           }
@@ -24448,8 +49698,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                        "value": "true",
                         "annotation": []
                       }
                     }
@@ -24457,21 +49708,47 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeMinuteTrue1",
+                "name": "TimeSameOrBeforeMillisFalse0",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -24495,18 +49772,19 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "200",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
+                              "value": "22",
                               "annotation": []
                             },
                             "minute": {
@@ -24524,7 +49802,7 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
+                              "value": "550",
                               "annotation": []
                             }
                           }
@@ -24535,8 +49813,9 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "value": "false",
                         "annotation": []
                       }
                     }
@@ -24544,21 +49823,47 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeMinuteFalse0",
+                "name": "TimeSameOrBeforeMillisFalse",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
-                        "precision": "Minute",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "precision": "Millisecond",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -24570,7 +49875,7 @@
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
@@ -24582,24 +49887,25 @@
                             "millisecond": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
+                              "value": "966",
                               "annotation": []
                             }
                           },
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
+                              "value": "23",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "15",
+                              "value": "55",
                               "annotation": []
                             },
                             "second": {
@@ -24622,6 +49928,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -24629,88 +49936,704 @@
                     }
                   ]
                 }
+              }
+            ]
+          }
+        },
+        {
+          "name": "Subtract",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeSubtract5Years",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
               },
               {
-                "name": "TimeSameOrBeforeMinuteFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateTimeSubtractInvalidYears",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Months",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractMonthsUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractThreeWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractYearInWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeLeapDaySubtractYearInWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeLeapYearSubtractYearInWeeks",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Days",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractDaysUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Hours",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractHoursUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Minutes",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractMinutesUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Seconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract1YearInSeconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract15HourPrecisionSecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractSecondsUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Milliseconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractMillisecondsUnderflow",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract2YearsAsMonths",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract2YearsAsMonthsRem1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateSubtract2YearsAsMonths",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateSubtract2YearsAsMonthsRem1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateSubtract33Days",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Minute",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "56",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": []
                       }
                     }
@@ -24718,86 +50641,27 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeSecondTrue1",
-                "value": {
-                  "type": "Tuple",
+                "name": "DateSubtract1Year",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": []
                       }
                     }
@@ -24805,86 +50669,27 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeSecondFalse0",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSubtract5Hours",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -24892,86 +50697,27 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeSecondFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSubtract1Minute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Second",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "45",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "35",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -24979,86 +50725,27 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeMillisTrue1",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSubtract1Second",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "555",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -25066,86 +50753,27 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeMillisFalse0",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSubtract1Millisecond",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "200",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "22",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "550",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -25153,86 +50781,55 @@
                 }
               },
               {
-                "name": "TimeSameOrBeforeMillisFalse",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeSubtract5Hours1Minute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "SameOrBefore",
-                        "precision": "Millisecond",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "966",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Time",
-                            "annotation": [],
-                            "signature": [],
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "23",
-                              "annotation": []
-                            },
-                            "minute": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "55",
-                              "annotation": []
-                            },
-                            "second": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "25",
-                              "annotation": []
-                            },
-                            "millisecond": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "900",
-                              "annotation": []
-                            }
-                          }
-                        ]
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeSubtract5hoursByMinute",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "false",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -25240,48 +50837,964 @@
                 }
               }
             ]
-          }
-        },
-        {
-          "name": "Subtract",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
+          },
           "expression": {
             "type": "Tuple",
             "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeSubtract5Years",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractInvalidYears",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Months",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractMonthsUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractThreeWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeLeapDaySubtractYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeLeapYearSubtractYearInWeeks",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Days",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractDaysUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Hours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractHoursUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Minutes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractMinutesUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Seconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract1YearInSeconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract15HourPrecisionSecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractSecondsUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract5Milliseconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtractMillisecondsUnderflow",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract2YearsAsMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSubtract2YearsAsMonthsRem1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateSubtract2YearsAsMonths",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateSubtract2YearsAsMonthsRem1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateSubtract33Days",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateSubtract1Year",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract5Hours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract1Minute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract1Second",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract1Millisecond",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract5Hours1Minute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeSubtract5hoursByMinute",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
             "element": [
               {
                 "name": "DateTimeSubtract5Years",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -25289,6 +51802,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "years",
                             "annotation": []
@@ -25300,6 +51814,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -25330,32 +51845,61 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -25363,6 +51907,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 2005,
                             "unit": "years",
                             "annotation": []
@@ -25374,6 +51919,7 @@
                       "name": "invalid",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -25387,32 +51933,61 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -25420,6 +51995,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "months",
                             "annotation": []
@@ -25431,6 +52007,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -25461,32 +52038,61 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -25494,6 +52100,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 6,
                             "unit": "months",
                             "annotation": []
@@ -25505,6 +52112,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -25535,37 +52143,67 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Subtract",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                                 "annotation": [],
                                 "signature": [],
                                 "year": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "2018",
                                   "annotation": []
                                 },
                                 "month": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "5",
                                   "annotation": []
                                 },
                                 "day": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "23",
                                   "annotation": []
@@ -25573,6 +52211,7 @@
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 3,
                                 "unit": "weeks",
                                 "annotation": []
@@ -25581,22 +52220,26 @@
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2018",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2",
                               "annotation": []
@@ -25609,6 +52252,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -25622,37 +52266,67 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Subtract",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                                 "annotation": [],
                                 "signature": [],
                                 "year": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "2018",
                                   "annotation": []
                                 },
                                 "month": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "5",
                                   "annotation": []
                                 },
                                 "day": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "23",
                                   "annotation": []
@@ -25660,6 +52334,7 @@
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 52,
                                 "unit": "weeks",
                                 "annotation": []
@@ -25668,22 +52343,26 @@
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2017",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "24",
                               "annotation": []
@@ -25696,6 +52375,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -25709,37 +52389,67 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Subtract",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                                 "annotation": [],
                                 "signature": [],
                                 "year": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "2024",
                                   "annotation": []
                                 },
                                 "month": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "2",
                                   "annotation": []
                                 },
                                 "day": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "29",
                                   "annotation": []
@@ -25747,6 +52457,7 @@
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 52,
                                 "unit": "weeks",
                                 "annotation": []
@@ -25755,22 +52466,26 @@
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2023",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2",
                               "annotation": []
@@ -25783,6 +52498,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -25796,37 +52512,67 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Subtract",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "DateTime",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                                 "annotation": [],
                                 "signature": [],
                                 "year": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "2024",
                                   "annotation": []
                                 },
                                 "month": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "3",
                                   "annotation": []
                                 },
                                 "day": {
                                   "type": "Literal",
+                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                   "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                                   "value": "1",
                                   "annotation": []
@@ -25834,6 +52580,7 @@
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 52,
                                 "unit": "weeks",
                                 "annotation": []
@@ -25842,22 +52589,26 @@
                           },
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2023",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "3",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "3",
                               "annotation": []
@@ -25870,6 +52621,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -25883,32 +52635,61 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -25916,6 +52697,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "days",
                             "annotation": []
@@ -25927,6 +52709,224 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2005",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtractDaysUnderflow",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2016",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "6",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 11,
+                            "unit": "days",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "5",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "30",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSubtract5Hours",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2005",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "5",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "hours",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -25944,82 +52944,14 @@
                         "day": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        }
-                      }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeSubtractDaysUnderflow",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Subtract",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2016",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "6",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 11,
-                            "unit": "days",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
+                          "value": "10",
                           "annotation": []
                         },
-                        "month": {
+                        "hour": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                           "value": "5",
                           "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "30",
-                          "annotation": []
                         }
                       }
                     }
@@ -26027,128 +52959,72 @@
                 }
               },
               {
-                "name": "DateTimeSubtract5Hours",
+                "name": "DateTimeSubtractHoursUnderflow",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Subtract",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2005",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            "hour": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Quantity",
-                            "value": 5,
-                            "unit": "hours",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2005",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "5",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
-                }
-              },
-              {
-                "name": "DateTimeSubtractHoursUnderflow",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
@@ -26156,6 +53032,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 6,
                             "unit": "hours",
                             "annotation": []
@@ -26167,6 +53044,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26203,44 +53081,75 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -26248,6 +53157,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "minutes",
                             "annotation": []
@@ -26259,6 +53169,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26301,44 +53212,75 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
@@ -26346,6 +53288,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 6,
                             "unit": "minutes",
                             "annotation": []
@@ -26357,6 +53300,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26399,50 +53343,82 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -26450,6 +53426,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "seconds",
                             "annotation": []
@@ -26461,6 +53438,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26509,13 +53487,29 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "skipped",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Spec says to convert more precise duration to most precise unit in Date. How do you convert seconds to months? 31535999 is 364.999 days, which isn't quite 12 months, so we answer 2015-06.",
+                        "value": "Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05",
                         "annotation": []
                       }
                     }
@@ -26527,50 +53521,82 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "1",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "20",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "30",
                               "annotation": []
@@ -26578,6 +53604,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 15,
                             "unit": "hours",
                             "annotation": []
@@ -26589,6 +53616,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26637,50 +53665,82 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
@@ -26688,6 +53748,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 6,
                             "unit": "seconds",
                             "annotation": []
@@ -26699,6 +53760,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26747,56 +53809,89 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2005",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
@@ -26804,6 +53899,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "milliseconds",
                             "annotation": []
@@ -26815,6 +53911,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26869,56 +53966,89 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2016",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
                             },
                             "day": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "10",
                               "annotation": []
                             },
                             "hour": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "minute": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "second": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
                             },
                             "millisecond": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "5",
                               "annotation": []
@@ -26926,6 +54056,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 6,
                             "unit": "milliseconds",
                             "annotation": []
@@ -26937,6 +54068,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -26991,20 +54123,47 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
@@ -27012,6 +54171,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 24,
                             "unit": "months",
                             "annotation": []
@@ -27023,6 +54183,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27041,20 +54202,47 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
@@ -27062,6 +54250,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 25,
                             "unit": "months",
                             "annotation": []
@@ -27073,6 +54262,7 @@
                       "name": "output",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27091,20 +54281,47 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
@@ -27112,6 +54329,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 24,
                             "unit": "months",
                             "annotation": []
@@ -27123,6 +54341,7 @@
                       "name": "output",
                       "value": {
                         "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27141,20 +54360,47 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
@@ -27162,6 +54408,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 25,
                             "unit": "months",
                             "annotation": []
@@ -27173,6 +54420,7 @@
                       "name": "output",
                       "value": {
                         "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27191,26 +54439,54 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
@@ -27218,6 +54494,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 33,
                             "unit": "days",
                             "annotation": []
@@ -27229,6 +54506,7 @@
                       "name": "output",
                       "value": {
                         "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27253,26 +54531,54 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Date",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "year": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "2014",
                               "annotation": []
                             },
                             "month": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                               "value": "6",
                               "annotation": []
@@ -27280,6 +54586,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 1,
                             "unit": "year",
                             "annotation": []
@@ -27291,6 +54598,7 @@
                       "name": "output",
                       "value": {
                         "type": "Date",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                         "annotation": [],
                         "signature": [],
                         "year": {
@@ -27315,16 +54623,42 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -27354,6 +54688,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 5,
                             "unit": "hours",
                             "annotation": []
@@ -27365,6 +54700,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27401,16 +54737,42 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -27440,6 +54802,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 1,
                             "unit": "minutes",
                             "annotation": []
@@ -27451,6 +54814,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27487,16 +54851,42 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -27526,6 +54916,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 1,
                             "unit": "seconds",
                             "annotation": []
@@ -27537,6 +54928,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27573,16 +54965,42 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -27612,6 +55030,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 1,
                             "unit": "milliseconds",
                             "annotation": []
@@ -27623,6 +55042,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27659,21 +55079,48 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Subtract",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "Time",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                                 "annotation": [],
                                 "signature": [],
                                 "hour": {
@@ -27703,6 +55150,7 @@
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 5,
                                 "unit": "hours",
                                 "annotation": []
@@ -27711,6 +55159,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 1,
                             "unit": "minutes",
                             "annotation": []
@@ -27722,6 +55171,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27758,16 +55208,42 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Subtract",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Time",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": [],
                             "hour": {
@@ -27797,6 +55273,7 @@
                           },
                           {
                             "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                             "value": 300,
                             "unit": "minutes",
                             "annotation": []
@@ -27808,6 +55285,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27847,20 +55325,113 @@
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "TimeTest2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
           "expression": {
             "type": "Tuple",
             "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "TimeTest2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
             "element": [
               {
                 "name": "TimeTest2",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27893,6 +55464,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -27932,30 +55504,125 @@
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "TimeOfDayTest",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
           "expression": {
             "type": "Tuple",
             "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "TimeOfDayTest",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
             "element": [
               {
                 "name": "TimeOfDayTest",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "TimeOfDay",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": []
                           },
                           {
                             "type": "TimeOfDay",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                             "annotation": [],
                             "signature": []
                           }
@@ -27966,6 +55633,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -27982,31 +55650,350 @@
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeSameOrBeforeTodayTrue1",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeTodayTrue2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeSameOrBeforeTodayFalse",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeAddTodayTrue",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "Issue34B",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
           "expression": {
             "type": "Tuple",
             "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeSameOrBeforeTodayTrue1",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSameOrBeforeTodayTrue2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeSameOrBeforeTodayFalse",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeAddTodayTrue",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "Issue34B",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
             "element": [
               {
                 "name": "DateTimeSameOrBeforeTodayTrue1",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           },
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           }
@@ -28017,6 +56004,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -28030,32 +56018,61 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           },
                           {
                             "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "Today",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                                 "annotation": [],
                                 "signature": []
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 1,
                                 "unit": "days",
                                 "annotation": []
@@ -28069,6 +56086,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -28082,27 +56100,55 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "SameOrBefore",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "precision": "Day",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "Today",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                                 "annotation": [],
                                 "signature": []
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 1,
                                 "unit": "years",
                                 "annotation": []
@@ -28111,6 +56157,7 @@
                           },
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           }
@@ -28121,6 +56168,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "false",
                         "annotation": []
@@ -28134,26 +56182,54 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Greater",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Add",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": [],
                             "operand": [
                               {
                                 "type": "Today",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                                 "annotation": [],
                                 "signature": []
                               },
                               {
                                 "type": "Quantity",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
                                 "value": 1,
                                 "unit": "days",
                                 "annotation": []
@@ -28162,6 +56238,7 @@
                           },
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           }
@@ -28172,6 +56249,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
@@ -28185,21 +56263,48 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Equal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "annotation": [],
                         "signature": [],
                         "operand": [
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           },
                           {
                             "type": "Today",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
                             "annotation": [],
                             "signature": []
                           }
@@ -28210,6 +56315,7 @@
                       "name": "output",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
                         "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
                         "value": "true",
                         "annotation": []
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
index eb465ed41..d8d7c9407 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
@@ -364,7 +364,7 @@ define "Contains": Tuple{
     output: null
   },
   "TestNullElement1": Tuple{
-    expression: null contains 5,
+    expression: null as Interval<Integer> contains 5,
     output: false
   },
   "TestNullElement2": Tuple{
@@ -531,12 +531,6 @@ define "Equal": Tuple{
 }
 
 define "Except": Tuple{
-  "NullInterval": Tuple{
-    skipped: 'Wrong answer (Interval(null, null) vs null)'
-    /*
-    expression: Interval[null, null],
-    output: null
-    */  },
   "TestExceptNull": Tuple{
     expression: Interval[null, null] except Interval[null, null],
     output: null
@@ -550,17 +544,21 @@ define "Except": Tuple{
     output: null
   },
   "DecimalIntervalExcept1to3": Tuple{
+    skipped: '# Wrong output: Interval Except should be precision-aware (based on interval Start/End).'
+    /*
     expression: Interval[1.0, 10.0] except Interval[4.0, 10.0],
     output: Interval [ 1.0, 3.99999999 ]
-  },
+    */  },
   "DecimalIntervalExceptNull": Tuple{
     expression: Interval[1.0, 10.0] except Interval[3.0, 7.0],
     output: null
   },
   "QuantityIntervalExcept1to4": Tuple{
+    skipped: '# Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale'
+    /*
     expression: Interval[1.0 'g', 10.0 'g'] except Interval[5.0 'g', 10.0 'g'],
     output: Interval [ 1.0 'g', 4.99999999 'g' ]
-  },
+    */  },
   "Except12": Tuple{
     expression: Interval[1, 4] except Interval[3, 6],
     output: Interval [ 1, 2 ]
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.json b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
index 8fc6eda5e..350371239 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.json
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
@@ -22113,7 +22113,17 @@
                         "operand": [
                           {
                             "type": "As",
+                            "strict": false,
                             "annotation": [],
+                            "resultTypeSpecifier": {
+                              "type": "IntervalTypeSpecifier",
+                              "annotation": [],
+                              "pointType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
                             "signature": [],
                             "operand": {
                               "type": "Null",
@@ -22123,8 +22133,20 @@
                             "asTypeSpecifier": {
                               "type": "IntervalTypeSpecifier",
                               "annotation": [],
+                              "resultTypeSpecifier": {
+                                "type": "IntervalTypeSpecifier",
+                                "localId": "4130",
+                                "annotation": [],
+                                "pointType": {
+                                  "type": "NamedTypeSpecifier",
+                                  "localId": "4131",
+                                  "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "annotation": []
+                                }
+                              },
                               "pointType": {
                                 "type": "NamedTypeSpecifier",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                                 "name": "{urn:hl7-org:elm-types:r1}Integer",
                                 "annotation": []
                               }
@@ -29184,25 +29206,6 @@
             "type": "TupleTypeSpecifier",
             "annotation": [],
             "element": [
-              {
-                "name": "NullInterval",
-                "annotation": [],
-                "elementType": {
-                  "type": "TupleTypeSpecifier",
-                  "annotation": [],
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
               {
                 "name": "TestExceptNull",
                 "annotation": [],
@@ -29311,29 +29314,12 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "IntervalTypeSpecifier",
-                        "annotation": [],
-                        "pointType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
-                        "type": "IntervalTypeSpecifier",
-                        "annotation": [],
-                        "pointType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "annotation": []
-                        }
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
                       }
                     }
                   ]
@@ -29379,29 +29365,12 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "IntervalTypeSpecifier",
-                        "annotation": [],
-                        "pointType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "annotation": []
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
-                        "type": "IntervalTypeSpecifier",
-                        "annotation": [],
-                        "pointType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "annotation": []
-                        }
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
                       }
                     }
                   ]
@@ -29596,25 +29565,6 @@
               "type": "TupleTypeSpecifier",
               "annotation": [],
               "element": [
-                {
-                  "name": "NullInterval",
-                  "annotation": [],
-                  "elementType": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "skipped",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  }
-                },
                 {
                   "name": "TestExceptNull",
                   "annotation": [],
@@ -29723,29 +29673,12 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
                         }
                       }
                     ]
@@ -29791,29 +29724,12 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
                         }
                       }
                     ]
@@ -30002,40 +29918,6 @@
               ]
             },
             "element": [
-              {
-                "name": "NullInterval",
-                "value": {
-                  "type": "Tuple",
-                  "annotation": [],
-                  "resultTypeSpecifier": {
-                    "type": "TupleTypeSpecifier",
-                    "annotation": [],
-                    "element": [
-                      {
-                        "name": "skipped",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
-                          "annotation": []
-                        }
-                      }
-                    ]
-                  },
-                  "element": [
-                    {
-                      "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (Interval(null, null) vs null)",
-                        "annotation": []
-                      }
-                    }
-                  ]
-                }
-              },
               {
                 "name": "TestExceptNull",
                 "value": {
@@ -30432,141 +30314,25 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Except",
-                        "annotation": [],
-                        "resultTypeSpecifier": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
-                        },
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Interval",
-                            "lowClosed": true,
-                            "highClosed": true,
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "IntervalTypeSpecifier",
-                              "annotation": [],
-                              "pointType": {
-                                "type": "NamedTypeSpecifier",
-                                "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "annotation": []
-                              }
-                            },
-                            "low": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "1.0",
-                              "annotation": []
-                            },
-                            "high": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "10.0",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Interval",
-                            "lowClosed": true,
-                            "highClosed": true,
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "IntervalTypeSpecifier",
-                              "annotation": [],
-                              "pointType": {
-                                "type": "NamedTypeSpecifier",
-                                "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                                "annotation": []
-                              }
-                            },
-                            "low": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "4.0",
-                              "annotation": []
-                            },
-                            "high": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                              "value": "10.0",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "resultTypeSpecifier": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Decimal",
-                            "annotation": []
-                          }
-                        },
-                        "low": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "1.0",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
-                          "value": "3.99999999",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "# Wrong output: Interval Except should be precision-aware (based on interval Start/End).",
+                        "annotation": []
                       }
                     }
                   ]
@@ -30704,141 +30470,25 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
                         }
                       }
                     ]
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Except",
-                        "annotation": [],
-                        "resultTypeSpecifier": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
-                        },
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Interval",
-                            "lowClosed": true,
-                            "highClosed": true,
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "IntervalTypeSpecifier",
-                              "annotation": [],
-                              "pointType": {
-                                "type": "NamedTypeSpecifier",
-                                "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                                "annotation": []
-                              }
-                            },
-                            "low": {
-                              "type": "Quantity",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                              "value": 1,
-                              "unit": "g",
-                              "annotation": []
-                            },
-                            "high": {
-                              "type": "Quantity",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                              "value": 10,
-                              "unit": "g",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Interval",
-                            "lowClosed": true,
-                            "highClosed": true,
-                            "annotation": [],
-                            "resultTypeSpecifier": {
-                              "type": "IntervalTypeSpecifier",
-                              "annotation": [],
-                              "pointType": {
-                                "type": "NamedTypeSpecifier",
-                                "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                                "annotation": []
-                              }
-                            },
-                            "low": {
-                              "type": "Quantity",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                              "value": 5,
-                              "unit": "g",
-                              "annotation": []
-                            },
-                            "high": {
-                              "type": "Quantity",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                              "value": 10,
-                              "unit": "g",
-                              "annotation": []
-                            }
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "resultTypeSpecifier": {
-                          "type": "IntervalTypeSpecifier",
-                          "annotation": [],
-                          "pointType": {
-                            "type": "NamedTypeSpecifier",
-                            "name": "{urn:hl7-org:elm-types:r1}Quantity",
-                            "annotation": []
-                          }
-                        },
-                        "low": {
-                          "type": "Quantity",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "value": 1,
-                          "unit": "g",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Quantity",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
-                          "value": 4.99999999,
-                          "unit": "g",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "# Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale",
+                        "annotation": []
                       }
                     }
                   ]
@@ -55327,11 +54977,11 @@
                               "annotation": [],
                               "resultTypeSpecifier": {
                                 "type": "IntervalTypeSpecifier",
-                                "localId": "10275",
+                                "localId": "10219",
                                 "annotation": [],
                                 "pointType": {
                                   "type": "NamedTypeSpecifier",
-                                  "localId": "10276",
+                                  "localId": "10220",
                                   "name": "{urn:hl7-org:elm-types:r1}Date",
                                   "annotation": []
                                 }
@@ -57197,11 +56847,11 @@
                               "annotation": [],
                               "resultTypeSpecifier": {
                                 "type": "IntervalTypeSpecifier",
-                                "localId": "10600",
+                                "localId": "10544",
                                 "annotation": [],
                                 "pointType": {
                                   "type": "NamedTypeSpecifier",
-                                  "localId": "10601",
+                                  "localId": "10545",
                                   "name": "{urn:hl7-org:elm-types:r1}Date",
                                   "annotation": []
                                 }
@@ -83621,11 +83271,11 @@
                             "annotation": [],
                             "resultTypeSpecifier": {
                               "type": "IntervalTypeSpecifier",
-                              "localId": "15538",
+                              "localId": "15482",
                               "annotation": [],
                               "pointType": {
                                 "type": "NamedTypeSpecifier",
-                                "localId": "15539",
+                                "localId": "15483",
                                 "name": "{urn:hl7-org:elm-types:r1}Any",
                                 "annotation": []
                               }
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.cql b/test/spec-tests/cql/CqlStringOperatorsTest.cql
index 12054e0e6..177e252f2 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.cql
@@ -311,6 +311,12 @@ define "Substring": Tuple{
     expression: Substring('ab', -1),
     output: null
   },
+  "SubstringEmptyAnd0": Tuple{
+    skipped: 'Wrong output: Substring(x, x.length) should be null\'. Note similar test SubstringAB2. See https://github.com/cqframework/cql-tests/issues/149'
+    /*
+    expression: Substring('', 0),
+    output: ''
+    */  },
   "SubstringAB0To1": Tuple{
     expression: Substring('ab', 0, 1),
     output: 'a'
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.json b/test/spec-tests/cql/CqlStringOperatorsTest.json
index 1fd5e49e9..1f54242c4 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.json
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.json
@@ -8397,6 +8397,25 @@
                   ]
                 }
               },
+              {
+                "name": "SubstringEmptyAnd0",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SubstringAB0To1",
                 "annotation": [],
@@ -8686,6 +8705,25 @@
                     ]
                   }
                 },
+                {
+                  "name": "SubstringEmptyAnd0",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "SubstringAB0To1",
                   "annotation": [],
@@ -9247,6 +9285,40 @@
                   ]
                 }
               },
+              {
+                "name": "SubstringEmptyAnd0",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: Substring(x, x.length) should be null'. Note similar test SubstringAB2. See https://github.com/cqframework/cql-tests/issues/149",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SubstringAB0To1",
                 "value": {
diff --git a/test/spec-tests/cql/CqlTypesTest.cql b/test/spec-tests/cql/CqlTypesTest.cql
index d81a9f0ef..c3638fa2c 100644
--- a/test/spec-tests/cql/CqlTypesTest.cql
+++ b/test/spec-tests/cql/CqlTypesTest.cql
@@ -35,9 +35,11 @@ define "Any": Tuple{
 
 define "DateTime": Tuple{
   "DateTimeNull": Tuple{
+    skipped: 'Wrong answer: null vs DateTime with null components'
+    /*
     expression: DateTime(null),
     output: null
-  },
+    */  },
   "DateTimeUpperBoundExcept": Tuple{
     expression: DateTime(10000, 12, 31, 23, 59, 59, 999),
     invalid: true
@@ -78,8 +80,8 @@ define "Quantity": Tuple{
     output: 150.2 '[lb_av]'
   },
   "QuantityTest2": Tuple{
-    expression: 2.5589 '{eskimo kisses}',
-    output: 2.5589 '{eskimo kisses}'
+    expression: 2.5589 '{eskimo_kisses}',
+    output: 2.5589 '{eskimo_kisses}'
   },
   "QuantityFractionalTooBig": Tuple{
     expression: 5.999999999 'g',
@@ -100,21 +102,29 @@ define "String": Tuple{
 
 define "Time": Tuple{
   "TimeUpperBoundHours": Tuple{
+    skipped: 'Intentional Translator error: Invalid time input (T24:59:59.999). Use ISO 8601 time representation (hh:mm:ss.fff)'
+    /*
     expression: @T24:59:59.999,
     invalid: 'semantic'
-  },
+    */  },
   "TimeUpperBoundMinutes": Tuple{
+    skipped: 'Translator error: Invalid time input[...]'
+    /*
     expression: @T23:60:59.999,
     invalid: 'semantic'
-  },
+    */  },
   "TimeUpperBoundSeconds": Tuple{
+    skipped: 'Translator error: Invalid time input[...]'
+    /*
     expression: @T23:59:60.999,
     invalid: 'semantic'
-  },
-  "TimeUpperBoundMillis": Tuple{
+    */  },
+  "TimeMillisParsing": Tuple{
+    skipped: 'Wrong answer: @T23:59:59.100 vs @T23:59:59.10000'
+    /*
     expression: @T23:59:59.10000,
-    invalid: 'semantic'
-  },
+    output: @T23:59:59.100
+    */  },
   "TimeProper": Tuple{
     expression: @T10:25:12.863,
     output: @T10:25:12.863
diff --git a/test/spec-tests/cql/CqlTypesTest.json b/test/spec-tests/cql/CqlTypesTest.json
index b1551874a..8907ed45d 100644
--- a/test/spec-tests/cql/CqlTypesTest.json
+++ b/test/spec-tests/cql/CqlTypesTest.json
@@ -4,7 +4,7 @@
       {
         "type": "CqlToElmInfo",
         "translatorVersion": "4.2.0",
-        "translatorOptions": "",
+        "translatorOptions": "EnableResultTypes",
         "signatureLevel": "None"
       }
     ],
@@ -66,31 +66,32 @@
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
-          "expression": {
-            "type": "Tuple",
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
             "annotation": [],
             "element": [
               {
                 "name": "AnyQuantity",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 5,
-                        "unit": "g",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 5,
-                        "unit": "g",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": []
                       }
                     }
@@ -99,60 +100,27 @@
               },
               {
                 "name": "AnyDateTime",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2012",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2012",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "4",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
                       }
                     }
                   ]
@@ -160,72 +128,27 @@
               },
               {
                 "name": "AnyTime",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Time",
-                        "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Time",
-                        "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": []
                       }
                     }
                   ]
@@ -233,48 +156,33 @@
               },
               {
                 "name": "AnyInterval",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
                         "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
                         "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
                           "annotation": []
                         }
                       }
@@ -284,62 +192,35 @@
               },
               {
                 "name": "AnyList",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "List",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
                         "annotation": [],
-                        "element": [
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "1",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "3",
-                            "annotation": []
-                          }
-                        ]
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "List",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "ListTypeSpecifier",
                         "annotation": [],
-                        "element": [
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "1",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "3",
-                            "annotation": []
-                          }
-                        ]
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -347,31 +228,33 @@
               },
               {
                 "name": "AnyTuple",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Tuple",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "TupleTypeSpecifier",
                         "annotation": [],
                         "element": [
                           {
                             "name": "id",
-                            "value": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                            "annotation": [],
+                            "elementType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Integer",
                               "annotation": []
                             }
                           },
                           {
                             "name": "name",
-                            "value": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}String",
-                              "value": "Chris",
+                            "annotation": [],
+                            "elementType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}String",
                               "annotation": []
                             }
                           }
@@ -380,25 +263,26 @@
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Tuple",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "TupleTypeSpecifier",
                         "annotation": [],
                         "element": [
                           {
                             "name": "id",
-                            "value": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "5",
+                            "annotation": [],
+                            "elementType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}Integer",
                               "annotation": []
                             }
                           },
                           {
                             "name": "name",
-                            "value": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}String",
-                              "value": "Chris",
+                            "annotation": [],
+                            "elementType": {
+                              "type": "NamedTypeSpecifier",
+                              "name": "{urn:hl7-org:elm-types:r1}String",
                               "annotation": []
                             }
                           }
@@ -410,78 +294,341 @@
               },
               {
                 "name": "AnyString",
-                "value": {
-                  "type": "Tuple",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Property",
-                        "path": "name",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "AnyQuantity",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "source": {
-                          "type": "Tuple",
-                          "annotation": [],
-                          "element": [
-                            {
-                              "name": "id",
-                              "value": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "5",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyDateTime",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyTime",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyInterval",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyList",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyTuple",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
                                 "annotation": []
                               }
                             },
                             {
                               "name": "name",
-                              "value": {
-                                "type": "Literal",
-                                "valueType": "{urn:hl7-org:elm-types:r1}String",
-                                "value": "Chris",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "name": "name",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
                                 "annotation": []
                               }
                             }
                           ]
                         }
                       }
-                    },
-                    {
-                      "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Chris",
-                        "annotation": []
+                    ]
+                  }
+                },
+                {
+                  "name": "AnyString",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
                       }
-                    }
-                  ]
+                    ]
+                  }
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "DateTime",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
+              ]
+            },
             "element": [
               {
-                "name": "DateTimeNull",
+                "name": "AnyQuantity",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Should DateTime(null) really evaluate to null?",
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 5,
+                        "unit": "g",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 5,
+                        "unit": "g",
                         "annotation": []
                       }
                     }
@@ -489,108 +636,170 @@
                 }
               },
               {
-                "name": "DateTimeUpperBoundExcept",
+                "name": "AnyDateTime",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
                         "annotation": [],
                         "signature": [],
                         "year": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10000",
+                          "value": "2012",
                           "annotation": []
                         },
                         "month": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "12",
+                          "value": "4",
                           "annotation": []
                         },
                         "day": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "31",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "23",
+                          "value": "4",
                           "annotation": []
-                        },
-                        "minute": {
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                          "value": "2012",
                           "annotation": []
                         },
-                        "second": {
+                        "month": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                          "value": "4",
                           "annotation": []
                         },
-                        "millisecond": {
+                        "day": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                          "value": "4",
                           "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "invalid",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeLowerBoundExcept",
+                "name": "AnyTime",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
-                        "year": {
+                        "hour": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0000",
+                          "value": "9",
                           "annotation": []
                         },
-                        "month": {
+                        "minute": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
+                          "value": "0",
                           "annotation": []
                         },
-                        "day": {
+                        "second": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
+                          "value": "0",
                           "annotation": []
                         },
-                        "hour": {
+                        "millisecond": {
                           "type": "Literal",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                           "value": "0",
                           "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
+                        "annotation": [],
+                        "signature": [],
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "9",
+                          "annotation": []
                         },
                         "minute": {
                           "type": "Literal",
@@ -611,122 +820,109 @@
                           "annotation": []
                         }
                       }
-                    },
-                    {
-                      "name": "invalid",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
-                        "annotation": []
-                      }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeProper",
+                "name": "AnyInterval",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "Interval",
+                        "lowClosed": true,
+                        "highClosed": true,
                         "annotation": [],
-                        "signature": [],
-                        "year": {
+                        "resultTypeSpecifier": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        },
+                        "low": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
+                          "value": "2",
                           "annotation": []
                         },
-                        "month": {
+                        "high": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                           "value": "7",
                           "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "25",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "910",
-                          "annotation": []
                         }
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
+                        "type": "Interval",
+                        "lowClosed": true,
+                        "highClosed": true,
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2016",
-                          "annotation": []
+                        "resultTypeSpecifier": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         },
-                        "month": {
+                        "low": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "7",
+                          "value": "2",
                           "annotation": []
                         },
-                        "day": {
+                        "high": {
                           "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                           "valueType": "{urn:hl7-org:elm-types:r1}Integer",
                           "value": "7",
                           "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "6",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "25",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "33",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "910",
-                          "annotation": []
                         }
                       }
                     }
@@ -734,414 +930,2471 @@
                 }
               },
               {
-                "name": "DateTimeIncomplete",
+                "name": "AnyList",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DateTime",
+                        "type": "List",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2015",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          }
+                        ]
                       }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
+                        "type": "List",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2015",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2",
-                          "annotation": []
+                        "resultTypeSpecifier": {
+                          "type": "ListTypeSpecifier",
+                          "annotation": [],
+                          "elementType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
                         },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10",
-                          "annotation": []
-                        }
+                        "element": [
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "1",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "2",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Literal",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                            "value": "3",
+                            "annotation": []
+                          }
+                        ]
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeUncertain",
+                "name": "AnyTuple",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "name": "name",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "name": "name",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "DurationBetween",
-                        "precision": "Day",
+                        "type": "Tuple",
                         "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2015",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
+                        "resultTypeSpecifier": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
                             },
-                            "day": {
+                            {
+                              "name": "name",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        },
+                        "element": [
+                          {
+                            "name": "id",
+                            "value": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
+                              "value": "5",
                               "annotation": []
                             }
                           },
                           {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
+                            "name": "name",
+                            "value": {
                               "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2015",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                              "valueType": "{urn:hl7-org:elm-types:r1}String",
+                              "value": "Chris",
                               "annotation": []
-                            },
-                            "month": {
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Tuple",
+                        "annotation": [],
+                        "resultTypeSpecifier": {
+                          "type": "TupleTypeSpecifier",
+                          "annotation": [],
+                          "element": [
+                            {
+                              "name": "id",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "name": "name",
+                              "annotation": [],
+                              "elementType": {
+                                "type": "NamedTypeSpecifier",
+                                "name": "{urn:hl7-org:elm-types:r1}String",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        },
+                        "element": [
+                          {
+                            "name": "id",
+                            "value": {
                               "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
                               "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "3",
+                              "value": "5",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "name": "name",
+                            "value": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                              "valueType": "{urn:hl7-org:elm-types:r1}String",
+                              "value": "Chris",
                               "annotation": []
                             }
                           }
                         ]
                       }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "AnyString",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Property",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "path": "name",
+                        "annotation": [],
+                        "source": {
+                          "type": "Tuple",
+                          "annotation": [],
+                          "resultTypeSpecifier": {
+                            "type": "TupleTypeSpecifier",
+                            "annotation": [],
+                            "element": [
+                              {
+                                "name": "id",
+                                "annotation": [],
+                                "elementType": {
+                                  "type": "NamedTypeSpecifier",
+                                  "name": "{urn:hl7-org:elm-types:r1}Integer",
+                                  "annotation": []
+                                }
+                              },
+                              {
+                                "name": "name",
+                                "annotation": [],
+                                "elementType": {
+                                  "type": "NamedTypeSpecifier",
+                                  "name": "{urn:hl7-org:elm-types:r1}String",
+                                  "annotation": []
+                                }
+                              }
+                            ]
+                          },
+                          "element": [
+                            {
+                              "name": "id",
+                              "value": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                                "value": "5",
+                                "annotation": []
+                              }
+                            },
+                            {
+                              "name": "name",
+                              "value": {
+                                "type": "Literal",
+                                "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                                "valueType": "{urn:hl7-org:elm-types:r1}String",
+                                "value": "Chris",
+                                "annotation": []
+                              }
+                            }
+                          ]
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Chris",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "DateTime",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "DateTimeNull",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeUpperBoundExcept",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeLowerBoundExcept",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeProper",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeIncomplete",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeUncertain",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "IntervalTypeSpecifier",
+                        "annotation": [],
+                        "pointType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeMin",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeMax",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeTimeUnspecified",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "DateTimeNull",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeUpperBoundExcept",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeLowerBoundExcept",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeProper",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeIncomplete",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeUncertain",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeMin",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeMax",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "DateTimeTimeUnspecified",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
+            "element": [
+              {
+                "name": "DateTimeNull",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: null vs DateTime with null components",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeUpperBoundExcept",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10000",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "31",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "23",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeLowerBoundExcept",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "invalid",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0000",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "invalid",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "value": "true",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeProper",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "25",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "910",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2016",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "7",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "6",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "25",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "33",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "910",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeIncomplete",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2015",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "DateTime",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                        "annotation": [],
+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2015",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "2",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "10",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeUncertain",
+                "value": {
+                  "type": "Tuple",
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+                        "name": "expression",
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+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
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+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "IntervalTypeSpecifier",
+                          "annotation": [],
+                          "pointType": {
+                            "type": "NamedTypeSpecifier",
+                            "name": "{urn:hl7-org:elm-types:r1}Integer",
+                            "annotation": []
+                          }
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
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+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Day",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2015",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2015",
+                              "annotation": []
+                            },
+                            "month": {
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+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "3",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
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+                        "highClosed": true,
+                        "annotation": [],
+                        "resultTypeSpecifier": {
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+                          "annotation": [],
+                          "pointType": {
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+                            "annotation": []
+                          }
+                        },
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "18",
+                          "annotation": []
+                        },
+                        "high": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "49",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "DateTimeMin",
+                "value": {
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+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        }
+                      }
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+                        "signature": [],
+                        "year": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0001",
+                          "annotation": []
+                        },
+                        "month": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "day": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
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+                        },
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
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+                        }
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+                      "name": "output",
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+                        "signature": [],
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "month": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "day": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "1",
+                          "annotation": []
+                        },
+                        "hour": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "minute": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "second": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        },
+                        "millisecond": {
+                          "type": "Literal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "0",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
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+                "value": {
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+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        }
+                      },
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+                        "name": "output",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}DateTime",
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+                        }
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+                        "signature": [],
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "9999",
+                          "annotation": []
+                        },
+                        "month": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "12",
+                          "annotation": []
+                        },
+                        "day": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "31",
+                          "annotation": []
+                        },
+                        "hour": {
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+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "23",
+                          "annotation": []
+                        },
+                        "minute": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
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+                          "value": "999",
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+                        }
+                      }
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+                      "name": "output",
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+                        "signature": [],
+                        "year": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "9999",
+                          "annotation": []
+                        },
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+                          "value": "12",
+                          "annotation": []
+                        },
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+                          "annotation": []
+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "23",
+                          "annotation": []
+                        },
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "second": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "59",
+                          "annotation": []
+                        },
+                        "millisecond": {
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+                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                          "value": "999",
+                          "annotation": []
+                        }
+                      }
+                    }
+                  ]
+                }
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+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
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+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Boolean",
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+                        }
+                      }
+                    ]
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+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Boolean",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "DateTimeComponentFrom",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                          "precision": "Hour",
+                          "annotation": [],
+                          "signature": [],
+                          "operand": {
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+                            "annotation": [],
+                            "signature": [],
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+                              "value": "2015",
+                              "annotation": []
+                            },
+                            "month": {
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+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "10",
+                              "annotation": []
+                            }
+                          }
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+                      }
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+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
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+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
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+                        "unit": "[lb_av]",
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+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 2.5589,
+                        "unit": "{eskimo_kisses}",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 2.5589,
+                        "unit": "{eskimo_kisses}",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "QuantityFractionalTooBig",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 5.999999999,
+                        "unit": "g",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 5.999999999,
+                        "unit": "g",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        },
+        {
+          "name": "String",
+          "context": "Patient",
+          "accessLevel": "Public",
+          "annotation": [],
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
+            "annotation": [],
+            "element": [
+              {
+                "name": "StringTestEscapeQuotes",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Interval",
-                        "lowClosed": true,
-                        "highClosed": true,
-                        "annotation": [],
-                        "low": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "18",
-                          "annotation": []
-                        },
-                        "high": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "49",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeMin",
-                "value": {
-                  "type": "Tuple",
+                "name": "StringUnicodeTest",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0001",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        }
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "DateTime",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              }
+            ]
+          },
+          "expression": {
+            "type": "Tuple",
+            "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "StringTestEscapeQuotes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "StringUnicodeTest",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "0",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
-                    }
-                  ]
+                    ]
+                  }
                 }
-              },
+              ]
+            },
+            "element": [
               {
-                "name": "DateTimeMax",
+                "name": "StringTestEscapeQuotes",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "DateTime",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
                         "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9999",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "12",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "31",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "23",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "'I start with a single quote and end with a double quote\"",
+                        "annotation": []
+                      }
                     },
                     {
                       "name": "output",
                       "value": {
-                        "type": "DateTime",
-                        "annotation": [],
-                        "signature": [],
-                        "year": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "9999",
-                          "annotation": []
-                        },
-                        "month": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "12",
-                          "annotation": []
-                        },
-                        "day": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "31",
-                          "annotation": []
-                        },
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "23",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "999",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "'I start with a single quote and end with a double quote\"",
+                        "annotation": []
                       }
                     }
                   ]
                 }
               },
               {
-                "name": "DateTimeTimeUnspecified",
+                "name": "StringUnicodeTest",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
-                        "type": "IsNull",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "DateTimeComponentFrom",
-                          "precision": "Hour",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": {
-                            "type": "DateTime",
-                            "annotation": [],
-                            "signature": [],
-                            "year": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2015",
-                              "annotation": []
-                            },
-                            "month": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            },
-                            "day": {
-                              "type": "Literal",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            }
-                          }
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Hi",
+                        "annotation": []
                       }
                     },
                     {
                       "name": "output",
                       "value": {
                         "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Boolean",
-                        "value": "true",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Hi",
                         "annotation": []
                       }
                     }
@@ -1152,35 +3405,46 @@
           }
         },
         {
-          "name": "Quantity",
+          "name": "Time",
           "context": "Patient",
           "accessLevel": "Public",
           "annotation": [],
-          "expression": {
-            "type": "Tuple",
+          "resultTypeSpecifier": {
+            "type": "TupleTypeSpecifier",
             "annotation": [],
             "element": [
               {
-                "name": "QuantityTest",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeUpperBoundHours",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 150.2,
-                        "unit": "[lb_av]",
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
-                    },
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeUpperBoundMinutes",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
                     {
-                      "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 150.2,
-                        "unit": "[lb_av]",
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -1188,17 +3452,18 @@
                 }
               },
               {
-                "name": "QuantityTest2",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeUpperBoundSeconds",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "skipped",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Invalid UCUM unit: According to UCUM spec, custom units only support ASCII characters 33-126, which does not include the space character",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -1206,65 +3471,74 @@
                 }
               },
               {
-                "name": "QuantityFractionalTooBig",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeMillisParsing",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "TimeProper",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 5.999999999,
-                        "unit": "g",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Quantity",
-                        "value": 5.999999999,
-                        "unit": "g",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
                   ]
                 }
-              }
-            ]
-          }
-        },
-        {
-          "name": "String",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
-          "expression": {
-            "type": "Tuple",
-            "annotation": [],
-            "element": [
+              },
               {
-                "name": "StringTestEscapeQuotes",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAllMax",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "'I start with a single quote and end with a double quote\"",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "'I start with a single quote and end with a double quote\"",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -1272,26 +3546,27 @@
                 }
               },
               {
-                "name": "StringUnicodeTest",
-                "value": {
-                  "type": "Tuple",
+                "name": "TimeAllMin",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
                   "annotation": [],
                   "element": [
                     {
                       "name": "expression",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Hi",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     },
                     {
                       "name": "output",
-                      "value": {
-                        "type": "Literal",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Hi",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": []
                       }
                     }
@@ -1299,29 +3574,205 @@
                 }
               }
             ]
-          }
-        },
-        {
-          "name": "Time",
-          "context": "Patient",
-          "accessLevel": "Public",
-          "annotation": [],
+          },
           "expression": {
             "type": "Tuple",
             "annotation": [],
+            "resultTypeSpecifier": {
+              "type": "TupleTypeSpecifier",
+              "annotation": [],
+              "element": [
+                {
+                  "name": "TimeUpperBoundHours",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeUpperBoundMinutes",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeUpperBoundSeconds",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeMillisParsing",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeProper",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAllMax",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "TimeAllMin",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                }
+              ]
+            },
             "element": [
               {
                 "name": "TimeUpperBoundHours",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "skipped",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Translation Error: Invalid time input (T24:59:59.999). Use ISO 8601 time representation (hh:mm:ss.fff).",
+                        "value": "Intentional Translator error: Invalid time input (T24:59:59.999). Use ISO 8601 time representation (hh:mm:ss.fff)",
                         "annotation": []
                       }
                     }
@@ -1333,13 +3784,29 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "skipped",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Translation Error: Invalid time input (T23:60:59.999). Use ISO 8601 time representation (hh:mm:ss.fff).",
+                        "value": "Translator error: Invalid time input[...]",
                         "annotation": []
                       }
                     }
@@ -1351,13 +3818,29 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "skipped",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Translation Error: Invalid time input (T23:59:60.999). Use ISO 8601 time representation (hh:mm:ss.fff).",
+                        "value": "Translator error: Invalid time input[...]",
                         "annotation": []
                       }
                     }
@@ -1365,49 +3848,33 @@
                 }
               },
               {
-                "name": "TimeUpperBoundMillis",
+                "name": "TimeMillisParsing",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
-                  "element": [
-                    {
-                      "name": "expression",
-                      "value": {
-                        "type": "Time",
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
                         "annotation": [],
-                        "signature": [],
-                        "hour": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "23",
-                          "annotation": []
-                        },
-                        "minute": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "second": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "59",
-                          "annotation": []
-                        },
-                        "millisecond": {
-                          "type": "Literal",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "10000",
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
-                    },
+                    ]
+                  },
+                  "element": [
                     {
-                      "name": "invalid",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "semantic",
+                        "value": "Wrong answer: @T23:59:59.100 vs @T23:59:59.10000",
                         "annotation": []
                       }
                     }
@@ -1419,11 +3886,36 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -1456,6 +3948,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -1492,11 +3985,36 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -1529,6 +4047,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -1565,11 +4084,36 @@
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Time",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
                   "element": [
                     {
                       "name": "expression",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
@@ -1602,6 +4146,7 @@
                       "name": "output",
                       "value": {
                         "type": "Time",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Time",
                         "annotation": [],
                         "signature": [],
                         "hour": {
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index 642e4f220..51c64424b 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -1,4 +1,9 @@
 # Invalid CQL (does not translate)
+CqlTypesTest.Time.TimeUpperBoundHours       Intentional Translator error: Invalid time input (T24:59:59.999). Use ISO 8601 time representation (hh:mm:ss.fff)
+CqlTypesTest.Time.TimeUpperBoundMinutes     Translator error: Invalid time input[...]
+CqlTypesTest.Time.TimeUpperBoundSeconds     Translator error: Invalid time input[...]
+"CqlDateTimeOperatorsTest.Uncertainty tests.TimeDurationBetweenHourDiffPrecision"       Translator error: Syntax error at Z
+CqlDateTimeOperatorsTest.DateTimeComponentFrom.DateTimeComponentFromTimezoneOffset      Translator error: Timezone keyword is only valid in 1.3 or lower
 
 # Invalid Translation (translates, but translates wrong)
 CqlAggregateTest.AggregateTests.RolledOutIntervals  CQL adds an integer to a date ("S + duration in days of X"). Should be "S + Quantity{ value: duration in days of X, unit: 'days' }". Translator translates it, but probably shouldn't.
@@ -11,14 +16,25 @@ CqlIntervalOperatorsTest.ProperIn.TimeProperInPrecisionFalse    Wrong output: Ac
 CqlIntervalOperatorsTest.ProperIn.TimeProperInFalse             Wrong output: According to spec, a contained point is properly in as long as the interval is not a unit interval
 CqlIntervalOperatorsTest.Expand.ExpandPer0D1                    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
 CqlIntervalOperatorsTest.Expand.ExpandPer0D1IntervalOverload    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
+CqlIntervalOperatorsTest.Except.DecimalIntervalExcept1to3       # Wrong output: Interval Except should be precision-aware (based on interval Start/End).
+CqlIntervalOperatorsTest.Except.QuantityIntervalExcept1to4      # Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale
+
 CqlListOperatorsTest.Equal.EqualNullNull                        Wrong output: According to spec, if either list contains a null, the result is null
 CqlListOperatorsTest.Sort.simpleSortAsc                         Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlListOperatorsTest.Sort.simpleSortDesc                        Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: Interval[null, null] is not a unit interval, nor is it null
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See test Divide1Q1Q which is correct
+"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See https://github.com/cqframework/cql-tests/pull/148
 "CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10By5DQuantity"           Wrong output: The resulting Quantity should have an appropriate unit
 "CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide414By206DQuantity"        Wrong output: The resulting Quantity should have an appropriate unit
 "CqlStringOperatorsTest.toString tests.QuantityToString"        Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1D          Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf101D        Wrong output: As of 2.0 Successor of Decimal should be precision-aware
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCM        Wrong output: As of 2.0 Successor of Decimal should be precision-aware
+CqlArithmeticFunctionsTest.Successor.SuccessorOf1D              Wrong output: As of 2.0 Successor of Decimal should be precision-aware
+CqlArithmeticFunctionsTest.Successor.SuccessorOf101D            Wrong output: As of 2.0 Successor of Decimal should be precision-aware
+CqlComparisonOperatorsTest.Equal.TupleEqDifferentNamesWithOneNullId                 Wrong output: Tuple equality with a known-unequal element should return false
+"CqlComparisonOperatorsTest.Not Equal.TupleNotEqDifferingNamesWithOneNullId"        Wrong output: Tuple inequality with a known-unequal element should return true
+CqlStringOperatorsTest.Substring.SubstringEmptyAnd0                   Wrong output: Substring(x, x.length) should be null'. Note similar test SubstringAB2. See https://github.com/cqframework/cql-tests/issues/149
 
 # Potentially Incorrect Expected Output
 "CqlStringOperatorsTest.toString tests.DateTimeToString2"         Answer does not include timezone offset, but default offset depends on test environment
@@ -27,8 +43,20 @@ CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: In
 
 # Incorrect answer
 CqlComparisonOperatorsTest.Equal.DateTimeEqNull                 Wrong answer (true vs null - due to not evaluating DateTime(null) as null)
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityMonthEqualMo"           Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityMonthNotEqualMo"        Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityMonthEquivalentMo"      Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityMonthsNotEqualMo"       Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityMonthsEquivalentMo"     Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityYearEqualA"             Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityYearNotEqualA"          Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityYearEquivalentA"        Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityYearsNotEqualA"         Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestQuantityYearsEquivalentA"       Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestYearEquivalentDays"             Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+"CqlComparisonOperatorsTest.Unit Comparison.TestMonthEquivalentDays"            Wrong answer: Quantity =/~ should have special semantics for calendar-based units
+
 CqlIntervalOperatorsTest.Collapse.TestCollapseNull              Wrong answer (Interval(null, null) vs null)
-CqlIntervalOperatorsTest.Except.NullInterval                    Wrong answer (Interval(null, null) vs null)
 CqlIntervalOperatorsTest.Expand.ExpandListWithNull                        Wrong answer (should be empty list due to removing nulls)
 CqlIntervalOperatorsTest.Intersect.TestIntersectNull            Wrong answer (Interval[5, 10] vs Interval[5, null))
 CqlTypeOperatorsTest.Convert.StringToDateTime                   Wrong answer (different offsets)
@@ -38,6 +66,13 @@ CqlTypeOperatorsTest.ToDateTime.ToDateTime3                     Wrong answer (di
 ValueLiteralsAndSelectors.Decimal.Decimal10Pow28ToZeroOneStepDecimalMaxValue    Wrong answer (null vs big number); intermediate value exceeds max Decimal
 ValueLiteralsAndSelectors.Decimal.DecimalPos10Pow28ToZeroOneStepDecimalMaxValue Wrong answer (null vs big number); intermediate value exceeds max Decimal
 
+"CqlDateTimeOperatorsTest.Uncertainty tests.DateTimeDurationBetweenUncertainInterval"   Wrong answer: [17, 44] vs [16, 44]
+"CqlDateTimeOperatorsTest.Uncertainty tests.TimeDurationBetweenHourDiffPrecision2"      Wrong answer: 1 vs uncertainty [0, 1]
+CqlDateTimeOperatorsTest.Subtract.DateTimeSubtract1YearInSeconds                        Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05
+CqlTypesTest.DateTime.DateTimeNull                                                      Wrong answer: null vs DateTime with null components
+CqlTypesTest.Time.TimeMillisParsing                                                     Wrong answer: @T23:59:59.100 vs @T23:59:59.10000
+
+
 # Unimplemented
 CqlArithmeticFunctionsTest.HighBoundary                 HighBoundary not implemented
 CqlArithmeticFunctionsTest.LowBoundary                  LowBoundary not implemented
diff --git a/test/spec-tests/spec-test.ts b/test/spec-tests/spec-test.ts
index b68768ded..32f774aef 100644
--- a/test/spec-tests/spec-test.ts
+++ b/test/spec-tests/spec-test.ts
@@ -69,6 +69,13 @@ describe('CQL Spec Tests (from XML)', () => {
                 if (!actual.equals(expected)) {
                   should.fail(actual, expected, 'Intervals are not equal');
                 }
+              } else if (actual && actual.isDateTime && expected && expected.isDateTime) {
+                // DateTime equality includes its Decimal timezoneOffset.
+                // Use equals instead of eql (deep nested object equality)
+                // to apply CQL rules about Decimal equality
+                if (!actual.equals(expected)) {
+                  should.fail(actual, expected, 'DateTimes are not equal');
+                }
               } else if (
                 actual &&
                 actual.isUncertainty &&
diff --git a/test/spec-tests/xml/CqlAggregateFunctionsTest.xml b/test/spec-tests/xml/CqlAggregateFunctionsTest.xml
index 9a7d40b31..b6369f9b3 100644
--- a/test/spec-tests/xml/CqlAggregateFunctionsTest.xml
+++ b/test/spec-tests/xml/CqlAggregateFunctionsTest.xml
@@ -1,232 +1,311 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlAggregateFunctionsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#aggregate-functions" version="1.5">
+	<capability code="aggregate-functions"/>
 	<group name="AllTrue" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="AllTrueAllTrue" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({true,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AllTrueTrueFirst" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({true,false})</expression>
 			<output>false</output>
 		</test>
 		<test name="AllTrueFalseFirst" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({false,true})</expression>
 			<output>false</output>
 		</test>
 		<test name="AllTrueAllTrueFalseTrue" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({true,false,true})</expression>
 			<output>false</output>
 		</test>
 		<test name="AllTrueAllFalseTrueFalse" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({false,true,false})</expression>
 			<output>false</output>
 		</test>
 		<test name="AllTrueNullFirst" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({null,true,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AllTrueEmptyList" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue({})</expression>
 			<output>true</output>
 		</test>
 		<test name="AllTrueIsTrueWhenNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AllTrue(null)</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="AnyTrue" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="AnyTrueAllTrue" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({true,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueAllFalse" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({false,false})</expression>
 			<output>false</output>
 		</test>
 		<test name="AnyTrueAllTrueFalseTrue" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({true,false,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueAllFalseTrueFalse" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({false,true,false})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueTrueFirst" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({true,false})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueFalseFirst" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({false,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueNullFirstThenTrue" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({null,true})</expression>
 			<output>true</output>
 		</test>
 		<test name="AnyTrueNullFirstThenFalse" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({null,false})</expression>
 			<output>false</output>
 		</test>
 		<test name="AnyTrueEmptyList" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue({})</expression>
 			<output>false</output>
 		</test>
 		<test name="AnyTrueIsFalseWhenNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>AnyTrue(null)</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Avg" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="AvgTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Avg({ 1.0, 2.0, 3.0, 6.0 })</expression>
 			<output>3.0</output>
 		</test>
 	</group>
 	<group name="Product" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="ProductLong" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="system.long"/>
 			<expression>Product({5L, 4L, 5L})</expression>
 			<output>100L</output>
 		</test>
 	</group>
 	<group name="Count" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="CountTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Count({ 15, 5, 99, null, 1 })</expression>
 			<output>4</output>
 		</test>
 		<test name="CountTestDateTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Count({ DateTime(2014), DateTime(2001), DateTime(2010) })</expression>
 			<output>3</output>
 		</test>
 		<test name="CountTestTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Count({ @T15:59:59.999, @T05:59:59.999, @T20:59:59.999 })</expression>
 			<output>3</output>
 		</test>
 		<test name="CountTestNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Count({})</expression>
 			<output>0</output>
 		</test>
 	</group>
 	<group name="Max" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="MaxTestInteger" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Max({ 5, 12, 1, 15, 0, 4, 90, 44 })</expression>
 			<output>90</output>
 		</test>
 		<test name="MaxTestLong" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="system.long"/>
 			<expression>Max({ 5L, 12L, 1L, 15L, 0L, 4L, 90L, 44L })</expression>
 			<output>90L</output>
 		</test>
 		<test name="MaxTestString" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Max({ 'hi', 'bye', 'zebra' })</expression>
 			<output>'zebra'</output>
 		</test>
 		<test name="MaxTestDateTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Max({ DateTime(2012, 10, 5), DateTime(2012, 9, 5), DateTime(2012, 10, 6) })</expression>
 			<output>@2012-10-06T</output>
 		</test>
 		<test name="MaxTestTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Max({ @T15:59:59.999, @T05:59:59.999, @T20:59:59.999 })</expression>
 			<output>@T20:59:59.999</output>
 		</test>
 	</group>
 	<group name="Median" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="MedianTestDecimal" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Median({6.0, 5.0, 4.0, 3.0, 2.0, 1.0})</expression>
 			<output>3.5</output>
 		</test>
 	</group>
 	<group name="Min" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="MinTestInteger" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Min({5, 12, 1, 15, 0, 4, 90, 44})</expression>
 			<output>0</output>
 		</test>
 		<test name="MinTestLong" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="system.long"/>
 			<expression>Min({5L, 12L, 1L, 15L, 0L, 4L, 90L, 44L})</expression>
 			<output>0L</output>
 		</test>
 		<test name="MinTestString" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Min({'hi', 'bye', 'zebra'})</expression>
 			<output>'bye'</output>
 		</test>
 		<test name="MinTestDateTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Min({ DateTime(2012, 10, 5), DateTime(2012, 9, 5), DateTime(2012, 10, 6) })</expression>
 			<output>@2012-09-05T</output>
 		</test>
 		<test name="MinTestTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Min({ @T15:59:59.999, @T05:59:59.999, @T20:59:59.999 })</expression>
 			<output>@T05:59:59.999</output>
 		</test>
 	</group>
 	<group name="Mode" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="ModeTestInteger" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Mode({ 2, 1, 8, 2, 9, 1, 9, 9 })</expression>
 			<output>9</output>
 		</test>
 		<test name="ModeTestDateTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Mode({ DateTime(2012, 10, 5), DateTime(2012, 9, 5), DateTime(2012, 10, 6), DateTime(2012, 9, 5) })</expression>
 			<output>@2012-09-05T</output>
 		</test>
 		<test name="ModeTestDateTime2" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Mode({ DateTime(2012, 10, 5), DateTime(2012, 10, 5), DateTime(2012, 10, 6), DateTime(2012, 9, 5) })</expression>
 			<output>@2012-10-05T</output>
 		</test>
 		<test name="ModeTestTime" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="date-and-time-operators"/>
 			<expression>Mode({ @T15:59:59.999, @T05:59:59.999, @T20:59:59.999, @T05:59:59.999 })</expression>
 			<output>@T05:59:59.999</output>
 		</test>
 	</group>
 	<group name="PopulationStdDev" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="PopStdDevTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>PopulationStdDev({ 1.0, 2.0, 3.0, 4.0, 5.0 })</expression>
 			<output>1.41421356</output>
 			<!-- 23730951454746218587388284504413604736328125 -->
 		</test>
 		<test name="PopulationStdDevIsNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>PopulationStdDev({ null as Quantity, null as Quantity, null as Quantity })</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="PopulationVariance" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="PopVarianceTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>PopulationVariance({ 1.0, 2.0, 3.0, 4.0, 5.0 })</expression>
 			<output>2.0</output>
 		</test>
 		<test name="PopVarianceIsNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>PopulationVariance({ null as Quantity, null as Quantity, null as Quantity })</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="StdDev" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="StdDevTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>StdDev({ 1.0, 2.0, 3.0, 4.0, 5.0 })</expression>
 			<output>1.58113883</output>
 			<!-- 00841897613935316257993690669536590576171875 -->
 		</test>
 		<test name="StdDevIsNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>StdDev({ null as Quantity, null as Quantity, null as Quantity })</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Sum" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="SumTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Sum({ 6.0, 2.0, 3.0, 4.0, 5.0 })</expression>
 			<output>20.0</output>
 		</test>
 		<test name="SumTestLong" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="system.long"/>
 			<expression>Sum({ 6L, 2L, 3L, 4L, 5L })</expression>
 			<output>20L</output>
 		</test>
 		<test name="SumTestQuantity" version="1.5">
+			<capability code="aggregate-functions"/>
+			<capability code="unit-conversion-support"/>
 			<expression>Sum({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})</expression>
 			<output>15 'ml'</output>
 		</test>
 		<test name="SumTestNull" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Sum({ null, 1, null })</expression>
 			<output>1</output>
 		</test>
 	</group>
 	<group name="Variance" version="1.5">
+		<capability code="aggregate-functions"/>
 		<test name="VarianceTest1" version="1.5">
+			<capability code="aggregate-functions"/>
 			<expression>Variance({ 1.0, 2.0, 3.0, 4.0, 5.0 })</expression>
 			<output>2.5</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlAggregateTest.xml b/test/spec-tests/xml/CqlAggregateTest.xml
index 98d8d232a..749bbb811 100644
--- a/test/spec-tests/xml/CqlAggregateTest.xml
+++ b/test/spec-tests/xml/CqlAggregateTest.xml
@@ -1,12 +1,18 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlAggregateTest" reference="http://build.fhir.org/ig/HL7/cql/03-developersguide.html#aggregate-queries" version="1.5">
+	<capability code="aggregate-clause-query"/>
 	<group name="AggregateTests" version="1.5">
+		<capability code="aggregate-clause-query"/>
 		<test name="FactorialOfFive" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>({ 1, 2, 3, 4, 5 }) Num aggregate Result starting 1: Result * Num</expression>
 			<output>120</output>
 		</test>
 		<test name="RolledOutIntervals" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				({
 				  Interval[@2012-01-01, @2012-02-28],
@@ -16,7 +22,7 @@
 				  aggregate R starting (null as List&lt;Interval&lt;DateTime>>): R union ({
 				    M X
 				      let S: Max({ end of Last(R) + 1 day, start of X }),
-				        E: S + duration in days of X
+				        E: S + Quantity{ value: duration in days of X, unit: 'days' }
 				      return Interval[S, E]
 				  })
 			</expression>
@@ -27,9 +33,10 @@
 				  Interval[@2012-04-29, @2012-06-28]
 				}
 			</output>
-			<!-- Execution Error: Invalid precision: 1. -->
 		</test>
 		<test name="AggregateSumWithStart" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				({ 1, 2, 3, 4, 5 }) Num
 				  aggregate Result starting 1: Result + Num
@@ -38,6 +45,8 @@
 			<!-- 15 + 1 (the initial value) -->
 		</test>
 		<test name="AggregateSumWithNull" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				({ 1, 2, 3, 4, 5 }) Num
 				  aggregate Result: Coalesce(Result, 0) + Num
@@ -46,6 +55,8 @@
 			<!-- 15 + 0 (the initial value from null) -->
 		</test>
 		<test name="AggregateSumAll" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				({ 1, 1, 2, 2, 2, 3, 4, 4, 5 }) Num
 				  aggregate all Result: Coalesce(Result, 0) + Num
@@ -54,6 +65,8 @@
 			<!-- 24 + 0 -->
 		</test>
 		<test name="AggregateSumDistinct" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				({ 1, 1, 2, 2, 2, 3, 4, 4, 5 }) Num
 				  aggregate distinct Result: Coalesce(Result, 0) + Num
@@ -62,6 +75,8 @@
 			<!-- 15 + 0 (the initial value) -->
 		</test>
 		<test name="Multi" version="1.5">
+			<capability code="single-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				from ({1}) X, ({2}) Y, ({3}) Z
 				  aggregate Agg: Coalesce(Agg, 0) + X + Y + Z
@@ -69,6 +84,8 @@
 			<output>6</output>
 		</test>
 		<test name="MegaMulti" version="1.5">
+			<capability code="multi-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				from ({1, 2}) X, ({1, 2}) Y, ({1, 2}) Z
 				  aggregate Agg starting 0: Agg + X + Y + Z
@@ -77,6 +94,8 @@
 			<!-- (1+1+1)+(1+1+2)+(1+2+1)+(1+2+2)+(2+1+1)+(2+1+2)+(2+2+1)+(2+2+2) -->
 		</test>
 		<test name="MegaMultiDistinct" version="1.5">
+			<capability code="multi-source-query"/>
+			<capability code="aggregate-clause-query"/>
 			<expression>
 				from ({1, 2, 2, 1}) X, ({1, 2, 1, 2}) Y, ({2, 1, 2, 1}) Z
 				  aggregate distinct Agg starting 1: Agg + X + Y + Z
diff --git a/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml b/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
index 3e580c82e..72e3d73c0 100644
--- a/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
+++ b/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
@@ -1,7 +1,10 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlArithmeticFunctionsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#arithmetic-operators-4" version="1.0">
+	<capability code="arithmetic-operators"/>
+	<capability code="decimal-precision-and-scale" value="28,8"/>
 	<group name="Abs" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="AbsNull" version="1.0">
 			<expression>Abs(null as Integer)</expression>
 			<output>null</output>
@@ -23,15 +26,18 @@
 			<output>0.0</output>
 		</test>
 		<test name="Abs1cm" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>Abs(-1.0'cm')</expression>
 			<output>1.0'cm'</output>
 		</test>
-		<test name="AbsLong" version="1.0">
+		<test name="AbsLong" version="1.5">
+			<capability code="system.long"/>
 			<expression>Abs(-1L)</expression>
 			<output>1L</output>
 		</test>
 	</group>
 	<group name="Add" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="AddNull" version="1.0">
 			<expression>1 + null</expression>
 			<output>null</output>
@@ -40,7 +46,8 @@
 			<expression>1 + 1</expression>
 			<output>2</output>
 		</test>
-		<test name="Add1L2L" version="1.0">
+		<test name="Add1L2L" version="1.5">
+			<capability code="system.long"/>
 			<expression>1L + 2L</expression>
 			<output>3L</output>
 		</test>
@@ -49,6 +56,7 @@
 			<output>2.0</output>
 		</test>
 		<test name="Add1Q1Q" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>1'g/cm3' + 1'g/cm3'</expression>
 			<output>2.0'g/cm3'</output>
 		</test>
@@ -56,12 +64,14 @@
 			<expression>1 + 2.0</expression>
 			<output>3.0</output>
 		</test>
-		<test name="Add1L1L" version="1.0">
+		<test name="Add1L1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>1L + 1L</expression>
 			<output>2L</output>
 		</test>
 	</group>
 	<group name="Ceiling" version="1.0">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
 		<test name="CeilingNull" version="1.0">
 			<expression>Ceiling(null as Decimal)</expression>
 			<output>null</output>
@@ -90,8 +100,49 @@
 			<expression>Ceiling(1)</expression>
 			<output>1</output>
 		</test>
+		<test name="CeilingMaxInteger" version="1.0">
+			<expression>Ceiling(2147483647)</expression>
+			<output>2147483647</output>
+		</test>
+		<test name="CeilingMaxIntegerAsDecimal" version="1.0">
+			<expression>Ceiling(2147483647.0)</expression>
+			<output>2147483647</output>
+		</test>
+		<test name="CeilingMaxIntegerAsDecimalWhereDecimalIsNonZero" version="1.0">
+			<expression>Ceiling(2147483647.2)</expression>
+			<output>null</output>
+		</test>
+		<test name="CeilingIntegerGreaterThanMaxInteger" version="1.0">
+			<expression invalid="syntax">Ceiling(2147483648)</expression>
+			<output>null</output>
+		</test>
+		<test name="CeilingDecimalGreaterThanMaxInteger" version="1.0">
+			<expression>Ceiling(2147483648.2)</expression>
+			<output>null</output>
+		</test>
+		<test name="CeilingMinInteger" version="1.0">
+			<expression>Ceiling(-2147483648)</expression>
+			<output>-2147483648</output>
+		</test>
+		<test name="CeilingMinIntegerAsDecimal" version="1.0">
+			<expression>Ceiling(-2147483648.0)</expression>
+			<output>-2147483648</output>
+		</test>
+		<test name="CeilingMinIntegerAsDecimalWhereDecimalIsNonZero" version="1.0">
+			<expression>Ceiling(-2147483648.2)</expression>
+			<output>-2147483648</output>
+		</test>
+		<test name="CeilingIntegerLessThanMinInteger" version="1.0">
+			<expression invalid="syntax">Ceiling(-2147483649)</expression>
+			<output>null</output>
+		</test>
+		<test name="CeilingDecimalLessThanMinInteger" version="1.0">
+			<expression>Ceiling(-2147483649.2)</expression>
+			<output>null</output>
+		</test>
 	</group>
 	<group name="Divide" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="DivideNull" version="1.0">
 			<expression>1 / null</expression>
 			<output>null</output>
@@ -108,7 +159,8 @@
 			<expression>1 / 1</expression>
 			<output>1.0</output>
 		</test>
-		<test name="Divide1L1L" version="1.0">
+		<test name="Divide1L1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>1L / 1L</expression>
 			<output>1.0</output>
 		</test>
@@ -117,10 +169,12 @@
 			<output>1.0</output>
 		</test>
 		<test name="Divide103" version="1.0">
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(10 / 3, 8)</expression>
 			<output>3.33333333</output>
 		</test>
 		<test name="Divide1Q1" version="1.4">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>1'g/cm3' / 1.0</expression>
 			<output>1.0'g/cm3'</output>
 			<!-- See HL7 STU comment #1443. -->
@@ -128,6 +182,7 @@
 			Decimal value to a Quantity, with the default UCUM unit of (`1`). -->
 		</test>
 		<test name="Divide1Q1Q" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>1'g/cm3' / 1'g/cm3'</expression>
 			<output>1.0'1'</output>
 			<!-- See http://unitsofmeasure.org/ucum.html#section-Semantics
@@ -148,11 +203,13 @@
 			<output>2.0</output>
 		</test>
 		<test name="Divide10Q5I" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.0 'g' / 5</expression>
 			<output>2.0'g'</output>
 		</test>
 	</group>
 	<group name="Floor" version="1.0">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
 		<test name="FloorNull" version="1.0">
 			<expression>Floor(null as Decimal)</expression>
 			<output>null</output>
@@ -185,8 +242,49 @@
 			<expression>Floor(2)</expression>
 			<output>2</output>
 		</test>
+		<test name="FloorMaxInteger" version="1.0">
+			<expression>Floor(2147483647)</expression>
+			<output>2147483647</output>
+		</test>
+		<test name="FloorMaxIntegerAsDecimal" version="1.0">
+			<expression>Floor(2147483647.0)</expression>
+			<output>2147483647</output>
+		</test>
+		<test name="FloorMaxIntegerAsDecimalWhereDecimalIsNonZero" version="1.0">
+			<expression>Floor(2147483647.2)</expression>
+			<output>2147483647</output>
+		</test>
+		<test name="FloorIntegerGreaterThanMaxInteger" version="1.0">
+			<expression>Floor(2147483648)</expression>
+			<output>null</output>
+		</test>
+		<test name="FloorDecimalGreaterThanMaxInteger" version="1.0">
+			<expression>Floor(2147483648.2)</expression>
+			<output>null</output>
+		</test>
+		<test name="FloorMinInteger" version="1.0">
+			<expression>Floor(-2147483648)</expression>
+			<output>-2147483648</output>
+		</test>
+		<test name="FloorMinIntegerAsDecimal" version="1.0">
+			<expression>Floor(-2147483648.0)</expression>
+			<output>-2147483648</output>
+		</test>
+		<test name="FloorMinIntegerAsDecimalWhereDecimalIsNonZero" version="1.0">
+			<expression>Floor(-2147483648.2)</expression>
+			<output>null</output>
+		</test>
+		<test name="FloorIntegerLessThanMinInteger" version="1.0">
+			<expression>Floor(-2147483649)</expression>
+			<output>null</output>
+		</test>
+		<test name="FloorDecimalLessThanMinInteger" version="1.0">
+			<expression>Floor(-2147483649.2)</expression>
+			<output>null</output>
+		</test>
 	</group>
 	<group name="Exp" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="ExpNull" version="1.0">
 			<expression>Exp(null as Decimal)</expression>
 			<output>null</output>
@@ -200,14 +298,18 @@
 			<output>1.0</output>
 		</test>
 		<test name="Exp1" version="1.0">
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(Exp(1), 8)</expression>
 			<output>2.71828183</output>
 		</test>
-		<test name="Exp1L" version="1.0">
+		<test name="Exp1L" version="1.5">
+			<capability code="system.long"/>
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(Exp(1L), 8)</expression>
 			<output>2.71828183</output>
 		</test>
 		<test name="ExpNeg1" version="1.0">
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(Exp(-1), 8)</expression>
 			<output>0.36787944</output>
 		</test>
@@ -221,6 +323,8 @@
 		</test>
 	</group>
 	<group name="HighBoundary" version="1.0">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
+		<capability code="date-and-time-operators"/>
 		<test name="HighBoundaryDecimal" version="1.4">
 			<expression>HighBoundary(1.587, 8)</expression>
 			<output>1.58799999</output>
@@ -237,8 +341,17 @@
 			<expression>HighBoundary(@T10:30, 9)</expression>
 			<output>@T10:30:59.999</output>
 		</test>
+		<test name="HighBoundaryNull">
+			<expression>HighBoundary(null as Decimal, 8)</expression>
+			<output>null</output>
+		</test>
+		<test name="HighBoundaryNullPrecision">
+			<expression>HighBoundary(1.58888, null)</expression>
+			<output>1.58888999</output>
+		</test>
 	</group>
 	<group name="Log" version="1.4">
+		<capability code="arithmetic-operators"/>
 		<test name="LogNullNull" version="1.4">
 			<expression>Log(null, null)</expression>
 			<output>null</output>
@@ -263,7 +376,8 @@
 			<expression>Log(1, 100)</expression>
 			<output>0.0</output>
 		</test>
-		<test name="Log1Base100L" version="1.4">
+		<test name="Log1Base100L" version="1.5">
+			<capability code="system.long"/>
 			<expression>Log(1L, 100L)</expression>
 			<output>0.0</output>
 		</test>
@@ -277,6 +391,8 @@
 		</test>
 	</group>
 	<group name="LowBoundary" version="1.4">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
+		<capability code="date-and-time-operators"/>
 		<test name="LowBoundaryDecimal" version="1.4">
 			<expression>LowBoundary(1.587, 8)</expression>
 			<output>1.58700000</output>
@@ -293,8 +409,17 @@
 			<expression>LowBoundary(@T10:30, 9)</expression>
 			<output>@T10:30:00.000</output>
 		</test>
+		<test name="LowBoundaryNull">
+			<expression>LowBoundary(null as Decimal, 8)</expression>
+			<output>null</output>
+		</test>
+		<test name="LowBoundaryNullPrecision">
+			<expression>LowBoundary(1.58888, null)</expression>
+			<output>1.58888000</output>
+		</test>
 	</group>
 	<group name="Ln" version="1.4">
+		<capability code="arithmetic-operators"/>
 		<test name="LnNull" version="1.4">
 			<expression>Ln(null)</expression>
 			<output>null</output>
@@ -311,7 +436,8 @@
 			<expression>Ln(1)</expression>
 			<output>0.0</output>
 		</test>
-		<test name="Ln1L" version="1.4">
+		<test name="Ln1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>Ln(1L)</expression>
 			<output>0.0</output>
 		</test>
@@ -320,21 +446,25 @@
 			<output>null</output>
 		</test>
 		<test name="Ln1000" version="1.4">
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(Ln(1000), 8)</expression>
 			<output>6.90775528</output>
 		</test>
 		<test name="Ln1000D" version="1.4">
+			<capability code="precision-operators-for-decimal-and-date-time-types"/>
 			<expression>Round(Ln(1000.0), 8)</expression>
 			<output>6.90775528</output>
 		</test>
 	</group>
 	<group name="MinValue" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="IntegerMinValue" version="1.0">
 			<expression>minimum Integer</expression>
 			<output>-2147483648</output>
 			<!-- TODO: make Engine parse -2147483648 holistically not as a negated positive -->
 		</test>
 		<test name="LongMinValue" version="1.5">
+			<capability code="system.long"/>
 			<expression>minimum Long</expression>
 			<output>-9223372036854775808L</output>
 		</test>
@@ -344,14 +474,17 @@
 		</test>
 		<!-- OBSOLETE: define QuantityMinValue: minimum Quantity -->
 		<test name="DateTimeMinValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>minimum DateTime</expression>
 			<output>@0001-01-01T00:00:00.000Z</output>
 		</test>
 		<test name="DateMinValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>minimum Date</expression>
 			<output>@0001-01-01</output>
 		</test>
 		<test name="TimeMinValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>minimum Time</expression>
 			<output>@T00:00:00.000</output>
 		</test>
@@ -361,11 +494,13 @@
 		</test>
 	</group>
 	<group name="MaxValue" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="IntegerMaxValue" version="1.0">
 			<expression>maximum Integer</expression>
 			<output>2147483647</output>
 		</test>
 		<test name="LongMaxValue" version="1.5">
+			<capability code="system.long"/>
 			<expression>maximum Long</expression>
 			<output>9223372036854775807L</output>
 		</test>
@@ -375,14 +510,17 @@
 		</test>
 		<!-- OBSOLETE: define QuantityMaxValue: maximum Quantity -->
 		<test name="DateTimeMaxValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>maximum DateTime</expression>
 			<output>@9999-12-31T23:59:59.999Z</output>
 		</test>
 		<test name="DateMaxValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>maximum Date</expression>
 			<output>@9999-12-31</output>
 		</test>
 		<test name="TimeMaxValue" version="1.4">
+			<capability code="date-and-time-operators"/>
 			<expression>maximum Time</expression>
 			<output>@T23:59:59.999</output>
 		</test>
@@ -392,6 +530,7 @@
 		</test>
 	</group>
 	<group name="Modulo" version="1.5">
+		<capability code="arithmetic-operators"/>
 		<test name="ModuloNull" version="1.5">
 			<expression>1 mod null</expression>
 			<output>null</output>
@@ -405,6 +544,7 @@
 			<output>0</output>
 		</test>
 		<test name="Modulo4LBy2L" version="1.5">
+			<capability code="system.long"/>
 			<expression>4L mod 2L</expression>
 			<output>0L</output>
 		</test>
@@ -429,19 +569,26 @@
 			<output>0.5</output>
 		</test>
 		<test name="ModuloQuantity" version="1.5">
+			<capability code="ucum-unit-conversion-support"/>
+			<capability code="modular-arithmetic-for-quantities"/>
 			<expression>3.5 'cm' mod 3 'cm'</expression>
 			<output>0.5 'cm'</output>
 		</test>
 		<test name="Modulo10By3Quantity" version="1.5">
+			<capability code="ucum-unit-conversion-support"/>
+			<capability code="modular-arithmetic-for-quantities"/>
 			<expression>10.0 'g' mod 3.0 'g'</expression>
 			<output>1.0 'g'</output>
 		</test>
 		<test name="Modulo10By0Quantity" version="1.5">
+			<capability code="ucum-unit-conversion-support"/>
+			<capability code="modular-arithmetic-for-quantities"/>
 			<expression>10.0 'g' mod 0.0 'g'</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Multiply" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="MultiplyNull" version="1.0">
 			<expression>1 * null</expression>
 			<output>null</output>
@@ -450,7 +597,8 @@
 			<expression>1 * 1</expression>
 			<output>1</output>
 		</test>
-		<test name="Multiply2LBy3L" version="1.0">
+		<test name="Multiply2LBy3L" version="1.5">
+			<capability code="system.long"/>
 			<expression>2L * 3L</expression>
 			<output>6L</output>
 		</test>
@@ -458,7 +606,8 @@
 			<expression>1.0 * 2.0</expression>
 			<output>2.0</output>
 		</test>
-		<test name="Multiply1By1L" version="1.0">
+		<test name="Multiply1By1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>1 * 1L</expression>
 			<output>1L</output>
 		</test>
@@ -467,12 +616,14 @@
 			<output>2.0</output>
 		</test>
 		<test name="Multiply1CMBy2CM" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>1.0 'cm' * 2.0 'cm'</expression>
 			<output>2.0'cm2'</output>
 			<!-- TODO: make the units multiply -->
 		</test>
 	</group>
 	<group name="Negate" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="NegateNull" version="1.0">
 			<expression>-(null as Integer)</expression>
 			<output>null</output>
@@ -489,11 +640,13 @@
 			<expression>-1</expression>
 			<output>-1</output>
 		</test>
-		<test name="Negate1L" version="1.0">
+		<test name="Negate1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>-1L</expression>
 			<output>-1L</output>
 		</test>
-		<test name="NegateMaxLong" version="1.0">
+		<test name="NegateMaxLong" version="1.5">
+			<capability code="system.long"/>
 			<expression>-9223372036854775807L</expression>
 			<output>-9223372036854775807L</output>
 		</test>
@@ -501,7 +654,8 @@
 			<expression>-(-1)</expression>
 			<output>1</output>
 		</test>
-		<test name="NegateNeg1L" version="1.0">
+		<test name="NegateNeg1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>-(-1L)</expression>
 			<output>1L</output>
 		</test>
@@ -522,11 +676,14 @@
 			<output>1.0</output>
 		</test>
 		<test name="Negate1CM" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>-(1'cm')</expression>
 			<output>-1.0'cm'</output>
 		</test>
 	</group>
 	<group name="Precision" version="1.4">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
+		<capability code="date-and-time-operators"/>
 		<test name="PrecisionDecimal" version="1.4">
 			<expression>Precision(1.58700)</expression>
 			<output>5</output>
@@ -549,6 +706,8 @@
 		</test>
 	</group>
 	<group name="Predecessor" version="1.0">
+		<capability code="arithmetic-operators"/>
+		<capability code="date-and-time-operators"/>
 		<test name="PredecessorNull" version="1.0">
 			<expression>predecessor of (null as Integer)</expression>
 			<output>null</output>
@@ -561,7 +720,8 @@
 			<expression>predecessor of 1</expression>
 			<output>0</output>
 		</test>
-		<test name="PredecessorOf1L" version="1.0">
+		<test name="PredecessorOf1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>predecessor of 1L</expression>
 			<output>0L</output>
 		</test>
@@ -574,6 +734,7 @@
 			<output>1.00999999</output>
 		</test>
 		<test name="PredecessorOf1QCM" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>predecessor of 1.0 'cm'</expression>
 			<output>0.99999999'cm'</output>
 		</test>
@@ -595,6 +756,7 @@
 		</test>
 	</group>
 	<group name="Power" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="PowerNullToNull" version="1.0">
 			<expression>Power(null as Integer, null as Integer)</expression>
 			<output>null</output>
@@ -615,7 +777,8 @@
 			<expression>Power(2, -2)</expression>
 			<output>0.25</output>
 		</test>
-		<test name="Power2LTo2L" version="1.0">
+		<test name="Power2LTo2L" version="1.5">
+			<capability code="system.long"/>
 			<expression>Power(2L, 2L)</expression>
 			<output>4L</output>
 		</test>
@@ -643,7 +806,8 @@
 			<expression>2^4</expression>
 			<output>16</output>
 		</test>
-		<test name="Power2LTo3L" version="1.0">
+		<test name="Power2LTo3L" version="1.5">
+			<capability code="system.long"/>
 			<expression>2L^3L</expression>
 			<output>8L</output>
 		</test>
@@ -657,6 +821,7 @@
 		</test>
 	</group>
 	<group name="Round" version="1.0">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
 		<test name="RoundNull" version="1.0">
 			<expression>Round(null as Decimal)</expression>
 			<output>null</output>
@@ -679,7 +844,7 @@
 		</test>
 		<test name="RoundNeg0D5" version="1.0">
 			<expression>Round(-0.5)</expression>
-			<output>0.0</output>
+			<output>-1.0</output>
 		</test>
 		<test name="RoundNeg0D4" version="1.0">
 			<expression>Round(-0.4)</expression>
@@ -695,7 +860,7 @@
 		</test>
 		<test name="RoundNeg1D5" version="1.0">
 			<expression>Round(-1.5)</expression>
-			<output>-1.0</output>
+			<output>-2.0</output>
 		</test>
 		<test name="RoundNeg1D6" version="1.0">
 			<expression>Round(-1.6)</expression>
@@ -703,6 +868,7 @@
 		</test>
 	</group>
 	<group name="Subtract" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="SubtractNull" version="1.0">
 			<expression>1 - null</expression>
 			<output>null</output>
@@ -711,7 +877,8 @@
 			<expression>1 - 1</expression>
 			<output>0</output>
 		</test>
-		<test name="Subtract1LAnd1L" version="1.0">
+		<test name="Subtract1LAnd1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>1L - 1L</expression>
 			<output>0L</output>
 		</test>
@@ -720,6 +887,7 @@
 			<output>-1.0</output>
 		</test>
 		<test name="Subtract1CMAnd2CM" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>1.0 'cm' - 2.0 'cm'</expression>
 			<output>-1.0'cm'</output>
 		</test>
@@ -729,6 +897,8 @@
 		</test>
 	</group>
 	<group name="Successor" version="1.0">
+		<capability code="arithmetic-operators"/>
+		<capability code="date-and-time-operators"/>
 		<test name="SuccessorNull" version="1.0">
 			<expression>successor of (null as Integer)</expression>
 			<output>null</output>
@@ -741,7 +911,8 @@
 			<expression>successor of 1</expression>
 			<output>2</output>
 		</test>
-		<test name="SuccessorOf1L" version="1.0">
+		<test name="SuccessorOf1L" version="1.5">
+			<capability code="system.long"/>
 			<expression>successor of 1L</expression>
 			<output>2L</output>
 		</test>
@@ -771,6 +942,7 @@
 		</test>
 	</group>
 	<group name="Truncate" version="1.0">
+		<capability code="precision-operators-for-decimal-and-date-time-types"/>
 		<test name="TruncateNull" version="1.0">
 			<expression>Truncate(null as Decimal)</expression>
 			<output>null</output>
@@ -821,6 +993,7 @@
 		</test>
 	</group>
 	<group name="Truncated Divide" version="1.0">
+		<capability code="arithmetic-operators"/>
 		<test name="TruncatedDivideNull" version="1.0">
 			<expression>(null as Integer) div (null as Integer)</expression>
 			<output>null</output>
@@ -837,11 +1010,13 @@
 			<expression>10 div 3</expression>
 			<output>3</output>
 		</test>
-		<test name="TruncatedDivide10LBy3L" version="1.0">
+		<test name="TruncatedDivide10LBy3L" version="1.5">
+			<capability code="system.long"/>
 			<expression>10L div 3L</expression>
 			<output>3L</output>
 		</test>
-		<test name="TruncatedDivide10LBy0L" version="1.0">
+		<test name="TruncatedDivide10LBy0L" version="1.5">
+			<capability code="system.long"/>
 			<expression>10L div 0L</expression>
 			<output>null</output>
 		</test>
@@ -894,18 +1069,22 @@
 			<output>2.0</output>
 		</test>
 		<test name="TruncatedDivide10d1ByNeg3D1Quantity" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.1 'cm' div -3.1 'cm'</expression>
 			<output>-3.0 'cm'</output>
 		</test>
 		<test name="TruncatedDivide10By5DQuantity" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.0 'g' div 5.0 'g'</expression>
 			<output>2.0 'g'</output>
 		</test>
 		<test name="TruncatedDivide414By206DQuantity" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>4.14 'm' div 2.06 'm'</expression>
 			<output>2.0 'm'</output>
 		</test>
 		<test name="TruncatedDivide10By0DQuantity" version="1.0">
+			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.0 'g' div 0.0 'g'</expression>
 			<output>null</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlComparisonOperatorsTest.xml b/test/spec-tests/xml/CqlComparisonOperatorsTest.xml
index 67eb1cee3..33aa9d7c4 100644
--- a/test/spec-tests/xml/CqlComparisonOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlComparisonOperatorsTest.xml
@@ -1,13 +1,16 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlComparisonOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#comparison-operators-4" version="1.0">
+	<capability code="comparison-operators"/>
 	<group name="Between" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="BetweenIntTrue" version="1.0">
 			<expression>4 between 2 and 6</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="Equal" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="SimpleEqTrueTrue" version="1.0">
 			<expression>true = true</expression>
 			<output>true</output>
@@ -44,6 +47,11 @@
 			<expression>1 = 2</expression>
 			<output>false</output>
 		</test>
+		<test name="SimpleEqLong1Long2" version="1.5">
+			<capability code="system.long"/>
+			<expression>1L = 2L</expression>
+			<output>false</output>
+		</test>
 		<test name="SimpleEqStringAStringA" version="1.0">
 			<expression>'a' = 'a'</expression>
 			<output>true</output>
@@ -60,6 +68,14 @@
 			<expression>1.0 = 2.0</expression>
 			<output>false</output>
 		</test>
+		<test name="SimpleEqFloat1Float1WithZ" version="1.0">
+			<expression>1.0 = 1.00</expression>
+			<output>true</output>
+		</test>
+		<test name="SimpleEqFloat1Float1WithPrecisionAndZ" version="1.0">
+			<expression>1.50 = 1.55</expression>
+			<output>false</output>
+		</test>
 		<test name="SimpleEqFloat1Int1" version="1.0">
 			<expression>1.0 = 1</expression>
 			<output>true</output>
@@ -73,6 +89,7 @@
 			<output>true</output>
 		</test>
 		<test name="QuantityEqCM1M01" version="1.4">
+			<capability code="unit-conversion-support"/>
 			<expression>1'cm' = 0.01'm'</expression>
 			<output>true</output>
 		</test>
@@ -80,51 +97,80 @@
 			<expression>2.0'cm' = 2.00'cm'</expression>
 			<output>true</output>
 		</test>
+		<test name="RatioEqual" version="1.0">
+			<expression>1'cm':2'cm' = 1'cm':2'cm'</expression>
+			<output>true</output>
+		</test>
+		<test name="RatioNotEqualDiffNumerator" version="1.0">
+			<expression>1'cm':2'cm' = 1.1'cm':2'cm'</expression>
+			<output>false</output>
+		</test>
+		<test name="RatioNotEqualDiffDenominator" version="1.0">
+			<expression>1'cm':2'cm' = 1'cm':2.1'cm'</expression>
+			<output>false</output>
+		</test>
 		<test name="TupleEqJohnJohn" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } = Tuple { Id : 1, Name : 'John' }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleEqJohnJane" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } = Tuple { Id : 2, Name : 'Jane' }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleEqJohn1John2" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } = Tuple { Id : 2, Name : 'John' }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleEqJohn1John2WithNullName" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } = Tuple { Id : 2, Name : null }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleEqDifferentNamesWithOneNullId" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : null, Name : 'John' } = Tuple { Id : 1, Name : 'James' }</expression>
-			<output>false</output>
+			<output>null</output>
 		</test>
 		<test name="TupleEqJohn1John1WithBothNamesNull" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : null } = Tuple { Id : 1, Name : null }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleEqJohnJohnWithBothIdsNull" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : null, Name : 'John' } = Tuple { Id : null, Name : 'John' }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleEqJohn1John1WithNullName" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } = Tuple { Id : 1, Name : null }</expression>
 			<output>null</output>
 		</test>
 		<test name="TupleEqDateTimeTrue" version="1.0">
+			<capability code="tuple"/>
 			<expression>Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 0, 0, 0, 0) } = Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 0, 0, 0, 0) }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleEqDateTimeFalse" version="1.0">
+			<capability code="tuple"/>
 			<expression>Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 0, 0, 0, 0) } = Tuple { dateId: 1, Date: DateTime(2012, 10, 5, 5, 0, 0, 0) }</expression>
 			<output>false</output>
 		</test>
+		<test name="TupleEqDateTimeTrue2" version="1.0">
+			<capability code="tuple"/>
+			<expression>Tuple { dateId: 12, Date: DateTime(2012, 1, 1) } = Tuple { dateId: 12, Date: DateTime(2012, 1, 1) }</expression>
+			<output>true</output>
+		</test>
 		<test name="TupleEqTimeTrue" version="1.0">
+			<capability code="tuple"/>
 			<expression>Tuple { timeId: 55, TheTime: @T05:15:15.541 } = Tuple { timeId: 55, TheTime: @T05:15:15.541 }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleEqTimeFalse" version="1.0">
+			<capability code="tuple"/>
 			<expression>Tuple { timeId: 55, TheTime: @T05:15:15.541 } = Tuple { timeId: 55, TheTime: @T05:15:15.540 }</expression>
 			<output>false</output>
 		</test>
@@ -144,10 +190,18 @@
 			<expression>DateTime(2014, 1, 5, 5, 0, 0, 0, 0) = DateTime(2014, 7, 5, 5, 0, 0, 0, 0)</expression>
 			<output>false</output>
 		</test>
+		<test name="DateTimeEqMissingArg" version="1.0">
+			<expression>DateTime(2015, 1, 5, 5, 0, 0) = DateTime(2015, 1, 5, 5, 0, 0)</expression>
+			<output>true</output>
+		</test>
 		<test name="DateTimeEqNull" version="1.0">
 			<expression>DateTime(null) = DateTime(null)</expression>
 			<output>null</output>
 		</test>
+		<test name="DateTimeEqTrue" version="1.0">
+			<expression>DateTime(2001, 1, 1, null) = DateTime(2001, 1, 1, null, null)</expression>
+			<output>true</output>
+		</test>
 		<test name="DateTimeUTC" version="1.0">
 			<expression>@2014-01-25T14:30:14.559+01:00 = @2014-01-25T14:30:14.559+01:00</expression>
 			<output>true</output>
@@ -166,6 +220,7 @@
 		</test>
 	</group>
 	<group name="Greater" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="GreaterZZ" version="1.0">
 			<expression>0 &gt; 0</expression>
 			<output>false</output>
@@ -174,6 +229,11 @@
 			<expression>0 &gt; 1</expression>
 			<output>false</output>
 		</test>
+		<test name="GreaterLong" version="1.5">
+			<capability code="system.long"/>
+			<expression>0L &gt; 10L</expression>
+			<output>false</output>
+		</test>
 		<test name="GreaterZNeg1" version="1.0">
 			<expression>0 &gt; -1</expression>
 			<output>true</output>
@@ -207,10 +267,12 @@
 			<output>true</output>
 		</test>
 		<test name="GreaterM1CM1" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &gt; 1'cm'</expression>
 			<output>true</output>
 		</test>
 		<test name="GreaterM1CM10" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &gt; 10'cm'</expression>
 			<output>true</output>
 		</test>
@@ -268,6 +330,7 @@
 		</test>
 	</group>
 	<group name="Greater Or Equal" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="GreaterOrEqualZZ" version="1.0">
 			<expression>0 &gt;= 0</expression>
 			<output>true</output>
@@ -276,6 +339,11 @@
 			<expression>0 &gt;= 1</expression>
 			<output>false</output>
 		</test>
+		<test name="GreaterOrEqualZ1Long" version="1.5">
+			<capability code="system.long"/>
+			<expression>0L &gt;= 10L</expression>
+			<output>false</output>
+		</test>
 		<test name="GreaterOrEqualZNeg1" version="1.0">
 			<expression>0 &gt;= -1</expression>
 			<output>true</output>
@@ -309,10 +377,12 @@
 			<output>true</output>
 		</test>
 		<test name="GreaterOrEqualM1CM1" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &gt;= 1'cm'</expression>
 			<output>true</output>
 		</test>
 		<test name="GreaterOrEqualM1CM10" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &gt;= 10'cm'</expression>
 			<output>true</output>
 		</test>
@@ -378,6 +448,7 @@
 		</test>
 	</group>
 	<group name="Less" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="LessZZ" version="1.0">
 			<expression>0 &lt; 0</expression>
 			<output>false</output>
@@ -386,6 +457,16 @@
 			<expression>0 &lt; 1</expression>
 			<output>true</output>
 		</test>
+		<test name="LessLong" version="1.5">
+			<capability code="system.long"/>
+			<expression>0L &lt; 10L</expression>
+			<output>true</output>
+		</test>
+		<test name="LessLongNeg" version="1.5">
+			<capability code="system.long"/>
+			<expression>-30L &lt; -20L</expression>
+			<output>true</output>
+		</test>
 		<test name="LessZNeg1" version="1.0">
 			<expression>0 &lt; -1</expression>
 			<output>false</output>
@@ -419,10 +500,12 @@
 			<output>false</output>
 		</test>
 		<test name="LessM1CM1" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &lt; 1'cm'</expression>
 			<output>false</output>
 		</test>
 		<test name="LessM1CM10" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &lt; 10'cm'</expression>
 			<output>false</output>
 		</test>
@@ -480,6 +563,7 @@
 		</test>
 	</group>
 	<group name="Less Or Equal" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="LessOrEqualZZ" version="1.0">
 			<expression>0 &lt;= 0</expression>
 			<output>true</output>
@@ -488,6 +572,11 @@
 			<expression>0 &lt;= 1</expression>
 			<output>true</output>
 		</test>
+		<test name="LessOrEqualZ1Long" version="1.5">
+			<capability code="system.long"/>
+			<expression>0L &lt;= 10L</expression>
+			<output>true</output>
+		</test>
 		<test name="LessOrEqualZNeg1" version="1.0">
 			<expression>0 &lt;= -1</expression>
 			<output>false</output>
@@ -521,10 +610,12 @@
 			<output>false</output>
 		</test>
 		<test name="LessOrEqualM1CM1" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &lt;= 1'cm'</expression>
 			<output>false</output>
 		</test>
 		<test name="LessOrEqualM1CM10" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'm' &lt;= 10'cm'</expression>
 			<output>false</output>
 		</test>
@@ -590,6 +681,7 @@
 		</test>
 	</group>
 	<group name="Equivalent" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="EquivTrueTrue" version="1.0">
 			<expression>true ~ true</expression>
 			<output>true</output>
@@ -634,6 +726,10 @@
 			<expression>'a' ~ 'b'</expression>
 			<output>false</output>
 		</test>
+		<test name="EquivStringIgnoreCase" version="1.0">
+			<expression>'Abel' ~ 'abel'</expression>
+			<output>true</output>
+		</test>
 		<test name="EquivFloat1Float1" version="1.0">
 			<expression>1.0 ~ 1.0</expression>
 			<output>true</output>
@@ -642,6 +738,22 @@
 			<expression>1.0 ~ 2.0</expression>
 			<output>false</output>
 		</test>
+		<test name="EquivFloat1Float1WithZ" version="1.0">
+			<expression>1.0 ~ 1.00</expression>
+			<output>true</output>
+		</test>
+		<test name="EquivFloat1Float1WithPrecision" version="1.0">
+			<expression>1.5 ~ 1.55</expression>
+			<output>false</output>
+		</test>
+		<test name="EquivFloat1Float1WithPrecisionAndZ" version="1.0">
+			<expression>1.50 ~ 1.55</expression>
+			<output>false</output>
+		</test>
+		<test name="EquivFloatTrailingZero" version="1.0">
+			<expression>1.001 ~ 1.000</expression>
+			<output>true</output>
+		</test>
 		<test name="EquivFloat1Int1" version="1.0">
 			<expression>1.0 ~ 1</expression>
 			<output>true</output>
@@ -655,22 +767,49 @@
 			<output>true</output>
 		</test>
 		<test name="EquivEqCM1M01" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'cm' ~ 0.01'm'</expression>
 			<output>true</output>
 		</test>
+		<test name="RatioEquivalent" version="1.0">
+			<expression>1'cm':2'cm' ~ 1'cm':2'cm'</expression>
+			<output>true</output>
+		</test>
+		<test name="RatioNotEquivalentDiffNumerator" version="1.0">
+			<expression>1'cm':2'cm' ~ 3'cm':2'cm'</expression>
+			<output>false</output>
+		</test>
+		<test name="RatioNotEquivalentDiffDenominator" version="1.0">
+			<expression>1'cm':2'cm' ~ 1'cm':3'cm'</expression>
+			<output>false</output>
+		</test>
 		<test name="EquivTupleJohnJohn" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 1, Name : 'John' }</expression>
 			<output>true</output>
 		</test>
 		<test name="EquivTupleJohnJohnWithNulls" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John', Position: null } ~ Tuple { Id : 1, Name : 'John', Position: null }</expression>
 			<output>true</output>
 		</test>
+		<test name="EquivTupleJohnJohnFalse" version="1.5">
+			<capability code="tuple"/>
+			<expression invalid="true">Tuple { Id : 1, Name : 'John', Position: 'Shift Manager' } ~ Tuple { Id : 1, Name : 'John' }</expression>
+			<!-- EXPECT: Could not resolve call to operator Equivalent with signature (tuple{Id:System.Integer,Name:System.String,Position:System.String},tuple{Id:System.Integer,Name:System.String}). -->
+		</test>
+		<test name="EquivTupleJohnJohnFalse2" version="1.5">
+			<capability code="tuple"/>
+			<expression invalid="true">Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 1, Name : 'John', Position: 'Shift Manager' }</expression>
+			<!-- EXPECT: Could not resolve call to operator Equivalent with signature (tuple{Id:System.Integer,Name:System.String},tuple{Id:System.Integer,Name:System.String,Position:System.String}). -->
+		</test>
 		<test name="EquivTupleJohnJane" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 2, Name : 'Jane' }</expression>
 			<output>false</output>
 		</test>
 		<test name="EquivTupleJohn1John2" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple { Id : 1, Name : 'John' } ~ Tuple { Id : 2, Name : 'John' }</expression>
 			<output>false</output>
 		</test>
@@ -692,6 +831,7 @@
 		</test>
 	</group>
 	<group name="Not Equal" version="1.0">
+		<capability code="comparison-operators"/>
 		<test name="SimpleNotEqTrueTrue" version="1.0">
 			<expression>true != true</expression>
 			<output>false</output>
@@ -728,6 +868,11 @@
 			<expression>1 != 2</expression>
 			<output>true</output>
 		</test>
+		<test name="SimpleNotEqLong1Long2" version="1.5">
+			<capability code="system.long"/>
+			<expression>1L != 2L</expression>
+			<output>true</output>
+		</test>
 		<test name="SimpleNotEqStringAStringA" version="1.0">
 			<expression>'a' != 'a'</expression>
 			<output>false</output>
@@ -757,38 +902,47 @@
 			<output>false</output>
 		</test>
 		<test name="QuantityNotEqCM1M01" version="1.0">
+			<capability code="unit-conversion-support"/>
 			<expression>1'cm' != 0.01'm'</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleNotEqJohnJohn" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : 'John' } != Tuple{ Id : 1, Name : 'John' }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleNotEqJohnJane" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : 'John' } != Tuple{ Id : 2, Name : 'Jane' }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleNotEqJohn1John2" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : 'John' } != Tuple{ Id : 2, Name : 'John' }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleNotEqJohn1John2WithNullName" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : 'John' } != Tuple{ Id : 2, Name : null }</expression>
 			<output>true</output>
 		</test>
 		<test name="TupleNotEqDifferingNamesWithOneNullId" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : null, Name : 'John' } != Tuple{ Id : 1, Name : 'Joe' }</expression>
-			<output>true</output>
+			<output>null</output>
 		</test>
 		<test name="TupleNotEqJohn1John1WithBothNamesNull" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : null } != Tuple{ Id : 1, Name : null }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleNotEqMatchingNamesWithNullIDs" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : null, Name : 'John' } != Tuple{ Id : null, Name : 'John' }</expression>
 			<output>false</output>
 		</test>
 		<test name="TupleNotEqJohn1John1WithNullName" version="1.5">
+			<capability code="tuple"/>
 			<expression>Tuple{ Id : 1, Name : 'John' } != Tuple{ Id : 1, Name : null }</expression>
 			<output>null</output>
 		</test>
@@ -809,4 +963,164 @@
 			<output>true</output>
 		</test>
 	</group>
+	<group name="Unit Comparison" version="1.0">
+		<test name="TestQuantityMillisecondEqualMs" version="1.0">
+			<expression>1 millisecond = 1 'ms'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMillisecondEqualMilliseconds" version="1.0">
+			<expression>1 millisecond = 1 milliseconds</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMillisecondsEqualMs" version="1.0">
+			<expression>1 milliseconds = 1 'ms'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantitySecondEqualS" version="1.0">
+			<expression>1 second = 1 's'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantitySecondEqualSeconds" version="1.0">
+			<expression>1 second = 1 seconds</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantitySecondsEqualS" version="1.0">
+			<expression>1 seconds = 1 's'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMinuteEqualMin" version="1.0">
+			<expression>1 minute = 1 'min'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMinuteEqualMinutes" version="1.0">
+			<expression>1 minute = 1 minutes</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMinutesEqualMin" version="1.0">
+			<expression>1 minutes = 1 'min'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityHourEqualH" version="1.0">
+			<expression>1 hour = 1 'h'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityHourEqualHours" version="1.0">
+			<expression>1 hour = 1 hours</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityHoursEqualH" version="1.0">
+			<expression>1 hours = 1 'h'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityDayEqualD" version="1.0">
+			<expression>1 day = 1 'd'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityDayEqualDays" version="1.0">
+			<expression>1 day = 1 days</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityDaysEqualD" version="1.0">
+			<expression>1 days = 1 'd'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityWeekEqualWk" version="1.0">
+			<expression>1 week = 1 'wk'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityWeekEqualWeeks" version="1.0">
+			<expression>1 week = 1 weeks</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityWeeksEqualWk" version="1.0">
+			<expression>1 weeks = 1 'wk'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMonthEqualMo" version="1.0">
+			<expression>1 month = 1 'mo'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityMonthNotEqualMo" version="1.0">
+			<expression>1 month != 1 'mo'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityMonthEquivalentMo" version="1.0">
+			<expression>1 month ~ 1 'mo'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMonthEqualMonths" version="1.0">
+			<expression>1 month = 1 months</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityMonthsNotEqualMo" version="1.0">
+			<expression>1 months != 1 'mo'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityMonthsEquivalentMo" version="1.0">
+			<expression>1 months ~ 1 'mo'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityYearEqualA" version="1.0">
+			<expression>1 year = 1 'a'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityYearNotEqualA" version="1.0">
+			<expression>1 year != 1 'a'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityYearEquivalentA" version="1.0">
+			<expression>1 year ~ 1 'a'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityYearsEqualYear" version="1.0">
+			<expression>1 years = 1 year</expression>
+			<output>true</output>
+		</test>
+		<test name="TestQuantityYearsNotEqualA" version="1.0">
+			<expression>1 years != 1 'a'</expression>
+			<output>null</output>
+			<!-- null (on the grounds that definite time and calendar units are not comparable) -->
+		</test>
+		<test name="TestQuantityYearsEquivalentA" version="1.0">
+			<expression>1 years ~ 1 'a'</expression>
+			<output>true</output>
+		</test>
+		<test name="TestYearEquivalentMonths" version="1.0">
+			<expression>1 year ~ 12 months</expression>
+			<output>true</output>
+		</test>
+		<test name="TestYearEquivalentDays" version="1.0">
+			<expression>1 year ~ 365 days</expression>
+			<output>true</output>
+		</test>
+		<test name="TestMonthEquivalentDays" version="1.0">
+			<expression>1 month ~ 30 days</expression>
+			<output>true</output>
+		</test>
+		<test name="TestWeekEqualDays" version="1.0">
+			<expression>1 week = 7 days</expression>
+			<output>true</output>
+		</test>
+		<test name="TestDayEqualHours" version="1.0">
+			<expression>1 day = 24 hours</expression>
+			<output>true</output>
+		</test>
+		<test name="TestHourEqualMinutes" version="1.0">
+			<expression>1 hour = 60 minutes</expression>
+			<output>true</output>
+		</test>
+		<test name="TestMinuteEqualSeconds" version="1.0">
+			<expression>1 minute = 60 seconds</expression>
+			<output>true</output>
+		</test>
+		<test name="TestSecondEqualMilliseconds" version="1.0">
+			<expression>1 second = 1000 milliseconds</expression>
+			<output>true</output>
+		</test>
+	</group>
 </tests>
diff --git a/test/spec-tests/xml/CqlConditionalOperatorsTest.xml b/test/spec-tests/xml/CqlConditionalOperatorsTest.xml
index ab3203be0..95416287b 100644
--- a/test/spec-tests/xml/CqlConditionalOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlConditionalOperatorsTest.xml
@@ -1,22 +1,43 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlConditionalOperatorsTest" reference="https://cql.hl7.org/03-developersguide.html#conditional-expressions" version="1.0">
+	<capability code="logical-operators"/>
+	<capability code="comparison-operators"/>
+	<capability code="arithmetic-operators"/>
 	<group name="if-then-else" version="1.0">
+		<capability code="logical-operators"/>
+		<capability code="comparison-operators"/>
+		<capability code="arithmetic-operators"/>
 		<test name="IfTrue1" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>if 10 &gt; 5 then 5 else 10</expression>
 			<output>5</output>
 		</test>
 		<test name="IfFalse1" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>if 10 = 5 then 10 + 5 else 10 - 5</expression>
 			<output>5</output>
 		</test>
 		<test name="IfNull1" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>if 10 = null then 5 else 10</expression>
 			<output>10</output>
 		</test>
 	</group>
 	<group name="standard case" version="1.0">
+		<capability code="logical-operators"/>
+		<capability code="comparison-operators"/>
+		<capability code="arithmetic-operators"/>
 		<test name="StandardCase1" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case
 					when 10 &gt; 5 then 5
@@ -27,6 +48,9 @@
 			<output>5</output>
 		</test>
 		<test name="StandardCase2" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case
 					when 5 &gt; 10 then 5 + 10
@@ -37,6 +61,9 @@
 			<output>5</output>
 		</test>
 		<test name="StandardCase3" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case
 					when null ~ 10 then null + 10
@@ -48,7 +75,13 @@
 		</test>
 	</group>
 	<group name="selected case" version="1.0">
+		<capability code="logical-operators"/>
+		<capability code="comparison-operators"/>
+		<capability code="arithmetic-operators"/>
 		<test name="SelectedCase1" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case 5
 					when 5 then 12
@@ -59,6 +92,9 @@
 			<output>12</output>
 		</test>
 		<test name="SelectedCase2" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case 10
 					when 5 then 12
@@ -69,6 +105,9 @@
 			<output>15</output>
 		</test>
 		<test name="SelectedCase3" version="1.0">
+			<capability code="logical-operators"/>
+			<capability code="comparison-operators"/>
+			<capability code="arithmetic-operators"/>
 			<expression>
 				case 10 + 5
 					when 5 then 12
diff --git a/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml b/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
index e2008411f..193a3903e 100644
--- a/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
@@ -1,24 +1,47 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlDateTimeOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#datetime-operators-2" version="1.4">
+	<capability code="date-time-arithmetic"/>
+	<capability code="precision-based-timing"/>
+	<capability code="timing-phrases.same-as"/>
+	<capability code="timing-phrases.before-after"/>
+	<capability code="timing-phrases.within"/>
+	<capability code="interval-comparisons"/>
+	<capability code="duration-between"/>
+	<capability code="difference-in"/>
+	<capability code="component-extraction"/>
+	<capability code="uncertainty-intervals"/>
+	<capability code="timezone-offset"/>
+	<capability code="constructor.datetime"/>
+	<capability code="constructor.date"/>
+	<capability code="constructor.time"/>
+	<capability code="function.Now"/>
+	<capability code="function.Today"/>
+	<capability code="function.TimeOfDay"/>
 	<group name="Add" version="1.4">
+		<capability code="date-time-arithmetic"/>
 		<test name="DateTimeAdd5Years" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 10, 10) + 5 years</expression>
 			<output>@2010-10-10T</output>
 		</test>
 		<test name="DateTimeAddInvalidYears" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression invalid="true">DateTime(2005, 10, 10) + 8000 years</expression>
 			<!-- EXPECT: The date time addition results in a year greater than the accepted range. -->
 		</test>
 		<test name="DateTimeAdd5Months" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) + 5 months</expression>
 			<output>@2005-10-10T</output>
 		</test>
 		<test name="DateTimeAddMonthsOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) + 10 months</expression>
 			<output>@2006-03-10T</output>
 		</test>
 		<test name="DateTimeAddThreeWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2018, 5, 2) + 3 weeks = DateTime(2018, 5, 23)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -26,6 +49,7 @@
 			<!-- 2018-05-23 is a Wednesday -->
 		</test>
 		<test name="DateTimeAddYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2018, 5, 23) + 52 weeks = DateTime(2019, 5, 22)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -33,6 +57,7 @@
 			<!-- 2019-05-22 is a Wednesday -->
 		</test>
 		<test name="DateTimeLeapDayAddYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2023, 3, 2) + 52 weeks = DateTime(2024, 2, 29)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -40,6 +65,7 @@
 			<!-- 2024-02-29 is a Thursday -->
 		</test>
 		<test name="DateTimeLeapYearAddYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2024, 2, 28) + 52 weeks = DateTime(2025, 2, 26)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -47,563 +73,742 @@
 			<!-- 2025-02-26 is a Wednesday -->
 		</test>
 		<test name="DateTimeAdd5Days" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) + 5 days</expression>
 			<output>@2005-05-15T</output>
 		</test>
 		<test name="DateTimeAddDaysOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10) + 21 days</expression>
 			<output>@2016-07-01T</output>
 		</test>
 		<test name="DateTimeAdd5Hours" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5) + 5 hours</expression>
 			<output>@2005-05-10T10</output>
 		</test>
 		<test name="DateTimeAdd5HoursWithLeftMinPrecisionSecond" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 20, 30) + 5 hours</expression>
 			<output>@2005-05-10T10:20:30</output>
 		</test>
 		<test name="DateTimeAdd5HoursWithLeftMinPrecisionDay" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) + 5 hours = DateTime(2005, 5, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAdd5HoursWithLeftMinPrecisionDayOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) + 25 hours = DateTime(2005, 5, 11)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateAdd2YearsAsMonths" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014) + 24 months</expression>
 			<output>@2016</output>
 		</test>
 		<test name="DateAdd2YearsAsMonthsRem1" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014) + 25 months</expression>
 			<output>@2016</output>
 		</test>
 		<test name="DateAdd33Days" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014,6) + 33 days</expression>
 			<output>@2014-07</output>
 		</test>
 		<test name="DateAdd1Year" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014,6) + 1 year</expression>
 			<output>@2015-06</output>
 		</test>
 		<test name="DateTimeAddHoursOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5) + 19 hours</expression>
 			<output>@2016-06-11T00</output>
 		</test>
 		<test name="DateTimeAdd5Minutes" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 5) + 5 minutes</expression>
 			<output>@2005-05-10T05:10</output>
 		</test>
 		<test name="DateTimeAddMinutesOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5) + 55 minutes</expression>
 			<output>@2016-06-10T06:00</output>
 		</test>
 		<test name="DateTimeAdd5Seconds" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 5, 5) + 5 seconds</expression>
 			<output>@2005-05-10T05:05:10</output>
 		</test>
 		<test name="DateTimeAddSecondsOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5, 5) + 55 seconds</expression>
 			<output>@2016-06-10T05:06:00</output>
 		</test>
 		<test name="DateTimeAdd5Milliseconds" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 5, 5, 5) + 5 milliseconds</expression>
 			<output>@2005-05-10T05:05:05.010</output>
 		</test>
 		<test name="DateTimeAddMillisecondsOverflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5, 5, 5) + 995 milliseconds</expression>
 			<output>@2016-06-10T05:05:06.000</output>
 		</test>
 		<test name="DateTimeAddLeapYear" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2012, 2, 29) + 1 year</expression>
 			<output>@2013-02-28T</output>
 		</test>
 		<test name="DateTimeAdd2YearsByMonths" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2014) + 24 months</expression>
 			<output>@2016T</output>
 		</test>
 		<test name="DateTimeAdd2YearsByDays" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2014) + 730 days</expression>
 			<output>@2016T</output>
 		</test>
 		<test name="DateTimeAdd2YearsByDaysRem5Days" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2014) + 735 days</expression>
 			<output>@2016T</output>
 		</test>
 		<test name="TimeAdd5Hours" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 + 5 hours</expression>
 			<output>@T20:59:59.999</output>
 		</test>
 		<test name="TimeAdd1Minute" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 + 1 minute</expression>
 			<output>@T16:00:59.999</output>
 		</test>
 		<test name="TimeAdd1Second" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 + 1 seconds</expression>
 			<output>@T16:00:00.999</output>
 		</test>
 		<test name="TimeAdd1Millisecond" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 + 1 milliseconds</expression>
 			<output>@T16:00:00.000</output>
 		</test>
 		<test name="TimeAdd5Hours1Minute" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 + 5 hours + 1 minutes</expression>
 			<output>@T21:00:59.999</output>
 		</test>
 		<test name="TimeAdd5hoursByMinute" version="1.4">
-			<expression>@T15:59:59.999 + 300 minutes</expression>
+		  	<capability code="date-time-arithmetic"/>
+ 			<expression>@T15:59:59.999 + 300 minutes</expression>
 			<output>@T20:59:59.999</output>
 		</test>
 	</group>
 	<group name="After" version="1.4">
+		<capability code="timing-phrases.before-after"/>
 		<test name="DateTimeAfterYearTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2005, 10, 10) after year of DateTime(2004, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterYearFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 11, 10) after year of DateTime(2004, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterMonthTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 12, 10) after month of DateTime(2004, 11, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterMonthFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 9, 10) after month of DateTime(2004, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterDayTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 12, 11) after day of DateTime(2004, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterDayTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 12, 09) after day of DateTime(2003, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterDayFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 9) after day of DateTime(2004, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterHourTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 10) after hour of DateTime(2004, 10, 10, 5)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20) after hour of DateTime(2004, 10, 10, 21)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30) after minute of DateTime(2004, 10, 10, 20, 29)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30) after minute of DateTime(2004, 10, 10, 20, 31)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15) after second of DateTime(2004, 10, 10, 20, 30, 14)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15) after second of DateTime(2004, 10, 10, 20, 30, 16)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterMillisecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15, 512) after millisecond of DateTime(2004, 10, 10, 20, 30, 15, 510)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15, 512) after millisecond of DateTime(2004, 10, 10, 20, 30, 15, 513)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterUncertain" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2005, 10, 10) after day of DateTime(2005, 9)</expression>
 			<output>true</output>
 		</test>
 		<test name="AfterTimezoneTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 after hour of @2012-03-10T08:20:00.999+06:00</expression>
 			<output>true</output>
 		</test>
 		<test name="AfterTimezoneFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 after hour of @2012-03-10T10:20:00.999+06:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterHourTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 after hour of @T14:59:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeAfterHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 after hour of @T16:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 after minute of @T15:58:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeAfterMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:58:59.999 after minute of @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 after second of @T15:59:58.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeAfterSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:58.999 after second of @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterMillisecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 after millisecond of @T15:59:59.998</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeAfterMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.998 after millisecond of @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterTimeCstor" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>Time(12, 30) after hour of Time(11, 55)</expression>
 			<output>true</output>
 		</test>
 		<!-- TODO: do uncertainty tests for Time once the Time(x,x,x,x,x) format has been implemented -->
 	</group>
 	<group name="Before" version="1.4">
+		<capability code="timing-phrases.before-after"/>
 		<test name="DateTimeBeforeYearTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2003) before year of DateTime(2004, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeYearFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 11, 10) before year of DateTime(2003, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeMonthTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10) before month of DateTime(2004, 11, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeMonthFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 11, 10) before month of DateTime(2004, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeDayTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 1) before day of DateTime(2004, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeDayTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2003, 10, 11) before day of DateTime(2004, 10, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeDayFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 11) before day of DateTime(2004, 10, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeHourTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 1) before hour of DateTime(2004, 10, 10, 5)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 23) before hour of DateTime(2004, 10, 10, 21)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 28) before minute of DateTime(2004, 10, 10, 20, 29)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 35) before minute of DateTime(2004, 10, 10, 20, 31)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 12) before second of DateTime(2004, 10, 10, 20, 30, 14)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 55) before second of DateTime(2004, 10, 10, 20, 30, 16)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeMillisecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15, 508) before millisecond of DateTime(2004, 10, 10, 20, 30, 15, 510)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2004, 10, 10, 20, 30, 15, 599) before millisecond of DateTime(2004, 10, 10, 20, 30, 15, 513)</expression>
 			<output>false</output>
 		</test>
 		<test name="BeforeTimezoneTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 before hour of @2012-03-10T10:20:00.999+06:00</expression>
 			<output>true</output>
 		</test>
 		<test name="BeforeTimezoneFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 before hour of @2012-03-10T09:20:00.999+06:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeBeforeHourTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T13:59:59.999 before hour of @T14:59:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeBeforeHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T16:59:59.999 before hour of @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeBeforeMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:57:59.999 before minute of @T15:58:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeBeforeMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.999 before minute of @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeBeforeSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:57.999 before second of @T15:59:58.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeBeforeSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:56.999 before second of @T15:59:55.999</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeBeforeMillisecondTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.997 before millisecond of @T15:59:59.998</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeBeforeMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T15:59:59.998 before millisecond of @T15:59:59.997</expression>
 			<output>false</output>
 		</test>
 		<!-- TODO: do uncertainty tests for Time once the Time(x,x,x,x,x) format has been implemented -->
 	</group>
 	<group name="DateTime" version="1.4">
+		<capability code="constructor.datetime"/>
 		<test name="DateTimeYear" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003)</expression>
 			<output>@2003T</output>
 		</test>
 		<test name="DateTimeMonth" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10)</expression>
 			<output>@2003-10T</output>
 		</test>
 		<test name="DateTimeDay" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10, 29)</expression>
 			<output>@2003-10-29T</output>
 		</test>
 		<test name="DateTimeHour" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10, 29, 20)</expression>
 			<output>@2003-10-29T20</output>
 		</test>
 		<test name="DateTimeMinute" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10, 29, 20, 50)</expression>
 			<output>@2003-10-29T20:50</output>
 		</test>
 		<test name="DateTimeSecond" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10, 29, 20, 50, 33)</expression>
 			<output>@2003-10-29T20:50:33</output>
 		</test>
 		<test name="DateTimeMillisecond" version="1.4">
+		  	<capability code="constructor.datetime"/>
 			<expression>DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>@2003-10-29T20:50:33.955</output>
 		</test>
 	</group>
 	<group name="DateTimeComponentFrom" version="1.4">
+		<capability code="component-extraction"/>
+		<capability code="timezone-offset"/>
 		<test name="DateTimeComponentFromYear" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>year from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>2003</output>
 		</test>
 		<test name="DateTimeComponentFromMonth" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>month from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>10</output>
 		</test>
 		<test name="DateTimeComponentFromMonthMinBoundary" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>month from DateTime(2003, 01, 29, 20, 50, 33, 955)</expression>
 			<output>1</output>
 		</test>
 		<test name="DateTimeComponentFromDay" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>day from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>29</output>
 		</test>
 		<test name="DateTimeComponentFromHour" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>hour from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>20</output>
 		</test>
 		<test name="DateTimeComponentFromMinute" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>minute from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>50</output>
 		</test>
 		<test name="DateTimeComponentFromSecond" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>second from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>33</output>
 		</test>
 		<test name="DateTimeComponentFromMillisecond" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>millisecond from DateTime(2003, 10, 29, 20, 50, 33, 955)</expression>
 			<output>955</output>
 		</test>
 		<test name="DateTimeComponentFromTimezone" version="1.4">
-			<expression invalid="true">timezone from DateTime(2003, 10, 29, 20, 50, 33, 955, 1)</expression>
-			<!-- EXPECTED: Timezone keyword is only valid in 1.3 or lower -->
-		</test>
-		<test name="DateTimeComponentFromTimezone2" version="1.4">
+			<capability code="component-extraction"/>
+			<capability code="timezone-offset"/>
 			<expression>timezoneoffset from DateTime(2003, 10, 29, 20, 50, 33, 955, 1)</expression>
 			<output>1.00</output>
 		</test>
+		<test name="DateTimeComponentFromTimezoneOffset" versionTo="1.3">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
+			<expression>timezone from DateTime(2003, 10, 29, 20, 50, 33, 955, 1)</expression>
+			<output>1.00</output>
+			<!-- EXPECTED: Timezone keyword is only valid in 1.3 or lower -->
+		</test>
 		<test name="DateTimeComponentFromDate" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>date from DateTime(2003, 10, 29, 20, 50, 33, 955, 1)</expression>
 			<output>@2003-10-29</output>
 		</test>
 		<test name="TimeComponentFromHour" version="1.4">
+		 	 <capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>hour from @T23:20:15.555</expression>
 			<output>23</output>
 		</test>
 		<test name="TimeComponentFromMinute" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>minute from @T23:20:15.555</expression>
 			<output>20</output>
 		</test>
 		<test name="TimeComponentFromSecond" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>second from @T23:20:15.555</expression>
 			<output>15</output>
 		</test>
 		<test name="TimeComponentFromMilli" version="1.4">
+		  	<capability code="component-extraction"/>
+		  	<capability code="timezone-offset"/>
 			<expression>millisecond from @T23:20:15.555</expression>
 			<output>555</output>
 		</test>
 	</group>
 	<group name="Difference" version="1.4">
+		<capability code="difference-in"/>
 		<test name="DateTimeDifferenceYear" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in years between DateTime(2000) and DateTime(2005, 12)</expression>
 			<output>5</output>
 		</test>
 		<test name="DateTimeDifferenceMonth" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in months between DateTime(2000, 2) and DateTime(2000, 10)</expression>
 			<output>8</output>
 		</test>
 		<test name="DateTimeDifferenceDay" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in days between DateTime(2000, 10, 15, 10, 30) and DateTime(2000, 10, 25, 10, 0)</expression>
 			<output>10</output>
 		</test>
 		<test name="DateTimeDifferenceHour" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in hours between DateTime(2000, 4, 1, 12) and DateTime(2000, 4, 1, 20)</expression>
 			<output>8</output>
 		</test>
 		<test name="DateTimeDifferenceMinute" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in minutes between DateTime(2005, 12, 10, 5, 16) and DateTime(2005, 12, 10, 5, 25)</expression>
 			<output>9</output>
 		</test>
 		<test name="DateTimeDifferenceSecond" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in seconds between DateTime(2000, 10, 10, 10, 5, 45) and DateTime(2000, 10, 10, 10, 5, 50)</expression>
 			<output>5</output>
 		</test>
 		<test name="DateTimeDifferenceMillisecond" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in milliseconds between DateTime(2000, 10, 10, 10, 5, 45, 500, -6.0) and DateTime(2000, 10, 10, 10, 5, 45, 900, -7.0)</expression>
 			<output>3600400</output>
 		</test>
 		<test name="DateTimeDifferenceWeeks" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in weeks between DateTime(2000, 10, 15) and DateTime(2000, 10, 28)</expression>
 			<output>1</output>
 		</test>
 		<test name="DateTimeDifferenceWeeks2" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in weeks between DateTime(2000, 10, 15) and DateTime(2000, 10, 29)</expression>
 			<output>2</output>
 		</test>
 		<test name="DateTimeDifferenceWeeks3" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in weeks between @2012-03-10T22:05:09 and @2012-03-24T07:19:33</expression>
 			<output>2</output>
 		</test>
 		<test name="DateTimeDifferenceNegative" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in years between DateTime(2016) and DateTime(1998)</expression>
 			<output>-18</output>
 		</test>
 		<test name="DateTimeDifferenceUncertain" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in months between DateTime(2005) and DateTime(2006, 7) &gt; 5</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeDifferenceHour" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in hours between @T20 and @T23:25:15.555</expression>
 			<output>3</output>
 		</test>
 		<test name="TimeDifferenceMinute" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in minutes between @T20:20:15.555 and @T20:25:15.555</expression>
 			<output>5</output>
 		</test>
 		<test name="TimeDifferenceSecond" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in seconds between @T20:20:15.555 and @T20:20:20.555</expression>
 			<output>5</output>
 		</test>
 		<test name="TimeDifferenceMillis" version="1.4">
+		  	<capability code="difference-in"/>
 			<expression>difference in milliseconds between @T20:20:15.555 and @T20:20:15.550</expression>
 			<output>-5</output>
 		</test>
 	</group>
 	<group name="From Github issue #29" version="1.4">
+		<capability code="timezone-offset"/>
+		<capability code="difference-in"/>
 		<test name="DateTimeA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-03-12T01:00:00-07:00</expression>
 			<output>@2017-03-12T01:00:00-07:00</output>
 		</test>
 		<test name="DateTimeAA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 3, 12, 1, 0, 0, 0, -7.0)</expression>
 			<output>@2017-03-12T01:00:00.000-07:00</output>
 		</test>
 		<test name="DateTimeB" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-03-12T03:00:00-06:00</expression>
 			<output>@2017-03-12T03:00:00-06:00</output>
 		</test>
 		<test name="DateTimeBB" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 3, 12, 3, 0, 0, 0, -6.0)</expression>
 			<output>@2017-03-12T03:00:00.000-06:00</output>
 		</test>
 		<test name="DateTimeC" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-11-05T01:30:00-06:00</expression>
 			<output>@2017-11-05T01:30:00-06:00</output>
 		</test>
 		<test name="DateTimeCC" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 11, 5, 1, 30, 0, 0, -6.0)</expression>
 			<output>@2017-11-05T01:30:00.000-06:00</output>
 		</test>
 		<test name="DateTimeD" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-11-05T01:15:00-07:00</expression>
 			<output>@2017-11-05T01:15:00-07:00</output>
 		</test>
 		<test name="DateTimeDD" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 11, 5, 1, 15, 0, 0, -7.0)</expression>
 			<output>@2017-11-05T01:15:00.000-07:00</output>
 		</test>
 		<test name="DateTimeE" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-03-12T00:00:00-07:00</expression>
 			<output>@2017-03-12T00:00:00-07:00</output>
 		</test>
 		<test name="DateTimeEE" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 3, 12, 0, 0, 0, 0, -7.0)</expression>
 			<output>@2017-03-12T00:00:00.000-07:00</output>
 		</test>
 		<test name="DateTimeF" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>@2017-03-13T00:00:00-06:00</expression>
 			<output>@2017-03-13T00:00:00-06:00</output>
 		</test>
 		<test name="DateTimeFF" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>DateTime(2017, 3, 13, 0, 0, 0, 0, -6.0)</expression>
 			<output>@2017-03-13T00:00:00.000-06:00</output>
 		</test>
 		<test name="DifferenceInHoursA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in hours between @2017-03-12T01:00:00-07:00 and @2017-03-12T03:00:00-06:00</expression>
 			<output>1</output>
 		</test>
 		<test name="DifferenceInMinutesA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in minutes between @2017-11-05T01:30:00-06:00 and @2017-11-05T01:15:00-07:00</expression>
 			<output>45</output>
 		</test>
 		<test name="DifferenceInDaysA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in days between @2017-03-12T00:00:00-07:00 and @2017-03-13T00:00:00-06:00</expression>
 			<output>1</output>
 		</test>
 		<test name="DifferenceInHoursAA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in hours between DateTime(2017, 3, 12, 1, 0, 0, 0, -7.0) and DateTime(2017, 3, 12, 3, 0, 0, 0, -6.0)</expression>
 			<output>1</output>
 		</test>
 		<test name="DifferenceInMinutesAA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in minutes between DateTime(2017, 11, 5, 1, 30, 0, 0, -6.0) and DateTime(2017, 11, 5, 1, 15, 0, 0, -7.0)</expression>
 			<output>45</output>
 		</test>
 		<test name="DifferenceInDaysAA" version="1.4">
+		  	<capability code="timezone-offset"/>
+		  	<capability code="difference-in"/>
 			<expression>difference in days between DateTime(2017, 3, 12, 0, 0, 0, 0, -7.0) and DateTime(2017, 3, 13, 0, 0, 0, 0, -6.0)</expression>
 			<output>1</output>
 		</test>
 		<!-- TODO: Time uncertainty tests -->
 	</group>
 	<group name="Duration" version="1.4">
+		<capability code="duration-between"/>
 		<test name="DateTimeDurationBetweenYear" version="1.4">
+		  	<capability code="duration-between"/>
 			<expression>years between DateTime(2005) and DateTime(2010)</expression>
 			<output>Interval[ 4, 5 ]</output>
 			<!-- TODO: How to handle the fact the question is resulting in an
@@ -612,28 +817,37 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenYearOffset" version="1.4">
+		  	<capability code="duration-between"/>
 			<expression>years between DateTime(2005, 5) and DateTime(2010, 4)</expression>
 			<output>4</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonth" version="1.4">
+		  	<capability code="duration-between"/>
 			<expression>months between @2014-01-31 and @2014-02-01</expression>
 			<output>0</output>
 		</test>
 		<test name="DateTimeDurationBetweenDaysDiffYears" version="1.4">
+		  	<capability code="duration-between"/>
 			<expression>days between DateTime(2010, 10, 12, 12, 5) and DateTime(2008, 8, 15, 8, 8)</expression>
 			<output>-788</output>
 		</test>
 	</group>
 	<group name="Uncertainty tests" version="1.4">
+		<capability code="precision-based-timing"/>
+		<capability code="uncertainty-intervals"/>
 		<test name="DateTimeDurationBetweenUncertainInterval" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>days between DateTime(2014, 1, 15) and DateTime(2014, 2)</expression>
-			<output>Interval[ 16, 44 ]</output>
+			<output>Interval[ 17, 44 ]</output>
 			<!-- TODO: How to handle the fact the question is resulting in an
 			undertainty interval and that CQL/ELM seem to provide no direct way of
 			selecting the same value, conceptually an implementation internal;
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenUncertainInterval2" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 5)</expression>
 			<output>Interval[ 4, 16 ]</output>
 			<!-- TODO: How to handle the fact the question is resulting in an
@@ -642,6 +856,8 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenUncertainAdd" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>(days between DateTime(2014, 1, 15) and DateTime(2014, 2))
 				+ (days between DateTime(2014, 1, 15) and DateTime(2014, 2))</expression>
 			<output>Interval[ 32, 88 ]</output>
@@ -651,6 +867,8 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenUncertainSubtract" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>(days between DateTime(2014, 1, 15) and DateTime(2014, 2))
 				- (months between DateTime(2005) and DateTime(2006, 5))</expression>
 			<output>Interval[ 0, 40 ]</output>
@@ -660,6 +878,8 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenUncertainMultiply" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>(days between DateTime(2014, 1, 15) and DateTime(2014, 2))
 				* (days between DateTime(2014, 1, 15) and DateTime(2014, 2))</expression>
 			<output>Interval[ 256, 1936 ]</output>
@@ -669,541 +889,704 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeDurationBetweenUncertainDiv" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression invalid="true">(days between DateTime(2014, 1, 15) and DateTime(2014, 2))
 				div (months between DateTime(2005) and DateTime(2006, 5))</expression>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) &gt; 5</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain2" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 2) &gt; 5</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain3" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) &gt; 25</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain4" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) &lt; 24</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain5" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) = 24</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain6" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) &gt;= 5</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeDurationBetweenMonthUncertain7" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>months between DateTime(2005) and DateTime(2006, 7) &lt;= 24</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTime1" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>@2012-03-10T10:20:00</expression>
 			<output>@2012-03-10T10:20:00</output>
 		</test>
 		<test name="DateTime2" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>@2013-03-10T09:20:00</expression>
 			<output>@2013-03-10T09:20:00</output>
 		</test>
 		<test name="DurationInYears" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>years between (date from @2012-03-10T10:20:00) and (date from @2013-03-10T09:20:00)</expression>
 			<output>1</output>
 		</test>
 		<test name="DurationInWeeks" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>weeks between @2012-03-10T22:05:09 and @2012-03-20T07:19:33</expression>
 			<output>1</output>
 		</test>
 		<test name="DurationInWeeks2" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>weeks between @2012-03-10T22:05:09 and @2012-03-24T07:19:33</expression>
 			<output>1</output>
 		</test>
 		<test name="DurationInWeeks3" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>weeks between @2012-03-10T06:05:09 and @2012-03-24T07:19:33</expression>
 			<output>2</output>
 		</test>
 		<test name="TimeDurationBetweenHour" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>hours between @T20:26:15.555 and @T23:25:15.555</expression>
 			<output>2</output>
 		</test>
 		<test name="TimeDurationBetweenHourDiffPrecision" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression invalid="true">hours between @T06Z and @T07:00:00Z</expression>
 			<!-- EXPECTED: Syntax error at Z -->
 		</test>
 		<test name="TimeDurationBetweenHourDiffPrecision2" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>hours between @T06 and @T07:00:00</expression>
 			<output>1</output>
 		</test>
 		<test name="TimeDurationBetweenMinute" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>minutes between @T23:20:16.555 and @T23:25:15.555</expression>
 			<output>4</output>
 		</test>
 		<test name="TimeDurationBetweenSecond" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>seconds between @T23:25:10.556 and @T23:25:15.555</expression>
 			<output>4</output>
 		</test>
 		<test name="TimeDurationBetweenMillis" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>milliseconds between @T23:25:25.555 and @T23:25:25.560</expression>
 			<output>5</output>
 		</test>
 		<!-- TODO: Time uncertainty tests -->
 		<test name="DurationInHoursA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>hours between @2017-03-12T01:00:00-07:00 and @2017-03-12T03:00:00-06:00</expression>
 			<output>1</output>
 		</test>
 		<test name="DurationInMinutesA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>minutes between @2017-11-05T01:30:00-06:00 and @2017-11-05T01:15:00-07:00</expression>
 			<output>45</output>
 		</test>
 		<test name="DurationInDaysA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>days between @2017-03-12T00:00:00-07:00 and @2017-03-13T00:00:00-06:00</expression>
 			<output>0</output>
 		</test>
 		<test name="DurationInHoursAA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>hours between DateTime(2017, 3, 12, 1, 0, 0, 0, -7.0) and DateTime(2017, 3, 12, 3, 0, 0, 0, -6.0)</expression>
 			<output>1</output>
 		</test>
 		<test name="DurationInMinutesAA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>minutes between DateTime(2017, 11, 5, 1, 30, 0, 0, -6.0) and DateTime(2017, 11, 5, 1, 15, 0, 0, -7.0)</expression>
 			<output>45</output>
 		</test>
 		<test name="DurationInDaysAA" version="1.4">
+		  	<capability code="precision-based-timing"/>
+		  	<capability code="uncertainty-intervals"/>
 			<expression>days between DateTime(2017, 3, 12, 0, 0, 0, 0, -7.0) and DateTime(2017, 3, 13, 0, 0, 0, 0, -6.0)</expression>
 			<output>0</output>
 		</test>
 	</group>
 	<group name="Now" version="1.4">
+		<capability code="function.Now"/>
 		<test name="DateTimeNow" version="1.4">
+		  	<capability code="function.Now"/>
 			<expression>Now() = Now()</expression>
 			<output>true</output>
 		</test>
 		<!-- <test name="Issue34A">
+		  	<capability code="function.Now"/>
 			<expression>Now()</expression>
 			<output>Now()</output>
 		</test> TODO: Replace this with Java-native test as with original. -->
 	</group>
 	<group name="SameAs" version="1.4">
+		<capability code="timing-phrases.same-as"/>
 		<test name="DateTimeSameAsYearTrue">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014) same year as DateTime(2014)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsYearFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2013) same year as DateTime(2014)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsMonthTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12) same month as DateTime(2014, 12)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsMonthFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12) same month as DateTime(2014, 10)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsDayTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12, 10) same day as DateTime(2014, 12, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsDayFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10, 10) same day as DateTime(2014, 10, 11)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsHourTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12, 10, 20) same hour as DateTime(2014, 12, 10, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsHourFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10, 10, 20) same hour as DateTime(2014, 10, 10, 21)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12, 10, 20, 55) same minute as DateTime(2014, 12, 10, 20, 55)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10, 10, 20, 55) same minute as DateTime(2014, 10, 10, 21, 56)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12, 10, 20, 55, 45) same second as DateTime(2014, 12, 10, 20, 55, 45)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10, 10, 20, 55, 45) same second as DateTime(2014, 10, 10, 21, 55, 44)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsMillisecondTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 12, 10, 20, 55, 45, 500) same millisecond as DateTime(2014, 12, 10, 20, 55, 45, 500)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameAsMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10, 10, 20, 55, 45, 500) same millisecond as DateTime(2014, 10, 10, 21, 55, 45, 501)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameAsNull" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>DateTime(2014, 10) same day as DateTime(2014, 10, 12)</expression>
 			<output>null</output>
 		</test>
 		<test name="SameAsTimezoneTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 same hour as @2012-03-10T09:20:00.999+06:00</expression>
 			<output>true</output>
 		</test>
 		<test name="SameAsTimezoneFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 same hour as @2012-03-10T10:20:00.999+06:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameAsHourTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:25:25.555 same hour as @T23:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameAsHourFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T22:25:25.555 same hour as @T23:25:25.555</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameAsMinuteTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:55:22.555 same minute as @T23:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameAsMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:26:25.555 same minute as @T23:25:25.555</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameAsSecondTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:55:25.555 same second as @T23:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameAsSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:25:35.555 same second as @T23:25:25.555</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameAsMillisTrue" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:55:25.555 same millisecond as @T23:55:25.555</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameAsMillisFalse" version="1.4">
+		  	<capability code="timing-phrases.same-as"/>
 			<expression>@T23:25:25.555 same millisecond as @T23:25:25.554</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="SameOrAfter" version="1.4">
+		<capability code="timing-phrases.before-after"/>
 		<test name="DateTimeSameOrAfterYearTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014) same year or after DateTime(2014)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterYearTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2016) same year or after DateTime(2014)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterYearFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2013) same year or after DateTime(2014)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterMonthTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12) same month or after DateTime(2014, 12)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMonthTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10) same month or after DateTime(2014, 9)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMonthFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10) same month or after DateTime(2014, 11)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterDayTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20) same day or after DateTime(2014, 12, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterDayTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25) same day or after DateTime(2014, 10, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterDayFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 20) same day or after DateTime(2014, 10, 25)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterHourTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12) same hour or after DateTime(2014, 12, 20, 12)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterHourTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 12) same hour or after DateTime(2014, 10, 25, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 12) same hour or after DateTime(2014, 10, 25, 15)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterMinuteTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30) same minute or after DateTime(2014, 12, 20, 12, 30)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMinuteTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 30) same minute or after DateTime(2014, 10, 25, 10, 25)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 30) same minute or after DateTime(2014, 10, 25, 15, 45)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterSecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30, 15) same second or after DateTime(2014, 12, 20, 12, 30, 15)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterSecondTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 25, 25) same second or after DateTime(2014, 10, 25, 10, 25, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 45, 20) same second or after DateTime(2014, 10, 25, 15, 45, 21)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterMillisecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30, 15, 250) same millisecond or after DateTime(2014, 12, 20, 12, 30, 15, 250)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMillisecondTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 25, 20, 500) same millisecond or after DateTime(2014, 10, 25, 10, 25, 20, 499)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrAfterMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 45, 20, 500) same millisecond or after DateTime(2014, 10, 25, 15, 45, 20, 501)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrAfterNull1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20) same day or after DateTime(2014, 12)</expression>
 			<output>null</output>
 		</test>
 		<test name="SameOrAfterTimezoneTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 same hour or after @2012-03-10T09:20:00.999+06:00</expression>
 			<output>true</output>
 		</test>
 		<test name="SameOrAfterTimezoneFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+07:00 same hour or after @2012-03-10T10:20:00.999+06:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrAfterHourTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same hour or after @T23:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterHourTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same hour or after @T22:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T22:25:25.555 same hour or after @T23:55:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrAfterMinuteTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same minute or after @T23:25:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterMinuteTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same minute or after @T22:15:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same minute or after @T23:55:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrAfterSecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same second or after @T23:25:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterSecondTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:35.555 same second or after @T22:25:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:55:25.555 same second or after @T23:55:35.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrAfterMillisTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same millisecond or after @T23:25:25.555</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterMillisTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same millisecond or after @T22:25:25.550</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrAfterMillisFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:55:25.555 same millisecond or after @T23:55:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="OnOrAfterTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2017-12-20T11:00:00.000 on or after @2017-12-20T11:00:00.000</expression>
 			<output>true</output>
 		</test>
 		<test name="Issue32DateTime" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2017-12-21T02:00:00.0 same or after @2017-12-20T11:00:00.0</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="SameOrBefore" version="1.4">
+		<capability code="timing-phrases.before-after"/>
 		<test name="DateTimeSameOrBeforeYearTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014) same year or before DateTime(2014)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeYearTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2013) same year or before DateTime(2014)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeYearFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2015) same year or before DateTime(2014)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMonthTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12) same month or before DateTime(2014, 12)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMonthTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 8) same month or before DateTime(2014, 9)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMonthFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12) same month or before DateTime(2014, 11)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeDayTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20) same day or before DateTime(2014, 12, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeDayTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 15) same day or before DateTime(2014, 10, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeDayFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 30) same day or before DateTime(2014, 10, 25)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeHourTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12) same hour or before DateTime(2014, 12, 20, 12)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeHourTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 5) same hour or before DateTime(2014, 10, 25, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 20) same hour or before DateTime(2014, 10, 25, 15)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMinuteTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30) same minute or before DateTime(2014, 12, 20, 12, 30)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMinuteTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 20) same minute or before DateTime(2014, 10, 25, 10, 25)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 55) same minute or before DateTime(2014, 10, 25, 15, 45)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeSecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30, 15) same second or before DateTime(2014, 12, 20, 12, 30, 15)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeSecondTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 25, 15) same second or before DateTime(2014, 10, 25, 10, 25, 20)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 45, 25) same second or before DateTime(2014, 10, 25, 15, 45, 21)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMillisecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20, 12, 30, 15, 250) same millisecond or before DateTime(2014, 12, 20, 12, 30, 15, 250)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMillisecondTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 10, 25, 20, 450) same millisecond or before DateTime(2014, 10, 25, 10, 25, 20, 499)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeMillisecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 10, 25, 15, 45, 20, 505) same millisecond or before DateTime(2014, 10, 25, 15, 45, 20, 501)</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeSameOrBeforeNull1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>DateTime(2014, 12, 20) same minute or before DateTime(2014, 12, 20, 15)</expression>
 			<output>null</output>
 		</test>
 		<test name="SameOrBeforeTimezoneTrue" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T09:20:00.999+07:00 same hour or before @2012-03-10T10:20:00.999+06:00</expression>
 			<output>true</output>
 		</test>
 		<test name="SameOrBeforeTimezoneFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@2012-03-10T10:20:00.999+06:00 same hour or before @2012-03-10T10:20:00.999+07:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeHourTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same hour or before @T23:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrBeforeHourTrue2" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T21:25:25.555 same hour or before @T22:55:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrBeforeHourFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T22:25:25.555 same hour or before @T21:55:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeMinuteTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same minute or before @T23:25:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrBeforeMinuteFalse0" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:10:25.555 same minute or before @T22:15:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeMinuteFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:56:25.555 same minute or before @T23:55:25.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeSecondTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same second or before @T23:25:25.900</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrBeforeSecondFalse0" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:35.555 same second or before @T22:25:45.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeSecondFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:55:45.555 same second or before @T23:55:35.900</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeMillisTrue1" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.555 same millisecond or before @T23:25:25.555</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeSameOrBeforeMillisFalse0" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:25:25.200 same millisecond or before @T22:25:25.550</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeSameOrBeforeMillisFalse" version="1.4">
+		  	<capability code="timing-phrases.before-after"/>
 			<expression>@T23:55:25.966 same millisecond or before @T23:55:25.900</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Subtract" version="1.4">
+		<capability code="date-time-arithmetic"/>
 		<test name="DateTimeSubtract5Years" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 10, 10) - 5 years</expression>
 			<output>@2000-10-10T</output>
 		</test>
 		<test name="DateTimeSubtractInvalidYears" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression invalid="true">DateTime(2005, 10, 10) - 2005 years</expression>
 			<!-- EXPECT: The date time addition results in a year less than the accepted range. -->
 		</test>
 		<test name="DateTimeSubtract5Months" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 6, 10) - 5 months</expression>
 			<output>@2005-01-10T</output>
 		</test>
 		<test name="DateTimeSubtractMonthsUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) - 6 months</expression>
 			<output>@2004-11-10T</output>
 		</test>
 		<test name="DateTimeSubtractThreeWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2018, 5, 23) - 3 weeks = DateTime(2018, 5, 2)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -1211,6 +1594,7 @@
 			<!-- 2018-05-23 is a Wednesday -->
 		</test>
 		<test name="DateTimeSubtractYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2018, 5, 23) - 52 weeks = DateTime(2017, 5, 24)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -1218,6 +1602,7 @@
 			<!-- 2017-05-24 is a Wednesday -->
 		</test>
 		<test name="DateTimeLeapDaySubtractYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2024, 2, 29) - 52 weeks = DateTime(2023, 3, 2)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -1225,6 +1610,7 @@
 			<!-- 2023-03-02 is a Thursday -->
 		</test>
 		<test name="DateTimeLeapYearSubtractYearInWeeks" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2024, 3, 1) - 52 weeks = DateTime(2023, 3, 3)</expression>
 			<output>true</output>
 			<!-- EXPECT: The resultant day of the week to match the original day of the week. -->
@@ -1232,132 +1618,178 @@
 			<!-- 2023-03-03 is a Thursday -->
 		</test>
 		<test name="DateTimeSubtract5Days" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10) - 5 days</expression>
 			<output>@2005-05-05T</output>
 		</test>
 		<test name="DateTimeSubtractDaysUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10) - 11 days</expression>
 			<output>@2016-05-30T</output>
 		</test>
 		<test name="DateTimeSubtract5Hours" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 10) - 5 hours</expression>
 			<output>@2005-05-10T05</output>
 		</test>
 		<test name="DateTimeSubtractHoursUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5) - 6 hours</expression>
 			<output>@2016-06-09T23</output>
 		</test>
 		<test name="DateTimeSubtract5Minutes" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 10) - 5 minutes</expression>
 			<output>@2005-05-10T05:05</output>
 		</test>
 		<test name="DateTimeSubtractMinutesUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5) - 6 minutes</expression>
 			<output>@2016-06-10T04:59</output>
 		</test>
 		<test name="DateTimeSubtract5Seconds" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 5, 10) - 5 seconds</expression>
 			<output>@2005-05-10T05:05:05</output>
 		</test>
 		<test name="DateTimeSubtract1YearInSeconds" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016,5) - 31535999 seconds = DateTime(2015, 5)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSubtract15HourPrecisionSecond" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 10, 1, 10, 20, 30) - 15 hours</expression>
 			<output>@2016-09-30T19:20:30</output>
 		</test>
 		<test name="DateTimeSubtractSecondsUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5, 5) - 6 seconds</expression>
 			<output>@2016-06-10T05:04:59</output>
 		</test>
 		<test name="DateTimeSubtract5Milliseconds" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2005, 5, 10, 5, 5, 5, 10) - 5 milliseconds</expression>
 			<output>@2005-05-10T05:05:05.005</output>
 		</test>
 		<test name="DateTimeSubtractMillisecondsUnderflow" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2016, 6, 10, 5, 5, 5, 5) - 6 milliseconds</expression>
 			<output>@2016-06-10T05:05:04.999</output>
 		</test>
 		<test name="DateTimeSubtract2YearsAsMonths" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2014) - 24 months</expression>
 			<output>@2012T</output>
 		</test>
 		<test name="DateTimeSubtract2YearsAsMonthsRem1" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>DateTime(2014) - 25 months</expression>
 			<output>@2012T</output>
 		</test>
 		<test name="DateSubtract2YearsAsMonths" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014) - 24 months</expression>
 			<output>@2012</output>
 		</test>
 		<test name="DateSubtract2YearsAsMonthsRem1" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014) - 25 months</expression>
 			<output>@2012</output>
 		</test>
 		<test name="DateSubtract33Days" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014,6) - 33 days</expression>
 			<output>@2014-05</output>
 		</test>
 		<test name="DateSubtract1Year" version="1.3">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Date(2014,6) - 1 year</expression>
 			<output>@2013-06</output>
 		</test>
 		<test name="TimeSubtract5Hours" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 - 5 hours</expression>
 			<output>@T10:59:59.999</output>
 		</test>
 		<test name="TimeSubtract1Minute" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 - 1 minutes</expression>
 			<output>@T15:58:59.999</output>
 		</test>
 		<test name="TimeSubtract1Second" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 - 1 seconds</expression>
 			<output>@T15:59:58.999</output>
 		</test>
 		<test name="TimeSubtract1Millisecond" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.0 - 1 milliseconds</expression>
 			<output>@T15:59:58.999</output>
 		</test>
 		<test name="TimeSubtract5Hours1Minute" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 - 5 hours - 1 minutes</expression>
 			<output>@T10:58:59.999</output>
 		</test>
 		<test name="TimeSubtract5hoursByMinute" version="1.4">
+		  	<capability code="date-time-arithmetic"/>
 			<expression>@T15:59:59.999 - 300 minutes</expression>
 			<output>@T10:59:59.999</output>
 		</test>
 	</group>
 	<group name="Time" version="1.4">
+		<capability code="constructor.time"/>
 		<test name="TimeTest2" version="1.4">
+		  	<capability code="constructor.time"/>
 			<expression>@T23:59:59.999</expression>
 			<output>@T23:59:59.999</output>
 		</test>
 	</group>
 	<group name="TimeOfDay" version="1.4">
+		<capability code="function.TimeOfDay"/>
 		<test name="TimeOfDayTest" version="1.4">
+		  	<capability code="function.TimeOfDay"/>
 			<expression>TimeOfDay() = TimeOfDay()</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="Today" version="1.4">
+		<capability code="function.Today"/>
+		<capability code="timing-phrases.before-after"/>
+		<capability code="date-time-arithmetic"/>
 		<test name="DateTimeSameOrBeforeTodayTrue1" version="1.4">
+		  	<capability code="function.Today"/>
+		  	<capability code="timing-phrases.before-after"/>
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Today() same day or before Today()</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeTodayTrue2" version="1.4">
+		  	<capability code="function.Today"/>
+		  	<capability code="timing-phrases.before-after"/>
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Today() same day or before Today() + 1 days</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeSameOrBeforeTodayFalse" version="1.4">
+		  	<capability code="function.Today"/>
+		  	<capability code="timing-phrases.before-after"/>
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Today() + 1 years same day or before Today()</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAddTodayTrue" version="1.4">
+		  	<capability code="function.Today"/>
+		  	<capability code="timing-phrases.before-after"/>
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Today() + 1 days &gt; Today()</expression>
 			<output>true</output>
 		</test>
 		<test name="Issue34B" version="1.4">
+		  	<capability code="function.Today"/>
+		  	<capability code="timing-phrases.before-after"/>
+		  	<capability code="date-time-arithmetic"/>
 			<expression>Today() = Today()</expression>
 			<output>true</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlErrorsAndMessagingOperatorsTest.xml b/test/spec-tests/xml/CqlErrorsAndMessagingOperatorsTest.xml
index 6ff7602cf..0470b8aca 100644
--- a/test/spec-tests/xml/CqlErrorsAndMessagingOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlErrorsAndMessagingOperatorsTest.xml
@@ -1,20 +1,26 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
 	xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd" name="CqlErrorsAndMessagingOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#errors-and-messaging" version="1.0">
+	<capability code="diagnostic-operators"/>
 	<group name="Messaging" version="1.0">
+		<capability code="diagnostic-operators"/>
 		<test name="TestMessageInfo" version="1.0">
+      		<capability code="diagnostic-operators"/>
 			<expression>Message(1, true, '100', 'Message', 'Test Message')</expression>
 			<output>1</output>
 		</test>
 		<test name="TestMessageWarn" version="1.0">
+      		<capability code="diagnostic-operators"/>
 			<expression>Message(2, true, '200', 'Warning', 'You have been warned!')</expression>
 			<output>2</output>
 		</test>
 		<test name="TestMessageTrace" version="1.0">
+      		<capability code="diagnostic-operators"/>
 			<expression>Message({3, 4, 5}, true, '300', 'Trace', 'This is a trace')</expression>
 			<output>{3, 4, 5}</output>
 		</test>
 		<test name="TestMessageError" version="1.0">
+      		<capability code="diagnostic-operators"/>
 			<expression invalid="true">Message(3 + 1, true, '400', 'Error', 'This is an error!')</expression>
 			<!-- EXPECT: 400: This is an error! -->
 		</test>
diff --git a/test/spec-tests/xml/CqlIntervalOperatorsTest.xml b/test/spec-tests/xml/CqlIntervalOperatorsTest.xml
index c7072ec16..64c8e2b47 100644
--- a/test/spec-tests/xml/CqlIntervalOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlIntervalOperatorsTest.xml
@@ -1,630 +1,789 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlIntervalOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#interval-operators-3" version="1.0">
+	<capability code="interval-operators"/>
 	<group name="After" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestAfterNull" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>(null as Integer) after Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11, 20] after Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[1, 10] after Interval[11, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalPointAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>12 after Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalPointAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9 after Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalAfterPointTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11, 20] after 5</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalAfterPointFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11, 20] after 12</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] after Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] after Interval[11.0, 20.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalPointAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>12.0 after Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalPointAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>9.0 after Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalAfterPointTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] after 5.0</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalAfterPointFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] after 12.0</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] after Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] after Interval[11.0 'g', 20.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalPointAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>12.0'g' after Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalPointAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>9.0'g' after Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalAfterPointTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] after 5.0'g'</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalAfterPointFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] after 12.0'g'</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] after DateTime(2011, 12, 31)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] after DateTime(2012, 12, 31)</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeAfterTrue" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[@T15:59:59.999, @T20:59:59.999] after @T12:59:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeAfterFalse" version="1.0">
+      		<capability code="interval-operators"/>
 			<expression>Interval[@T15:59:59.999, @T20:59:59.999] after @T17:59:59.999</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Before" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestBeforeNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>(null as Integer) before Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11, 20] before Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] before Interval[11, 20]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalPointBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9 before Interval[11, 20]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalPointBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9 before Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalBeforePointTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] before 11</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalBeforePointFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] before 8</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] before Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] before Interval[11.0, 20.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalPointBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9.0 before Interval[11.0, 20.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalPointBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9.0 before Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalBeforePointTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] before 11.0</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalBeforePointFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] before 8.0</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] before Interval[11.0 'g', 20.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] before Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalPointBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] before 12.0'g'</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalPointBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] before 9.0'g'</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalBeforePointTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>5.0'g' before Interval[11.0 'g', 20.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalBeforePointFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>12.0'g' before Interval[11.0 'g', 20.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] before DateTime(2012, 2, 27)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] before DateTime(2011, 12, 31)</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T15:59:59.999, @T20:59:59.999] before @T22:59:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T15:59:59.999, @T20:59:59.999] before @T10:59:59.999</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Collapse" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestCollapseNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse {Interval(null, null)}</expression>
 			<output>{ }</output>
 		</test>
 		<test name="IntegerIntervalCollapse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[1,5], Interval[3,7], Interval[12,19], Interval[7,10] }</expression>
 			<output>{Interval [ 1, 10 ], Interval [ 12, 19 ]}</output>
+			<!-- Failing - issue https://github.com/cqframework/clinical_quality_language/issues/1744 -->
 		</test>
 		<test name="IntegerIntervalCollapse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[1,2], Interval[3,7], Interval[10,19], Interval[7,10] }</expression>
 			<output>{Interval [ 1, 19 ]}</output>
 		</test>
 		<test name="IntegerIntervalCollapse3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[4,6], Interval[7,8] }</expression>
 			<output>{Interval [ 4, 8 ]}</output>
 		</test>
 		<test name="DecimalIntervalCollapse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[1.0,5.0], Interval[3.0,7.0], Interval[12.0,19.0], Interval[7.0,10.0] }</expression>
 			<output>{Interval [ 1.0, 10.0 ], Interval [ 12.0, 19.0 ]}</output>
 		</test>
 		<test name="DecimalIntervalCollapse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[4.0,6.0], Interval[6.00000001,8.0] }</expression>
 			<output>{Interval [ 4.0, 8.0 ]}</output>
 		</test>
 		<test name="QuantityIntervalCollapse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[1.0 'g',5.0 'g'], Interval[3.0 'g',7.0 'g'], Interval[12.0 'g',19.0 'g'], Interval[7.0 'g',10.0 'g'] }</expression>
 			<output>{Interval [ 1.0 'g', 10.0 'g' ], Interval [ 12.0 'g', 19.0 'g' ]}</output>
 		</test>
 		<test name="DateTimeCollapse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)], Interval[DateTime(2012, 1, 10), DateTime(2012, 1, 25)], Interval[DateTime(2012, 5, 10), DateTime(2012, 5, 25)], Interval[DateTime(2012, 5, 20), DateTime(2012, 5, 30)] }</expression>
 			<output>{Interval [ @2012-01-01T, @2012-01-25T ], Interval [ @2012-05-10T, @2012-05-30T ]}</output>
 		</test>
 		<test name="DateTimeCollapse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)], Interval[DateTime(2012, 1, 16), DateTime(2012, 5, 25)] }</expression>
 			<output>{Interval [ @2012-01-01T, @2012-05-25T ]}</output>
 		</test>
 		<test name="TimeCollapse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[@T01:59:59.999, @T10:59:59.999], Interval[@T08:59:59.999, @T15:59:59.999], Interval[@T17:59:59.999, @T20:59:59.999], Interval[@T18:59:59.999, @T22:59:59.999] }</expression>
 			<output>{Interval [ @T01:59:59.999, @T15:59:59.999 ], Interval [ @T17:59:59.999, @T22:59:59.999 ]}</output>
 		</test>
 		<test name="TimeCollapse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>collapse { Interval[@T01:59:59.999, @T10:59:59.999], Interval[@T11:00:00.000, @T15:59:59.999] }</expression>
 			<output>{Interval [ @T01:59:59.999, @T15:59:59.999 ]}</output>
 		</test>
 	</group>
 	<group name="Expand" version="1.3">
+		<capability code="interval-operators"/>
 		<test name="ExpandNull" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand null</expression>
 			<output>null</output>
 		</test>
 		<test name="ExpandEmptyList" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { }</expression>
 			<output>{ }</output>
 		</test>
 		<test name="ExpandListWithNull" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { null }</expression>
 			<output>{ }</output>
 		</test>
 		<test name="ExpandPerDay" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[@2018-01-01, @2018-01-04] } per day</expression>
 			<output>{ Interval[@2018-01-01, @2018-01-01], Interval[@2018-01-02, @2018-01-02], Interval[@2018-01-03, @2018-01-03], Interval[@2018-01-04, @2018-01-04] }</output>
 		</test>
 		<test name="ExpandPerDayIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[@2018-01-01, @2018-01-04] per day</expression>
 			<output>{ @2018-01-01, @2018-01-02, @2018-01-03, @2018-01-04 }</output>
 		</test>
 		<test name="ExpandPer2Days" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[@2018-01-01, @2018-01-04] } per 2 days</expression>
 			<output>{ Interval[@2018-01-01, @2018-01-02], Interval[@2018-01-03, @2018-01-04] }</output>
 		</test>
 		<test name="ExpandPer2DaysIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[@2018-01-01, @2018-01-04] per 2 days</expression>
 			<output>{ @2018-01-01, @2018-01-03 }</output>
 		</test>
 		<test name="ExpandPerHour" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[@T10:00, @T12:30] } per hour</expression>
 			<output>{ Interval[@T10, @T10], Interval[@T11, @T11], Interval[@T12, @T12] }</output>
 		</test>
 		<test name="ExpandPerHourIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[@T10:00, @T12:30] per hour</expression>
 			<output>{ @T10, @T11, @T12 }</output>
 		</test>
 		<test name="ExpandPerHourOpen" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[@T10:00, @T12:30) } per hour</expression>
 			<output>{ Interval[@T10, @T10], Interval[@T11, @T11], Interval[@T12, @T12] }</output>
 		</test>
 		<test name="ExpandPerHourOpenIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[@T10:00, @T12:30) per hour</expression>
 			<output>{ @T10, @T11, @T12 }</output>
 		</test>
 		<test name="ExpandPer1" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[10.0, 12.5] } per 1</expression>
 			<output>{ Interval[10, 10], Interval[11, 11], Interval[12, 12] }</output>
 		</test>
 		<test name="ExpandPer1IntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[10.0, 12.5] per 1</expression>
 			<output>{ 10, 11, 12 }</output>
 		</test>
 		<test name="ExpandPer1Open" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[10.0, 12.5) } per 1</expression>
 			<output>{ Interval[10, 10], Interval[11, 11], Interval[12, 12] }</output>
 		</test>
 		<test name="ExpandPer1OpenIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[10.0, 12.5) per 1</expression>
 			<output>{ 10, 11, 12 }</output>
 		</test>
 		<test name="ExpandPerMinute" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[@T10, @T10] } per minute</expression>
 			<output>{ }</output>
 		</test>
 		<test name="ExpandPerMinuteIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[@T10, @T10] per minute</expression>
 			<output>{ }</output>
 		</test>
 		<test name="ExpandPer0D1" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[10, 10] } per 0.1</expression>
 			<output>{ Interval[10.0, 10.0], Interval[10.1, 10.1], Interval[10.2, 10.2], Interval[10.3, 10.3], Interval[10.4, 10.4], Interval[10.5, 10.5], Interval[10.6, 10.6], Interval[10.7, 10.7], Interval[10.8, 10.8], Interval[10.9, 10.9] }</output>
 		</test>
 		<test name="ExpandPer0D1IntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[10, 10] per 0.1</expression>
 			<output>{ 10.0, 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8, 10.9 }</output>
 		</test>
 		<test name="ExpandInterval" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[1, 10] }</expression>
 			<output>{ Interval[1, 1], Interval[2, 2], Interval[3, 3], Interval[4, 4], Interval[5, 5], Interval[6, 6], Interval[7, 7], Interval[8, 8], Interval[9, 9], Interval[10, 10] }</output>
 		</test>
 		<test name="ExpandIntegerIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[1, 10]</expression>
 			<output>{ 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 }</output>
 		</test>
 		<test name="ExpandIntervalOpen" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[1, 10) }</expression>
 			<output>{ Interval[1, 1], Interval[2, 2], Interval[3, 3], Interval[4, 4], Interval[5, 5], Interval[6, 6], Interval[7, 7], Interval[8, 8], Interval[9, 9] }</output>
 		</test>
 		<test name="ExpandIntegerOpenIntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[1, 10)</expression>
 			<output>{ 1, 2, 3, 4, 5, 6, 7, 8, 9 }</output>
 		</test>
 		<test name="ExpandIntervalPer2" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[1, 10] } per 2</expression>
 			<output>{ Interval[1, 2], Interval[3, 4], Interval[5, 6], Interval[7, 8], Interval[9, 10] }</output>
 		</test>
 		<test name="ExpandIntervalPer2IntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[1, 10] per 2</expression>
 			<output>{ 1, 3, 5, 7, 9 }</output>
 		</test>
 		<test name="ExpandIntervalOpenPer2" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand { Interval[1, 10) } per 2</expression>
 			<output>{ Interval[1, 2], Interval[3, 4], Interval[5, 6], Interval[7, 8] }</output>
 		</test>
 		<test name="ExpandIntervalOpenPer2IntervalOverload" version="1.3">
+			<capability code="interval-operators"/>
 			<expression>expand Interval[1, 10) per 2</expression>
 			<output>{ 1, 3, 5, 7 }</output>
 		</test>
 	</group>
 	<group name="Contains" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestContainsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] contains null</expression>
 			<output>null</output>
 		</test>
 		<test name="TestNullElement1" version="1.0">
-			<expression>null contains 5</expression>
+			<capability code="interval-operators"/>
+			<expression>null as Interval&lt;Integer&gt; contains 5</expression>
 			<output>false</output>
 		</test>
 		<test name="TestNullElement2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, 5] contains 10</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] contains 5</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] contains 25</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] contains 8.0</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] contains 255.0</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] contains 2.0 'g'</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] contains 100.0 'g'</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] contains DateTime(2012, 1, 10)</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)] contains DateTime(2012, 1, 16)</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T01:59:59.999, @T10:59:59.999] contains @T05:59:59.999</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T01:59:59.999, @T10:59:59.999] contains @T15:59:59.999</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="End" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalEnd" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>end of Interval[1, 10]</expression>
 			<output>10</output>
 		</test>
 		<test name="DecimalIntervalEnd" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>end of Interval[1.0, 10.0]</expression>
 			<output>10.0</output>
 		</test>
 		<test name="QuantityIntervalEnd" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>end of Interval[1.0 'g', 10.0 'g']</expression>
 			<output>10.0'g'</output>
 		</test>
 		<test name="DateTimeIntervalEnd" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>end of Interval[@2016-05-01T00:00:00.000, @2016-05-02T00:00:00.000]</expression>
 			<output>@2016-05-02T00:00:00.000</output>
 		</test>
 		<test name="TimeIntervalEnd" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>end of Interval[@T00:00:00.000, @T23:59:59.599]</expression>
 			<output>@T23:59:59.599</output>
 		</test>
 	</group>
 	<group name="Ends" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestEndsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] ends Interval(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalEndsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] ends Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalEndsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[44, 50] ends Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalEndsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] ends Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalEndsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] ends Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalEndsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] ends Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalEndsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] ends Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeEndsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)] ends Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 15)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeEndsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)] ends Interval[DateTime(2012, 1, 1), DateTime(2012, 1, 16)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeEndsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] ends Interval[@T01:59:59.999, @T10:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeEndsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] ends Interval[@T01:59:59.999, @T11:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Equal" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestEqualNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] = Interval(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] = Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] = Interval[11, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] = Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] = Interval[11.0, 20.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] = Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] = Interval[11.0 'g', 20.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5, 0, 0, 0, 0), DateTime(2012, 1, 15, 0, 0, 0, 0)] = Interval[DateTime(2012, 1, 5, 0, 0, 0, 0), DateTime(2012, 1, 15, 0, 0, 0, 0)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5, 0, 0, 0, 0), DateTime(2012, 1, 15, 0, 0, 0, 0)] = Interval[DateTime(2012, 1, 5, 0, 0, 0, 0), DateTime(2012, 1, 16, 0, 0, 0, 0)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] = Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] = Interval[@T05:59:59.999, @T10:58:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Except" version="1.0">
-		<test name="NullInterval" version="1.0">
-			<expression>Interval[null, null]</expression>
-			<output>null</output>
-		</test>
+		<capability code="interval-operators"/>
 		<test name="TestExceptNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] except Interval[null, null]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalExcept1to3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] except Interval[4, 10]</expression>
 			<output>Interval [ 1, 3 ]</output>
 		</test>
 		<test name="IntegerIntervalExceptNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] except Interval[3, 7]</expression>
 			<output>null</output>
 		</test>
 		<test name="DecimalIntervalExcept1to3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] except Interval[4.0, 10.0]</expression>
 			<output>Interval [ 1.0, 3.99999999 ]</output>
 		</test>
 		<test name="DecimalIntervalExceptNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] except Interval[3.0, 7.0]</expression>
 			<output>null</output>
 		</test>
 		<test name="QuantityIntervalExcept1to4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] except Interval[5.0 'g', 10.0 'g']</expression>
 			<output>Interval [ 1.0 'g', 4.99999999 'g' ]</output>
 		</test>
 		<test name="Except12" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 4] except Interval[3, 6]</expression>
 			<output>Interval [ 1, 2 ]</output>
 		</test>
 		<test name="ExceptDateTimeInterval" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)] except Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 15)]</expression>
 			<output>Interval [ @2012-01-05T, @2012-01-06T ]</output>
 		</test>
 		<test name="ExceptDateTime2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 16)] except Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 12)]</expression>
 			<output>Interval [ @2012-01-13T, @2012-01-16T ]</output>
 		</test>
 		<test name="ExceptTimeInterval" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] except Interval[@T08:59:59.999, @T10:59:59.999]</expression>
 			<output>Interval [ @T05:59:59.999, @T08:59:59.998 ]</output>
 		</test>
 		<test name="ExceptTime2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T08:59:59.999, @T11:59:59.999] except Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>Interval [ @T11:00:00.000, @T11:59:59.999 ]</output>
 		</test>
 	</group>
 	<group name="In" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestInNullBoundaries" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>5 in Interval[null, null]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>5 in Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>500 in Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>9.0 in Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>-2.0 in Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>1.0 'g' in Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>55.0 'g' in Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>DateTime(2012, 1, 7) in Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>DateTime(2012, 1, 17) in Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)]</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeInNullTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>DateTime(2012, 1, 7) in Interval[DateTime(2012, 1, 5), null]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T07:59:59.999 in Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T17:59:59.999 in Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeInNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>null in Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>null</output>
 		</test>
 		<test name="TestPeriod1" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2017-12-20T11:00:00, @2017-12-21T21:00:00]</expression>
 			<output>Interval [ @2017-12-20T11:00:00, @2017-12-21T21:00:00 ]</output>
 		</test>
 		<test name="TestPeriod2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2017-12-20T10:30:00, @2017-12-20T12:00:00]</expression>
 			<output>Interval [ @2017-12-20T10:30:00, @2017-12-20T12:00:00 ]</output>
 		</test>
 		<test name="Issue32Interval" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>
 				Interval[@2017-12-20T10:30:00, @2017-12-20T12:00:00]
 				starts 1 day or less on or after day of start of
@@ -634,1101 +793,1385 @@
 		</test>
 	</group>
 	<group name="Includes" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestIncludesNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] includes null</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] includes Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] includes Interval[44, 50]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] includes Interval[4.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] includes Interval[11.0, 20.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] includes Interval[5.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] includes Interval[11.0 'g', 20.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)] includes Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)] includes Interval[DateTime(2012, 1, 4), DateTime(2012, 1, 14)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] includes Interval[@T06:59:59.999, @T09:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T10:59:59.999] includes Interval[@T04:59:59.999, @T09:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Included In" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestIncludedInNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>null included in Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] included in Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[44, 50] included in Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] included in Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] included in Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] included in Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] included in Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] included in Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 4), DateTime(2012, 1, 14)] included in Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 15)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T06:59:59.999, @T09:59:59.999] included in Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] included in Interval[@T05:59:59.999, @T10:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeIncludedInNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval [@2017-09-01T00:00:00, @2017-09-01T00:00:00] included in Interval [@2017-09-01T00:00:00.000, @2017-12-30T23:59:59.999]</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeIncludedInPrecisionTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval [@2017-09-01T00:00:00, @2017-09-01T00:00:00] included in day of Interval [@2017-09-01T00:00:00.000, @2017-12-30T23:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeIncludedInPrecisionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval [@2017-09-01T00:00:00, @2017-09-01T00:00:00] included in millisecond of Interval [@2017-09-01T00:00:00.000, @2017-12-30T23:59:59.999]</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Intersect" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestIntersectNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] intersect Interval[5, null)</expression>
 			<output>Interval[5, null)</output>
 		</test>
 		<test name="TestIntersectNull1" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of (Interval[1, 10] intersect Interval[5, null)) &lt;= 10</expression>
 			<output>true</output>
 		</test>
 		<test name="TestIntersectNull2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of (Interval[1, 10] intersect Interval[5, null)) &gt;= 5</expression>
 			<output>true</output>
 		</test>
 		<test name="TestIntersectNull3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of (Interval[1, 10] intersect Interval[5, null)) &gt; 10</expression>
 			<output>false</output>
 		</test>
 		<test name="TestIntersectNull4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of (Interval[1, 10] intersect Interval[5, null)) &lt; 5</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalIntersectTest4to10" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] intersect Interval[4, 10]</expression>
 			<output>Interval [ 4, 10 ]</output>
 		</test>
 		<test name="IntegerIntervalIntersectTestNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] intersect Interval[11, 20]</expression>
 			<output>null</output>
 		</test>
 		<test name="DecimalIntervalIntersectTest4to10" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] intersect Interval[4.0, 10.0]</expression>
 			<output>Interval [ 4.0, 10.0 ]</output>
 		</test>
 		<test name="DecimalIntervalIntersectTestNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] intersect Interval[11.0, 20.0]</expression>
 			<output>null</output>
 		</test>
 		<test name="QuantityIntervalIntersectTest5to10" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] intersect Interval[5.0 'g', 10.0 'g']</expression>
 			<output>Interval [ 5.0 'g', 10.0 'g' ]</output>
 		</test>
 		<test name="QuantityIntervalIntersectTestNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] intersect Interval[11.0 'g', 20.0 'g']</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeIntersect" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] intersect Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 10)]</expression>
 			<output>Interval [ @2012-01-07T, @2012-01-10T ]</output>
 		</test>
 		<test name="TimeIntersect" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] intersect Interval[@T04:59:59.999, @T06:59:59.999]</expression>
 			<output>Interval [ @T04:59:59.999, @T06:59:59.999 ]</output>
 		</test>
 	</group>
 	<group name="Equivalent" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalEquivalentTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] ~ Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalEquivalentFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[44, 50] ~ Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalEquivalentTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] ~ Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalEquivalentFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0] ~ Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalEquivalentTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] ~ Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalEquivalentFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g'] ~ Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeEquivalentTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] ~ Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeEquivalentFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] ~ Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 15)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeEquivalentTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] ~ Interval[@T04:59:59.999, @T09:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeEquivalentFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] ~ Interval[@T04:58:59.999, @T09:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Meets" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestMeetsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(null, 5] meets Interval(null, 15)</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalMeetsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] meets Interval[11, 20]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalMeetsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] meets Interval[44, 50]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalMeetsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.01, 5.00000001] meets Interval[5.00000002, 8.50]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalMeetsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.01, 5.00000001] meets Interval[5.5, 8.50]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalMeetsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.01 'g', 5.00000001 'g'] meets Interval[5.00000002 'g', 8.50 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalMeetsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.01 'g', 5.00000001 'g'] meets Interval[5.5 'g', 8.50 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeMeetsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] meets Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 25)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeMeetsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] meets Interval[DateTime(2012, 1, 20), DateTime(2012, 1, 25)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeMeetsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] meets Interval[@T10:00:00.000, @T19:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeMeetsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] meets Interval[@T10:12:00.000, @T19:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="MeetsBefore" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestMeetsBeforeNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(null, 5] meets before Interval(null, 25]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalMeetsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] meets before Interval[11, 20]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalMeetsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] meets before Interval[44, 50]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalMeetsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.50000001, 5.00000011] meets before Interval[5.00000012, 8.50]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalMeetsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[8.01, 15.00000001] meets before Interval[15.00000000, 18.50]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalMeetsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[3.50000001 'g', 5.00000011 'g'] meets before Interval[5.00000012 'g', 8.50 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalMeetsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[8.01 'g', 15.00000001 'g'] meets before Interval[15.00000000 'g', 18.50 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeMeetsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] meets Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 25)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeMeetsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)] meets Interval[DateTime(2012, 1, 20), DateTime(2012, 1, 25)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeMeetsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] meets Interval[@T10:00:00.000, @T19:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeMeetsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T04:59:59.999, @T09:59:59.999] meets Interval[@T10:12:00.000, @T19:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="MeetsAfter" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestMeetsAfterNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(null, 5] meets after Interval[11, null)</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalMeetsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11, 20] meets after Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalMeetsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[44, 50] meets after Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalMeetsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[55.00000123, 128.032156] meets after Interval[12.00258, 55.00000122]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalMeetsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[55.00000124, 150.222222] meets after Interval[12.00258, 55.00000122]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalMeetsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[55.00000123 'g', 128.032156 'g'] meets after Interval[12.00258 'g', 55.00000122 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalMeetsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[55.00000124 'g', 150.222222 'g'] meets after Interval[12.00258 'g', 55.00000122 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeMeetsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 25)] meets Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeMeetsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 20), DateTime(2012, 1, 25)] meets Interval[DateTime(2012, 1, 7), DateTime(2012, 1, 14)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeMeetsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] meets Interval[@T04:59:59.999, @T09:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeMeetsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:12:00.000, @T19:59:59.999] meets Interval[@T04:59:59.999, @T09:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="NotEqual" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalNotEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] != Interval[11, 20]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalNotEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] != Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalNotEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] != Interval[11.0, 20.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalNotEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] != Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalNotEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] != Interval[11.0 'g', 20.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalNotEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] != Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeNotEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15, 0, 0, 0, 0), DateTime(2012, 1, 25, 0, 0, 0, 0)] != Interval[DateTime(2012, 1, 15, 0, 0, 0, 0), DateTime(2012, 1, 25, 0, 0, 0, 22)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeNotEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15, 0, 0, 0, 0), DateTime(2012, 1, 25, 0, 0, 0, 0)] != Interval[DateTime(2012, 1, 15, 0, 0, 0, 0), DateTime(2012, 1, 25, 0, 0, 0, 0)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeNotEqualTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] != Interval[@T10:10:00.000, @T19:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeNotEqualFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] != Interval[@T10:00:00.000, @T19:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="OnOrAfter" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestOnOrAfterNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2012-12-01, @2013-12-01] on or after (null as Interval&lt;Date&gt;)</expression>
 			<output>null</output>
 		</test>
 		<test name="TestOnOrAfterDateTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2012-12-01, @2013-12-01] on or after month of @2012-11-15</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrAfterDateFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@2012-11-15 on or after month of Interval[@2012-12-01, @2013-12-01]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrAfterTimeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] on or after hour of Interval[@T08:00:00.000, @T09:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrAfterTimeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] on or after hour of Interval[@T08:00:00.000, @T11:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrAfterIntegerTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[6, 10] on or after 6</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrAfterDecimalFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>2.5 on or after Interval[1.666, 2.50000001]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrAfterQuantityTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>2.5 'mg' on or after Interval[1.666 'mg', 2.50000000 'mg']</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="OnOrBefore" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestOnOrBeforeNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2012-12-01, @2013-12-01] on or before (null as Interval&lt;Date&gt;)</expression>
 			<output>null</output>
 		</test>
 		<test name="TestOnOrBeforeDateTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2012-10-01, @2012-11-01] on or before month of @2012-11-15</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrBeforeDateFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@2012-11-15 on or before month of Interval[@2012-10-01, @2013-12-01]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrBeforeTimeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:00:00.000, @T07:59:59.999] on or before hour of Interval[@T08:00:00.000, @T09:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrBeforeTimeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] on or before hour of Interval[@T08:00:00.000, @T11:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrBeforeIntegerTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 6] on or before 6</expression>
 			<output>true</output>
 		</test>
 		<test name="TestOnOrBeforeDecimalFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>1.6667 on or before Interval[1.666, 2.50000001]</expression>
 			<output>false</output>
 		</test>
 		<test name="TestOnOrBeforeQuantityTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>1.666 'mg' on or before Interval[1.666 'mg', 2.50000000 'mg']</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="Overlaps" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestOverlapsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] overlaps Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] overlaps Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalOverlapsTrue2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalOverlapsTrue3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[10, 15] overlaps Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] overlaps Interval[11, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10) overlaps Interval[4, 10)</expression>
 			<output>true</output>
 			<!-- `overlaps` is true for equal intervals -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsTrue2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps Interval[10, 20]</expression>
 			<output>true</output>
 			<!-- both intervals include 10 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsTrue3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps Interval(9, 20]</expression>
 			<output>true</output>
 			<!-- both intervals include 10 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsTrue4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps Interval(9, 20]</expression>
 			<output>true</output>
 			<!-- both intervals include 10 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps Interval(10, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsFalse2" version="1.0">
+			<capability code="interval-operators"/>
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10) overlaps Interval[10, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsFalse3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10) overlaps Interval(10, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsFalse4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10) overlaps Interval(9, 20]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] overlaps Interval[4.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] overlaps Interval[11.0, 20.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] overlaps Interval[5.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] overlaps Interval[11.0 'g', 20.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] overlaps Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] overlaps Interval[DateTime(2012, 1, 26), DateTime(2012, 1, 28)]</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeOverlapsPrecisionLeftPossiblyStartsDuringRight" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 2, 25), DateTime(2012, 3, 26)] overlaps Interval[DateTime(2012, 1, 10), DateTime(2012, 2)]</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeOverlapsPrecisioLeftPossiblyEndsDuringRight" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 25), DateTime(2012, 2, 26)] overlaps Interval[DateTime(2012, 2), DateTime(2012, 3, 28)]</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeOverlapsPrecisionLeftPossiblyStartsAndEndsDuringRight" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 2), DateTime(2012, 3)] overlaps Interval[DateTime(2011, 1, 10), DateTime(2012)]</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeOverlapsPrecisionRightPossiblyStartsDuringLeftButEndsDuringLeft" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012), DateTime(2013, 3)] overlaps Interval[DateTime(2012, 2), DateTime(2013, 2)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeOverlapsPrecisionRightStartsDuringLeftAndPossiblyEndsDuringLeft" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 2), DateTime(2013)] overlaps Interval[DateTime(2012, 3), DateTime(2013, 2)]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeOverlapsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] overlaps Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeOverlapsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] overlaps Interval[@T20:00:00.000, @T21:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="OverlapsBefore" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestOverlapsBeforeNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] overlaps before Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] overlaps before Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps before Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalOverlapsBeforeFalse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps before Interval[4, 10]</expression>
 			<output>false</output>
     </test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps before Interval(4, 10]</expression>
 			<output>true</output>
 			<!-- 4 is before 5 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeTrue2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(3, 10] overlaps before Interval(4, 10]</expression>
 			<output>true</output>
 			<!-- 4 is before 5 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeTrue3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(3, 10] overlaps before Interval[5, 10]</expression>
 			<output>true</output>
 			<!-- 4 is before 5 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(3, 10] overlaps before Interval(3, 10]</expression>
 			<output>false</output>
 			<!-- `overlaps before` is false for equal intervals (4 is not before 4) -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeFalse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval(3, 10] overlaps before Interval[4, 10]</expression>
 			<output>false</output>
 			<!-- 4 is not before 4 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsBeforeFalse3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps before Interval(3, 10]</expression>
 			<output>false</output>
 			<!-- 4 is not before 4 -->
 		</test>
 		<test name="DecimalIntervalOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] overlaps before Interval[4.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] overlaps before Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] overlaps before Interval[5.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] overlaps before Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] overlaps Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] overlaps Interval[DateTime(2012, 1, 26), DateTime(2012, 1, 28)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeOverlapsBeforeTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] overlaps Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeOverlapsBeforeFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T10:00:00.000, @T19:59:59.999] overlaps Interval[@T20:00:00.000, @T21:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="OverlapsAfter" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestOverlapsAfterNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] overlaps after Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 15] overlaps after Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps after Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="IntegerIntervalOverlapsAfterFalse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps after Interval[4, 10]</expression>
 			<output>false</output>
     </test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps after Interval[4, 9]</expression>
 			<output>true</output>
 			<!-- 10 is after 9 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterTrue2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps after Interval[4, 10)</expression>
 			<output>true</output>
 			<!-- 10 is after 9 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterTrue3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps after Interval[4, 10)</expression>
 			<output>true</output>
 			<!-- 10 is after 9 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps after Interval[4, 11)</expression>
 			<output>false</output>
 			<!-- `overlaps after` is false for equal intervals (10 is not after 10) -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterFalse2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 11) overlaps after Interval[4, 10]</expression>
 			<output>false</output>
 			<!-- 10 is not after 10 -->
 		</test>
 		<test name="IntegerIntervalExclusiveOverlapsAfterFalse3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] overlaps after Interval[4, 11)</expression>
 			<output>false</output>
 			<!-- 10 is not after 10 -->
 		</test>
 		<test name="DecimalIntervalOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 15.0] overlaps after Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] overlaps after Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 15.0 'g'] overlaps after Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] overlaps after Interval[1.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)] overlaps Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 26), DateTime(2012, 1, 28)] overlaps Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeOverlapsAfterTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] overlaps Interval[@T10:00:00.000, @T19:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeOverlapsAfterFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T20:00:00.000, @T21:59:59.999] overlaps Interval[@T10:00:00.000, @T19:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="PointFrom" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestPointFromNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>point from Interval[null, null]</expression>
 			<output>null</output>
 		</test>
 		<test name="TestPointFromInteger" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>point from Interval[1, 1]</expression>
 			<output>1</output>
 		</test>
 		<test name="TestPointFromDecimal" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>point from Interval[1.0, 1.0]</expression>
 			<output>1.0</output>
 		</test>
 		<test name="TestPointFromQuantity" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>point from Interval[1.0 'cm', 1.0 'cm']</expression>
 			<output>1.0'cm'</output>
 		</test>
 	</group>
 	<group name="ProperContains" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TimeProperContainsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] properly includes @T12:00:00.001</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperContainsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] properly includes @T12:00:00.000</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperContainsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.001, @T21:59:59.999] properly includes @T12:00:00</expression>
 			<output>null</output>
 		</test>
 		<test name="TimeProperContainsPrecisionTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] properly includes second of @T12:00:01</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperContainsPrecisionFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.001, @T21:59:59.999] properly includes second of @T12:00:00</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperContainsPrecisionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.001, @T21:59:59.999] properly includes millisecond of @T12:00:00</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="ProperIn" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TimeProperInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:00.001 properly included in Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:00.000 properly included in  Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperInNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:00 properly included in Interval[@T12:00:00.001, @T21:59:59.999]</expression>
 			<output>null</output>
 		</test>
 		<test name="TimeProperInPrecisionTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:01 properly included in second of Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperInPrecisionFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:00 properly included in second of Interval[@T12:00:00.001, @T21:59:59.999]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperInPrecisionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>@T12:00:00 properly included in millisecond of Interval[@T12:00:00.001, @T21:59:59.999]</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="ProperlyIncludes" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="NullBoundariesProperlyIncludesIntegerInterval" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null as Integer, null as Integer] properly includes Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalProperlyIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] properly includes Interval[4, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalProperlyIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] properly includes Interval[4, 15]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalProperlyIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] properly includes Interval[4.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalProperlyIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] properly includes Interval[4.0, 15.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalProperlyIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] properly includes Interval[5.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalProperlyIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] properly includes Interval[5.0 'g', 15.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeProperlyIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)] properly includes Interval[DateTime(2012, 1, 16), DateTime(2012, 1, 27)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeProperlyIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)] properly includes Interval[DateTime(2012, 1, 16), DateTime(2012, 1, 29)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperlyIncludesTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] properly includes Interval[@T12:01:01.000, @T21:59:59.998]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperlyIncludesFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:00:00.000, @T21:59:59.999] properly includes Interval[@T12:01:01.000, @T22:00:00.000]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="ProperlyIncludedIn" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalProperlyIncludedInNullBoundaries" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] properly included in Interval[null, null]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalProperlyIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] properly included in Interval[1, 10]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalProperlyIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 15] properly included in Interval[1, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalProperlyIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] properly included in Interval[1.0, 10.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalProperlyIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 15.0] properly included in Interval[1.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalProperlyIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] properly included in Interval[1.0 'g', 10.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalProperlyIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] properly included in Interval[5.0 'g', 15.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeProperlyIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 16), DateTime(2012, 1, 27)] properly included in Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeProperlyIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 16), DateTime(2012, 1, 29)] properly included in Interval[DateTime(2012, 1, 15), DateTime(2012, 1, 28)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeProperlyIncludedInTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:01:01.000, @T21:59:59.998] properly included in Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeProperlyIncludedInFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T12:01:01.000, @T22:00:00.000] properly included in Interval[@T12:00:00.000, @T21:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Start" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalStart" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of Interval[1, 10]</expression>
 			<output>1</output>
 		</test>
 		<test name="DecimalIntervalStart" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of Interval[1.0, 10.0]</expression>
 			<output>1.0</output>
 		</test>
 		<test name="QuantityIntervalStart" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of Interval[1.0 'g', 10.0 'g']</expression>
 			<output>1.0'g'</output>
 		</test>
 		<test name="DateTimeIntervalStart" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of Interval[@2016-05-01T00:00:00.000, @2016-05-02T00:00:00.000]</expression>
 			<output>@2016-05-01T00:00:00.000</output>
 		</test>
 		<test name="TimeIntervalStart" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>start of Interval[@T00:00:00.000, @T23:59:59.599]</expression>
 			<output>@T00:00:00.000</output>
 		</test>
 	</group>
 	<group name="Starts" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestStartsNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] starts Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalStartsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10] starts Interval[4, 15]</expression>
 			<output>true</output>
 		</test>
 		<test name="IntegerIntervalStartsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] starts Interval[4, 10]</expression>
 			<output>false</output>
 		</test>
 		<test name="DecimalIntervalStartsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0] starts Interval[4.0, 15.0]</expression>
 			<output>true</output>
 		</test>
 		<test name="DecimalIntervalStartsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] starts Interval[4.0, 10.0]</expression>
 			<output>false</output>
 		</test>
 		<test name="QuantityIntervalStartsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g'] starts Interval[5.0 'g', 15.0 'g']</expression>
 			<output>true</output>
 		</test>
 		<test name="QuantityIntervalStartsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] starts Interval[5.0 'g', 10.0 'g']</expression>
 			<output>false</output>
 		</test>
 		<test name="DateTimeStartsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] starts Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 27)]</expression>
 			<output>true</output>
 		</test>
 		<test name="DateTimeStartsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] starts Interval[DateTime(2012, 1, 6), DateTime(2012, 1, 27)]</expression>
 			<output>false</output>
 		</test>
 		<test name="TimeStartsTrue" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T15:59:59.999] starts Interval[@T05:59:59.999, @T17:59:59.999]</expression>
 			<output>true</output>
 		</test>
 		<test name="TimeStartsFalse" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T15:59:59.999] starts Interval[@T04:59:59.999, @T17:59:59.999]</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Union" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="TestUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[null, null] union Interval[1, 10]</expression>
 			<output>null</output>
 		</test>
 		<test name="IntegerIntervalUnion1To15" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] union Interval[4, 15]</expression>
 			<output>Interval [ 1, 15 ]</output>
 		</test>
 		<test name="IntegerIntervalUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10] union Interval[44, 50]</expression>
 			<output>null</output>
 		</test>
 		<test name="DecimalIntervalUnion1To15" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] union Interval[4.0, 15.0]</expression>
 			<output>Interval [ 1.0, 15.0 ]</output>
 		</test>
 		<test name="DecimalIntervalUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0] union Interval[14.0, 15.0]</expression>
 			<output>null</output>
 		</test>
 		<test name="QuantityIntervalUnion1To15" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] union Interval[5.0 'g', 15.0 'g']</expression>
 			<output>Interval [ 1.0 'g', 15.0 'g' ]</output>
 		</test>
 		<test name="QuantityIntervalUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g'] union Interval[14.0 'g', 15.0 'g']</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeUnion" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] union Interval[DateTime(2012, 1, 25), DateTime(2012, 1, 28)]</expression>
 			<output>Interval [ @2012-01-05T, @2012-01-28T ]</output>
 		</test>
 		<test name="DateTimeUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)] union Interval[DateTime(2012, 1, 27), DateTime(2012, 1, 28)]</expression>
 			<output>null</output>
 		</test>
 		<test name="TimeUnion" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T15:59:59.999] union Interval[@T10:59:59.999, @T20:59:59.999]</expression>
 			<output>Interval [ @T05:59:59.999, @T20:59:59.999 ]</output>
 		</test>
 		<test name="TimeUnionNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T05:59:59.999, @T15:59:59.999] union Interval[@T16:59:59.999, @T20:59:59.999]</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Width" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalTestWidth9" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>width of Interval[1, 10]</expression>
 			<output>9</output>
 		</test>
 		<test name="IntervalTestWidthNull" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>width of (null as Interval&lt;Any&gt;)</expression>
 			<output>null</output>
 		</test>
 		<test name="DecimalIntervalTestWidth11" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>width of Interval[4.0, 15.0]</expression>
 			<output>11.0</output>
 		</test>
 		<test name="QuantityIntervalTestWidth5" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>width of Interval[5.0 'g', 10.0 'g']</expression>
 			<output>5.0'g'</output>
 		</test>
 		<test name="DateTimeWidth" version="1.0">
+			<capability code="interval-operators"/>
 			<expression invalid="true">width of Interval[DateTime(2012, 1, 5), DateTime(2012, 1, 25)]</expression>
 		</test>
 		<test name="TimeWidth" version="1.0">
+			<capability code="interval-operators"/>
 			<expression invalid="true">width of Interval[@T05:59:59.999, @T15:59:59.999]</expression>
 		</test>
 	</group>
 	<group name="Interval" version="1.0">
+		<capability code="interval-operators"/>
 		<test name="IntegerIntervalTest" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1, 10]</expression>
 			<output>Interval[1, 10]</output>
 		</test>
 		<test name="IntegerIntervalTest2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11, 20]</expression>
 			<output>Interval[11, 20]</output>
 		</test>
 		<test name="IntegerIntervalTest3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[44, 50]</expression>
 			<output>Interval[44, 50]</output>
 		</test>
 		<test name="IntegerIntervalTest4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 10]</expression>
 			<output>Interval[4, 10]</output>
 		</test>
 		<test name="IntegerIntervalTest5" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4, 15]</expression>
 			<output>Interval[4, 15]</output>
 		</test>
 		<test name="DecimalIntervalTest" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0, 10.0]</expression>
 			<output>Interval[1.0, 10.0]</output>
 		</test>
 		<test name="DecimalIntervalTest2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0, 20.0]</expression>
 			<output>Interval[11.0, 20.0]</output>
 		</test>
 		<test name="DecimalIntervalTest3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 10.0]</expression>
 			<output>Interval[4.0, 10.0]</output>
 		</test>
 		<test name="DecimalIntervalTest4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[4.0, 15.0]</expression>
 			<output>Interval[4.0, 15.0]</output>
 		</test>
 		<test name="DecimalIntervalTest5" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[14.0, 15.0]</expression>
 			<output>Interval[14.0, 15.0]</output>
 		</test>
 		<test name="QuantityIntervalTest" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[1.0 'g', 10.0 'g']</expression>
 			<output>Interval[1.0 'g', 10.0 'g']</output>
 		</test>
 		<test name="QuantityIntervalTest2" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[11.0 'g', 20.0 'g']</expression>
 			<output>Interval[11.0 'g', 20.0 'g']</output>
 		</test>
 		<test name="QuantityIntervalTest3" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 10.0 'g']</expression>
 			<output>Interval[5.0 'g', 10.0 'g']</output>
 		</test>
 		<test name="QuantityIntervalTest4" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[5.0 'g', 15.0 'g']</expression>
 			<output>Interval[5.0 'g', 15.0 'g']</output>
 		</test>
 		<test name="QuantityIntervalTest5" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[14.0 'g', 15.0 'g']</expression>
 			<output>Interval[14.0 'g', 15.0 'g']</output>
 		</test>
 		<test name="DateTimeIntervalTest" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@2016-05-01T00:00:00.000, @2016-05-02T00:00:00.000]</expression>
 			<output>Interval[@2016-05-01T00:00:00.000, @2016-05-02T00:00:00.000]</output>
 		</test>
 		<test name="TimeIntervalTest" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>Interval[@T00:00:00.000, @T23:59:59.599]</expression>
 			<output>Interval[@T00:00:00.000, @T23:59:59.599]</output>
 		</test>
 		<test name="CollapseIntervalTestInteger" version="1.0">
+			<capability code="interval-operators"/>
 			<expression>{Interval[1, 10], Interval[11, 20], Interval[44, 50]}</expression>
 			<output>{Interval[1, 10], Interval[11, 20], Interval[44, 50]}</output>
 		</test>
 		<test name="InvalidIntegerInterval" version="1.0">
+			<capability code="interval-operators"/>
 			<expression invalid="true">Interval[5, 3]</expression>
 			<!-- EXPECT: Invalid Interval - the ending boundary must be greater than or equal to the starting boundary. -->
 		</test>
 		<test name="InvalidIntegerIntervalA" version="1.0">
+			<capability code="interval-operators"/>
 			<expression invalid="true">Interval[5, 5)</expression>
 			<!-- EXPECT: Invalid Interval - the ending boundary must be greater than or equal to the starting boundary. -->
 		</test>
diff --git a/test/spec-tests/xml/CqlLogicalOperatorsTest.xml b/test/spec-tests/xml/CqlLogicalOperatorsTest.xml
index 36062aa65..5b7137121 100644
--- a/test/spec-tests/xml/CqlLogicalOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlLogicalOperatorsTest.xml
@@ -1,169 +1,214 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlLogicalOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#logical-operators-3" version="1.0">
+	<capability code="logical-operators"/>
 	<group name="And" version="1.0">
+		<capability code="logical-operators"/>
 		<test name="TrueAndTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true and true</expression>
 			<output>true</output>
 		</test>
 		<test name="TrueAndFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true and false</expression>
 			<output>false</output>
 		</test>
 		<test name="TrueAndNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true and null</expression>
 			<output>null</output>
 		</test>
 		<test name="FalseAndTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false and true</expression>
 			<output>false</output>
 		</test>
 		<test name="FalseAndFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false and false</expression>
 			<output>false</output>
 		</test>
 		<test name="FalseAndNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false and null</expression>
 			<output>false</output>
 		</test>
 		<test name="NullAndTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null and true</expression>
 			<output>null</output>
 		</test>
 		<test name="NullAndFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null and false</expression>
 			<output>false</output>
 		</test>
 		<test name="NullAndNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null and null</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Implies" version="1.0">
+		<capability code="logical-operators"/>
 		<!-- TODO: make Translator resolve Implies operator signatures -->
 		<test name="TrueImpliesTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true implies true</expression>
 			<output>true</output>
 		</test>
 		<test name="TrueImpliesFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true implies false</expression>
 			<output>false</output>
 		</test>
 		<test name="TrueImpliesNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true implies null</expression>
 			<output>null</output>
 		</test>
 		<test name="FalseImpliesTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false implies true</expression>
 			<output>true</output>
 		</test>
 		<test name="FalseImpliesFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false implies false</expression>
 			<output>true</output>
 		</test>
 		<test name="FalseImpliesNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false implies null</expression>
 			<output>true</output>
 		</test>
 		<test name="NullImpliesTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null implies true</expression>
 			<output>true</output>
 		</test>
 		<test name="NullImpliesFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null implies false</expression>
 			<output>null</output>
 		</test>
 		<test name="NullImpliesNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null implies null</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Not" version="1.0">
+		<capability code="logical-operators"/>
 		<test name="NotTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>not true</expression>
 			<output>false</output>
 		</test>
 		<test name="NotFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>not false</expression>
 			<output>true</output>
 		</test>
 		<test name="NotNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>not null</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Or" version="1.0">
+		<capability code="logical-operators"/>
 		<test name="TrueOrTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true or true</expression>
 			<output>true</output>
 		</test>
 		<test name="TrueOrFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true or false</expression>
 			<output>true</output>
 		</test>
 		<test name="TrueOrNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true or null</expression>
 			<output>true</output>
 		</test>
 		<test name="FalseOrTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false or true</expression>
 			<output>true</output>
 		</test>
 		<test name="FalseOrFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false or false</expression>
 			<output>false</output>
 		</test>
 		<test name="FalseOrNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false or null</expression>
 			<output>null</output>
 		</test>
 		<test name="NullOrTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null or true</expression>
 			<output>true</output>
 		</test>
 		<test name="NullOrFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null or false</expression>
 			<output>null</output>
 		</test>
 		<test name="NullOrNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null or null</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Xor" version="1.0">
+		<capability code="logical-operators"/>
 		<test name="TrueXorTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true xor true</expression>
 			<output>false</output>
 		</test>
 		<test name="TrueXorFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true xor false</expression>
 			<output>true</output>
 		</test>
 		<test name="TrueXorNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>true xor null</expression>
 			<output>null</output>
 		</test>
 		<test name="FalseXorTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false xor true</expression>
 			<output>true</output>
 		</test>
 		<test name="FalseXorFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false xor false</expression>
 			<output>false</output>
 		</test>
 		<test name="FalseXorNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>false xor null</expression>
 			<output>null</output>
 		</test>
 		<test name="NullXorTrue" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null xor true</expression>
 			<output>null</output>
 		</test>
 		<test name="NullXorFalse" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null xor false</expression>
 			<output>null</output>
 		</test>
 		<test name="NullXorNull" version="1.0">
+			<capability code="logical-operators"/>
 			<expression>null xor null</expression>
 			<output>null</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlNullologicalOperatorsTest.xml b/test/spec-tests/xml/CqlNullologicalOperatorsTest.xml
index 5af5c10d1..d3b89bc69 100644
--- a/test/spec-tests/xml/CqlNullologicalOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlNullologicalOperatorsTest.xml
@@ -1,98 +1,125 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlNullologicalOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#nullological-operators-3" version="1.0">
+	<capability code="nullological-operators" />
 	<group name="Coalesce" version="1.0">
+		<capability code="nullological-operators" />
 		<test name="CoalesceANull" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce('a', null)</expression>
 			<output>'a'</output>
 		</test>
 		<test name="CoalesceNullA" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce(null, 'a')</expression>
 			<output>'a'</output>
 		</test>
 		<test name="CoalesceEmptyList" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({})</expression>
 			<output>null</output>
 		</test>
 		<test name="CoalesceListFirstA" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({'a', null, null})</expression>
 			<output>'a'</output>
 		</test>
 		<test name="CoalesceListLastA" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({null, null, 'a'})</expression>
 			<output>'a'</output>
 		</test>
 		<test name="CoalesceFirstList" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({'a'},null, null)</expression>
 			<output>{'a'}</output>
 		</test>
 		<test name="CoalesceLastList" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce(null, null, {'a'})</expression>
 			<output>{'a'}</output>
 		</test>
 		<test name="DateTimeCoalesce" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce(null, null, DateTime(2012, 5, 18))</expression>
 			<output>@2012-05-18T</output>
 		</test>
 		<test name="DateTimeListCoalesce" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({ null, null, DateTime(2012, 5, 18) })</expression>
 			<output>@2012-05-18T</output>
 		</test>
 		<test name="TimeCoalesce" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce(null, null, @T05:15:33.556)</expression>
 			<output>@T05:15:33.556</output>
 		</test>
 		<test name="TimeListCoalesce" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>Coalesce({ null, null, @T05:15:33.556 })</expression>
 			<output>@T05:15:33.556</output>
 		</test>
 	</group>
 	<group name="IsNull" version="1.0">
+		<capability code="nullological-operators" />
 		<test name="IsNullTrue" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsNull(null)</expression>
 			<output>true</output>
 		</test>
 		<test name="IsNullFalseEmptyString" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsNull('')</expression>
 			<output>false</output>
 		</test>
 		<test name="IsNullAlsoFalseAbcString" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsNull('abc')</expression>
 			<output>false</output>
 		</test>
 		<test name="IsNullAlsoFalseNumber1" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsNull(1)</expression>
 			<output>false</output>
 		</test>
 		<test name="IsNullAlsoFalseNumberZero" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsNull(0)</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="IsFalse" version="1.0">
+		<capability code="nullological-operators" />
 		<test name="IsFalseFalse" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsFalse(false)</expression>
 			<output>true</output>
 		</test>
 		<test name="IsFalseTrue" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsFalse(true)</expression>
 			<output>false</output>
 		</test>
 		<test name="IsFalseNull" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsFalse(null)</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="IsTrue" version="1.0">
+		<capability code="nullological-operators" />
 		<test name="IsTrueTrue" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsTrue(true)</expression>
 			<output>true</output>
 		</test>
 		<test name="IsTrueFalse" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsTrue(false)</expression>
 			<output>false</output>
 		</test>
 		<test name="IsTrueNull" version="1.0">
+			<capability code="nullological-operators" />
 			<expression>IsTrue(null)</expression>
 			<output>false</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlQueryTests.xml b/test/spec-tests/xml/CqlQueryTests.xml
index 43e738ea4..c7ce16750 100644
--- a/test/spec-tests/xml/CqlQueryTests.xml
+++ b/test/spec-tests/xml/CqlQueryTests.xml
@@ -1,56 +1,72 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
     xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd" name="CqlQueryTest" reference="https://cql.hl7.org/02-authorsguide.html#queries" version="1.0">
+    <capability code="queries" />
     <group name="SimpleQueries" version="1.0">
+        <capability code="queries" />
         <test name="NonListSource" version="1.0">
+            <capability code="queries" />
             <expression>(4) l</expression>
             <output>4</output>
         </test>
         <test name="NonListSourceWithReturn" version="1.0">
+            <capability code="queries" />
             <expression>(4) l return 'Hello World'</expression>
             <output>'Hello World'</output>
         </test>
         <test name="MultiSource" version="1.0">
+            <capability code="queries" />
             <expression>from ({2, 3}) A, ({5, 6}) B</expression>
             <output>{{ A: 2, B: 5 }, { A: 2, B: 6 }, { A: 3, B: 5 }, { A: 3, B: 6 }}</output>
         </test>
     </group>
     <group name="Sort" version="1.0">
+        <capability code="queries" />
         <test name="IntegerDescending" version="1.0">
+            <capability code="queries" />
             <expression>({1, 2, 3}) l sort desc</expression>
             <output>{3, 2, 1}</output>
         </test>
         <test name="IntegerAscending" version="1.0">
+            <capability code="queries" />
             <expression>({1, 3, 2}) l sort ascending</expression>
             <output>{1, 2, 3}</output>
         </test>
         <test name="DateTimeDescending" version="1.0">
+            <capability code="queries" />
             <expression>({@2013-01-02T00:00:00.000Z, @2014-01-02T00:00:00.000Z, @2015-01-02T00:00:00.000Z}) l sort desc</expression>
             <output>{@2015-01-02T00:00:00.000Z, @2014-01-02T00:00:00.000Z, @2013-01-02T00:00:00.000Z}</output>
         </test>
         <test name="DateTimeAscending" version="1.0">
+            <capability code="queries" />
             <expression>({@2013-01-02T00:00:00.000Z, @2015-01-02T00:00:00.000Z, @2014-01-02T00:00:00.000Z}) l sort ascending</expression>
             <output>{@2013-01-02T00:00:00.000Z, @2014-01-02T00:00:00.000Z, @2015-01-02T00:00:00.000Z}</output>
         </test>
     </group>
     <group name="Aggregate" version="1.0">
+        <capability code="queries" />
         <test name="MultiplyIntegers" version="1.0">
+            <capability code="queries" />
             <expression>({1, 2, 3, 3, 4}) L aggregate A starting 1: A * L</expression>
             <output>72</output>
         </test>
         <test name="MultiplyIntegersAll" version="1.0">
+            <capability code="queries" />
             <expression>({1, 2, 3, 3, 4}) L aggregate all A starting 1: A * L</expression>
             <output>72</output>
         </test>
         <test name="MultiplyIntegersDistinct" version="1.0">
+            <capability code="queries" />
             <expression>({1, 2, 3, 3, 4}) L aggregate distinct A starting 1: A * L</expression>
             <output>24</output>
         </test>
         <test name="MultiplyIntegersNoStartingExpression" version="1.0">
+            <capability code="queries" />
             <expression>({1, 2, 3}) L aggregate A : A * L</expression>
             <output>null</output>
         </test>
         <test name="Multi-Source" version="1.0">
+            <capability code="queries" />
             <expression>from ({1, 2, 3}) B, (4) C aggregate A : A + B + C</expression>
             <output>null</output>
         </test>
diff --git a/test/spec-tests/xml/CqlStringOperatorsTest.xml b/test/spec-tests/xml/CqlStringOperatorsTest.xml
index 007789f96..e1836aaa8 100644
--- a/test/spec-tests/xml/CqlStringOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlStringOperatorsTest.xml
@@ -1,359 +1,461 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlStringOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#string-operators-3" version="1.0">
+	<capability code="string-operators" />
 	<group name="Combine" version="1.0">
+		<capability code="string-operators" />
 		<test name="CombineNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Combine(null)</expression>
 			<output>null</output>
 		</test>
 		<test name="CombineEmptyList" version="1.0">
+			<capability code="string-operators" />
 			<expression>Combine({})</expression>
 			<output>null</output>
 		</test>
 		<test name="CombineABC" version="1.0">
+			<capability code="string-operators" />
 			<expression>Combine({'a', 'b', 'c'})</expression>
 			<output>'abc'</output>
 		</test>
 		<test name="CombineABCSepDash" version="1.0">
+			<capability code="string-operators" />
 			<expression>Combine({'a', 'b', 'c'}, '-')</expression>
 			<output>'a-b-c'</output>
 		</test>
 	</group>
 	<group name="Concatenate" version="1.0">
+		<capability code="string-operators" />
 		<test name="ConcatenateNullNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Concatenate(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="ConcatenateANull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Concatenate('a', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="ConcatenateNullB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Concatenate(null, 'b')</expression>
 			<output>null</output>
 		</test>
 		<test name="ConcatenateAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Concatenate('a', 'b')</expression>
 			<output>'ab'</output>
 		</test>
 		<test name="ConcatenateABWithAdd" version="1.0">
+			<capability code="string-operators" />
 			<expression>'a' + 'b'</expression>
 			<output>'ab'</output>
 		</test>
 	</group>
 	<group name="EndsWith" version="1.0">
+		<capability code="string-operators" />
 		<test name="EndsWithNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>EndsWith(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="EndsWithTrue" version="1.0">
+			<capability code="string-operators" />
 			<expression>EndsWith('Chris Schuler is the man!!', 'n!!')</expression>
 			<output>true</output>
 		</test>
 		<test name="EndsWithFalse" version="1.0">
+			<capability code="string-operators" />
 			<expression>EndsWith('Chris Schuler is the man!!', 'n!')</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Indexer" version="1.0">
+		<capability code="string-operators" />
 		<test name="IndexerNullNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer(null as String, null)</expression>
 			<output>null</output>
 			<!-- cast is required due to ambiguity with Indexer(String) and Indexer(List&lt;Any&gt;) -->
 		</test>
 		<test name="IndexerANull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer('a', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="IndexerNull1String" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer(null as String, 1)</expression>
 			<output>null</output>
 			<!-- cast is required due to ambiguity with Indexer(String) and Indexer(List&lt;Any&gt;) -->
 		</test>
 		<test name="IndexerAB0" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer('ab', 0)</expression>
 			<output>'a'</output>
 		</test>
 		<test name="IndexerAB1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer('ab', 1)</expression>
 			<output>'b'</output>
 		</test>
 		<test name="IndexerAB2" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer('ab', 2)</expression>
 			<output>null</output>
 		</test>
 		<test name="IndexerABNeg1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Indexer('ab', -1)</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="LastPositionOf" version="1.0">
+		<capability code="string-operators" />
 		<test name="LastPositionOfNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>LastPositionOf(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="LastPositionOfNull1" version="1.0">
+			<capability code="string-operators" />
 			<expression>LastPositionOf(null, 'hi')</expression>
 			<output>null</output>
 		</test>
 		<test name="LastPositionOfNull2" version="1.0">
+			<capability code="string-operators" />
 			<expression>LastPositionOf('hi', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="LastPositionOf1" version="1.0">
+			<capability code="string-operators" />
 			<expression>LastPositionOf('hi', 'Ohio is the place to be!')</expression>
 			<output>1</output>
 		</test>
 		<test name="LastPositionOf2" version="1.0">
+			<capability code="string-operators" />
 			<expression>LastPositionOf('hi', 'Say hi to Ohio!')</expression>
 			<output>11</output>
 		</test>
 	</group>
 	<group name="Length" version="1.0">
+		<capability code="string-operators" />
 		<test name="LengthNullString" version="1.0">
+			<capability code="string-operators" />
 			<expression>Length(null as String)</expression>
 			<output>null</output>
 			<!-- cast is required due to ambiguity with Length(String) and Length(List&lt;Any&gt;) -->
 		</test>
 		<test name="LengthEmptyString" version="1.0">
+			<capability code="string-operators" />
 			<expression>Length('')</expression>
 			<output>0</output>
 		</test>
 		<test name="LengthA" version="1.0">
+			<capability code="string-operators" />
 			<expression>Length('a')</expression>
 			<output>1</output>
 		</test>
 		<test name="LengthAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Length('ab')</expression>
 			<output>2</output>
 		</test>
 	</group>
 	<group name="Lower" version="1.0">
+		<capability code="string-operators" />
 		<test name="LowerNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Lower(null)</expression>
 			<output>null</output>
 		</test>
 		<test name="LowerEmpty" version="1.0">
+			<capability code="string-operators" />
 			<expression>Lower('')</expression>
 			<output>''</output>
 		</test>
 		<test name="LowerA" version="1.0">
+			<capability code="string-operators" />
 			<expression>Lower('A')</expression>
 			<output>'a'</output>
 		</test>
 		<test name="LowerB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Lower('b')</expression>
 			<output>'b'</output>
 		</test>
 		<test name="LowerAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Lower('Ab')</expression>
 			<output>'ab'</output>
 		</test>
 	</group>
 	<group name="Matches" version="1.0">
+		<capability code="string-operators" />
 		<test name="MatchesNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="MatchesNumberFalse" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost', '.*\\d+')</expression>
 			<output>false</output>
 		</test>
 		<test name="MatchesNumberTrue" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost - circa 2017', '.*\\d+')</expression>
 			<output>true</output>
 		</test>
 		<test name="MatchesAllTrue" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost', '.*')</expression>
 			<output>true</output>
 		</test>
 		<test name="MatchesWordsAndSpacesTrue" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost', '[\\w|\\s]+')</expression>
 			<output>true</output>
 		</test>
 		<test name="MatchesWordsAndSpacesFalse" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('Not all who wander are lost - circa 2017', '^[\\w\\s]+$')</expression>
 			<output>false</output>
 		</test>
 		<test name="MatchesNotWords" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches('   ', '\\W+')</expression>
 			<output>true</output>
 		</test>
 		<test name="MatchesWhiteSpace" version="1.0">
+			<capability code="string-operators" />
 			<expression>Matches(' \n\t', '\\s+')</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="PositionOf" version="1.0">
+		<capability code="string-operators" />
 		<test name="PositionOfNullNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="PositionOfANull" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf('a', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="PositionOfNullA" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf(null, 'a')</expression>
 			<output>null</output>
 		</test>
 		<test name="PositionOfAInAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf('a', 'ab')</expression>
 			<output>0</output>
 		</test>
 		<test name="PositionOfBInAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf('b', 'ab')</expression>
 			<output>1</output>
 		</test>
 		<test name="PositionOfCInAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>PositionOf('c', 'ab')</expression>
 			<output>-1</output>
 		</test>
 	</group>
 	<group name="ReplaceMatches" version="1.0">
+		<capability code="string-operators" />
 		<test name="ReplaceMatchesNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>ReplaceMatches('Not all who wander are lost', null, 'But I am...')</expression>
 			<output>null</output>
 		</test>
 		<test name="ReplaceMatchesAll" version="1.0">
+			<capability code="string-operators" />
 			<expression>ReplaceMatches('Not all who wander are lost', 'Not all who wander are lost', 'But still waters run deep')</expression>
 			<output>'But still waters run deep'</output>
 		</test>
 		<test name="ReplaceMatchesMany" version="1.0">
+			<capability code="string-operators" />
 			<expression>ReplaceMatches('Who put the bop in the bop she bop she bop?', 'bop', 'bang')</expression>
 			<output>'Who put the bang in the bang she bang she bang?'</output>
 		</test>
 		<test name="ReplaceMatchesSpaces" version="1.0">
+			<capability code="string-operators" />
 			<expression>ReplaceMatches('All that glitters is not gold', '\\s', '\\$')</expression>
 			<output>'All$that$glitters$is$not$gold'</output>
 		</test>
 	</group>
 	<group name="Split" version="1.0">
+		<capability code="string-operators" />
 		<test name="SplitNullNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Split(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="SplitNullComma" version="1.0">
+			<capability code="string-operators" />
 			<expression>Split(null, ',')</expression>
 			<output>null</output>
 		</test>
 		<test name="SplitABNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Split('a,b', null)</expression>
 			<output>{'a,b'}</output>
 		</test>
 		<test name="SplitABDash" version="1.0">
+			<capability code="string-operators" />
 			<expression>Split('a,b', '-')</expression>
 			<output>{'a,b'}</output>
 		</test>
 		<test name="SplitABComma" version="1.0">
+			<capability code="string-operators" />
 			<expression>Split('a,b', ',')</expression>
 			<output>{'a','b'}</output>
 		</test>
 	</group>
 	<group name="StartsWith" version="1.0">
+		<capability code="string-operators" />
 		<test name="StartsWithNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>StartsWith(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="StartsWithNull1" version="1.0">
+			<capability code="string-operators" />
 			<expression>StartsWith('hi', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="StartsWithNull2" version="1.0">
+			<capability code="string-operators" />
 			<expression>StartsWith(null, 'hi')</expression>
 			<output>null</output>
 		</test>
 		<test name="StartsWithTrue1" version="1.0">
+			<capability code="string-operators" />
 			<expression>StartsWith('Breathe deep the gathering gloom', 'Bre')</expression>
 			<output>true</output>
 		</test>
 		<test name="StartsWithFalse1" version="1.0">
+			<capability code="string-operators" />
 			<expression>StartsWith('Breathe deep the gathering gloom', 'bre')</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="Substring" version="1.0">
+		<capability code="string-operators" />
 		<test name="SubstringNullNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring(null, null)</expression>
 			<output>null</output>
 		</test>
 		<test name="SubstringANull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('a', null)</expression>
 			<output>null</output>
 		</test>
 		<test name="SubstringNull1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring(null, 1)</expression>
 			<output>null</output>
 		</test>
 		<test name="SubstringAB0" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', 0)</expression>
 			<output>'ab'</output>
 		</test>
 		<test name="SubstringAB1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', 1)</expression>
 			<output>'b'</output>
 		</test>
 		<test name="SubstringAB2" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', 2)</expression>
 			<output>null</output>
 		</test>
 		<test name="SubstringABNeg1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', -1)</expression>
 			<output>null</output>
 		</test>
+		<test name="SubstringEmptyAnd0" version="1.0">
+			<capability code="string-operators" />
+			<expression>Substring('', 0)</expression>
+			<output>''</output>
+		</test>
 		<test name="SubstringAB0To1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', 0, 1)</expression>
 			<output>'a'</output>
 		</test>
 		<test name="SubstringABC1To1" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('abc', 1, 1)</expression>
 			<output>'b'</output>
 		</test>
 		<test name="SubstringAB0To3" version="1.0">
+			<capability code="string-operators" />
 			<expression>Substring('ab', 0, 3)</expression>
 			<output>'ab'</output>
 		</test>
 	</group>
 	<group name="Upper" version="1.0">
+		<capability code="string-operators" />
 		<test name="UpperNull" version="1.0">
+			<capability code="string-operators" />
 			<expression>Upper(null)</expression>
 			<output>null</output>
 		</test>
 		<test name="UpperEmpty" version="1.0">
+			<capability code="string-operators" />
 			<expression>Upper('')</expression>
 			<output>''</output>
 		</test>
 		<test name="UpperA" version="1.0">
+			<capability code="string-operators" />
 			<expression>Upper('a')</expression>
 			<output>'A'</output>
 		</test>
 		<test name="UpperB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Upper('B')</expression>
 			<output>'B'</output>
 		</test>
 		<test name="UpperAB" version="1.0">
+			<capability code="string-operators" />
 			<expression>Upper('aB')</expression>
 			<output>'AB'</output>
 		</test>
 	</group>
 	<group name="toString tests" version="1.0">
+		<capability code="string-operators" />
 		<test name="QuantityToString" version="1.0">
+			<capability code="string-operators" />
 			<expression>ToString(125 'cm')</expression>
 			<output>'125 \'cm\''</output>
 		</test>
 		<test name="DateTimeToString1" version="1.0">
+			<capability code="string-operators" />
 			<expression>ToString(DateTime(2000, 1, 1))</expression>
 			<output>'2000-01-01'</output>
 		</test>
 		<test name="DateTimeToString2" version="1.0">
+			<capability code="string-operators" />
 			<expression>ToString(DateTime(2000, 1, 1, 15, 25, 25, 300))</expression>
 			<output>'2000-01-01T15:25:25.300'</output>
 		</test>
 		<test name="DateTimeToString3" version="1.0">
+			<capability code="string-operators" />
 			<expression>ToString(DateTime(2000, 1, 1, 8, 25, 25, 300, -7))</expression>
 			<output>'2000-01-01T08:25:25.300-07:00'</output>
 		</test>
 		<test name="TimeToString1" version="1.0">
+			<capability code="string-operators" />
 			<expression>ToString(@T09:30:01.003)</expression>
 			<output>'09:30:01.003'</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlTypeOperatorsTest.xml b/test/spec-tests/xml/CqlTypeOperatorsTest.xml
index e5f1d91a2..64bff2354 100644
--- a/test/spec-tests/xml/CqlTypeOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlTypeOperatorsTest.xml
@@ -1,69 +1,89 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="CqlTypeOperatorsTest" reference="https://cql.hl7.org/09-b-cqlreference.html#type-operators-1" version="1.0">
+	<capability code="type-operators" />
 	<group name="As" version="1.0">
+		<capability code="type-operators" />
 		<test name="AsQuantity" version="1.0">
+			<capability code="type-operators" />
 			<expression>45.5 'g' as Quantity</expression>
 			<output>45.5 'g'</output>
 		</test>
 		<test name="CastAsQuantity" version="1.0">
+			<capability code="type-operators" />
 			<expression>cast 45.5 'g' as Quantity</expression>
 			<output>45.5 'g'</output>
 		</test>
 		<test name="AsDateTime" version="1.0">
+			<capability code="type-operators" />
 			<expression>DateTime(2014, 01, 01) as DateTime</expression>
 			<output>@2014-01-01T</output>
 		</test>
 	</group>
 	<group name="Convert" version="1.0">
+		<capability code="type-operators" />
 		<test name="IntegerToDecimal" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert 5 to Decimal</expression>
 			<output>5.0</output>
 		</test>
 		<test name="IntegerToString" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert 5 to String</expression>
 			<output>'5'</output>
 		</test>
 		<test name="StringToIntegerError" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert 'foo' to Integer</expression>
 			<output>null</output>
 		</test>
 		<test name="StringToDateTime" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert '2014-01-01' to DateTime</expression>
 			<output>@2014-01-01T</output>
 		</test>
 		<test name="StringToTime" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert 'T14:30:00.0' to Time</expression>
 			<output>@T14:30:00.000</output>
 		</test>
 		<test name="StringToDateTimeMalformed" version="1.0">
+			<capability code="type-operators" />
 			<expression>convert '2014/01/01' to DateTime</expression>
 			<output>null</output>
 		</test>
 	</group>
 	<group name="Is" version="1.0">
+		<capability code="type-operators" />
 		<test name="IntegerIsInteger" version="1.0">
+			<capability code="type-operators" />
 			<expression>5 is Integer</expression>
 			<output>true</output>
 		</test>
 		<test name="StringIsInteger" version="1.0">
+			<capability code="type-operators" />
 			<expression>'5' is Integer</expression>
 			<output>false</output>
 		</test>
 		<test name="ValueSetIsVocabulary" version="1.5">
+			<capability code="type-operators" />
 			<expression>System.ValueSet{id: '123'} is Vocabulary</expression>
 			<output>true</output>
 			<notes>This should return true because ValueSet is derived from Vocabulary.</notes>
 		</test>
 	</group>
 	<group name="ToBoolean" version="1.0">
+		<capability code="type-operators" />
 		<test name="StringNoToBoolean" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToBoolean('NO')</expression>
 			<output>false</output>
 		</test>
 	</group>
 	<group name="ToConcept" version="1.0">
+		<capability code="type-operators" />
 		<test name="CodeToConcept1" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToConcept(Code { code: '8480-6' })</expression>
 			<output>
 				Concept {
@@ -73,97 +93,124 @@
 		</test>
 	</group>
 	<group name="ToDateTime" version="1.0">
+		<capability code="type-operators" />
 		<test name="ToDateTime1" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01')</expression>
 			<output>@2014-01-01T</output>
 		</test>
 		<test name="ToDateTime2" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01T12:05')</expression>
 			<output>@2014-01-01T12:05</output>
 		</test>
 		<test name="ToDateTime3" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01T12:05:05.955')</expression>
 			<output>@2014-01-01T12:05:05.955</output>
 		</test>
 		<test name="ToDateTime4" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01T12:05:05.955+01:30')</expression>
 			<output>@2014-01-01T12:05:05.955+01:30</output>
 		</test>
 		<test name="ToDateTime5" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01T12:05:05.955-01:15')</expression>
 			<output>@2014-01-01T12:05:05.955-01:15</output>
 		</test>
 		<test name="ToDateTime6" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014-01-01T12:05:05.955Z')</expression>
 			<output>@2014-01-01T12:05:05.955+00:00</output>
 		</test>
 		<test name="ToDateTimeMalformed" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime('2014/01/01T12:05:05.955Z')</expression>
 			<output>null</output>
 		</test>
 		<test name="ToDateTimeDate" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDateTime(@2014-01-01)</expression>
 			<output>@2014-01-01T</output>
 		</test>
 		<test name="ToDateTimeTimeUnspecified" version="1.0">
+			<capability code="type-operators" />
 			<expression>hour from ToDateTime(@2014-01-01) is null</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="ToDecimal" version="1.4">
+		<capability code="type-operators" />
 		<test name="String25D5ToDecimal" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToDecimal('+25.5')</expression>
 			<output>25.5</output>
 		</test>
 	</group>
 	<group name="ToInteger" version="1.4">
+		<capability code="type-operators" />
 		<test name="StringNeg25ToInteger" version="1.0">
+			<capability code="type-operators" />
 			<expression>ToInteger('-25')</expression>
 			<output>-25</output>
 		</test>
 	</group>
 	<group name="ToQuantity" version="1.4">
+		<capability code="type-operators" />
 		<test name="String5D5CMToQuantity" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToQuantity('5.5 \'cm\'')</expression>
 			<output>5.5'cm'</output>
 		</test>
 	</group>
 	<group name="ToString" version="1.4">
+		<capability code="type-operators" />
 		<test name="IntegerNeg5ToString" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToString(-5)</expression>
 			<output>'-5'</output>
 		</test>
 		<test name="Decimal18D55ToString" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToString(18.55)</expression>
 			<output>'18.55'</output>
 		</test>
 		<test name="Quantity5D5CMToString" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToString(5.5 'cm')</expression>
 			<output>'5.5 \'cm\''</output>
 		</test>
 		<test name="BooleanTrueToString" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToString(true)</expression>
 			<output>'true'</output>
 		</test>
 	</group>
 	<group name="ToTime" version="1.4">
+		<capability code="type-operators" />
 		<test name="ToTime1" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToTime('T14:30:00.0')</expression>
 			<output>@T14:30:00.000</output>
 		</test>
 		<test name="ToTime2" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToTime('T14:30:00.0+05:30')</expression>
 			<output>@T14:30:00.000</output>
 		</test>
 		<test name="ToTime3" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToTime('T14:30:00.0-05:45')</expression>
 			<output>@T14:30:00.000</output>
 		</test>
 		<test name="ToTime4" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToTime('T14:30:00.0Z')</expression>
 			<output>@T14:30:00.000</output>
 		</test>
 		<test name="ToTimeMalformed" version="1.4">
+			<capability code="type-operators" />
 			<expression>ToTime('T14-30-00.0')</expression>
 			<output>null</output>
 		</test>
diff --git a/test/spec-tests/xml/CqlTypesTest.xml b/test/spec-tests/xml/CqlTypesTest.xml
index 639776ae6..53df4b8f1 100644
--- a/test/spec-tests/xml/CqlTypesTest.xml
+++ b/test/spec-tests/xml/CqlTypesTest.xml
@@ -3,6 +3,7 @@
 	name="CqlTypesTest" reference="https://cql.hl7.org/09-b-cqlreference.html#types-2" version="1.0">
 	<!-- TODO: Go through this file and flesh out or correct
 	all the bounds checking against the CQL spec. -->
+	<capability code="types" />
 	<group name="Any" version="1.0">
 		<!-- REPLACED BY TestIsolatedCqlExprs : ValueLiteralsAndSelectors.xml
 		<test name="AnyInteger">
@@ -15,35 +16,43 @@
 		</test>
 		-->
 		<test name="AnyQuantity" version="1.0">
+			<capability code="types" />
 			<expression>5.0 'g'</expression>
 			<output>5.0'g'</output>
 		</test>
 		<test name="AnyDateTime" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(2012, 4, 4)</expression>
 			<output>@2012-04-04T</output>
 		</test>
 		<test name="AnyTime" version="1.0">
+			<capability code="types" />
 			<expression>@T09:00:00.000</expression>
 			<output>@T09:00:00.000</output>
 		</test>
 		<test name="AnyInterval" version="1.0">
+			<capability code="types" />
 			<expression>Interval[2, 7]</expression>
 			<output>Interval[2, 7]</output>
 		</test>
 		<test name="AnyList" version="1.0">
+			<capability code="types" />
 			<expression>{1, 2, 3}</expression>
 			<output>{1, 2, 3}</output>
 		</test>
 		<test name="AnyTuple" version="1.5">
+			<capability code="types" />
 			<expression>Tuple { id: 5, name: 'Chris'}</expression>
 			<output>Tuple { id: 5, name: 'Chris'}</output>
 		</test>
 		<test name="AnyString" version="1.5">
+			<capability code="types" />
 			<expression>Tuple { id: 5, name: 'Chris'}.name</expression>
 			<output>'Chris'</output>
 		</test>
 	</group>
 	<group name="Boolean" version="1.0">
+		<capability code="types" />
 		<!-- REPLACED BY TestIsolatedCqlExprs : ValueLiteralsAndSelectors.xml
 		<test name="BooleanTestTrue">
 			<expression>true</expression>
@@ -56,27 +65,34 @@
 		-->
 	</group>
 	<group name="DateTime" version="1.0">
+		<capability code="types" />
 		<test name="DateTimeNull" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(null)</expression>
 			<output>null</output>
 		</test>
 		<test name="DateTimeUpperBoundExcept" version="1.0">
+			<capability code="types" />
 			<expression invalid="true">DateTime(10000, 12, 31, 23, 59, 59, 999)</expression>
 			<!-- The year: 10000 falls above the accepted bounds of 0001-9999. -->
 		</test>
 		<test name="DateTimeLowerBoundExcept" version="1.0">
+			<capability code="types" />
 			<expression invalid="true">DateTime(0000, 1, 1, 0, 0, 0, 0)</expression>
 			<!-- The year: 0 falls below the accepted bounds of 0001-9999. -->
 		</test>
 		<test name="DateTimeProper" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(2016, 7, 7, 6, 25, 33, 910)</expression>
 			<output>@2016-07-07T06:25:33.910</output>
 		</test>
 		<test name="DateTimeIncomplete" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(2015, 2, 10)</expression>
 			<output>@2015-02-10T</output>
 		</test>
 		<test name="DateTimeUncertain" version="1.0">
+			<capability code="types" />
 			<expression>days between DateTime(2015, 2, 10) and DateTime(2015, 3)</expression>
 			<output>Interval [ 18, 49 ]</output>
 			<!-- TODO: How to handle the fact the question is resulting in an
@@ -85,19 +101,23 @@
 			currently Equivalent() results in null from comparing with an Interval. -->
 		</test>
 		<test name="DateTimeMin" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(0001, 1, 1, 0, 0, 0, 0)</expression>
 			<output>@0001-01-01T00:00:00.000</output>
 		</test>
 		<test name="DateTimeMax" version="1.0">
+			<capability code="types" />
 			<expression>DateTime(9999, 12, 31, 23, 59, 59, 999)</expression>
 			<output>@9999-12-31T23:59:59.999</output>
 		</test>
 		<test name="DateTimeTimeUnspecified" version="1.0">
+			<capability code="types" />
 			<expression>hour from @2015-02-10T is null</expression>
 			<output>true</output>
 		</test>
 	</group>
 	<group name="Decimal" version="1.0">
+		<capability code="types" />
 		<!-- REPLACED BY TestIsolatedCqlExprs : ValueLiteralsAndSelectors.xml
 		<test name="DecimalUpperBoundExcept">
 			<expression>10000000000000000000000000000000000.00000000</expression>
@@ -118,6 +138,7 @@
 		-->
 	</group>
 	<group name="Integer" version="1.0">
+		<capability code="types" />
 		<!-- REPLACED BY TestIsolatedCqlExprs : ValueLiteralsAndSelectors.xml
 		<test name="IntegerUpperBoundExcept">
 			<expression invalid="true">2147483649</expression>
@@ -132,57 +153,74 @@
 		-->
 	</group>
 	<group name="Interval" version="1.0">
+		<capability code="types" />
 	</group>
 	<group name="Quantity" version="1.0">
+		<capability code="types" />
 		<test name="QuantityTest" version="1.0">
+			<capability code="types" />
 			<expression>150.2 '[lb_av]'</expression>
 			<output>150.2 '[lb_av]'</output>
 		</test>
 		<test name="QuantityTest2" version="1.0">
-			<expression>2.5589 '{eskimo kisses}'</expression>
-			<output>2.5589 '{eskimo kisses}'</output>
+			<capability code="types" />
+			<expression>2.5589 '{eskimo_kisses}'</expression>
+			<output>2.5589 '{eskimo_kisses}'</output>
 		</test>
 		<test name="QuantityFractionalTooBig" version="1.0">
+			<capability code="types" />
 			<expression>5.999999999 'g'</expression>
 			<output>5.999999999 'g'</output>
 		</test>
 	</group>
 	<group name="String" version="1.0">
+		<capability code="types" />
 		<test name="StringTestEscapeQuotes" version="1.0">
+			<capability code="types" />
 			<expression>'\'I start with a single quote and end with a double quote\"'</expression>
 			<output>'\u0027I start with a single quote and end with a double quote\u0022'</output>
 		</test>
 		<test name="StringUnicodeTest" version="1.0">
+			<capability code="types" />
 			<expression>'\u0048\u0069'</expression>
 			<output>'Hi'</output>
 		</test>
 	</group>
 	<group name="Time" version="1.0">
+		<capability code="types" />
 		<test name="TimeUpperBoundHours" version="1.0">
+			<capability code="types" />
 			<expression invalid="semantic">@T24:59:59.999</expression>
 			<!-- Translation Error: Invalid date-time input (T24:59:59.999). Use ISO 8601 date time representation (yyyy-MM-ddThh:mm:ss.mmmmZhh:mm). -->
 		</test>
 		<test name="TimeUpperBoundMinutes" version="1.0">
+			<capability code="types" />
 			<expression invalid="semantic">@T23:60:59.999</expression>
 			<!-- Translation Error: Invalid date-time input (T23:60:59.999). Use ISO 8601 date time representation (yyyy-MM-ddThh:mm:ss.mmmmZhh:mm). -->
 		</test>
 		<test name="TimeUpperBoundSeconds" version="1.0">
+			<capability code="types" />
 			<expression invalid="semantic">@T23:59:60.999</expression>
 			<!--Translation Error: Invalid date-time input (T23:59:60.999). Use ISO 8601 date time representation (yyyy-MM-ddThh:mm:ss.mmmmZhh:mm).  -->
 		</test>
-		<test name="TimeUpperBoundMillis" version="1.0">
-			<expression invalid="semantic">@T23:59:59.10000</expression>
-			<!-- Value 10000 for millisOfSecond must not be larger than 999 -->
+		<test name="TimeMillisParsing" version="1.0">
+			<capability code="types" />
+			<expression>@T23:59:59.10000</expression>
+			<output>@T23:59:59.100</output>
+			<!-- ".10000" in the time literal means "0.10000 seconds". -->
 		</test>
 		<test name="TimeProper" version="1.0">
+			<capability code="types" />
 			<expression>@T10:25:12.863</expression>
 			<output>@T10:25:12.863</output>
 		</test>
 		<test name="TimeAllMax" version="1.0">
+			<capability code="types" />
 			<expression>@T23:59:59.999</expression>
 			<output>@T23:59:59.999</output>
 		</test>
 		<test name="TimeAllMin" version="1.0">
+			<capability code="types" />
 			<expression>@T00:00:00.000</expression>
 			<output>@T00:00:00.000</output>
 		</test>
diff --git a/test/spec-tests/xml/ValueLiteralsAndSelectors.xml b/test/spec-tests/xml/ValueLiteralsAndSelectors.xml
index 35dd55f89..8317b89d4 100644
--- a/test/spec-tests/xml/ValueLiteralsAndSelectors.xml
+++ b/test/spec-tests/xml/ValueLiteralsAndSelectors.xml
@@ -1,10 +1,13 @@
 <?xml version="1.0" encoding="utf-8"?>
 <tests xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://hl7.org/fhirpath/tests" xsi:schemaLocation="http://hl7.org/fhirpath/tests ../../testSchema/testSchema.xsd"
 	name="ValueLiteralsAndSelectors" reference="https://cql.hl7.org/03-developersguide.html#literals" version="1.0">
+	<capability code="literals"/>
 	<!-- CQL spec section 3.1.3 Literals:
 	Null - The null literal (null) -->
 	<group name="Null" version="1.0">
+		<capability code="literals"/>
 		<test name="Null" version="1.0">
+			<capability code="literals"/>
 			<expression>null</expression>
 			<output>null</output>
 		</test>
@@ -14,11 +17,14 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	Boolean | Range: false..true | Step Size: N/A -->
 	<group name="Boolean" version="1.0">
+		<capability code="literals"/>
 		<test name="BooleanFalse" version="1.0">
+			<capability code="literals"/>
 			<expression>false</expression>
 			<output>false</output>
 		</test>
 		<test name="BooleanTrue" version="1.0">
+			<capability code="literals"/>
 			<expression>true</expression>
 			<output>true</output>
 		</test>
@@ -28,92 +34,114 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	Integer | Range: -2^31..2^31 – 1 | Step Size: 1 -->
 	<group name="Integer" version="1.0">
+		<capability code="literals"/>
 		<test name="IntegerZero" version="1.0">
+			<capability code="literals"/>
 			<expression>0</expression>
 			<output>0</output>
 		</test>
 		<test name="IntegerPosZero" version="1.0">
+			<capability code="literals"/>
 			<expression>+0</expression>
 			<output>0</output>
 		</test>
 		<test name="IntegerNegZero" version="1.0">
+			<capability code="literals"/>
 			<expression>-0</expression>
 			<output>0</output>
 		</test>
 		<test name="IntegerOne" version="1.0">
+			<capability code="literals"/>
 			<expression>1</expression>
 			<output>1</output>
 		</test>
 		<test name="IntegerPosOne" version="1.0">
+			<capability code="literals"/>
 			<expression>+1</expression>
 			<output>1</output>
 		</test>
 		<test name="IntegerNegOne" version="1.0">
+			<capability code="literals"/>
 			<expression>-1</expression>
 			<output>-1</output>
 		</test>
 		<test name="IntegerTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>2</expression>
 			<output>2</output>
 		</test>
 		<test name="IntegerPosTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>+2</expression>
 			<output>2</output>
 		</test>
 		<test name="IntegerNegTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>-2</expression>
 			<output>-2</output>
 		</test>
 		<test name="Integer10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(10,9)</expression>
 			<output>1000000000</output>
 		</test>
 		<test name="IntegerPos10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(10,9)</expression>
 			<output>1000000000</output>
 		</test>
 		<test name="IntegerNeg10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(10,9)</expression>
 			<output>-1000000000</output>
 		</test>
 		<test name="Integer2Pow31ToZero1IntegerMaxValue" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(2,30)-1+Power(2,30)</expression>
 			<output>2147483647</output>
 		</test>
 		<test name="IntegerPos2Pow31ToZero1IntegerMaxValue" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(2,30)-1+Power(2,30)</expression>
 			<output>2147483647</output>
 		</test>
 		<test name="IntegerNeg2Pow31ToZero1" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(2,30)+1-Power(2,30)</expression>
 			<output>-2147483647</output>
 		</test>
 		<test name="Integer2Pow31" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">2147483648</expression>
 			<!-- TODO: Have a nicer error of our own rather than internal Java exception. -->
 			<!-- EXPECT: java.lang.NumberFormatException: For input string: "2147483648" -->
 		</test>
 		<test name="IntegerPos2Pow31" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">+2147483648</expression>
 			<!-- TODO: Have a nicer error of our own rather than internal Java exception. -->
 			<!-- EXPECT: java.lang.NumberFormatException: For input string: "2147483648" -->
 		</test>
 		<test name="IntegerNeg2Pow31IntegerMinValue" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(2,30)-Power(2,30)</expression>
 			<output>-2147483648</output>
 			<!-- TODO: Fix evaluation failed in Engine: java.lang.NumberFormatException: For input string: "2147483648" -->
 		</test>
 		<test name="Integer2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">2147483649</expression>
 			<!-- TODO: Have a nicer error of our own rather than internal Java exception. -->
 			<!-- EXPECT: java.lang.NumberFormatException: For input string: "2147483649" -->
 		</test>
 		<test name="IntegerPos2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">+2147483649</expression>
 			<!-- TODO: Have a nicer error of our own rather than internal Java exception. -->
 			<!-- EXPECT: java.lang.NumberFormatException: For input string: "2147483649" -->
 		</test>
 		<test name="IntegerNeg2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">-2147483649</expression>
 			<!-- TODO: Have a nicer error of our own rather than internal Java exception. -->
 			<!-- EXPECT: java.lang.NumberFormatException: For input string: "-2147483649" -->
@@ -124,179 +152,222 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	Decimal | Range: -10^28 – 10^-8..10^28 – 10^-8 | Step Size: 10^-8 -->
 	<group name="Decimal" version="1.0">
+		<capability code="literals"/>
 		<test name="DecimalZero" version="1.0">
+			<capability code="literals"/>
 			<expression>0.0</expression>
 			<output>0.0</output>
 		</test>
 		<test name="DecimalPosZero" version="1.0">
+			<capability code="literals"/>
 			<expression>+0.0</expression>
 			<output>0.0</output>
 		</test>
 		<test name="DecimalNegZero" version="1.0">
+			<capability code="literals"/>
 			<expression>-0.0</expression>
 			<output>0.0</output>
 		</test>
 		<test name="DecimalOne" version="1.0">
+			<capability code="literals"/>
 			<expression>1.0</expression>
 			<output>1.0</output>
 		</test>
 		<test name="DecimalPosOne" version="1.0">
+			<capability code="literals"/>
 			<expression>+1.0</expression>
 			<output>1.0</output>
 		</test>
 		<test name="DecimalNegOne" version="1.0">
+			<capability code="literals"/>
 			<expression>-1.0</expression>
 			<output>-1.0</output>
 		</test>
 		<test name="DecimalTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>2.0</expression>
 			<output>2.0</output>
 		</test>
 		<test name="DecimalPosTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>+2.0</expression>
 			<output>2.0</output>
 		</test>
 		<test name="DecimalNegTwo" version="1.0">
+			<capability code="literals"/>
 			<expression>-2.0</expression>
 			<output>-2.0</output>
 		</test>
 		<test name="Decimal10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(10.0,9.0)</expression>
 			<output>1000000000.0</output>
 		</test>
 		<test name="DecimalPos10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(10.0,9.0)</expression>
 			<output>1000000000.0</output>
 		</test>
 		<test name="DecimalNeg10Pow9" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(10.0,9.0)</expression>
 			<output>-1000000000.0</output>
 		</test>
 		<test name="Decimal2Pow31ToZero1" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(2.0,30.0)-1+Power(2.0,30.0)</expression>
 			<output>2147483647.0</output>
 		</test>
 		<test name="DecimalPos2Pow31ToZero1" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(2.0,30.0)-1+Power(2.0,30.0)</expression>
 			<output>2147483647.0</output>
 		</test>
 		<test name="DecimalNeg2Pow31ToZero1" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(2.0,30.0)+1.0-Power(2.0,30.0)</expression>
 			<output>-2147483647.0</output>
 		</test>
 		<test name="Decimal2Pow31" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(2.0,30.0)+Power(2.0,30.0)</expression>
 			<output>2147483648.0</output>
 		</test>
 		<test name="DecimalPos2Pow31" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(2.0,30.0)+Power(2.0,30.0)</expression>
 			<output>2147483648.0</output>
 		</test>
 		<test name="DecimalNeg2Pow31" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(2.0,30.0)-Power(2.0,30.0)</expression>
 			<output>-2147483648.0</output>
 		</test>
 		<test name="Decimal2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(2.0,30.0)+1.0+Power(2.0,30.0)</expression>
 			<output>2147483649.0</output>
 		</test>
 		<test name="DecimalPos2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(2.0,30.0)+1.0+Power(2.0,30.0)</expression>
 			<output>2147483649.0</output>
 		</test>
 		<test name="DecimalNeg2Pow31ToInf1" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(2.0,30.0)-1.0-Power(2.0,30.0)</expression>
 			<output>-2147483649.0</output>
 		</test>
 		<test name="DecimalZeroStep" version="1.0">
+			<capability code="literals"/>
 			<expression>0.00000000</expression>
 			<output>0.00000000</output>
 		</test>
 		<test name="DecimalPosZeroStep" version="1.0">
+			<capability code="literals"/>
 			<expression>+0.00000000</expression>
 			<output>0.00000000</output>
 		</test>
 		<test name="DecimalNegZeroStep" version="1.0">
+			<capability code="literals"/>
 			<expression>-0.00000000</expression>
 			<output>0.00000000</output>
 		</test>
 		<test name="DecimalOneStep" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(10,-8)</expression>
 			<output>0.00000001</output>
 		</test>
 		<test name="DecimalPosOneStep" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(10,-8)</expression>
 			<output>0.00000001</output>
 		</test>
 		<test name="DecimalNegOneStep" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(10,-8)</expression>
 			<output>-0.00000001</output>
 		</test>
 		<test name="DecimalTwoStep" version="1.0">
+			<capability code="literals"/>
 			<expression>2.0*Power(10,-8)</expression>
 			<output>0.00000002</output>
 		</test>
 		<test name="DecimalPosTwoStep" version="1.0">
+			<capability code="literals"/>
 			<expression>+2.0*Power(10,-8)</expression>
 			<output>0.00000002</output>
 		</test>
 		<test name="DecimalNegTwoStep" version="1.0">
+			<capability code="literals"/>
 			<expression>-2.0*Power(10,-8)</expression>
 			<output>-0.00000002</output>
 		</test>
 		<test name="DecimalTenStep" version="1.0">
+			<capability code="literals"/>
 			<expression>Power(10,-7)</expression>
 			<output>0.0000001</output>
 		</test>
 		<test name="DecimalPosTenStep" version="1.0">
+			<capability code="literals"/>
 			<expression>+Power(10,-7)</expression>
 			<output>0.0000001</output>
 		</test>
 		<test name="DecimalNegTenStep" version="1.0">
+			<capability code="literals"/>
 			<expression>-Power(10,-7)</expression>
 			<output>-0.0000001</output>
 		</test>
 		<test name="DecimalTenthStep" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">0.000000001</expression>
 			<!-- TODO: Fix Engine to either raise an error on this input or to round this input. -->
 			<!-- EXPECT: Either some error saying the literal uses more
 			precision than the Decimal step size, or round to a whole step. -->
 		</test>
 		<test name="DecimalPosTenthStep" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">+0.000000001</expression>
 			<!-- TODO: Fix Engine to either raise an error on this input or to round this input. -->
 			<!-- EXPECT: Either some error saying the literal uses more
 			precision than the Decimal step size, or round to a whole step. -->
 		</test>
 		<test name="DecimalNegTenthStep" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">-0.000000001</expression>
 			<!-- TODO: Fix Engine to either raise an error on this input or to round this input. -->
 			<!-- EXPECT: Either some error saying the literal uses more
 			precision than the Decimal step size, or round to a whole step. -->
 		</test>
 		<test name="Decimal10Pow28ToZeroOneStepDecimalMaxValue" version="1.0">
+			<capability code="literals"/>
 			<expression>10*1000000000000000000000000000.00000000-0.00000001</expression>
 			<output>9999999999999999999999999999.99999999</output>
 		</test>
 		<test name="DecimalPos10Pow28ToZeroOneStepDecimalMaxValue" version="1.0">
+			<capability code="literals"/>
 			<expression>+10*1000000000000000000000000000.00000000-0.00000001</expression>
 			<output>9999999999999999999999999999.99999999</output>
 		</test>
 		<test name="DecimalNeg10Pow28ToZeroOneStepDecimalMinValue" version="1.0">
+			<capability code="literals"/>
 			<expression>-10*1000000000000000000000000000.00000000+0.00000001</expression>
 			<output>-9999999999999999999999999999.99999999</output>
 		</test>
 		<test name="Decimal10Pow28" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">10000000000000000000000000000.00000000</expression>
 			<!-- TODO: Fix Engine to raise an error on this input. -->
 			<!-- EXPECT: Some error saying the literal is a greater magnitude than a Decimal supports. -->
 		</test>
 		<test name="DecimalPos10Pow28" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">+10000000000000000000000000000.00000000</expression>
 			<!-- TODO: Fix Engine to raise an error on this input. -->
 			<!-- EXPECT: Some error saying the literal is a greater magnitude than a Decimal supports. -->
 		</test>
 		<test name="DecimalNeg10Pow28" version="1.0">
+			<capability code="literals"/>
 			<expression invalid="true">-10000000000000000000000000000.00000000</expression>
 			<!-- TODO: Fix Engine to raise an error on this input. -->
 			<!-- EXPECT: Some error saying the literal is a greater magnitude than a Decimal supports. -->
@@ -307,6 +378,7 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	String | Range: All strings of length 2^31-1 or less. | Step Size: N/A -->
 	<group name="String" version="1.0">
+		<capability code="literals"/>
 		<!-- Note: See also Translator test files such as EscapeSequenceTests.cql -->
 		<!-- TODO: Add tests here. -->
 	</group>
@@ -315,6 +387,7 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	DateTime | Range: @0001-01-01T00:00:00.0..@9999-12-31T23:59:59.999 | Step Size: 1 millisecond -->
 	<group name="DateTime" version="1.0">
+		<capability code="literals"/>
 		<!-- Note: See also Translator test files such as DateTimeLiteralTest.cql -->
 		<!-- TODO: Add tests here. -->
 	</group>
@@ -323,30 +396,38 @@
 	<!-- CQL spec section 3.4.1 System-Defined Types:
 	Time | Range: @T00:00:00.0..@T23:59:59.999 | Step Size: 1 millisecond -->
 	<group name="Time" version="1.0">
+		<capability code="literals"/>
 		<!-- Note: See also Translator test files such as DateTimeLiteralTest.cql -->
 		<!-- TODO: Add tests here. -->
 	</group>
 	<group name="List" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here. -->
 	</group>
 	<group name="Interval" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here. -->
 	</group>
 	<group name="Tuple" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here. -->
 	</group>
 	<!-- CQL spec section 3.1.3 Literals:
 	Quantity - An integer or decimal literal followed by a datetime precision specifier, or a UCUM unit specifier -->
 	<group name="Quantity" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here. -->
 	</group>
 	<group name="Code" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here, maybe. -->
 	</group>
 	<group name="Concept" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here, maybe. -->
 	</group>
 	<group name="Instance" version="1.0">
+		<capability code="literals"/>
 		<!-- TODO: Add tests here, maybe. -->
 	</group>
 </tests>

From bb8ac72c6f980c45eb4152a7161378d1d34d5cea Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 8 Sep 2026 14:09:23 -0400
Subject: [PATCH 21/62] Use Decimal equals in DateTime.isUTC

---
 src/datatypes/datetime.ts | 2 +-
 1 file changed, 1 insertion(+), 1 deletion(-)

diff --git a/src/datatypes/datetime.ts b/src/datatypes/datetime.ts
index 5b30779cb..096f5ad29 100644
--- a/src/datatypes/datetime.ts
+++ b/src/datatypes/datetime.ts
@@ -829,7 +829,7 @@ export class DateTime extends AbstractDate {
 
   isUTC() {
     // A timezoneOffset of 0 indicates UTC time.
-    return !this.timezoneOffset;
+    return this.timezoneOffset?.equals(0);
   }
 
   getPrecision() {

From ffa7d8fb000bd34d9786c799c225df58235e821c Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 8 Sep 2026 14:11:25 -0400
Subject: [PATCH 22/62] Add scale field and support to Decimal class

---
 src/datatypes/decimal.ts | 190 ++++++++++++++++++++++++++++++---------
 1 file changed, 150 insertions(+), 40 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 3a04017c5..fb546ca39 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -11,19 +11,30 @@ export type DecimalInput = Decimal | string | number | bigint;
 
 export type DecimalRoundingMode = DecimalJS.Rounding;
 
-const MIN_PRECISION_VALUE = CQLDecimalJS.pow(10, -8);
-
 const CQL_IMPLICIT_SCALE = 8;
 const CQL_IMPLICIT_ROUNDING = CQLDecimalJS.ROUND_HALF_UP;
+const TRUNCATE_TO_PRECISION = CQLDecimalJS.ROUND_DOWN;
 
 export class Decimal {
-  private value: DecimalJS;
+  private readonly value: DecimalJS;
+  public readonly scale: number;
 
-  private constructor(value: string | number | bigint | DecimalJS) {
+  private constructor(value: string | number | bigint | DecimalJS, scale?: number) {
     this.value = new CQLDecimalJS(value);
     if (!this.value.isFinite()) {
       throw new Error('Cannot create a decimal with a non-finite value');
     }
+
+    if (scale == null) {
+      scale = determineScale(value, this.value);
+    } else if (!Number.isInteger(scale) || scale < 0) {
+      throw new RangeError('Decimal scale must be a non-negative integer');
+    } else if (scale < this.value.decimalPlaces()) {
+      // scale and value both provided, but the value has more decimal places,
+      // so apply the scale to the value to ensure internal consistency
+      this.value = this.value.toDecimalPlaces(scale, CQL_IMPLICIT_ROUNDING);
+    }
+    this.scale = scale;
   }
 
   static from(value: DecimalInput) {
@@ -39,37 +50,82 @@ export class Decimal {
   }
 
   normalized() {
-    if (this.value.decimalPlaces() <= CQL_IMPLICIT_SCALE) {
+    if (this.scale <= CQL_IMPLICIT_SCALE) {
       return this;
     }
-    return this.setScale(CQL_IMPLICIT_SCALE, CQL_IMPLICIT_ROUNDING);
+    return this.withScale(CQL_IMPLICIT_SCALE);
   }
 
   // Helper function to reduce repeated boilerplate.
   // Apply the given function with the given operand, and wrap the result in a Decimal.
-  private applyWrapper(operation: (value: any) => DecimalJS, other: DecimalInput): Decimal {
-    const operand = other instanceof Decimal ? other.value : other;
-
-    return new Decimal(operation.call(this.value, operand));
+  // A function to set an appropriate scale based on the scales of the inputs may also be provided.
+  private applyWrapper(
+    operation: (value: DecimalJS) => DecimalJS,
+    other: DecimalInput,
+    scaleLogic?: (scaleL: number, scaleR: number) => number
+  ): Decimal {
+    const decimalOther = Decimal.from(other);
+
+    const unscaledResult = new Decimal(operation.call(this.value, decimalOther.value));
+
+    if (scaleLogic) {
+      const targetScale = scaleLogic.call(null, this.scale, decimalOther.scale);
+      return unscaledResult.withScale(targetScale);
+    }
+    return unscaledResult;
   }
 
   add(other: DecimalInput): Decimal {
-    return this.applyWrapper(this.value.add, other);
+    // scale logic: max(scale(left), scale(right))
+    return this.applyWrapper(this.value.add, other, Math.max);
   }
 
   subtract(other: DecimalInput): Decimal {
-    return this.applyWrapper(this.value.minus, other);
+    // scale logic: max(scale(left), scale(right))
+    return this.applyWrapper(this.value.minus, other, Math.max);
   }
 
   multiplyBy(other: DecimalInput): Decimal {
-    return this.applyWrapper(this.value.times, other);
+    const scaleLogic = (l: number, r: number) => Math.min(l + r, CQL_IMPLICIT_SCALE);
+    return this.applyWrapper(this.value.times, other, scaleLogic);
   }
 
   divideBy(other: DecimalInput): Decimal {
-    if (Decimal.from(other).equals(0)) {
+    const decimalOther = Decimal.from(other);
+    if (decimalOther.equals(0)) {
       throw new RangeError('Cannot divide a decimal by zero');
     }
-    return this.applyWrapper(this.value.dividedBy, other);
+    // division scaling is more complex, depends on whether the actual result can be represented exactly
+    const unscaledResult = this.applyWrapper(this.value.dividedBy, decimalOther);
+    const unscaledDecimalPlaces = unscaledResult.value.decimalPlaces();
+    if (unscaledDecimalPlaces > CQL_IMPLICIT_SCALE) {
+      // it either doesn't terminate, or terminates with more than 8 digits, eg:
+      // 1/3 = 0.33333333...
+      // 1/512 = 0.001953125 (9 digits)
+      return unscaledResult.withScale(CQL_IMPLICIT_SCALE);
+    }
+
+    // multiplication uses min(scale(l) + scale(r), cql_max_scale)
+    // division is the inverse of multiplication, so we'll define a lower bound "preferred scale" as the inverse:
+    // max(scale(l)-scale(r), 0)
+    const preferredScale = Math.max(this.scale - decimalOther.scale, 0);
+
+    // examples:
+    // |               | Preferred |  Expected  |
+    // | Expression    |  scale    |   result   |
+    // | ------------- | --------: | ---------: |
+    // | 4.0 / 2       |         1 |        2.0 |
+    // | 9.9 / 3.0     |         0 |        3.3 |
+    // | 1.0 / 2.0     |         0 |        0.5 |
+    // | 1.0 / 4.0     |         0 |       0.25 |
+    // | 1.0 / 8.0     |         0 |      0.125 |
+    // | 1.0 / 3.0     |         0 | 0.33333333 |
+    // | 2.0 / 3.0     |         0 | 0.66666667 |
+    // | 1.00000 / 2.0 |         4 |     0.5000 |
+    // | 1.0 / 1.00000 |         0 |          1 | (as Decimal, scale 0)
+    // | 1.00000 / 1.0 |         4 |     1.0000 |
+
+    return unscaledResult.withMinimumScale(preferredScale);
   }
 
   modulo(other: DecimalInput) {
@@ -106,32 +162,59 @@ export class Decimal {
     return this.compareTo(other) === 0;
   }
 
+  equivalent(other: DecimalInput) {
+    // For decimals, equivalent means the values are the same
+    // with the comparison done on values rounded to
+    // the precision of the least precise operand;
+    // trailing zeroes after the decimal are ignored in determining precision
+    // for equivalent comparison.
+
+    // Because it ignores trailing zeros, we use decimal.js .decimalPlaces() instead of this.scale
+    const decimalOther = Decimal.from(other);
+    const lessPreciseScale = Math.min(
+      this.value.decimalPlaces(),
+      decimalOther.value.decimalPlaces()
+    );
+
+    return this.withScale(lessPreciseScale).equals(decimalOther.withScale(lessPreciseScale));
+  }
+
   successor() {
-    // TODO: successor should be based on current precision
-    // For Decimal, successor is equivalent to adding 1 * the precision of the argument.
-    return new Decimal(this.value.add(MIN_PRECISION_VALUE));
+    // "For Decimal, successor is equivalent to adding 1 * the precision of the argument."
+    // note that this is not 1 * Precision(this), since Precision is a number 0-8
+    const precision = Decimal.from(0.1).power(this.scale);
+    return this.add(precision);
   }
 
   predecessor() {
-    // TODO: predecessor should be based on current precision
-    // For Decimal, predecessor is equivalent to subtracting 1 * the precision of the argument.
-    return new Decimal(this.value.minus(MIN_PRECISION_VALUE));
+    // "For Decimal, predecessor is equivalent to subtracting 1 * the precision of the argument."
+    // note that this is not literally 1 * Precision(this), since Precision is a number 0-8
+    const precision = Decimal.from(0.1).power(this.scale);
+    return this.subtract(precision);
   }
 
   negate() {
-    return new Decimal(this.value.neg());
+    return new Decimal(this.value.neg(), this.scale);
   }
 
   abs() {
-    return new Decimal(this.value.abs());
+    return new Decimal(this.value.abs(), this.scale);
   }
 
   truncate(): number {
     return this.value.truncated().toNumber();
   }
 
-  truncated(): Decimal {
-    return new Decimal(this.value.truncated());
+  truncated(scale?: number): Decimal {
+    // specifying a scale here allows for "truncating to a precision"
+    // this is currently used in Interval.expand
+
+    if (!scale) {
+      // undefined or 0 both mean truncated to an integer
+      return new Decimal(this.truncate(), 0);
+    }
+
+    return this.withScale(scale, TRUNCATE_TO_PRECISION);
   }
 
   ceil(): number {
@@ -151,7 +234,7 @@ export class Decimal {
   }
 
   sqrt() {
-    return new Decimal(this.value.sqrt());
+    return new Decimal(this.value.sqrt()).withMinimumScale(this.scale);
   }
 
   ln() {
@@ -163,7 +246,7 @@ export class Decimal {
   }
 
   log(base: DecimalInput) {
-    return this.applyWrapper(this.value.log, base);
+    return this.applyWrapper(this.value.log, base).withMinimumScale(this.scale);
   }
 
   round(scale: number) {
@@ -173,29 +256,33 @@ export class Decimal {
     // ROUND_HALF_CEIL "Rounds towards nearest neighbour. If equidistant, rounds towards Infinity"
     // rounds 0.5 -> 1.0, -0.5 -> 0.0
     // https://mikemcl.github.io/decimal.js/#modes
-    return this.setScale(scale, CQLDecimalJS.ROUND_HALF_CEIL);
+    return this.withScale(scale, CQL_IMPLICIT_ROUNDING);
   }
 
-  setScale(scale: number, roundingMode: DecimalRoundingMode = CQLDecimalJS.ROUND_DOWN) {
+  withScale(scale: number, roundingMode: DecimalRoundingMode = CQL_IMPLICIT_ROUNDING) {
     if (!Number.isInteger(scale) || scale < 0) {
       throw new RangeError('Decimal scale must be a non-negative integer');
     }
 
-    return new Decimal(this.value.toDecimalPlaces(scale, roundingMode));
+    return new Decimal(this.value.toDecimalPlaces(scale, roundingMode), scale);
   }
 
-  toInteger() {
-    // note that this is permissive and converts non-integral values
-    return this.truncate();
+  // Some functions would prefer a given scale for the result but will allow a greater one
+  // if needed to represent the value.
+  // Eg, 1.0 / 1.0 and 1.0 / 3.0 both have exactly the same input scales, but expect different output scales.
+  withMinimumScale(scale: number, roundingMode: DecimalRoundingMode = CQL_IMPLICIT_ROUNDING) {
+    if (this.scale > scale) {
+      return this;
+    }
+    return this.withScale(scale, roundingMode);
   }
 
-  toNumber() {
-    return this.value.toNumber();
+  withoutTrailingZeros() {
+    return this.withScale(this.value.decimalPlaces());
   }
 
-  toLong() {
-    // note that this is permissive and converts non-integral values
-    return BigInt(this.value.truncated().toString());
+  toNumber() {
+    return this.value.toNumber();
   }
 
   toString() {
@@ -207,12 +294,35 @@ export class Decimal {
     // (# means any number of digits, including none; 0 means a digit must appear)
     // a regex for this is -?\d+\.\d+
     // so Decimal.from(1).toString() --> "1.0"
-    const places = Math.max(1, this.value.decimalPlaces());
+    const places = Math.max(1, this.scale);
     return this.value.toFixed(places);
   }
 
   toJSON() {
-    return this.toString();
+    // The FHIR spec serializes `decimal` as a number, so we follow that convention here,
+    // but note the risk of loss of precision.
+    // https://hl7.org/fhir/json.html#primitive
+    return this.toNumber();
+  }
+}
+
+function determineScale(rawValue: string | number | bigint | DecimalJS, parsedValue?: DecimalJS) {
+  // decimal.js doesn't retain trailing zeros,
+  // so if provided a string we have to count the decimal places
+  if (typeof rawValue === 'string') {
+    const dpIndex = rawValue.indexOf('.');
+    if (dpIndex >= 0) {
+      return rawValue.length - dpIndex - 1;
+      // note this may be larger than our max scale; handle that in calling functions if necessary
+    } else {
+      return 0; // No decimal point found
+    }
+  } else {
+    // If not a string, fall back to parsing by decimal.js and use its decimalPlaces function
+    if (!parsedValue) {
+      parsedValue = new DecimalJS(rawValue);
+    }
+    return parsedValue.decimalPlaces();
   }
 }
 

From 5c570a02ea3c7ac0bea6d4a512cb35ad3ddf9897 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:10:35 -0400
Subject: [PATCH 23/62] remove resultTypeName from generic number math

---
 src/elm/arithmetic.ts |  4 ++--
 src/util/math.ts      | 34 +++++++++++++++++-----------------
 2 files changed, 19 insertions(+), 19 deletions(-)

diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index ffff1a73f..cc8a5935a 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -43,7 +43,7 @@ export class Add extends Expression {
       return null;
     }
 
-    const sum = MathUtil.add(args[0], args[1], this.resultTypeName);
+    const sum = MathUtil.add(args[0], args[1]);
     return finalizeArithmeticResult(sum);
   }
 }
@@ -59,7 +59,7 @@ export class Subtract extends Expression {
       return null;
     }
 
-    const difference = MathUtil.subtract(args[0], args[1], this.resultTypeName);
+    const difference = MathUtil.subtract(args[0], args[1]);
     return finalizeArithmeticResult(difference);
   }
 }
diff --git a/src/util/math.ts b/src/util/math.ts
index 48d913c00..487393751 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -110,7 +110,7 @@ export function isValidDecimal(decimal: any) {
   return true;
 }
 
-export function add(a: any, b: any, type?: string): any {
+export function add(a: any, b: any): any {
   if (a == null || b == null) {
     return null;
   }
@@ -119,16 +119,16 @@ export function add(a: any, b: any, type?: string): any {
     const aHigh = a?.isUncertainty ? a.high : a;
     const bLow = b?.isUncertainty ? b.low : b;
     const bHigh = b?.isUncertainty ? b.high : b;
-    const low = add(aLow, bLow, type);
-    const high = add(aHigh, bHigh, type);
+    const low = add(aLow, bLow);
+    const high = add(aHigh, bHigh);
     return low == null || high == null ? null : new Uncertainty(low, high);
   }
 
-  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+  if (a.isDecimal || b.isDecimal) {
     const sum = Decimal.from(a).add(Decimal.from(b));
     return overflowsOrUnderflows(sum) ? null : sum;
   }
-  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+  if (typeof a === 'bigint' || typeof b === 'bigint') {
     const sum = BigInt(a) + BigInt(b);
     return overflowsOrUnderflows(sum) ? null : sum;
   }
@@ -158,7 +158,7 @@ export function add(a: any, b: any, type?: string): any {
   throw new Error('Unsupported argument types.');
 }
 
-export function subtract(a: any, b: any, type?: string): any {
+export function subtract(a: any, b: any): any {
   if (a == null || b == null) {
     return null;
   }
@@ -167,30 +167,30 @@ export function subtract(a: any, b: any, type?: string): any {
     const aHigh = a?.isUncertainty ? a.high : a;
     const bLow = b?.isUncertainty ? b.low : b;
     const bHigh = b?.isUncertainty ? b.high : b;
-    const low = subtract(aLow, bHigh, type);
-    const high = subtract(aHigh, bLow, type);
+    const low = subtract(aLow, bHigh);
+    const high = subtract(aHigh, bLow);
     return low == null || high == null ? null : new Uncertainty(low, high);
   }
   if (typeof b === 'number' || typeof b === 'bigint') {
-    return add(a, -b, type);
+    return add(a, -b);
   }
   if (b?.isDecimal) {
-    return add(a, (b as Decimal).negate(), type);
+    return add(a, (b as Decimal).negate());
   }
   if (b?.isQuantity) {
     // Note - this path uses a fake Quantity object to defer validation of the unit
-    return add(a, { isQuantity: true, value: b.value.negate(), unit: b.unit }, type);
+    return add(a, { isQuantity: true, value: b.value.negate(), unit: b.unit });
   }
 
   throw new Error('Unsupported argument types.');
 }
 
-export function multiply(a: any, b: any, type?: string) {
-  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+export function multiply(a: any, b: any) {
+  if (a.isDecimal || b.isDecimal) {
     const product = Decimal.from(a).multiplyBy(b);
     return overflowsOrUnderflows(product) ? null : product;
   }
-  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+  if (typeof a === 'bigint' || typeof b === 'bigint') {
     const product = BigInt(a) * BigInt(b);
     return overflowsOrUnderflows(product) ? null : product;
   }
@@ -202,8 +202,8 @@ export function multiply(a: any, b: any, type?: string) {
   throw new Error('Unsupported argument types.');
 }
 
-export function divide(a: any, b: any, type?: string) {
-  if (a.isDecimal || b.isDecimal || type === ELM_DECIMAL_TYPE) {
+export function divide(a: any, b: any) {
+  if (a.isDecimal || b.isDecimal) {
     b = Decimal.from(b);
     if (b.equals(0)) {
       return null;
@@ -211,7 +211,7 @@ export function divide(a: any, b: any, type?: string) {
     const quotient = Decimal.from(a).divideBy(b);
     return overflowsOrUnderflows(quotient) ? null : quotient;
   }
-  if (typeof a === 'bigint' || typeof b === 'bigint' || type === ELM_LONG_TYPE) {
+  if (typeof a === 'bigint' || typeof b === 'bigint') {
     if (b === 0 || b === 0n) {
       return null;
     }

From 42b6246925111fa80f6c9cbf648489897f5f501f Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:11:13 -0400
Subject: [PATCH 24/62] reintroduce numeric integer check

---
 src/runtime/context.ts | 4 ++--
 1 file changed, 2 insertions(+), 2 deletions(-)

diff --git a/src/runtime/context.ts b/src/runtime/context.ts
index 84ec265a0..d72ba99f5 100644
--- a/src/runtime/context.ts
+++ b/src/runtime/context.ts
@@ -343,7 +343,7 @@ export class Context {
       case ELM_DECIMAL_TYPE:
         return val && val.isDecimal;
       case ELM_INTEGER_TYPE:
-        return typeof val === 'number';
+        return typeof val === 'number' && Number.isInteger(val);
       case ELM_LONG_TYPE:
         return typeof val === 'bigint';
       case ELM_STRING_TYPE:
@@ -390,7 +390,7 @@ export class Context {
     } else if (inst.isDecimalLiteral) {
       return val && val.isDecimal;
     } else if (inst.isIntegerLiteral) {
-      return typeof val === 'number';
+      return typeof val === 'number' && Number.isInteger(val);
     } else if (inst.isLongLiteral) {
       return typeof val === 'bigint';
     } else if (inst.isStringLiteral) {

From 2965dc1feed148c48244fc5a1da737659b33cb94 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:12:17 -0400
Subject: [PATCH 25/62] Remove conversions that aren't supported in ELM, and
 clarify Decimal.ToString

---
 src/elm/type.ts | 23 ++++-------------------
 1 file changed, 4 insertions(+), 19 deletions(-)

diff --git a/src/elm/type.ts b/src/elm/type.ts
index e7184691d..ae95006b6 100644
--- a/src/elm/type.ts
+++ b/src/elm/type.ts
@@ -96,15 +96,10 @@ export class ToBoolean extends Expression {
   async exec(ctx: Context) {
     const arg = await this.execArgs(ctx);
     if (arg != null) {
-      if (typeof arg === 'boolean') {
-        return arg;
-      } else if (typeof arg === 'number' || typeof arg === 'bigint') {
-        if (arg == 1) {
-          return true;
-        } else if (arg == 0) {
-          return false;
-        }
-      } else if (arg instanceof Decimal) {
+      if (arg instanceof Decimal) {
+        // Unlike other types, Decimal.toString doesn't line up
+        // with the defined truthy/falsy values below.
+        // Check numeric equality (ignores scale) for the two values that map to boolean
         if (arg.equals('1.0')) {
           return true;
         } else if (arg.equals('0.0')) {
@@ -230,11 +225,6 @@ export class ToInteger extends Expression {
       if (isValidInteger(integer)) {
         return integer;
       }
-    } else if (arg && arg.isDecimal) {
-      const integer = (arg as Decimal).toInteger();
-      if (isValidInteger(integer)) {
-        return integer;
-      }
     } else if (typeof arg === 'string') {
       // check for blank string because Number('') and Number(' ') evaluate to 0.
       if (arg.trim().length === 0) {
@@ -272,11 +262,6 @@ export class ToLong extends Expression {
       } catch {
         return null;
       }
-    } else if (arg && arg.isDecimal) {
-      const long = (arg as Decimal).toLong();
-      if (isValidLong(long)) {
-        return long;
-      }
     } else if (typeof arg === 'string') {
       // check string format because BigInt throws for invalid strings
       if (!/^[+-]?\d+$/.test(arg)) {

From e98761616302128f6255fde296b46367867375f5 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:12:55 -0400
Subject: [PATCH 26/62] use Decimal comparison methods for uncertainty
 boundaries

---
 src/datatypes/uncertainty.ts | 11 +++++++++--
 1 file changed, 9 insertions(+), 2 deletions(-)

diff --git a/src/datatypes/uncertainty.ts b/src/datatypes/uncertainty.ts
index 8a089e217..0264d08e9 100644
--- a/src/datatypes/uncertainty.ts
+++ b/src/datatypes/uncertainty.ts
@@ -22,6 +22,9 @@ export class Uncertainty {
       }
       if (typeof a.after === 'function') {
         return a.after(b);
+      }
+      if (typeof a.greaterThan === 'function') {
+        return a.greaterThan(b);
       } else {
         return a > b;
       }
@@ -66,6 +69,8 @@ export class Uncertainty {
 
       if (typeof a.sameOrBefore === 'function') {
         return a.sameOrBefore(b);
+      } else if (typeof a.lessThanOrEquals === 'function') {
+        return a.lessThanOrEquals(b);
       } else {
         return a <= b;
       }
@@ -75,8 +80,10 @@ export class Uncertainty {
         return null;
       }
 
-      if (typeof a.sameOrBefore === 'function') {
+      if (typeof a.sameOrAfter === 'function') {
         return a.sameOrAfter(b);
+      } else if (typeof a.greaterThanOrEquals === 'function') {
+        return a.greaterThanOrEquals(b);
       } else {
         return a >= b;
       }
@@ -143,7 +150,7 @@ export class Uncertainty {
 
       if (typeof a.before === 'function') {
         return a.before(b, precision);
-      } else if (a.isDecimal) {
+      } else if (typeof a.lessThan === 'function') {
         return a.lessThan(b);
       } else {
         return a < b;

From bd9772b1191fc2260d6c220efa5a1ddc46931226 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:19:24 -0400
Subject: [PATCH 27/62] update UCUM conversion logic to handle special cases
 and decimal scale

---
 src/types/ucum-lhc.d.ts          | 11 +++-
 src/util/units.ts                | 49 +++++++++++++++--
 test/elm/convert/convert-test.ts |  4 ++
 test/elm/convert/data.cql        |  1 +
 test/elm/convert/data.js         | 94 +++++++++++++++++++++++++++-----
 5 files changed, 140 insertions(+), 19 deletions(-)

diff --git a/src/types/ucum-lhc.d.ts b/src/types/ucum-lhc.d.ts
index 15445e0f6..47c4f1db5 100644
--- a/src/types/ucum-lhc.d.ts
+++ b/src/types/ucum-lhc.d.ts
@@ -30,17 +30,26 @@ declare module '@lhncbc/ucum-lhc' {
 
   export interface ConversionResponse {
     status: 'succeeded' | 'failed' | 'error';
-    toVal: string;
+    toVal: number;
     msg: string[];
     suggestions?: ConversionSuggestion[];
     fromUnit: Unit;
     toUnit: Unit;
   }
 
+  export interface BaseUnitConversionResponse {
+    status: 'succeeded' | 'invalid' | 'failed' | 'error';
+    msg: string[];
+    magnitude: number;
+    fromUnitIsSpecial?: boolean;
+    unitToExp: object; // a map of base units in fromUnit to their exponent
+  }
+
   export class UcumLhcUtils {
     static getInstance(): UcumLhcUtils;
     validateUnitString(uStr: string, suggest?: boolean, valConv?: string): ValidationResponse;
     convertUnitTo(fromUnitCode: string, fromVal: number, toUnitCode: string): ConversionResponse;
     commensurablesList(fromName: string): [Unit[] | null, string[]];
+    convertToBaseUnits(fromUnit: string, fromVal: number): BaseUnitConversionResponse;
   }
 }
diff --git a/src/util/units.ts b/src/util/units.ts
index 20abc8435..0a539c194 100644
--- a/src/util/units.ts
+++ b/src/util/units.ts
@@ -73,15 +73,54 @@ export function convertUnit(fromVal: Decimal, fromUnit: any, toUnit: any) {
     return fromVal;
   }
   // IMPORTANT: the UCUM library operates on raw JS numbers, not our Decimal
-  // this means that extremely large or extremely small numbers would lose precision via this function.
+  // this means that extremely large or extremely small numbers could lose precision via this function.
   // To prevent this, instead of converting fromVal directly, convert 1 unit to get the conversion factor,
   // and manually multiply the fromVal by it.
-  const result = utils.convertUnitTo(fromUnit, 1, toUnit);
-  if (result.status !== 'succeeded') {
+  // First though, make sure the units can be safely converted by simple scalar factor.
+  // Units that cannot because they require a special function, such as C <--> F,
+  // fall back to calling the UCUM library directly.
+
+  const testFrom = utils.convertToBaseUnits(fromUnit, 1);
+  const testTo = utils.convertToBaseUnits(toUnit, 1);
+
+  if (testFrom.status !== 'succeeded' || testTo.status !== 'succeeded') {
     return;
   }
-  const conversionFactor = result.toVal;
-  return fromVal.multiplyBy(conversionFactor).normalized();
+
+  let rawResult: Decimal;
+  if (testFrom.fromUnitIsSpecial === false && testTo.fromUnitIsSpecial === false) {
+    // try both directions to see if one is more exact,
+    // eg, days to weeks is * 0.142857... but weeks to days is * 7, so days to weeks could be / 7 instead
+    const fromToTo = utils.convertUnitTo(fromUnit, 1, toUnit);
+    const toToFrom = utils.convertUnitTo(toUnit, 1, fromUnit);
+    if (fromToTo.status !== 'succeeded' || toToFrom.status !== 'succeeded') {
+      return;
+    }
+
+    const multFactor = fromToTo.toVal;
+    const divFactor = toToFrom.toVal;
+    // NOTE: conversion factor is a JS number and can itself be imprecise, eg, inches to m is 0.025400000000000002
+    if (Number.isInteger(divFactor)) {
+      rawResult = fromVal.divideBy(divFactor);
+    } else {
+      // We could consider more heuristics here, but for now just fall back to the multiplication factor
+      rawResult = fromVal.multiplyBy(multFactor);
+    }
+  } else {
+    // units are special, so call the library with the exact value
+    const result = utils.convertUnitTo(fromUnit, fromVal.toNumber(), toUnit);
+    if (result.status !== 'succeeded') {
+      return;
+    }
+    rawResult = Decimal.from(result.toVal);
+  }
+  // IMPORTANT: Experimentation shows JS number issues are more common than one might anticipate,
+  // eg 0 C to F produces "31.999999999999943" which gets normalized to "32.00000000".
+  // Since Decimal scale is relevant, drop trailing zeros here,
+  // then ensure a minimum scale matching the input value's scale.
+  // This may produce results with different scale than pure Decimal arithmetic would,
+  // but should never impact the value, only the scale.
+  return rawResult.normalized().withoutTrailingZeros().withMinimumScale(fromVal.scale);
 }
 
 export function normalizeUnitsWhenPossible(val1: Decimal, unit1: any, val2: Decimal, unit2: any) {
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index f8986052c..c99fb3b18 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -1070,6 +1070,10 @@ describe('ConvertQuantity', () => {
     (await this.convertQuantityToKg.exec(this.ctx)).should.eql(new Quantity(5, 'kg'));
   });
 
+  it('should return converted Quantity with Celsius', async function () {
+    (await this.convertQuantityToC.exec(this.ctx)).should.eql(new Quantity(0, 'Cel'));
+  });
+
   it('should return converted Quantity with weeks', async function () {
     (await this.convertQuantityToWeeks.exec(this.ctx)).should.eql(new Quantity(4, 'weeks'));
   });
diff --git a/test/elm/convert/data.cql b/test/elm/convert/data.cql
index 68c1742c6..458b9ee5d 100644
--- a/test/elm/convert/data.cql
+++ b/test/elm/convert/data.cql
@@ -265,6 +265,7 @@ define IsNull: ConvertsToTime(null as String)
 define ConvertQuantityGood: ConvertQuantity(5 'mg', 'g')
 define ConvertSyntax: convert 5 'mg' to 'g'
 define ConvertQuantityToKg: ConvertQuantity(5000 'g', 'kg')
+define ConvertQuantityToC: ConvertQuantity(32 '[degF]', 'Cel')
 define ConvertQuantityToWeeks: ConvertQuantity(28 'days', 'weeks')
 define NullConvertQuantity: ConvertQuantity(5 'mg', 'fox')
 
diff --git a/test/elm/convert/data.js b/test/elm/convert/data.js
index 764975694..c5eb11c97 100644
--- a/test/elm/convert/data.js
+++ b/test/elm/convert/data.js
@@ -13476,6 +13476,7 @@ context Patient
 define ConvertQuantityGood: ConvertQuantity(5 'mg', 'g')
 define ConvertSyntax: convert 5 'mg' to 'g'
 define ConvertQuantityToKg: ConvertQuantity(5000 'g', 'kg')
+define ConvertQuantityToC: ConvertQuantity(32 '[degF]', 'Cel')
 define ConvertQuantityToWeeks: ConvertQuantity(28 'days', 'weeks')
 define NullConvertQuantity: ConvertQuantity(5 'mg', 'fox')
 */
@@ -13492,7 +13493,7 @@ module.exports['ConvertQuantity'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "261",
+        "r" : "274",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -13761,7 +13762,7 @@ module.exports['ConvertQuantity'] = {
       }, {
         "localId" : "248",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "ConvertQuantityToWeeks",
+        "name" : "ConvertQuantityToC",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -13770,7 +13771,7 @@ module.exports['ConvertQuantity'] = {
           "s" : {
             "r" : "248",
             "s" : [ {
-              "value" : [ "", "define ", "ConvertQuantityToWeeks", ": " ]
+              "value" : [ "", "define ", "ConvertQuantityToC", ": " ]
             }, {
               "r" : "256",
               "s" : [ {
@@ -13778,14 +13779,14 @@ module.exports['ConvertQuantity'] = {
               }, {
                 "r" : "249",
                 "s" : [ {
-                  "value" : [ "28 ", "'days'" ]
+                  "value" : [ "32 ", "'[degF]'" ]
                 } ]
               }, {
                 "value" : [ ", " ]
               }, {
                 "r" : "250",
                 "s" : [ {
-                  "value" : [ "'weeks'" ]
+                  "value" : [ "'Cel'" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -13813,22 +13814,22 @@ module.exports['ConvertQuantity'] = {
             "type" : "Quantity",
             "localId" : "249",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-            "value" : 28,
-            "unit" : "days",
+            "value" : 32,
+            "unit" : "[degF]",
             "annotation" : [ ]
           }, {
             "type" : "Literal",
             "localId" : "250",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
             "valueType" : "{urn:hl7-org:elm-types:r1}String",
-            "value" : "weeks",
+            "value" : "Cel",
             "annotation" : [ ]
           } ]
         }
       }, {
         "localId" : "261",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-        "name" : "NullConvertQuantity",
+        "name" : "ConvertQuantityToWeeks",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -13837,7 +13838,7 @@ module.exports['ConvertQuantity'] = {
           "s" : {
             "r" : "261",
             "s" : [ {
-              "value" : [ "", "define ", "NullConvertQuantity", ": " ]
+              "value" : [ "", "define ", "ConvertQuantityToWeeks", ": " ]
             }, {
               "r" : "269",
               "s" : [ {
@@ -13845,14 +13846,14 @@ module.exports['ConvertQuantity'] = {
               }, {
                 "r" : "262",
                 "s" : [ {
-                  "value" : [ "5 ", "'mg'" ]
+                  "value" : [ "28 ", "'days'" ]
                 } ]
               }, {
                 "value" : [ ", " ]
               }, {
                 "r" : "263",
                 "s" : [ {
-                  "value" : [ "'fox'" ]
+                  "value" : [ "'weeks'" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -13880,12 +13881,79 @@ module.exports['ConvertQuantity'] = {
             "type" : "Quantity",
             "localId" : "262",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "value" : 28,
+            "unit" : "days",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "263",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+            "valueType" : "{urn:hl7-org:elm-types:r1}String",
+            "value" : "weeks",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "274",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "NullConvertQuantity",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "274",
+            "s" : [ {
+              "value" : [ "", "define ", "NullConvertQuantity", ": " ]
+            }, {
+              "r" : "282",
+              "s" : [ {
+                "value" : [ "ConvertQuantity", "(" ]
+              }, {
+                "r" : "275",
+                "s" : [ {
+                  "value" : [ "5 ", "'mg'" ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "r" : "276",
+                "s" : [ {
+                  "value" : [ "'fox'" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "ConvertQuantity",
+          "localId" : "282",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "283",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "284",
+            "name" : "{urn:hl7-org:elm-types:r1}String",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Quantity",
+            "localId" : "275",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
             "value" : 5,
             "unit" : "mg",
             "annotation" : [ ]
           }, {
             "type" : "Literal",
-            "localId" : "263",
+            "localId" : "276",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
             "valueType" : "{urn:hl7-org:elm-types:r1}String",
             "value" : "fox",

From 43aaa72d58849deaead831f189b9734f290c77f5 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:21:44 -0400
Subject: [PATCH 28/62] sum Quantities by value so values are only normalized
 once at the end

---
 src/elm/aggregate.ts | 5 +++--
 1 file changed, 3 insertions(+), 2 deletions(-)

diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 6d9e91536..741fad6d9 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -67,8 +67,9 @@ export class Sum extends AggregateExpression {
 
     let sum;
     if (hasOnlyQuantities(items)) {
-      // note doAddition is Quantity addition
-      sum = items.reduce(doAddition);
+      // note that processQuantities above converted everything
+      // to match the unit of the first item in the list
+      sum = sumOfDecimals(items.map((q: Quantity) => q.value));
     } else {
       if (hasDecimals(items)) {
         sum = sumOfDecimals(items.map(Decimal.from));

From ad82f420dc4b0f42c37271bd0b79a6218f1767c7 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:23:00 -0400
Subject: [PATCH 29/62] cleanup aggregate file; use explicit lambda functions
 to avoid risk of passing in index from Array.map

---
 src/elm/aggregate.ts | 16 ++++++++--------
 1 file changed, 8 insertions(+), 8 deletions(-)

diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 741fad6d9..caae0f591 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -1,6 +1,6 @@
 import { Expression } from './expression';
 import { typeIsArray, allTrue, anyTrue, removeNulls } from '../util/util';
-import { doAddition, Quantity } from '../datatypes/datatypes';
+import { Quantity } from '../datatypes/datatypes';
 import { Decimal } from '../datatypes/decimal';
 import { Context } from '../runtime/context';
 import { Exception } from '../datatypes/exception';
@@ -72,7 +72,7 @@ export class Sum extends AggregateExpression {
       sum = sumOfDecimals(items.map((q: Quantity) => q.value));
     } else {
       if (hasDecimals(items)) {
-        sum = sumOfDecimals(items.map(Decimal.from));
+        sum = sumOfDecimals(items.map((x: any) => Decimal.from(x)));
       } else {
         sum = items.reduce((x: any, y: any) => x + y);
       }
@@ -175,7 +175,7 @@ export class Avg extends AggregateExpression {
       decimals = getValuesFromQuantities(items);
     } else {
       // return type is always Decimal, so just map everything to Decimals
-      decimals = items.map(Decimal.from);
+      decimals = items.map((x: any) => Decimal.from(x));
     }
     const sum = sumOfDecimals(decimals);
     const avg = sum.divideBy(items.length);
@@ -210,7 +210,7 @@ export class Median extends AggregateExpression {
       // Note that the Median signature is Median(argument List<Decimal>) Decimal
       // because median on a list of even number of items takes the average of the 2 middle items
       // so we can treat all the input as decimals
-      decimals = items.map(Decimal.from);
+      decimals = items.map((x: any) => Decimal.from(x));
     }
 
     const sorted = [...decimals].sort((a, b) => a.compareTo(b));
@@ -310,7 +310,7 @@ export class StdDev extends AggregateExpression {
     if (hasOnlyQuantities(items)) {
       values = getValuesFromQuantities(items);
     } else {
-      values = items.map(Decimal.from);
+      values = items.map((x: any) => Decimal.from(x));
     }
 
     const stdDev = this.standardDeviation(values);
@@ -378,7 +378,7 @@ export class Product extends AggregateExpression {
     if (hasOnlyQuantities(items)) {
       product = productOfDecimals(getValuesFromQuantities(items));
     } else if (hasDecimals(items)) {
-      product = productOfDecimals(items.map(Decimal.from));
+      product = productOfDecimals(items.map((x: any) => Decimal.from(x)));
     } else {
       product = items.reduce((x: number, y: number) => x * y);
     }
@@ -412,7 +412,7 @@ export class GeometricMean extends AggregateExpression {
     if (hasOnlyQuantities(items)) {
       decimals = getValuesFromQuantities(items);
     } else {
-      decimals = items.map(Decimal.from);
+      decimals = items.map((x: any) => Decimal.from(x));
     }
 
     try {
@@ -476,7 +476,7 @@ export class AnyTrue extends AggregateExpression {
 }
 
 function hasDecimals(values: any[]) {
-  return values.some(value => value && value.isDecimal);
+  return values.some(value => value?.isDecimal);
 }
 
 function processQuantities(values: any[]) {

From 293f03a7d2101a1448ff7cc1e3f1ad9c7da97b08 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:27:43 -0400
Subject: [PATCH 30/62] Power operator always returns Decimal

---
 src/elm/arithmetic.ts                  | 30 ++++----------------------
 test/elm/arithmetic/arithmetic-test.ts | 20 ++++++++---------
 test/spec-tests/skip-list.txt          | 13 +++++++++++
 3 files changed, 27 insertions(+), 36 deletions(-)

diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index cc8a5935a..ac862c9f0 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -399,36 +399,14 @@ export class Power extends Expression {
       return null;
     }
 
-    // Note: The resultTypeName may be wrong if the exponent is a negative number.
-    // E.g., CQL-to-ELM says 10^-1 is an Integer result type, but the correct result is a 0.1 (a Decimal)
-    // doPower handles this scenario
-    let power;
+    // As of CQL 2.0.0, return type of Power is always a Decimal
     try {
-      power = doPower(args[0], args[1]);
+      const power = Decimal.from(args[0]).power(args[1]);
+      return finalizeArithmeticResult(power);
     } catch {
+      // if the value is too large to represent
       return null;
     }
-
-    return finalizeArithmeticResult(power);
-  }
-}
-
-function doPower(x: any, y: any) {
-  if (
-    x.isDecimal ||
-    y.isDecimal ||
-    (typeof y == 'number' && y < 0) ||
-    (typeof y === 'bigint' && y < 0n)
-  ) {
-    // Decimal values or negative powers always produce Decimal result
-    return Decimal.from(x).power(y);
-  }
-
-  try {
-    return x ** y;
-  } catch {
-    // will throw if BigInt goes out of range
-    return null;
   }
 }
 
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index f3475e0c1..31e8ba6d5 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -318,27 +318,27 @@ describe('Power', () => {
   });
 
   it('should be able to calculate the power of a number', async function () {
-    (await this.pow.exec(this.ctx)).should.eql(81);
+    (await this.pow.exec(this.ctx)).should.equalDecimal(81);
   });
 
   it('should be able to calculate the negative power of a number', async function () {
-    (await this.negPow.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
+    (await this.negPow.exec(this.ctx)).should.equalDecimal(0.1);
   });
 
   it('should be able to calculate the power of a long', async function () {
-    (await this.threeExpFourLong.exec(this.ctx)).should.equal(81n);
+    (await this.threeExpFourLong.exec(this.ctx)).should.equalDecimal(81);
   });
 
   it('should be able to calculate the long power of an integer', async function () {
-    (await this.threeExpFourMixed.exec(this.ctx)).should.equal(81n);
+    (await this.threeExpFourMixed.exec(this.ctx)).should.equalDecimal(81);
   });
 
   it('should be able to calculate the integer power of a long', async function () {
-    (await this.threeExpFourReverseMixed.exec(this.ctx)).should.equal(81n);
+    (await this.threeExpFourReverseMixed.exec(this.ctx)).should.equalDecimal(81);
   });
 
   it('should be able to calculate the negative power of a long', async function () {
-    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
+    (await this.tenLongExpNegativeOneLong.exec(this.ctx)).should.equalDecimal(0.1);
   });
 
   it('should return null when a long power exponent is too large (beyond max Long value)', async function () {
@@ -1071,11 +1071,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Power near overflow', async function () {
-      should(await this.integerPowerNearOverflow.exec(this.ctx)).equal(MAX_INT_VALUE);
+      should(await this.integerPowerNearOverflow.exec(this.ctx)).equalDecimal(MAX_INT_VALUE);
     });
 
     it('should return value for Power near underflow', async function () {
-      should(await this.integerPowerNearUnderflow.exec(this.ctx)).equal(MIN_INT_VALUE);
+      should(await this.integerPowerNearUnderflow.exec(this.ctx)).equalDecimal(MIN_INT_VALUE);
     });
 
     it('should return null for successor overflow', async function () {
@@ -1182,11 +1182,11 @@ describe('OutOfBounds', () => {
     });
 
     it('should return value for Power near overflow', async function () {
-      should(await this.longPowerNearOverflow.exec(this.ctx)).equal(MAX_LONG_VALUE);
+      should(await this.longPowerNearOverflow.exec(this.ctx)).equalDecimal(MAX_LONG_VALUE);
     });
 
     it('should return value for Power near underflow', async function () {
-      should(await this.longPowerNearUnderflow.exec(this.ctx)).equal(MIN_LONG_VALUE);
+      should(await this.longPowerNearUnderflow.exec(this.ctx)).equalDecimal(MIN_LONG_VALUE);
     });
 
     it('should return null for successor overflow', async function () {
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index 51c64424b..1c8fbd74d 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -32,6 +32,19 @@ CqlArithmeticFunctionsTest.Predecessor.PredecessorOf101D        Wrong output: As
 CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCM        Wrong output: As of 2.0 Successor of Decimal should be precision-aware
 CqlArithmeticFunctionsTest.Successor.SuccessorOf1D              Wrong output: As of 2.0 Successor of Decimal should be precision-aware
 CqlArithmeticFunctionsTest.Successor.SuccessorOf101D            Wrong output: As of 2.0 Successor of Decimal should be precision-aware
+CqlArithmeticFunctionsTest.Power.Power0To0                      Wrong output: As of CQL 2.0, Power always returns Decimal
+CqlArithmeticFunctionsTest.Power.Power2To2                      Wrong output: As of CQL 2.0, Power always returns Decimal
+CqlArithmeticFunctionsTest.Power.PowerNeg2To2                   Wrong output: As of CQL 2.0, Power always returns Decimal
+CqlArithmeticFunctionsTest.Power.Power2LTo2L                    Wrong output: As of CQL 2.0, Power always returns Decimal
+CqlArithmeticFunctionsTest.Power.Power2To4                      Wrong output: As of CQL 2.0, Power always returns Decimal
+CqlArithmeticFunctionsTest.Power.Power2LTo3L                    Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.Integer10Pow9                             Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.IntegerPos10Pow9                          Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.IntegerNeg10Pow9                          Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.Integer2Pow31ToZero1IntegerMaxValue       Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.IntegerPos2Pow31ToZero1IntegerMaxValue    Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.IntegerNeg2Pow31ToZero1                   Wrong output: As of CQL 2.0, Power always returns Decimal
+ValueLiteralsAndSelectors.Integer.IntegerNeg2Pow31IntegerMinValue           Wrong output: As of CQL 2.0, Power always returns Decimal
 CqlComparisonOperatorsTest.Equal.TupleEqDifferentNamesWithOneNullId                 Wrong output: Tuple equality with a known-unequal element should return false
 "CqlComparisonOperatorsTest.Not Equal.TupleNotEqDifferingNamesWithOneNullId"        Wrong output: Tuple inequality with a known-unequal element should return true
 CqlStringOperatorsTest.Substring.SubstringEmptyAnd0                   Wrong output: Substring(x, x.length) should be null'. Note similar test SubstringAB2. See https://github.com/cqframework/cql-tests/issues/149

From b3555d2b2b3e76029d2126d8fbd0735472d7fe21 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:33:15 -0400
Subject: [PATCH 31/62] remove/clarify calls to Quantity arithmetic

---
 src/elm/arithmetic.ts | 17 ++++++++++-------
 1 file changed, 10 insertions(+), 7 deletions(-)

diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index ac862c9f0..bf39d8b4b 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -1,6 +1,6 @@
 import { Expression } from './expression';
 import * as MathUtil from '../util/math';
-import { Quantity, doMultiplication, doDivision } from '../datatypes/quantity';
+import { Quantity, doMultiplication as doQuantityMultiplication } from '../datatypes/quantity';
 import { Uncertainty } from '../datatypes/uncertainty';
 import { Context } from '../runtime/context';
 import { build } from './builder';
@@ -85,10 +85,13 @@ export class Multiply extends Expression {
 
     let product;
     if (x.isQuantity || y.isQuantity) {
-      product = doMultiplication(x, y);
+      product = doQuantityMultiplication(x, y);
     } else if (x.isUncertainty && y.isUncertainty) {
       if (x.low.isQuantity) {
-        product = new Uncertainty(doMultiplication(x.low, y.low), doMultiplication(x.high, y.high));
+        product = new Uncertainty(
+          doQuantityMultiplication(x.low, y.low),
+          doQuantityMultiplication(x.high, y.high)
+        );
       } else {
         product = new Uncertainty(
           MathUtil.multiply(x.low, y.low),
@@ -124,12 +127,12 @@ export class Divide extends Expression {
       }
 
       if (x.isQuantity) {
-        quotient = doDivision(x, y);
+        quotient = x.dividedBy(y);
       } else if (x.isUncertainty && y.isUncertainty) {
         let low, high;
         if (x.low.isQuantity) {
-          low = doDivision(x.low, y.high);
-          high = doDivision(x.high, y.low);
+          low = x.low.dividedBy(y.high);
+          high = x.high.dividedBy(y.low);
         } else {
           low = MathUtil.divide(x.low, y.high);
           high = MathUtil.divide(x.high, y.low);
@@ -161,7 +164,7 @@ export class TruncatedDivide extends Expression {
     const [x, y] = args;
     let quotient;
     if (x.isQuantity) {
-      quotient = doDivision(x, y);
+      quotient = x.dividedBy(y);
       if (quotient instanceof Quantity) {
         quotient = new Quantity(quotient.value.truncated(), quotient.unit);
       }

From 7511707989d3b2117192b72f60d6bdab929b1d34 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:34:16 -0400
Subject: [PATCH 32/62] regenerate spec-tests with latest

---
 .../cql/CqlArithmeticFunctionsTest.cql        |  24 +-
 .../cql/CqlArithmeticFunctionsTest.json       | 438 ++---------
 .../cql/ValueLiteralsAndSelectors.cql         |  28 +-
 .../cql/ValueLiteralsAndSelectors.json        | 717 ++----------------
 4 files changed, 175 insertions(+), 1032 deletions(-)

diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
index 10d8a19ca..624ae2173 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
@@ -735,25 +735,33 @@ define "Power": Tuple{
     output: null
   },
   "Power0To0": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(0, 0),
     output: 1
-  },
+    */  },
   "Power2To2": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(2, 2),
     output: 4
-  },
+    */  },
   "PowerNeg2To2": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(-2, 2),
     output: 4
-  },
+    */  },
   "Power2ToNeg2": Tuple{
     expression: Power(2, -2),
     output: 0.25
   },
   "Power2LTo2L": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(2L, 2L),
     output: 4L
-  },
+    */  },
   "Power2DTo2D": Tuple{
     expression: Power(2.0, 2.0),
     output: 4.0
@@ -775,13 +783,17 @@ define "Power": Tuple{
     output: 4.0
   },
   "Power2To4": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: 2^4,
     output: 16
-  },
+    */  },
   "Power2LTo3L": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: 2L^3L,
     output: 8L
-  },
+    */  },
   "Power2DTo4D": Tuple{
     expression: 2.0^4.0,
     output: 16.0
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
index a0552b7d3..82e90b7ee 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
@@ -19557,20 +19557,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19585,20 +19576,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19613,20 +19595,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19669,20 +19642,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Long",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Long",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19837,20 +19801,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19865,20 +19820,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Long",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Long",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -19986,20 +19932,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20014,20 +19951,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20042,20 +19970,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20098,20 +20017,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20266,20 +20176,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20294,20 +20195,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20471,20 +20363,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20492,37 +20375,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "0",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "0",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -20539,20 +20397,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20560,37 +20409,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "4",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -20607,20 +20431,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20628,43 +20443,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Negate",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "2",
-                              "annotation": []
-                            }
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "4",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -20755,20 +20539,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -20776,37 +20551,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                            "value": "2",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                        "value": "4",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -21185,20 +20935,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21206,37 +20947,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "4",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "16",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -21253,20 +20969,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Long",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -21274,37 +20981,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                            "value": "2",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                            "value": "3",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Long",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Long",
-                        "value": "8",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/ValueLiteralsAndSelectors.cql b/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
index 1bf057dab..83aa557f0 100644
--- a/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
+++ b/test/spec-tests/cql/ValueLiteralsAndSelectors.cql
@@ -58,29 +58,41 @@ define "Integer": Tuple{
     output: -2
   },
   "Integer10Pow9": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(10,9),
     output: 1000000000
-  },
+    */  },
   "IntegerPos10Pow9": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: +Power(10,9),
     output: 1000000000
-  },
+    */  },
   "IntegerNeg10Pow9": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: -Power(10,9),
     output: -1000000000
-  },
+    */  },
   "Integer2Pow31ToZero1IntegerMaxValue": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: Power(2,30)-1+Power(2,30),
     output: 2147483647
-  },
+    */  },
   "IntegerPos2Pow31ToZero1IntegerMaxValue": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: +Power(2,30)-1+Power(2,30),
     output: 2147483647
-  },
+    */  },
   "IntegerNeg2Pow31ToZero1": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: -Power(2,30)+1-Power(2,30),
     output: -2147483647
-  },
+    */  },
   "Integer2Pow31": Tuple{
     expression: 2147483648,
     invalid: true
@@ -90,9 +102,11 @@ define "Integer": Tuple{
     invalid: true
   },
   "IntegerNeg2Pow31IntegerMinValue": Tuple{
+    skipped: 'Wrong output: As of CQL 2.0, Power always returns Decimal'
+    /*
     expression: -Power(2,30)-Power(2,30),
     output: -2147483648
-  },
+    */  },
   "Integer2Pow31ToInf1": Tuple{
     expression: 2147483649,
     invalid: true
diff --git a/test/spec-tests/cql/ValueLiteralsAndSelectors.json b/test/spec-tests/cql/ValueLiteralsAndSelectors.json
index b4743e7c5..f653ed0ed 100644
--- a/test/spec-tests/cql/ValueLiteralsAndSelectors.json
+++ b/test/spec-tests/cql/ValueLiteralsAndSelectors.json
@@ -701,20 +701,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -729,20 +720,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -757,20 +739,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -785,20 +758,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -813,20 +777,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -841,20 +796,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -925,20 +871,11 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "expression",
-                      "annotation": [],
-                      "elementType": {
-                        "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": []
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
                         "annotation": []
                       }
                     }
@@ -1298,20 +1235,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1326,20 +1254,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1354,20 +1273,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1382,20 +1292,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1410,20 +1311,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1438,20 +1330,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -1522,20 +1405,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2146,20 +2020,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2167,37 +2032,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "9",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1000000000",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -2214,20 +2054,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2235,37 +2066,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Power",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "10",
-                            "annotation": []
-                          },
-                          {
-                            "type": "Literal",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                            "value": "9",
-                            "annotation": []
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "1000000000",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -2282,20 +2088,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2303,50 +2100,13 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Power",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": [],
-                          "signature": [],
-                          "operand": [
-                            {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "10",
-                              "annotation": []
-                            },
-                            {
-                              "type": "Literal",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                              "value": "9",
-                              "annotation": []
-                            }
-                          ]
-                        }
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "1000000000",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2362,20 +2122,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2383,82 +2134,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Subtract",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Power",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "annotation": [],
-                                "signature": [],
-                                "operand": [
-                                  {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "2",
-                                    "annotation": []
-                                  },
-                                  {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "30",
-                                    "annotation": []
-                                  }
-                                ]
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "1",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Power",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2",
-                                "annotation": []
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "30",
-                                "annotation": []
-                              }
-                            ]
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2147483647",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -2475,20 +2156,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2496,82 +2168,12 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Add",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Subtract",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Power",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "annotation": [],
-                                "signature": [],
-                                "operand": [
-                                  {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "2",
-                                    "annotation": []
-                                  },
-                                  {
-                                    "type": "Literal",
-                                    "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                    "value": "30",
-                                    "annotation": []
-                                  }
-                                ]
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "1",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Power",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2",
-                                "annotation": []
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "30",
-                                "annotation": []
-                              }
-                            ]
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                        "value": "2147483647",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
                         "annotation": []
                       }
                     }
@@ -2588,20 +2190,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2609,95 +2202,13 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Subtract",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Add",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Negate",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "annotation": [],
-                                "signature": [],
-                                "operand": {
-                                  "type": "Power",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "annotation": [],
-                                  "signature": [],
-                                  "operand": [
-                                    {
-                                      "type": "Literal",
-                                      "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "value": "2",
-                                      "annotation": []
-                                    },
-                                    {
-                                      "type": "Literal",
-                                      "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                      "value": "30",
-                                      "annotation": []
-                                    }
-                                  ]
-                                }
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "1",
-                                "annotation": []
-                              }
-                            ]
-                          },
-                          {
-                            "type": "Power",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2",
-                                "annotation": []
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "30",
-                                "annotation": []
-                              }
-                            ]
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2147483647",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
+                        "annotation": []
                       }
                     }
                   ]
@@ -2819,20 +2330,11 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "expression",
-                        "annotation": [],
-                        "elementType": {
-                          "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
-                          "annotation": []
-                        }
-                      },
-                      {
-                        "name": "output",
+                        "name": "skipped",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
                           "annotation": []
                         }
                       }
@@ -2840,80 +2342,13 @@
                   },
                   "element": [
                     {
-                      "name": "expression",
-                      "value": {
-                        "type": "Subtract",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": [
-                          {
-                            "type": "Negate",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": {
-                              "type": "Power",
-                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                              "annotation": [],
-                              "signature": [],
-                              "operand": [
-                                {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "2",
-                                  "annotation": []
-                                },
-                                {
-                                  "type": "Literal",
-                                  "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                  "value": "30",
-                                  "annotation": []
-                                }
-                              ]
-                            }
-                          },
-                          {
-                            "type": "Power",
-                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                            "annotation": [],
-                            "signature": [],
-                            "operand": [
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "2",
-                                "annotation": []
-                              },
-                              {
-                                "type": "Literal",
-                                "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                                "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                                "value": "30",
-                                "annotation": []
-                              }
-                            ]
-                          }
-                        ]
-                      }
-                    },
-                    {
-                      "name": "output",
+                      "name": "skipped",
                       "value": {
-                        "type": "Negate",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                        "annotation": [],
-                        "signature": [],
-                        "operand": {
-                          "type": "Literal",
-                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
-                          "valueType": "{urn:hl7-org:elm-types:r1}Integer",
-                          "value": "2147483648",
-                          "annotation": []
-                        }
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong output: As of CQL 2.0, Power always returns Decimal",
+                        "annotation": []
                       }
                     }
                   ]

From 986e48d397f31e330a954df1e06d529e577c72ff Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:39:47 -0400
Subject: [PATCH 33/62] replace limitDecimalPrecision with
 finalizeNumericResult

---
 src/datatypes/interval.ts | 10 ++++------
 src/util/math.ts          | 21 ---------------------
 2 files changed, 4 insertions(+), 27 deletions(-)

diff --git a/src/datatypes/interval.ts b/src/datatypes/interval.ts
index 120b0b31d..af1343115 100644
--- a/src/datatypes/interval.ts
+++ b/src/datatypes/interval.ts
@@ -5,7 +5,7 @@ import {
   predecessor,
   maxValueForType,
   minValueForType,
-  limitDecimalPrecision,
+  finalizeNumericResult,
   subtract,
   add
 } from '../util/math';
@@ -673,7 +673,7 @@ export class Interval {
     // "The result of this operator is equivalent to invoking: (end of argument – start of argument)."
     const end = this.end();
     const start = this.start();
-    return limitDecimalPrecision(subtract(end, start, this.pointType));
+    return finalizeNumericResult(subtract(end, start));
   }
 
   // https://cql.hl7.org/R2/09-b-cqlreference.html#size
@@ -691,9 +691,7 @@ export class Interval {
     // "The result of this operator is equivalent to invoking:
     // (end of argument – start of argument) + point-size, where point-size is determined by
     // successor of minimum T - minimum T."
-    return limitDecimalPrecision(
-      add(subtract(this.end(), this.start(), this.pointType), this.getPointSize(), this.pointType)
-    );
+    return finalizeNumericResult(add(subtract(this.end(), this.start()), this.getPointSize()));
   }
 
   // https://cql.hl7.org/R2/09-b-cqlreference.html#size
@@ -709,7 +707,7 @@ export class Interval {
         // E.g., point size of Interval[@2012-01, @2012-12] is 1 month, not 1 ms.
         return new Quantity(1, (this.low ?? this.high).getPrecision());
       }
-      return subtract(successor(minValue), minValue, this.pointType);
+      return subtract(successor(minValue), minValue);
     }
 
     throw new Error('Point type of interval cannot be determined.');
diff --git a/src/util/math.ts b/src/util/math.ts
index 487393751..934fe48eb 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -231,27 +231,6 @@ export function divide(a: any, b: any) {
   throw new Error('Unsupported argument types.');
 }
 
-export function limitDecimalPrecision<
-  T extends number | bigint | Quantity | Uncertainty | Decimal | undefined
->(val?: T): T | undefined {
-  if (val == null) {
-    return val;
-  } else if (typeof val === 'number') {
-    return (Math.round(val * Math.pow(10, 8)) / Math.pow(10, 8)) as T;
-  } else if ((val as Quantity).isQuantity) {
-    return new Quantity(
-      limitDecimalPrecision((val as Quantity).value) as Decimal,
-      (val as Quantity).unit
-    ) as T;
-  } else if ((val as Uncertainty).isUncertainty) {
-    return new Uncertainty(
-      limitDecimalPrecision((val as Uncertainty).low),
-      limitDecimalPrecision((val as Uncertainty).high)
-    ) as T;
-  }
-  return val;
-}
-
 export class OverFlowException extends Exception {}
 
 export function successor(val: any, precision?: string): any {

From c2befb63f0208e4ee55f7f7b5a4de469a50872cd Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:42:07 -0400
Subject: [PATCH 34/62] update interval Expand with latest understanding

---
 src/elm/interval.ts                | 87 +++++++++++++-----------------
 test/elm/interval/interval-test.ts | 44 +++++++--------
 2 files changed, 59 insertions(+), 72 deletions(-)

diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index d4288fb70..a967726c2 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -1,7 +1,7 @@
 import { Expression } from './expression';
 import { MAX_DATETIME_VALUE, MIN_DATETIME_VALUE } from '../datatypes/datetime';
 import { Quantity } from '../datatypes/quantity';
-import { add, successor, predecessor, subtract } from '../util/math';
+import { add, subtract } from '../util/math';
 import { greaterThan, lessThan } from '../util/comparison';
 import { convertUnit, compareUnits, convertToCQLDateUnit } from '../util/units';
 import * as dtivl from '../datatypes/interval';
@@ -594,7 +594,7 @@ export class Expand extends Expression {
     return value;
   }
 
-  expandQuantityInterval(interval: any, per: any) {
+  expandQuantityInterval(interval: dtivl.Interval, per: Quantity) {
     // we want to convert everything to the more precise of the interval.low or per
     let result_units;
     const res = compareUnits(interval.low.unit, per.unit);
@@ -604,28 +604,12 @@ export class Expand extends Expression {
     } else {
       result_units = interval.low.unit;
     }
-    let low_value = interval.low.value;
-    let high_value = interval.high.value;
 
-    // Quantity values are always Decimal, but successor is expected to know if the value is an integer
-    // this needs to happen before converting units
-    if (!interval.lowClosed) {
-      if (low_value.isInteger()) {
-        low_value = low_value.add(1);
-      } else {
-        low_value = successor(low_value);
-      }
-    }
-    if (!interval.highClosed) {
-      if (high_value.isInteger()) {
-        high_value = high_value.subtract(1);
-      } else {
-        high_value = predecessor(high_value);
-      }
-    }
+    const closed = interval.toClosed();
+    // getting the closed form of the interval needs to happen before unit conversion
 
-    low_value = convertUnit(low_value, interval.low.unit, result_units);
-    high_value = convertUnit(high_value, interval.high.unit, result_units);
+    const low_value = convertUnit(closed.low.value, closed.low.unit, result_units);
+    const high_value = convertUnit(closed.high.value, closed.high.unit, result_units);
     const per_value = convertUnit(per.value, per.unit, result_units);
 
     // return null if unit conversion failed, must have mismatched units
@@ -646,46 +630,49 @@ export class Expand extends Expression {
     if (per.unit !== '1' && per.unit !== '') {
       return null;
     }
-    const low = interval.lowClosed ? interval.low : successor(interval.low);
-    const high = interval.highClosed ? interval.high : predecessor(interval.high);
-
-    return this.makeNumericIntervalList(low, high, per.value);
+    const closed = interval.toClosed();
+    return this.makeNumericIntervalList(closed.low, closed.high, per.value);
   }
 
-  makeNumericIntervalList(low: any, high: any, perValue: any) {
-    // If the per value is a decimal, 8 decimal places are appropriate
-    // Integers should have 0 Decimal places
+  makeNumericIntervalList(lowValue: any, highValue: any, perValue: Decimal) {
+    if (lowValue == null || highValue == null) {
+      return [];
+    }
     const perIsIntegral = perValue.isInteger();
-    const decimalPrecision = perIsIntegral ? 0 : 8;
 
     // For the purposes of this function, we'll perform all the arithmetic using Decimals,
     // then convert the results back to the required type as necessary
-    const origLow = low;
-    const origHigh = high;
+    let low = Decimal.from(lowValue);
+    let high = Decimal.from(highValue);
 
-    low = Decimal.from(low);
-    high = Decimal.from(high);
+    if (low.greaterThan(high)) {
+      return [];
+    }
 
     let convertBound: (d: Decimal) => Decimal | number | bigint;
     if (!perIsIntegral) {
       // If per is not an integer value, then regardless of the original point types, the values will be Decimals
       convertBound = d => d;
-    } else if (typeof origLow === 'bigint' || typeof origHigh === 'bigint') {
-      convertBound = d => d.toLong();
-    } else if (typeof origLow === 'number' || typeof origHigh === 'number') {
-      convertBound = d => d.toInteger();
+    } else if (typeof lowValue === 'bigint' || typeof highValue === 'bigint') {
+      // the bounds were integral and the per was integral, so there should be no risk of non-integral values
+      convertBound = d => BigInt(d.truncate());
+    } else if (typeof lowValue === 'number' || typeof highValue === 'number') {
+      convertBound = d => d.truncate();
     } else {
-      // per is an integer but the original bounds of the interval were Decimal.
+      // per is integral but the original bounds of the interval were Decimal.
       // Make the resulting intervals either Long or Integer based on the original bounds.
+      // TODO: this approach is based on the literals shown in the spec examples and may be incorrect.
+      // It's possible the correct approach should be to keep the point type as Decimal.
+      // See Zulip thread https://chat.fhir.org/#narrow/channel/179220-cql/topic/Ambiguous.20Decimal.2FInteger.20Literals.20in.20Spec.20and.20Tests/with/621765103
       if (
         low.lessThan(MIN_INT_VALUE) ||
         low.greaterThan(MAX_INT_VALUE) ||
         high.lessThan(MIN_INT_VALUE) ||
         high.greaterThan(MAX_INT_VALUE)
       ) {
-        convertBound = d => d.toLong();
+        convertBound = d => BigInt(d.truncate());
       } else {
-        convertBound = d => d.toInteger();
+        convertBound = d => d.truncate();
       }
     }
 
@@ -695,17 +682,17 @@ export class Expand extends Expression {
     // If the interval boundaries are more precise than the per quantity, the
     // more precise values will be truncated to the precision specified by the
     // per quantity.
-    low = low.setScale(decimalPrecision);
-    high = high.setScale(decimalPrecision);
-
-    if (low == null || high == null) {
-      return [];
-    }
-    if (low.greaterThan(high)) {
-      return [];
-    }
+    low = low.truncated(perValue.scale);
+    high = high.truncated(perValue.scale);
 
     const perUnitSize = perIsIntegral ? 1 : 0.00000001;
+    // NOTE: This is based on the size of an interval being based on the point-size of the type.
+    // If, as currently seems to be the intent, the size of an interval changes to be based on
+    // Decimal precision, or if "intervals of size per" doesn't necessarily mean based on the size operator,
+    // use this:
+    // const perUnitSize = perValue.successor().subtract(perValue);
+    // And update both current_high below to:
+    // current_high = current_low.add(perValue).predecessor();
 
     let current_low = low;
     const results = [];
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 77dc2c701..207073d11 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -9,8 +9,7 @@ import {
   MIN_INT_VALUE,
   MAX_INT_VALUE,
   MIN_LONG_VALUE,
-  MAX_LONG_VALUE,
-  MIN_FLOAT_PRECISION_VALUE
+  MAX_LONG_VALUE
 } from '../../../src/util/limits';
 
 describe('Interval', () => {
@@ -1621,7 +1620,8 @@ describe('Width', () => {
     // define RealWidth: width of Interval[1.23, 4.56]
     (await this.realWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.33));
     // define RealOpenWidth: width of Interval(1.23, 4.56)
-    (await this.realOpenWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.32999998));
+    // width of Interval(1.23, 4.56) = predecessor(4.56) - successor (1.23) = 4.55 - 1.24 = 3.31
+    (await this.realOpenWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.31));
   });
 
   it('should calculate the width of infinite intervals', async function () {
@@ -1686,13 +1686,10 @@ describe('Size', () => {
 
   it('should calculate the size of real intervals', async function () {
     // define RealSize: Size(Interval[1.23, 4.56])
-    (await this.realSize.exec(this.ctx)).should.equalDecimal(
-      Decimal.from(3.33 + MIN_FLOAT_PRECISION_VALUE)
-    );
+    (await this.realSize.exec(this.ctx)).should.equalDecimal(Decimal.from('3.33000001'));
     // define RealOpenSize: Size(Interval(1.23, 4.56))
-    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(
-      Decimal.from(3.32999998 + MIN_FLOAT_PRECISION_VALUE)
-    );
+    // (1.23, 4.56) --> [1.24, 4.55], 4.55 - 1.24 = 3.31
+    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(Decimal.from('3.31000001'));
   });
 
   it('should calculate the size of infinite intervals', async function () {
@@ -3604,16 +3601,17 @@ describe('IntegerIntervalExpand', () => {
     // Skip for now until we have more clarity on what the expected result should be
     // https://jira.hl7.org/browse/FHIR-58705 and
     // https://chat.fhir.org/#narrow/channel/179220-cql/topic/Interval.20Expand.20example/with/619051021
-    // Note that as of this writing the produced result is { } (empty list)
-    // but I believe the correct answer is either { } or { [ Interval[10.0, 10.0 ] }
-    // depending on whether the size of the interval is based on the precision of the decimals (not currently supported)
+    // There are two possible answers to consider:
+    // 1. { } (empty list) - I believe this is the correct answer per how the spec is currently written
+    // 2. { Interval[10.0, 10.0 ] } - this is the other possible answer, suggested in the Zulip thread.
+    //    This would be the correct answer if either:
+    //    - "intervals of size per" does not require the Size operator on the resulting intervals to = per
+    //    - the Size operator on an interval is based on the precision of its bounds, not Decimal point-size
+    //      (this one is likely the _intent_, but not how it is currently defined)
 
     // define PerDecimalMorePrecise: expand { Interval[10, 10] } per 0.1
     const a = await this.perDecimalMorePrecise.exec(this.ctx);
-    // JavaScript truncates 10.0 to 10.
-    prettyList(a).should.equal(
-      '{ [10, 10.09999999], [10.1, 10.19999999], [10.2, 10.29999999], [10.3, 10.39999999], [10.4, 10.49999999], [10.5, 10.59999999], [10.6, 10.69999999], [10.7, 10.79999999], [10.8, 10.89999999], [10.9, 10.99999999] }'
-    );
+    prettyList(a).should.equal('{  }');
   });
 });
 
@@ -3686,14 +3684,16 @@ describe('LongIntervalExpand', () => {
     // Skip for now until we have more clarity on what the expected result should be
     // https://jira.hl7.org/browse/FHIR-58705 and
     // https://chat.fhir.org/#narrow/channel/179220-cql/topic/Interval.20Expand.20example/with/619051021
-    // Note that as of this writing the produced result is { } (empty list)
-    // which I believe is the correct result.
-    // But an empty list doesn't clearly show the intent of the test.
+    // There are two possible answers to consider:
+    // 1. { } (empty list) - I believe this is the correct answer per how the spec is currently written
+    // 2. { Interval[10.0, 10.0 ] } - this is the other possible answer, suggested in the Zulip thread.
+    //    This would be the correct answer if either:
+    //    - "intervals of size per" does not require the Size operator on the resulting intervals to = per
+    //    - the Size operator on an interval is based on the precision of its bounds, not Decimal point-size
+    //      (this one is likely the _intent_, but not how it is currently defined)
 
     const a = await this.longPerDecimalMorePrecise.exec(this.ctx);
-    prettyList(a).should.equal(
-      '{ [10, 10.09999999], [10.1, 10.19999999], [10.2, 10.29999999], [10.3, 10.39999999], [10.4, 10.49999999], [10.5, 10.59999999], [10.6, 10.69999999], [10.7, 10.79999999], [10.8, 10.89999999], [10.9, 10.99999999] }'
-    );
+    prettyList(a).should.equal('{  }');
   });
 });
 

From 31f143901c28256f472bfe233d4fbce4d476573e Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:45:01 -0400
Subject: [PATCH 35/62] light cleanup

---
 src/datatypes/datetime.ts | 5 ++++-
 src/util/comparison.ts    | 2 +-
 2 files changed, 5 insertions(+), 2 deletions(-)

diff --git a/src/datatypes/datetime.ts b/src/datatypes/datetime.ts
index 096f5ad29..b406d704b 100644
--- a/src/datatypes/datetime.ts
+++ b/src/datatypes/datetime.ts
@@ -1275,7 +1275,10 @@ function compareWithDefaultResult(a: any, b: any, defaultResult: any) {
   }
 
   // make a copy of other in the correct timezone offset if they don't match.
-  const differentTZ = (a.timeZoneOffset == null) ? (b.timezoneOffset != null) : !(a.timezoneOffset.equals(b.timezoneOffset));
+  const differentTZ =
+    a.timeZoneOffset == null
+      ? b.timezoneOffset != null
+      : !a.timezoneOffset.equals(b.timezoneOffset);
   if (differentTZ) {
     b = b.convertToTimezoneOffset(a.timezoneOffset);
   }
diff --git a/src/util/comparison.ts b/src/util/comparison.ts
index ce1cf55ab..e31a97dc0 100644
--- a/src/util/comparison.ts
+++ b/src/util/comparison.ts
@@ -13,7 +13,7 @@ function areStrings(a: any, b: any) {
 }
 
 function areDecimals(a: any, b: any) {
-  return a && a.isDecimal && b && b.isDecimal;
+  return a?.isDecimal && b?.isDecimal;
 }
 
 function areDateTimesOrQuantities(a: any, b: any) {

From d849e9684d80e4c67c4e5a1042816649a3dbf4c4 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:46:11 -0400
Subject: [PATCH 36/62] update equalDecimal to take all numeric types + string

---
 test/should-extensions.ts | 4 ++--
 1 file changed, 2 insertions(+), 2 deletions(-)

diff --git a/test/should-extensions.ts b/test/should-extensions.ts
index f57ba3890..0f5770141 100644
--- a/test/should-extensions.ts
+++ b/test/should-extensions.ts
@@ -5,7 +5,7 @@ import { Decimal } from '../src/datatypes/decimal';
 declare module 'should' {
   interface Assertion {
     equalInterval(expected: Interval): this;
-    equalDecimal(expected: Decimal): this;
+    equalDecimal(expected: number | bigint | Decimal | string): this;
   }
 }
 
@@ -33,7 +33,7 @@ declare module 'should' {
 
 (should as any).Assertion.add(
   'equalDecimal',
-  function (this: any, expected: number | bigint | Decimal) {
+  function (this: any, expected: number | bigint | Decimal | string) {
     this.params = {
       operator: 'to equal Decimal',
       expected: expected.toString(),

From 708ec6aff5e9ba3305c0969e2266ca29e2fa8e58 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 11:48:02 -0400
Subject: [PATCH 37/62] update tests to be explicit about decimal scale where
 necessary

---
 test/datatypes/interval-data.ts        |  5 ++-
 test/datatypes/interval-test.ts        | 52 ++++++++++++-------------
 test/elm/arithmetic/arithmetic-test.ts | 16 ++++----
 test/elm/interval/data.cql             | 18 ++++-----
 test/elm/interval/data.js              | 54 +++++++++++++-------------
 test/spec-tests/spec-test.ts           |  2 +-
 test/util/math-test.ts                 | 20 +++++-----
 7 files changed, 86 insertions(+), 81 deletions(-)

diff --git a/test/datatypes/interval-data.ts b/test/datatypes/interval-data.ts
index 4ce09e61c..bb1f73eb0 100644
--- a/test/datatypes/interval-data.ts
+++ b/test/datatypes/interval-data.ts
@@ -298,6 +298,9 @@ export default () => {
     }
   };
   data['zeroPointFiveToNinePointFive'] = new TestInterval(Decimal.from(0.5), Decimal.from(9.5));
-  data['zeroToHundredMg'] = new TestInterval(new Quantity(0, 'mg'), new Quantity(100, 'mg'));
+  data['zeroToHundredMg'] = new TestInterval(
+    new Quantity('0.0', 'mg'),
+    new Quantity('100.0', 'mg')
+  );
   return data;
 };
diff --git a/test/datatypes/interval-test.ts b/test/datatypes/interval-test.ts
index 7772a8ac1..64a4408c4 100644
--- a/test/datatypes/interval-test.ts
+++ b/test/datatypes/interval-test.ts
@@ -158,7 +158,7 @@ describe('Interval', () => {
       d.zeroToHundred.closed.start().should.equal(0);
       d.zeroPointFiveToNinePointFive.closed.start().should.equalDecimal(Decimal.from(0.5));
       d.zeroToHundredLong.closed.start().should.equal(0n);
-      d.zeroToHundredMg.closed.start().should.eql(new Quantity(0, 'mg'));
+      d.zeroToHundredMg.closed.start().should.eql(new Quantity('0.0', 'mg'));
       d.all2012date.closed.start().should.eql(Date.parse('2012-01-01'));
       d.all2012.closed.start().should.eql(DateTime.parse('2012-01-01T00:00:00.0'));
       d.alldaytime.closed.start().should.eql(DateTime.parse('0001-01-01T00:00:00.0').getTime());
@@ -166,11 +166,9 @@ describe('Interval', () => {
 
     it('should return successor of low for intervals with open low', () => {
       d.zeroToHundred.openClosed.start().should.equal(1);
-      d.zeroPointFiveToNinePointFive.openClosed
-        .start()
-        .should.equalDecimal(Decimal.from('0.50000001'));
+      d.zeroPointFiveToNinePointFive.openClosed.start().should.equalDecimal(Decimal.from('0.6'));
       d.zeroToHundredLong.openClosed.start().should.equal(1n);
-      d.zeroToHundredMg.openClosed.start().should.eql(new Quantity(0.00000001, 'mg'));
+      d.zeroToHundredMg.openClosed.start().should.eql(new Quantity('0.1', 'mg'));
       d.all2012date.openClosed.start().should.eql(Date.parse('2012-01-02'));
       d.all2012.openClosed.start().should.eql(DateTime.parse('2012-01-01T00:00:00.001'));
       d.alldaytime.openClosed
@@ -210,7 +208,7 @@ describe('Interval', () => {
       d.zeroToHundredMg.withNullStart.openClosed
         .start()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(100, 'mg'))
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity('100.0', 'mg'))
         );
       d.all2012date.withNullStart.openClosed
         .start()
@@ -232,11 +230,11 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(MIN_LONG_VALUE, 99n));
       d.zeroPointFiveToNinePointFive.withNullStart.open
         .start()
-        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, Decimal.from(9.49999999)));
+        .should.eql(new Uncertainty(MIN_DECIMAL_VALUE, Decimal.from(9.4)));
       d.zeroToHundredMg.withNullStart.open
         .start()
         .should.eql(
-          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(99.99999999, 'mg'))
+          new Uncertainty(new Quantity(MIN_DECIMAL_VALUE, 'mg'), new Quantity(99.9, 'mg'))
         );
       d.all2012date.withNullStart.open
         .start()
@@ -305,9 +303,9 @@ describe('Interval', () => {
 
     it('should return high for intervals with closed high', () => {
       d.zeroToHundred.closed.end().should.equal(100);
-      d.zeroPointFiveToNinePointFive.closed.end().should.equalDecimal(Decimal.from(9.5));
+      d.zeroPointFiveToNinePointFive.closed.end().should.equalDecimal(Decimal.from('9.5'));
       d.zeroToHundredLong.closed.end().should.equal(100n);
-      d.zeroToHundredMg.closed.end().should.eql(new Quantity(100, 'mg'));
+      d.zeroToHundredMg.closed.end().should.eql(new Quantity('100.0', 'mg'));
       d.all2012date.closed.end().should.eql(Date.parse('2012-12-31'));
       d.all2012.closed.end().should.eql(DateTime.parse('2012-12-31T23:59:59.999'));
       d.alldaytime.closed.end().should.eql(DateTime.parse('0001-01-01T23:59:59.999').getTime());
@@ -315,9 +313,9 @@ describe('Interval', () => {
 
     it('should return predecessor of high for intervals with open high', () => {
       d.zeroToHundred.closedOpen.end().should.equal(99);
-      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equalDecimal(Decimal.from(9.49999999));
+      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equalDecimal(Decimal.from('9.4'));
       d.zeroToHundredLong.closedOpen.end().should.equal(99n);
-      d.zeroToHundredMg.closedOpen.end().should.eql(new Quantity(99.99999999, 'mg'));
+      d.zeroToHundredMg.closedOpen.end().should.eql(new Quantity('99.9', 'mg'));
       d.all2012date.closedOpen.end().should.eql(Date.parse('2012-12-30'));
       d.all2012.closedOpen.end().should.eql(DateTime.parse('2012-12-31T23:59:59.998'));
       d.alldaytime.closedOpen.end().should.eql(DateTime.parse('0001-01-01T23:59:59.998').getTime());
@@ -348,7 +346,9 @@ describe('Interval', () => {
         .should.eql(new Uncertainty(Decimal.from(0.5), MAX_DECIMAL_VALUE));
       d.zeroToHundredMg.withNullEnd.closedOpen
         .end()
-        .should.eql(new Uncertainty(new Quantity(0, 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg')));
+        .should.eql(
+          new Uncertainty(new Quantity('0.0', 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg'))
+        );
       d.all2012date.withNullEnd.closedOpen
         .end()
         .should.eql(new Uncertainty(Date.parse('2012-01-01'), MAX_DATE_VALUE));
@@ -367,11 +367,11 @@ describe('Interval', () => {
       d.zeroToHundredLong.withNullEnd.open.end().should.eql(new Uncertainty(1n, MAX_LONG_VALUE));
       d.zeroPointFiveToNinePointFive.withNullEnd.open
         .end()
-        .should.eql(new Uncertainty(Decimal.from(0.50000001), MAX_DECIMAL_VALUE));
+        .should.eql(new Uncertainty(Decimal.from('0.6'), MAX_DECIMAL_VALUE));
       d.zeroToHundredMg.withNullEnd.open
         .end()
         .should.eql(
-          new Uncertainty(new Quantity(0.00000001, 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg'))
+          new Uncertainty(new Quantity('0.1', 'mg'), new Quantity(MAX_DECIMAL_VALUE, 'mg'))
         );
       d.all2012date.withNullEnd.open
         .end()
@@ -7028,25 +7028,25 @@ describe('DecimalInterval', () => {
     interval.size().should.equalDecimal(Decimal.from('3000000000.00000001'));
   });
 
-  it('should close open decimal uncertainty endpoints using decimal point size', () => {
+  it('should close open decimal uncertainty endpoints using decimal precision', () => {
     const closed = new Interval(
-      new Uncertainty(Decimal.from(1), Decimal.from(2)),
-      new Uncertainty(Decimal.from(3), Decimal.from(4)),
+      new Uncertainty(Decimal.from('1.0'), Decimal.from('2.0')),
+      new Uncertainty(Decimal.from('3.0'), Decimal.from('4.0')),
       false,
       false,
       ELM_DECIMAL_TYPE
     ).toClosed();
 
-    closed.low.should.eql(new Uncertainty(Decimal.from(1.00000001), Decimal.from(2.00000001)));
-    closed.high.should.eql(new Uncertainty(Decimal.from(2.99999999), Decimal.from(3.99999999)));
+    closed.low.should.eql(new Uncertainty(Decimal.from('1.1'), Decimal.from('2.1')));
+    closed.high.should.eql(new Uncertainty(Decimal.from('2.9'), Decimal.from('3.9')));
     closed.lowClosed.should.be.true();
     closed.highClosed.should.be.true();
   });
 
-  it('should use decimal point size for meetsBefore decimal uncertainty bounds', () => {
-    const earlier = new Interval(Decimal.from(1), Decimal.from(1.99999999));
+  it('should use decimal precision for meetsBefore decimal uncertainty bounds', () => {
+    const earlier = new Interval(Decimal.from('1.0'), Decimal.from('1.9'));
     const later = new Interval(
-      new Uncertainty(Decimal.from(2), Decimal.from(2)),
+      new Uncertainty(Decimal.from('2.0'), Decimal.from('2.0')),
       null,
       true,
       false,
@@ -7056,15 +7056,15 @@ describe('DecimalInterval', () => {
     earlier.meetsBefore(later).should.be.true();
   });
 
-  it('should use decimal point size for meetsAfter decimal uncertainty bounds', () => {
+  it('should use decimal precision for meetsAfter decimal uncertainty bounds', () => {
     const earlier = new Interval(
       null,
-      new Uncertainty(Decimal.from(1), Decimal.from(1)),
+      new Uncertainty(Decimal.from('1.0'), Decimal.from('1.0')),
       false,
       true,
       ELM_DECIMAL_TYPE
     );
-    const later = new Interval(Decimal.from(1.00000001), Decimal.from(2));
+    const later = new Interval(Decimal.from('1.1'), Decimal.from('2.0'));
 
     later.meetsAfter(earlier).should.be.true();
   });
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 31e8ba6d5..df6cb69be 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -664,9 +664,9 @@ describe('Round', () => {
     (await this.down_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.4));
   });
 
-  it('should round negative exact-half values toward positive infinity', async function () {
-    (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
-    (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(Decimal.from(-1));
+  it('should round negative exact-half values toward nearest whole number', async function () {
+    (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(Decimal.from(-1));
+    (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(Decimal.from(-2));
   });
 });
 
@@ -683,8 +683,9 @@ describe('Successor', () => {
     (await this.ls.exec(this.ctx)).should.equal(3n);
   });
 
-  it('should be able to get Real Successor', async function () {
-    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from(2.2 + Math.pow(10, -8)));
+  it('should be able to get Decimal Successor', async function () {
+    // successor of 2.2
+    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from(2.3));
   });
 
   it('should return null for Successor greater than Integer Max value', async function () {
@@ -786,8 +787,9 @@ describe('Predecessor', () => {
     (await this.ls.exec(this.ctx)).should.equal(1n);
   });
 
-  it('should be able to get Real Predecessor', async function () {
-    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from('2.19999999'));
+  it('should be able to get Decimal Predecessor', async function () {
+    // Rs: predecessor of 2.2
+    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from('2.1'));
   });
 
   it('should return null for Predecessor greater than Integer Max value', async function () {
diff --git a/test/elm/interval/data.cql b/test/elm/interval/data.cql
index 635fd182a..a0f21523c 100644
--- a/test/elm/interval/data.cql
+++ b/test/elm/interval/data.cql
@@ -653,9 +653,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets DateIvl
@@ -724,9 +724,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets after Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets after Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets after Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets after Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets after Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets after Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets after Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets after Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets after Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets after Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets after DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets after DateIvl
@@ -795,9 +795,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets before Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets before Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets before Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets before Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets before Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets before Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets before Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets before Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets before Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets before Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets before DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets before DateIvl
diff --git a/test/elm/interval/data.js b/test/elm/interval/data.js
index d07c26671..4ad13753e 100644
--- a/test/elm/interval/data.js
+++ b/test/elm/interval/data.js
@@ -125250,9 +125250,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets DateIvl
@@ -126186,7 +126186,7 @@ module.exports['Meets'] = {
                 "r" : "325",
                 "s" : [ {
                   "r" : "323",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               }, {
                 "r" : "333",
@@ -126249,7 +126249,7 @@ module.exports['Meets'] = {
               "localId" : "323",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -126323,7 +126323,7 @@ module.exports['Meets'] = {
                 "r" : "348",
                 "s" : [ {
                   "r" : "346",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               } ]
             } ]
@@ -126410,7 +126410,7 @@ module.exports['Meets'] = {
               "localId" : "346",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -126451,7 +126451,7 @@ module.exports['Meets'] = {
                 "r" : "366",
                 "s" : [ {
                   "r" : "364",
-                  "value" : [ "Interval[", "1.1", ", ", "2.0", "]" ]
+                  "value" : [ "Interval[", "1.2", ", ", "2.0", "]" ]
                 } ]
               } ]
             } ]
@@ -126538,7 +126538,7 @@ module.exports['Meets'] = {
               "localId" : "364",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.1",
+              "value" : "1.2",
               "annotation" : [ ]
             },
             "high" : {
@@ -140748,9 +140748,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets after Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets after Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets after Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets after Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets after Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets after Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets after Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets after Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets after Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets after Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets after DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets after DateIvl
@@ -141684,7 +141684,7 @@ module.exports['MeetsAfter'] = {
                 "r" : "325",
                 "s" : [ {
                   "r" : "323",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               }, {
                 "r" : "333",
@@ -141747,7 +141747,7 @@ module.exports['MeetsAfter'] = {
               "localId" : "323",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -141821,7 +141821,7 @@ module.exports['MeetsAfter'] = {
                 "r" : "348",
                 "s" : [ {
                   "r" : "346",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               } ]
             } ]
@@ -141908,7 +141908,7 @@ module.exports['MeetsAfter'] = {
               "localId" : "346",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -141949,7 +141949,7 @@ module.exports['MeetsAfter'] = {
                 "r" : "366",
                 "s" : [ {
                   "r" : "364",
-                  "value" : [ "Interval[", "1.1", ", ", "2.0", "]" ]
+                  "value" : [ "Interval[", "1.2", ", ", "2.0", "]" ]
                 } ]
               } ]
             } ]
@@ -142036,7 +142036,7 @@ module.exports['MeetsAfter'] = {
               "localId" : "364",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.1",
+              "value" : "1.2",
               "annotation" : [ ]
             },
             "high" : {
@@ -156246,9 +156246,9 @@ define NotMeetsIntIvl: Interval[1, 2] meets before Interval[5, 10]
 define MeetsAfterLongIvl: Interval[11L, 15L] meets before Interval[5L, 10L]
 define MeetsBeforeLongIvl: Interval[1L, 4L] meets before Interval[5L, 10L]
 define NotMeetsLongIvl: Interval[1L, 2L] meets before Interval[5L, 10L]
-define MeetsAfterRealIvl: Interval[1.50000001, 2.5] meets before Interval[0.5, 1.5]
-define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets before Interval[1.50000001, 2.5]
-define NotMeetsRealIvl: Interval[0.0, 1.0] meets before Interval[1.1, 2.0]
+define MeetsAfterRealIvl: Interval[1.6, 2.5] meets before Interval[0.5, 1.5]
+define MeetsBeforeRealIvl: Interval[0.5, 1.5] meets before Interval[1.6, 2.5]
+define NotMeetsRealIvl: Interval[0.0, 1.0] meets before Interval[1.2, 2.0]
 define DateIvl: Interval[DateTime(2012, 3, 1, 0, 0, 0, 0), DateTime(2012, 9, 1, 0, 0, 0, 0))
 define MeetsAfterDateIvl: Interval[DateTime(2012, 9, 1, 0, 0, 0, 0), DateTime(2012, 12, 1, 0, 0, 0, 0)) meets before DateIvl
 define MeetsBeforeDateIvl: Interval[DateTime(2012, 1, 1, 0, 0, 0, 0), DateTime(2012, 3, 1, 0, 0, 0, 0)) meets before DateIvl
@@ -157182,7 +157182,7 @@ module.exports['MeetsBefore'] = {
                 "r" : "325",
                 "s" : [ {
                   "r" : "323",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               }, {
                 "r" : "333",
@@ -157245,7 +157245,7 @@ module.exports['MeetsBefore'] = {
               "localId" : "323",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -157319,7 +157319,7 @@ module.exports['MeetsBefore'] = {
                 "r" : "348",
                 "s" : [ {
                   "r" : "346",
-                  "value" : [ "Interval[", "1.50000001", ", ", "2.5", "]" ]
+                  "value" : [ "Interval[", "1.6", ", ", "2.5", "]" ]
                 } ]
               } ]
             } ]
@@ -157406,7 +157406,7 @@ module.exports['MeetsBefore'] = {
               "localId" : "346",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.50000001",
+              "value" : "1.6",
               "annotation" : [ ]
             },
             "high" : {
@@ -157447,7 +157447,7 @@ module.exports['MeetsBefore'] = {
                 "r" : "366",
                 "s" : [ {
                   "r" : "364",
-                  "value" : [ "Interval[", "1.1", ", ", "2.0", "]" ]
+                  "value" : [ "Interval[", "1.2", ", ", "2.0", "]" ]
                 } ]
               } ]
             } ]
@@ -157534,7 +157534,7 @@ module.exports['MeetsBefore'] = {
               "localId" : "364",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "1.1",
+              "value" : "1.2",
               "annotation" : [ ]
             },
             "high" : {
diff --git a/test/spec-tests/spec-test.ts b/test/spec-tests/spec-test.ts
index 32f774aef..969df94a6 100644
--- a/test/spec-tests/spec-test.ts
+++ b/test/spec-tests/spec-test.ts
@@ -134,7 +134,7 @@ describe('CQL Spec Tests (from XML)', () => {
   function roundDecimalsWhenApplicable(item: any) {
     if (item instanceof Decimal) {
       // Round to 8 places since that's the number of places used by expected outputs
-      item = item.setScale(8);
+      item = item.withScale(8);
     }
     return item;
   }
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index ac82ebe3e..2576d29e1 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -11,14 +11,14 @@ describe('successor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
-    result.low.should.equalDecimal(Decimal.from('1.00000001'));
-    result.high.should.equalDecimal(Decimal.from('2.00000001'));
+    const result = successor(new Uncertainty(Decimal.from('1.0'), Decimal.from('2.0')));
+    result.low.should.equalDecimal(Decimal.from('1.1'));
+    result.high.should.equalDecimal(Decimal.from('2.1'));
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
-    const result = successor(new Uncertainty(Decimal.from(1), MAX_FLOAT_VALUE));
-    result.should.eql(new Uncertainty(Decimal.from('1.00000001'), MAX_FLOAT_VALUE));
+    const result = successor(new Uncertainty(Decimal.from('1.0'), MAX_FLOAT_VALUE));
+    result.should.eql(new Uncertainty(Decimal.from('1.1'), MAX_FLOAT_VALUE));
   });
 });
 
@@ -30,14 +30,14 @@ describe('predecessor', () => {
   });
 
   it('should preserve decimals in an Uncertainty', () => {
-    const result = successor(new Uncertainty(Decimal.from(1.0), Decimal.from(2.0)));
-    result.low.should.equalDecimal(Decimal.from('1.00000001'));
-    result.high.should.equalDecimal(Decimal.from('2.00000001'));
+    const result = successor(new Uncertainty(Decimal.from('1.0'), Decimal.from('2.0')));
+    result.low.should.equalDecimal(Decimal.from('1.1'));
+    result.high.should.equalDecimal(Decimal.from('2.1'));
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
-    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from(2)));
-    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from('1.99999999')));
+    const result = predecessor(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from('2.0')));
+    result.should.eql(new Uncertainty(MIN_FLOAT_VALUE, Decimal.from('1.9')));
   });
 });
 

From 945238bbae06439d42e049cf1c5627316ecf3d80 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 12:33:00 -0400
Subject: [PATCH 38/62] update comment to point to reported issue

---
 test/elm/aggregate/data.cql | 4 +++-
 1 file changed, 3 insertions(+), 1 deletion(-)

diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index 48c754ae4..60fa73630 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -170,7 +170,9 @@ define decimals_at_min_value_product: Product({-99999999999999999999.99999999, 1
 define decimals_below_min_value_product: Product({-99999999999999999999.99999999, 2.0})
 define quantity_product: Product({1.0 'g', 2.0 'g', 3.0 'g', 4.0 'g'})
 // Max/Min-valued quantities are described using the "maximum" and "minimum" operators
-// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+// to avoid them being represented in ELM as +/-1.0e20, which is not a legal Decimal
+// (Note that the ELM for Quantity literals uses a plain number for the value)
+// See https://jira.hl7.org/browse/FHIR-58825
 define MaxValueGramQuantity: Quantity { value: maximum Decimal, unit: 'g' }
 define MinValueGramQuantity: Quantity { value: minimum Decimal, unit: 'g' }
 define quantities_at_max_value_product: Product({MaxValueGramQuantity, 1.0 'g'})

From 9e205824a1637a73ef2a4957c5ea7b6ab234695d Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 13:58:35 -0400
Subject: [PATCH 39/62] rework Decimal tests to cover all methods

---
 src/datatypes/decimal.ts       |   2 +-
 test/datatypes/decimal-test.ts | 350 ++++++++++++++++++++++++++++-----
 2 files changed, 304 insertions(+), 48 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index fb546ca39..b1edcf49f 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -271,7 +271,7 @@ export class Decimal {
   // if needed to represent the value.
   // Eg, 1.0 / 1.0 and 1.0 / 3.0 both have exactly the same input scales, but expect different output scales.
   withMinimumScale(scale: number, roundingMode: DecimalRoundingMode = CQL_IMPLICIT_ROUNDING) {
-    if (this.scale > scale) {
+    if (this.scale >= scale) {
       return this;
     }
     return this.withScale(scale, roundingMode);
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 171ca129d..f4511ae45 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -1,72 +1,328 @@
-import { Decimal as DecimalJS } from 'decimal.js';
 import { Decimal } from '../../src/datatypes/decimal';
 
 describe('Decimal', () => {
-  it('should retain Decimal runtime identity for a whole-number value', () => {
-    const decimal = Decimal.from('2.0');
+  describe('from', () => {
+    it('should preserve Decimal instances', () => {
+      const decimal = Decimal.from('2.0');
+      Decimal.from(decimal).should.equal(decimal);
+      Decimal.from(decimal).should.eql(decimal);
+    });
 
-    decimal.isDecimal.should.equal(true);
-    (typeof decimal).should.equal('object');
-    decimal.toNumber().should.equal(2);
+    it('should parse scale from passed-in strings', () => {
+      Decimal.from('2').scale.should.equal(0);
+      Decimal.from('2.0').scale.should.equal(1);
+      Decimal.from('2.00').scale.should.equal(2);
+      Decimal.from('2.000').scale.should.equal(3);
+    });
+
+    it('should reject invalid values', () => {
+      (() => Decimal.from('not a number')).should.throw();
+      (() => Decimal.from('NaN')).should.throw();
+      (() => Decimal.from('Infinity')).should.throw();
+      (() => Decimal.from(Number.NaN)).should.throw();
+      (() => Decimal.from(Number.POSITIVE_INFINITY)).should.throw();
+    });
+  });
+
+  describe('isDecimal', () => {
+    it('should identify Decimal values', () => {
+      Decimal.from(2).isDecimal.should.be.true();
+    });
+  });
+
+  describe('normalized', () => {
+    it('should round to CQL-implicit eight decimal places', () => {
+      Decimal.from('0.12345678901234').normalized().should.equalDecimal('0.12345679');
+    });
+
+    it('should preserve an already normalized value', () => {
+      const value = Decimal.from('1.23456789');
+      value.normalized().should.equal(value);
+    });
+  });
+
+  describe('add', () => {
+    it('should add values with scale matching the most precise operand', () => {
+      const result = Decimal.from('1.2').add('0.03');
+      result.should.equalDecimal('1.23');
+      result.scale.should.equal(2);
+    });
   });
 
-  it('should expose arithmetic and comparison operations', () => {
-    const value = Decimal.from('1.5').subtract('0.5');
+  describe('subtract', () => {
+    it('should subtract values with scale matching the most precise operand', () => {
+      const result = Decimal.from('3.14').subtract('3.1');
+      result.should.equalDecimal('0.04');
+      result.scale.should.equal(2);
+    });
+  });
+
+  describe('multiplyBy', () => {
+    it('should cap the result scale at eight places', () => {
+      const result = Decimal.from('1.2345').multiplyBy('2.0000');
+      result.should.equalDecimal('2.46900000');
+      result.scale.should.equal(8);
+    });
+
+    it('should round when the product exceeds the eight-place scale cap', () => {
+      const result = Decimal.from('1.23456789').multiplyBy('1.00000001');
+      result.should.equalDecimal('1.23456790');
+      result.scale.should.equal(8);
+    });
+  });
 
-    value.compareTo('1').should.equal(0);
-    value.add(2).toString().should.equal('3.0');
-    value.multiplyBy(2).toString().should.equal('2.0');
-    value.divideBy(2).toString().should.equal('0.5');
-    Decimal.from(3).modulo(2).toString().should.equal('1.0');
+  describe('divideBy', () => {
+    it('should apply CQL rounding and preferred scale', () => {
+      Decimal.from('1.00000').divideBy('2.0').should.equalDecimal('0.5000');
+      Decimal.from(1).divideBy(3).should.equalDecimal('0.33333333');
+      (() => Decimal.from(1).divideBy('1e-1000')).should.not.throw();
+    });
+
+    it('should round a terminating quotient that exceeds eight decimal places', () => {
+      const result = Decimal.from(1).divideBy(512);
+      result.should.equalDecimal('0.00195313');
+      result.scale.should.equal(8);
+    });
+
+    it('should preserve the preferred scale of an exact quotient', () => {
+      const result = Decimal.from('4.0').divideBy(2);
+      result.should.equalDecimal('2.0');
+      result.scale.should.equal(1);
+    });
+
+    it('should reject a zero divisor', () => {
+      (() => Decimal.from(1).divideBy(0)).should.throw(RangeError);
+    });
   });
 
-  it('should provide an explicit scale and JSON representation', () => {
-    Decimal.from('0.444444444').setScale(8).toString().should.equal('0.44444444');
-    JSON.stringify({ value: Decimal.from('1.25') }).should.equal('{"value":"1.25"}');
+  describe('modulo', () => {
+    it('should calculate a remainder', () => {
+      Decimal.from('5.5').modulo(2).should.equalDecimal('1.5');
+    });
+
+    it('should reject a zero divisor', () => {
+      (() => Decimal.from(1).modulo(0)).should.throw(RangeError);
+    });
   });
 
-  it('should serialize using fixed-point CQL Decimal notation', () => {
-    Decimal.from(1).toString().should.equal('1.0');
-    Decimal.from('-12.5').toString().should.equal('-12.5');
-    Decimal.from('0.00000001').toString().should.equal('0.00000001');
-    JSON.stringify({ value: Decimal.from(1) }).should.equal('{"value":"1.0"}');
+  describe('compareTo', () => {
+    it('should order numeric values', () => {
+      Decimal.from('1.20').compareTo('1.2').should.equal(0);
+      Decimal.from('1.21').compareTo('1.2').should.equal(1);
+      Decimal.from('1.19').compareTo('1.2').should.equal(-1);
+    });
+  });
+
+  describe('greaterThan', () => {
+    it('should compare values', () => {
+      Decimal.from('1.21').greaterThan('1.2').should.be.true();
+      Decimal.from('1.2').greaterThan('1.2').should.be.false();
+    });
+  });
+
+  describe('greaterThanOrEquals', () => {
+    it('should compare values', () => {
+      Decimal.from('1.20').greaterThanOrEquals('1.2').should.be.true();
+      Decimal.from('1.19').greaterThanOrEquals('1.2').should.be.false();
+    });
+  });
+
+  describe('lessThan', () => {
+    it('should compare values', () => {
+      Decimal.from('1.19').lessThan('1.2').should.be.true();
+      Decimal.from('1.2').lessThan('1.2').should.be.false();
+    });
+  });
+
+  describe('lessThanOrEquals', () => {
+    it('should compare values', () => {
+      Decimal.from('1.20').lessThanOrEquals('1.2').should.be.true();
+      Decimal.from('1.21').lessThanOrEquals('1.2').should.be.false();
+    });
+  });
+
+  describe('equals', () => {
+    it('should test numeric equality', () => {
+      Decimal.from('1.20').equals('1.2').should.be.true();
+      Decimal.from('1.21').equals('1.2').should.be.false();
+    });
+  });
+
+  describe('equivalent', () => {
+    it('should compare at the least precise operand precision, ignoring trailing zeros', () => {
+      Decimal.from('1.2').equivalent('1.24').should.be.true();
+      Decimal.from('1.20').equivalent('1.24').should.be.true();
+      Decimal.from('1.20').equivalent('1.26').should.be.false();
+    });
+  });
+
+  describe('successor', () => {
+    it('should return the precision-aware successor', () => {
+      Decimal.from('1.0').successor().should.equalDecimal('1.1');
+      Decimal.from('1.00').successor().should.equalDecimal('1.01');
+    });
+
+    it('should preserve scale when crossing an integer boundary', () => {
+      const result = Decimal.from('1.99').successor();
+      result.should.equalDecimal('2.00');
+      result.scale.should.equal(2);
+    });
   });
 
-  it('should provide CQL arithmetic helpers without exposing a number', () => {
-    Decimal.from('-1.9').truncate().should.equal(-1);
-    Decimal.from('1.1').ceil().should.equal(2);
-    Decimal.from('1.9').floor().should.equal(1);
-    Decimal.from('-0.5').setScale(0).should.equalDecimal(Decimal.from(0));
-    Decimal.from('2').power(3).should.equalDecimal(Decimal.from(8));
-    Decimal.from('9').sqrt().should.equalDecimal(Decimal.from(3));
-    Decimal.from('8').log(2).should.equalDecimal(Decimal.from(3));
+  describe('predecessor', () => {
+    it('should return the precision-aware predecessor', () => {
+      Decimal.from('1.0').predecessor().should.equalDecimal('0.9');
+      Decimal.from('1.00').predecessor().should.equalDecimal('0.99');
+    });
   });
 
-  it('should reject an invalid scale', () => {
-    (() => Decimal.from(1).setScale(-1)).should.throw(RangeError);
-    (() => Decimal.from(1).setScale(1.5)).should.throw(RangeError);
+  describe('negate', () => {
+    it('should preserve scale', () => {
+      Decimal.from('1.20').negate().should.equalDecimal('-1.20');
+    });
   });
 
-  it('should reject non-finite and divide-by-zero values', () => {
-    (() => Decimal.from('not a number')).should.throw();
-    (() => Decimal.from(1).divideBy(0)).should.throw();
+  describe('abs', () => {
+    it('should preserve scale', () => {
+      Decimal.from('-1.20').abs().should.equalDecimal('1.20');
+    });
   });
 
-  it('should not coerce a nonzero Decimal divisor through a JavaScript number', () => {
-    (() => Decimal.from(1).divideBy('1e-1000')).should.not.throw();
+  describe('truncate', () => {
+    it('should return the integer component', () => {
+      Decimal.from('-1.9').truncate().should.equal(-1);
+    });
   });
 
-  it('should keep CQL Decimal precision independent from the base decimal.js constructor', () => {
-    const basePrecision = DecimalJS.precision;
-    try {
-      DecimalJS.set({ precision: 5 });
+  describe('truncated', () => {
+    it('should truncate to an optional decimal scale', () => {
+      Decimal.from('-1.239').truncated(2).should.equalDecimal('-1.23');
+      Decimal.from('1.9').truncated().should.equalDecimal('1.0');
+    });
 
-      const oneThird = Decimal.from(1).divideBy(3);
-      oneThird.toString().should.equal('0.333333333333333333333333333333'); // we specify precision of 30 = significant figures
+    it('should treat scale zero as integer truncation', () => {
+      const result = Decimal.from('1.99').truncated(0);
+      result.should.equalDecimal('1.0');
+      result.scale.should.equal(0);
+    });
+  });
+
+  describe('ceil', () => {
+    it('should return the smallest integer not less than the value', () => {
+      Decimal.from('1.1').ceil().should.equal(2);
+      Decimal.from('-1.1').ceil().should.equal(-1);
+    });
+  });
+
+  describe('floor', () => {
+    it('should return the largest integer not greater than the value', () => {
+      Decimal.from('1.1').floor().should.equal(1);
+      Decimal.from('-1.1').floor().should.equal(-2);
+    });
+  });
+
+  describe('isInteger', () => {
+    it('should identify integer values', () => {
+      Decimal.from('2.0').isInteger().should.be.true();
+      Decimal.from('2.1').isInteger().should.be.false();
+      Decimal.from('2.0000000000001').isInteger().should.be.false();
+    });
+  });
+
+  describe('power', () => {
+    it('should raise values to a power', () => {
+      Decimal.from(2).power(3).should.equalDecimal('8.0');
+    });
+  });
+
+  describe('sqrt', () => {
+    it('should calculate square roots', () => {
+      const result = Decimal.from('9.00').sqrt();
+      result.should.equalDecimal('3.00');
+      result.scale.should.equal(2);
+    });
+  });
+
+  describe('ln', () => {
+    it('should calculate natural logarithms', () => {
+      Decimal.from(1).ln().should.equalDecimal('0.0');
+    });
+  });
+
+  describe('exp', () => {
+    it('should calculate exponential values', () => {
+      Decimal.from(0).exp().should.equalDecimal('1.0');
+    });
+  });
+
+  describe('log', () => {
+    it('should calculate logarithms using the supplied base', () => {
+      const result = Decimal.from('8.00').log(2);
+      result.should.equalDecimal('3.00');
+      result.scale.should.equal(2);
+    });
+  });
+
+  describe('round', () => {
+    it('should round half away from zero to a requested scale', () => {
+      Decimal.from('1.235').round(2).should.equalDecimal('1.24');
+      Decimal.from('-1.235').round(2).should.equalDecimal('-1.24');
+    });
+  });
+
+  describe('withScale', () => {
+    it('should use CQL half-up rounding', () => {
+      Decimal.from('-0.5').withScale(0).should.equalDecimal('-1.0');
+      Decimal.from('0.444444444').withScale(8).should.equalDecimal('0.44444444');
+    });
+
+    it('should reject invalid scales', () => {
+      (() => Decimal.from(1).withScale(-1)).should.throw(RangeError);
+      (() => Decimal.from(1).withScale(1.5)).should.throw(RangeError);
+    });
+  });
+
+  describe('withMinimumScale', () => {
+    it('should only retain or extend scale', () => {
+      const value = Decimal.from('1.20');
+      value.withMinimumScale(0).should.equal(value);
+      value.withMinimumScale(0).scale.should.equal(2);
+      value.withMinimumScale(1).should.equal(value);
+      value.withMinimumScale(1).scale.should.equal(2);
+      value.withMinimumScale(2).should.equal(value);
+      value.withMinimumScale(2).scale.should.equal(2);
+      value.withMinimumScale(3).should.equalDecimal('1.200');
+      value.withMinimumScale(3).scale.should.equal(3);
+      value.withMinimumScale(4).should.equalDecimal('1.2000');
+      value.withMinimumScale(4).scale.should.equal(4);
+    });
+  });
+
+  describe('withoutTrailingZeros', () => {
+    it('should remove insignificant trailing zeros', () => {
+      const value = Decimal.from('1.200').withoutTrailingZeros();
+      value.should.equalDecimal('1.2');
+      value.scale.should.equal(1);
+    });
+  });
+
+  describe('toNumber', () => {
+    it('should convert to a JavaScript number', () => {
+      Decimal.from('1.25').toNumber().should.equal(1.25);
+    });
+  });
+
+  describe('toString', () => {
+    it('should serialize in fixed-point CQL Decimal notation', () => {
+      Decimal.from(1).toString().should.equal('1.0');
+      Decimal.from('-12.5').toString().should.equal('-12.5');
+      Decimal.from('0.00000001').toString().should.equal('0.00000001');
+    });
+  });
 
-      oneThird.normalized().toString().should.equal('0.33333333');
-    } finally {
-      DecimalJS.set({ precision: basePrecision });
-    }
+  describe('toJSON', () => {
+    it('should serialize as a FHIR decimal number', () => {
+      JSON.stringify({ value: Decimal.from('1.25') }).should.equal('{"value":1.25}');
+    });
   });
 });

From 4e5c81f1a9436c6e82b426c7c674b9eccc2a489d Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 14:06:31 -0400
Subject: [PATCH 40/62] remove redundant Decimal.from() in should.equalDecimal
 calls

---
 test/datatypes/date-test.ts            |  6 +-
 test/datatypes/datetime-test.ts        |  4 +-
 test/datatypes/interval-test.ts        | 14 ++---
 test/elm/aggregate/aggregate-test.ts   | 42 ++++++-------
 test/elm/aggregate/data.js             |  6 +-
 test/elm/arithmetic/arithmetic-test.ts | 82 +++++++++++---------------
 test/elm/convert/convert-test.ts       | 36 +++++------
 test/elm/datetime/datetime-test.ts     | 12 ++--
 test/elm/interval/interval-test.ts     | 22 +++----
 test/elm/literal/literal-test.ts       |  7 +--
 test/elm/message/message-test.ts       |  5 +-
 test/elm/parameters/parameters-test.ts |  6 +-
 test/elm/quantity/quantity-test.ts     |  3 +-
 test/elm/query/query-test.ts           |  5 +-
 test/util/math-test.ts                 | 18 +++---
 test/util/units-test.ts                | 22 +++----
 16 files changed, 136 insertions(+), 154 deletions(-)

diff --git a/test/datatypes/date-test.ts b/test/datatypes/date-test.ts
index dd8150016..c4e433b52 100644
--- a/test/datatypes/date-test.ts
+++ b/test/datatypes/date-test.ts
@@ -889,7 +889,7 @@ describe('Date.getDateTime', () => {
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);
-    dateTime.timezoneOffset.should.equalDecimal(Decimal.from(2));
+    dateTime.timezoneOffset.should.equalDecimal(2);
   });
 
   it('should return a DateTime with a timeZoneOffset when one is not passed in', () => {
@@ -898,9 +898,7 @@ describe('Date.getDateTime', () => {
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);
-    dateTime.timezoneOffset.should.equalDecimal(
-      Decimal.from((new jsDate().getTimezoneOffset() / 60) * -1)
-    );
+    dateTime.timezoneOffset.should.equalDecimal((new jsDate().getTimezoneOffset() / 60) * -1);
   });
 
   it('should return a DateTime without a timeZoneOffset when a null timeZoneOffset is passed in', () => {
diff --git a/test/datatypes/datetime-test.ts b/test/datatypes/datetime-test.ts
index cc3105cb3..8d9102604 100644
--- a/test/datatypes/datetime-test.ts
+++ b/test/datatypes/datetime-test.ts
@@ -60,13 +60,13 @@ describe('DateTime', () => {
     d.minute.should.equal(25);
     d.second.should.equal(59);
     d.millisecond.should.equal(246);
-    d.timezoneOffset.should.equalDecimal(Decimal.from(5.5));
+    d.timezoneOffset.should.equalDecimal(5.5);
   });
 
   it('should leave unset properties as undefined', () => {
     const d = new DateTime(2000);
     d.year.should.equal(2000);
-    d.timezoneOffset.should.equalDecimal(Decimal.from((new Date().getTimezoneOffset() / 60) * -1));
+    d.timezoneOffset.should.equalDecimal((new Date().getTimezoneOffset() / 60) * -1);
     should.not.exist(d.month);
     should.not.exist(d.day);
     should.not.exist(d.hour);
diff --git a/test/datatypes/interval-test.ts b/test/datatypes/interval-test.ts
index 64a4408c4..091ac09d6 100644
--- a/test/datatypes/interval-test.ts
+++ b/test/datatypes/interval-test.ts
@@ -134,7 +134,7 @@ describe('Interval', () => {
     it('should return the point size for Decimal intervals', () => {
       new Interval(Decimal.from(0.5), Decimal.from(9.5))
         .getPointSize()
-        .should.equalDecimal(Decimal.from(0.00000001));
+        .should.equalDecimal(0.00000001);
     });
 
     it('should return the point size for Quantity intervals', () => {
@@ -156,7 +156,7 @@ describe('Interval', () => {
 
     it('should return low for intervals with closed low', () => {
       d.zeroToHundred.closed.start().should.equal(0);
-      d.zeroPointFiveToNinePointFive.closed.start().should.equalDecimal(Decimal.from(0.5));
+      d.zeroPointFiveToNinePointFive.closed.start().should.equalDecimal(0.5);
       d.zeroToHundredLong.closed.start().should.equal(0n);
       d.zeroToHundredMg.closed.start().should.eql(new Quantity('0.0', 'mg'));
       d.all2012date.closed.start().should.eql(Date.parse('2012-01-01'));
@@ -166,7 +166,7 @@ describe('Interval', () => {
 
     it('should return successor of low for intervals with open low', () => {
       d.zeroToHundred.openClosed.start().should.equal(1);
-      d.zeroPointFiveToNinePointFive.openClosed.start().should.equalDecimal(Decimal.from('0.6'));
+      d.zeroPointFiveToNinePointFive.openClosed.start().should.equalDecimal('0.6');
       d.zeroToHundredLong.openClosed.start().should.equal(1n);
       d.zeroToHundredMg.openClosed.start().should.eql(new Quantity('0.1', 'mg'));
       d.all2012date.openClosed.start().should.eql(Date.parse('2012-01-02'));
@@ -303,7 +303,7 @@ describe('Interval', () => {
 
     it('should return high for intervals with closed high', () => {
       d.zeroToHundred.closed.end().should.equal(100);
-      d.zeroPointFiveToNinePointFive.closed.end().should.equalDecimal(Decimal.from('9.5'));
+      d.zeroPointFiveToNinePointFive.closed.end().should.equalDecimal('9.5');
       d.zeroToHundredLong.closed.end().should.equal(100n);
       d.zeroToHundredMg.closed.end().should.eql(new Quantity('100.0', 'mg'));
       d.all2012date.closed.end().should.eql(Date.parse('2012-12-31'));
@@ -313,7 +313,7 @@ describe('Interval', () => {
 
     it('should return predecessor of high for intervals with open high', () => {
       d.zeroToHundred.closedOpen.end().should.equal(99);
-      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equalDecimal(Decimal.from('9.4'));
+      d.zeroPointFiveToNinePointFive.closedOpen.end().should.equalDecimal('9.4');
       d.zeroToHundredLong.closedOpen.end().should.equal(99n);
       d.zeroToHundredMg.closedOpen.end().should.eql(new Quantity('99.9', 'mg'));
       d.all2012date.closedOpen.end().should.eql(Date.parse('2012-12-30'));
@@ -7024,8 +7024,8 @@ describe('DecimalInterval', () => {
       ELM_DECIMAL_TYPE
     );
 
-    interval.width().should.equalDecimal(Decimal.from('3000000000.0'));
-    interval.size().should.equalDecimal(Decimal.from('3000000000.00000001'));
+    interval.width().should.equalDecimal('3000000000.0');
+    interval.size().should.equalDecimal('3000000000.00000001');
   });
 
   it('should close open decimal uncertainty endpoints using decimal precision', () => {
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index f9300bc0c..1f41fff0a 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -1,6 +1,6 @@
 import should from 'should';
 import setup from '../../setup';
-import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
+import { MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
 const data = require('./data');
 const validateQuantity = function (object: any, expectedValue: any, expectedUnit: any) {
   object.isQuantity.should.be.true();
@@ -73,7 +73,7 @@ describe('Sum', () => {
   });
 
   it('should be able to sum lists with decimals', async function () {
-    (await this.decimals.exec(this.ctx)).should.equalDecimal(Decimal.from(16.5));
+    (await this.decimals.exec(this.ctx)).should.equalDecimal(16.5);
   });
 
   it('should be able to sum decimals up to max decimal value', async function () {
@@ -176,7 +176,7 @@ describe('Min', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMin.exec(this.ctx)).should.equalDecimal(Decimal.from(-5));
+    (await this.decimalMin.exec(this.ctx)).should.equalDecimal(-5);
   });
 
   it('list of DateTimes', async function () {
@@ -253,7 +253,7 @@ describe('Max', () => {
   });
 
   it('list of Decimals', async function () {
-    (await this.decimalMax.exec(this.ctx)).should.equalDecimal(Decimal.from(5.1));
+    (await this.decimalMax.exec(this.ctx)).should.equalDecimal(5.1);
   });
 
   it('list of DateTimes', async function () {
@@ -302,15 +302,15 @@ describe('Avg', () => {
   });
 
   it('should be able to find average for lists without nulls', async function () {
-    (await this.not_null.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
+    (await this.not_null.exec(this.ctx)).should.equalDecimal(3);
   });
 
   it('should be able to find average for lists with nulls', async function () {
-    (await this.has_null.exec(this.ctx)).should.equalDecimal(Decimal.from(1.5));
+    (await this.has_null.exec(this.ctx)).should.equalDecimal(1.5);
   });
 
   it('should normalize repeating Decimal averages at the aggregate boundary', async function () {
-    (await this.repeating_decimal.exec(this.ctx)).should.equalDecimal(Decimal.from('1.66666667'));
+    (await this.repeating_decimal.exec(this.ctx)).should.equalDecimal('1.66666667');
   });
 
   it('should return null for empty list', async function () {
@@ -347,19 +347,19 @@ describe('Median', () => {
   });
 
   it('should be able to find median of odd numbered list', async function () {
-    (await this.odd.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
+    (await this.odd.exec(this.ctx)).should.equalDecimal(3);
   });
 
   it('should be able to find median of even numbered list', async function () {
-    (await this.even.exec(this.ctx)).should.equalDecimal(Decimal.from(3.5));
+    (await this.even.exec(this.ctx)).should.equalDecimal(3.5);
   });
 
   it('should be able to find median of odd numbered list that contains duplicates', async function () {
-    (await this.dup_vals_odd.exec(this.ctx)).should.equalDecimal(Decimal.from(3));
+    (await this.dup_vals_odd.exec(this.ctx)).should.equalDecimal(3);
   });
 
   it('should be able to find median of even numbered list that contians duplicates', async function () {
-    (await this.dup_vals_even.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.dup_vals_even.exec(this.ctx)).should.equalDecimal(2.5);
   });
 
   it('should return null for empty list', async function () {
@@ -443,7 +443,7 @@ describe('PopulationVariance', () => {
     setup(this, data);
   });
   it('should be able to find PopulationVariance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.equalDecimal(Decimal.from(2));
+    (await this.v.exec(this.ctx)).should.equalDecimal(2);
   });
   it('should be able to find PopulationVariance of a list of like quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2, 'ml');
@@ -459,7 +459,7 @@ describe('PopulationVariance', () => {
   });
 
   it('should return zero for a single-item population variance', async function () {
-    (await this.single_value.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    (await this.single_value.exec(this.ctx)).should.equalDecimal(0);
     validateQuantity(await this.single_value_q.exec(this.ctx), 0, 'ml');
   });
 });
@@ -469,7 +469,7 @@ describe('Variance', () => {
     setup(this, data);
   });
   it('should be able to find Variance of a list ', async function () {
-    (await this.v.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.v.exec(this.ctx)).should.equalDecimal(2.5);
   });
   it('should be able to find Variance of a list of matched quantities', async function () {
     validateQuantity(await this.v_q.exec(this.ctx), 2.5, 'ml');
@@ -494,7 +494,7 @@ describe('StdDev', () => {
     setup(this, data);
   });
   it('should be able to find Standard Dev of a list ', async function () {
-    (await this.std.exec(this.ctx)).should.equalDecimal(Decimal.from('1.58113883'));
+    (await this.std.exec(this.ctx)).should.equalDecimal('1.58113883');
   });
   it('should be able to find Standard Dev of a list of like quantities', async function () {
     validateQuantity(await this.std_q.exec(this.ctx), '1.58113883', 'ml');
@@ -519,7 +519,7 @@ describe('PopulationStdDev', () => {
     setup(this, data);
   });
   it('should be able to find Population Standard Dev of a list ', async function () {
-    (await this.dev.exec(this.ctx)).should.equalDecimal(Decimal.from('1.41421356'));
+    (await this.dev.exec(this.ctx)).should.equalDecimal('1.41421356');
   });
   it('should be able to find Population Standard Dev of a list of quantities', async function () {
     validateQuantity(await this.dev_q.exec(this.ctx), '1.41421356', 'ml');
@@ -535,7 +535,7 @@ describe('PopulationStdDev', () => {
   });
 
   it('should return zero for a single-item population standard deviation', async function () {
-    (await this.single_value.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    (await this.single_value.exec(this.ctx)).should.equalDecimal(0);
     validateQuantity(await this.single_value_q.exec(this.ctx), 0, 'ml');
   });
 });
@@ -586,7 +586,7 @@ describe('Product', () => {
   });
 
   it('should return a decimal product', async function () {
-    (await this.decimal_product.exec(this.ctx)).should.equalDecimal(Decimal.from(24.0));
+    (await this.decimal_product.exec(this.ctx)).should.equalDecimal(24.0);
   });
 
   it('should return decimal product up to max decimal value', async function () {
@@ -673,15 +673,15 @@ describe('GeometricMean', () => {
   });
 
   it('should return decimal geometric mean', async function () {
-    (await this.decimal_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from(4.0));
+    (await this.decimal_geometric_mean.exec(this.ctx)).should.equalDecimal(4.0);
   });
 
   it('should retun 0 as a geometric mean', async function () {
-    (await this.zero_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from(0));
+    (await this.zero_geometric_mean.exec(this.ctx)).should.equalDecimal(0);
   });
 
   it('should return value when pass in list that contains nulls', async function () {
-    (await this.null_geometric_mean.exec(this.ctx)).should.equalDecimal(Decimal.from('1.41421356'));
+    (await this.null_geometric_mean.exec(this.ctx)).should.equalDecimal('1.41421356');
   });
 
   it('should return null when list is all null', async function () {
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index f3ef86c20..7173f9b42 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -15985,7 +15985,9 @@ define decimals_at_min_value_product: Product({-99999999999999999999.99999999, 1
 define decimals_below_min_value_product: Product({-99999999999999999999.99999999, 2.0})
 define quantity_product: Product({1.0 'g', 2.0 'g', 3.0 'g', 4.0 'g'})
 // Max/Min-valued quantities are described using the "maximum" and "minimum" operators
-// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
+// to avoid them being represented in ELM as +/-1.0e20, which is not a legal Decimal
+// (Note that the ELM for Quantity literals uses a plain number for the value)
+// See https://jira.hl7.org/browse/FHIR-58825
 define MaxValueGramQuantity: Quantity { value: maximum Decimal, unit: 'g' }
 define MinValueGramQuantity: Quantity { value: minimum Decimal, unit: 'g' }
 define quantities_at_max_value_product: Product({MaxValueGramQuantity, 1.0 'g'})
@@ -17540,7 +17542,7 @@ module.exports['Product'] = {
           "s" : {
             "r" : "475",
             "s" : [ {
-              "value" : [ "// Max/Min-valued quantities are described using the \"maximum\" and \"minimum\" operators\n// to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal\n", "define ", "MaxValueGramQuantity", ": " ]
+              "value" : [ "// Max/Min-valued quantities are described using the \"maximum\" and \"minimum\" operators\n// to avoid them being represented in ELM as +/-1.0e20, which is not a legal Decimal\n// (Note that the ELM for Quantity literals uses a plain number for the value)\n// See https://jira.hl7.org/browse/FHIR-58825\n", "define ", "MaxValueGramQuantity", ": " ]
             }, {
               "r" : "476",
               "s" : [ {
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index df6cb69be..67f80f136 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -215,64 +215,64 @@ describe('Divide', () => {
   });
 
   it('should divide two numbers', async function () {
-    (await this.tenDividedByTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.tenDividedByTwo.exec(this.ctx)).should.equalDecimal(5);
   });
 
   it("should divide two numbers that don't evenly divide", async function () {
-    (await this.tenDividedByFour.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.tenDividedByFour.exec(this.ctx)).should.equalDecimal(2.5);
   });
 
   it('should divide multiple numbers', async function () {
-    (await this.divideMultiple.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.divideMultiple.exec(this.ctx)).should.equalDecimal(5);
   });
 
   it('should divide variables', async function () {
-    (await this.divideVariables.exec(this.ctx)).should.equalDecimal(Decimal.from(25));
+    (await this.divideVariables.exec(this.ctx)).should.equalDecimal(25);
   });
 
   it('should divide two longs', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoLong.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.tenDividedByTwoLong.exec(this.ctx)).should.equalDecimal(5);
   });
 
   it('should divide integer by long', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.tenDividedByTwoMixed.exec(this.ctx)).should.equalDecimal(5);
   });
 
   it('should divide long by integer', async function () {
     // NOTE: Divide always returns a Decimal
-    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
+    (await this.tenDividedByTwoReverseMixed.exec(this.ctx)).should.equalDecimal(5);
   });
 
   it('should divide two longs with decimal result', async function () {
-    (await this.tenDividedByFourLong.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.tenDividedByFourLong.exec(this.ctx)).should.equalDecimal(2.5);
   });
 
   it('should divide integer by long with decimal result', async function () {
-    (await this.tenDividedByFourMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.tenDividedByFourMixed.exec(this.ctx)).should.equalDecimal(2.5);
   });
 
   it('should divide long by integer with decimal result', async function () {
-    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.equalDecimal(Decimal.from(2.5));
+    (await this.tenDividedByFourReverseMixed.exec(this.ctx)).should.equalDecimal(2.5);
   });
 
   it('should divide uncertainty by uncertainty', async function () {
     const result = await this.divideUncertainties.exec(this.ctx);
-    result.low.should.equalDecimal(Decimal.from('0.42857143')); // 6/14
-    result.high.should.equalDecimal(Decimal.from(9));
+    result.low.should.equalDecimal('0.42857143'); // 6/14
+    result.high.should.equalDecimal(9);
   });
 
   it('should divide uncertainty by number', async function () {
     const result = await this.divideUncertaintyByNumber.exec(this.ctx);
-    result.low.should.equalDecimal(Decimal.from(3));
-    result.high.should.equalDecimal(Decimal.from(9));
+    result.low.should.equalDecimal(3);
+    result.high.should.equalDecimal(9);
   });
 
   it('should divide number by uncertainty', async function () {
     const result = await this.divideNumberByUncertainty.exec(this.ctx);
-    result.low.should.equalDecimal(Decimal.from(2));
-    result.high.should.equalDecimal(Decimal.from(6));
+    result.low.should.equalDecimal(2);
+    result.high.should.equalDecimal(6);
   });
 });
 
@@ -304,11 +304,11 @@ describe('MathPrecedence', () => {
   });
 
   it('should follow order of operations', async function () {
-    (await this.mixed.exec(this.ctx)).should.equalDecimal(Decimal.from(46));
+    (await this.mixed.exec(this.ctx)).should.equalDecimal(46);
   });
 
   it('should allow parentheses to override order of operations', async function () {
-    (await this.parenthetical.exec(this.ctx)).should.equalDecimal(Decimal.from(-10));
+    (await this.parenthetical.exec(this.ctx)).should.equalDecimal(-10);
   });
 });
 
@@ -346,13 +346,11 @@ describe('Power', () => {
   });
 
   it('should return an infinitesimally small number when the exponent is the minimum Long value', async function () {
-    (await this.twoLongExpMinLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.0));
+    (await this.twoLongExpMinLong.exec(this.ctx)).should.equalDecimal(0.0);
   });
 
   it('should normalize Decimal power results at the ELM boundary', async function () {
-    (await this.decimalPowerNeedsNormalization.exec(this.ctx)).should.equalDecimal(
-      Decimal.from('1.52415788')
-    );
+    (await this.decimalPowerNeedsNormalization.exec(this.ctx)).should.equalDecimal('1.52415788');
   });
 
   it('should return null for Decimal powers that cannot be represented', async function () {
@@ -583,11 +581,11 @@ describe('Log', () => {
   });
 
   it('should be able to return the log of a number based on an arbitrary base value', async function () {
-    (await this.log.exec(this.ctx)).should.equalDecimal(Decimal.from(0.25));
+    (await this.log.exec(this.ctx)).should.equalDecimal(0.25);
   });
 
   it('should be able to return the log of a long based on an arbitrary base value', async function () {
-    (await this.logLong.exec(this.ctx)).should.equalDecimal(Decimal.from(0.25));
+    (await this.logLong.exec(this.ctx)).should.equalDecimal(0.25);
   });
 });
 
@@ -656,17 +654,17 @@ describe('Round', () => {
   });
 
   it('should be able to round a number up or down to the closest integer value', async function () {
-    (await this.up.exec(this.ctx)).should.equalDecimal(Decimal.from(5));
-    (await this.down.exec(this.ctx)).should.equalDecimal(Decimal.from(4));
+    (await this.up.exec(this.ctx)).should.equalDecimal(5);
+    (await this.down.exec(this.ctx)).should.equalDecimal(4);
   });
   it('should be able to round a number up or down to the closest decimal place ', async function () {
-    (await this.up_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.6));
-    (await this.down_percent.exec(this.ctx)).should.equalDecimal(Decimal.from(4.4));
+    (await this.up_percent.exec(this.ctx)).should.equalDecimal(4.6);
+    (await this.down_percent.exec(this.ctx)).should.equalDecimal(4.4);
   });
 
   it('should round negative exact-half values toward nearest whole number', async function () {
-    (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(Decimal.from(-1));
-    (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(Decimal.from(-2));
+    (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(-1);
+    (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(-2);
   });
 });
 
@@ -685,7 +683,7 @@ describe('Successor', () => {
 
   it('should be able to get Decimal Successor', async function () {
     // successor of 2.2
-    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from(2.3));
+    (await this.rs.exec(this.ctx)).should.equalDecimal(2.3);
   });
 
   it('should return null for Successor greater than Integer Max value', async function () {
@@ -789,7 +787,7 @@ describe('Predecessor', () => {
 
   it('should be able to get Decimal Predecessor', async function () {
     // Rs: predecessor of 2.2
-    (await this.rs.exec(this.ctx)).should.equalDecimal(Decimal.from('2.1'));
+    (await this.rs.exec(this.ctx)).should.equalDecimal('2.1');
   });
 
   it('should return null for Predecessor greater than Integer Max value', async function () {
@@ -916,13 +914,13 @@ describe('Quantity', () => {
 
   it('should be able to perform Quantity Absolution', async function () {
     const q = await this.abs.exec(this.ctx);
-    q.value.should.equalDecimal(Decimal.from(10));
+    q.value.should.equalDecimal(10);
     q.unit.should.equal('days');
   });
 
   it('should be able to perform Quantity Negation', async function () {
     const q = await this.neg.exec(this.ctx);
-    q.value.should.equalDecimal(Decimal.from(-10));
+    q.value.should.equalDecimal(-10);
     q.unit.should.equal('days');
   });
 
@@ -1048,16 +1046,12 @@ describe('OutOfBounds', () => {
 
     it('should return value for Divide near overflow', async function () {
       // not really near overflow, but more than max integer and near JavaScript max safe number
-      should(await this.integerDivideNearOverflow.exec(this.ctx)).equalDecimal(
-        Decimal.from(8589934588000000)
-      );
+      should(await this.integerDivideNearOverflow.exec(this.ctx)).equalDecimal(8589934588000000);
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but less than min integer and near JavaScript min safe number
-      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equalDecimal(
-        Decimal.from(-8589934592000000)
-      );
+      should(await this.integerDivideNearUnderflow.exec(this.ctx)).equalDecimal(-8589934592000000);
     });
 
     it('should return null for Divide By Zero', async function () {
@@ -1159,16 +1153,12 @@ describe('OutOfBounds', () => {
       // note that all division in CQL (except truncated division) is really decimal division
       // note also that MAX_LONG_VALUE is (2^63)-1,
       // 9223372036854775807 = 7^2 * 73 * 127 * 337 * 92737 * 649657
-      should(await this.longDivideNearOverflow.exec(this.ctx)).equalDecimal(
-        Decimal.from(99457304386111n)
-      );
+      should(await this.longDivideNearOverflow.exec(this.ctx)).equalDecimal(99457304386111n);
     });
 
     it('should return value for Divide near underflow', async function () {
       // not really near underflow, but near JavaScript min safe number
-      should(await this.longDivideNearUnderflow.exec(this.ctx)).equalDecimal(
-        Decimal.from(-9007199254740992n)
-      );
+      should(await this.longDivideNearUnderflow.exec(this.ctx)).equalDecimal(-9007199254740992n);
     });
 
     it('should return null for Divide By Zero', async function () {
diff --git a/test/elm/convert/convert-test.ts b/test/elm/convert/convert-test.ts
index c99fb3b18..ec396ae65 100644
--- a/test/elm/convert/convert-test.ts
+++ b/test/elm/convert/convert-test.ts
@@ -29,7 +29,7 @@ describe('FromString', () => {
   });
 
   it("should convert '10.2' to Decimal", async function () {
-    (await this.decimalValid.exec(this.ctx)).should.equalDecimal(Decimal.from(10.2));
+    (await this.decimalValid.exec(this.ctx)).should.equalDecimal(10.2);
   });
 
   it("should be null trying to convert 'abc' to Decimal", async function () {
@@ -62,25 +62,25 @@ describe('FromString', () => {
 
   it('should convert "10 \'A\'" to Quantity', async function () {
     const quantity = await this.quantityStr.exec(this.ctx);
-    quantity.value.should.equalDecimal(Decimal.from(10));
+    quantity.value.should.equalDecimal(10);
     quantity.unit.should.equal('A');
   });
 
   it('should convert "+10 \'A\'" to Quantity', async function () {
     const quantity = await this.posQuantityStr.exec(this.ctx);
-    quantity.value.should.equalDecimal(Decimal.from(10));
+    quantity.value.should.equalDecimal(10);
     quantity.unit.should.equal('A');
   });
 
   it('should convert "-10 \'A\'" to Quantity', async function () {
     const quantity = await this.negQuantityStr.exec(this.ctx);
-    quantity.value.should.equalDecimal(Decimal.from(-10));
+    quantity.value.should.equalDecimal(-10);
     quantity.unit.should.equal('A');
   });
 
   it('should convert "10.0\'mA\'" to Quantity', async function () {
     const quantity = await this.quantityStrDecimal.exec(this.ctx);
-    quantity.value.should.equalDecimal(Decimal.from(10.0));
+    quantity.value.should.equalDecimal(10.0);
     quantity.unit.should.equal('mA');
   });
 
@@ -129,7 +129,7 @@ describe('FromInteger', () => {
   });
 
   it('should convert 10 to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.equalDecimal(Decimal.from(10.0));
+    (await this.decimal10.exec(this.ctx)).should.equalDecimal(10.0);
   });
 
   it('should convert null to null', async function () {
@@ -155,7 +155,7 @@ describe('FromLong', () => {
   });
 
   it('should convert 10L to 10.0', async function () {
-    (await this.decimal10.exec(this.ctx)).should.equalDecimal(Decimal.from(10.0));
+    (await this.decimal10.exec(this.ctx)).should.equalDecimal(10.0);
   });
 
   it('should convert null to null', async function () {
@@ -186,7 +186,7 @@ describe('FromQuantity', () => {
 
   it('should convert "10 \'A\'" to "10 \'A\'"', async function () {
     const quantity = await this.quantityQuantity.exec(this.ctx);
-    quantity.value.should.equalDecimal(Decimal.from(10));
+    quantity.value.should.equalDecimal(10);
     quantity.unit.should.equal('A');
   });
 });
@@ -243,7 +243,7 @@ describe('FromDateTime', () => {
     dateTime.minute.should.equal(1);
     dateTime.second.should.equal(2);
     dateTime.millisecond.should.equal(321);
-    dateTime.timezoneOffset.should.equalDecimal(Decimal.from(-6));
+    dateTime.timezoneOffset.should.equalDecimal(-6);
   });
 });
 
@@ -345,19 +345,19 @@ describe('ToDecimal', () => {
   });
 
   it("should convert '0.0' to 0.0", async function () {
-    (await this.noSign.exec(this.ctx)).should.equalDecimal(Decimal.from(0.0));
+    (await this.noSign.exec(this.ctx)).should.equalDecimal(0.0);
   });
 
   it("should convert '+1.1' to 1.1", async function () {
-    (await this.positiveSign.exec(this.ctx)).should.equalDecimal(Decimal.from(1.1));
+    (await this.positiveSign.exec(this.ctx)).should.equalDecimal(1.1);
   });
 
   it("should convert '-1.1' to -1.1", async function () {
-    (await this.negativeSign.exec(this.ctx)).should.equalDecimal(Decimal.from(-1.1));
+    (await this.negativeSign.exec(this.ctx)).should.equalDecimal(-1.1);
   });
 
   it('should truncate decimal to 8 digits after decimal point', async function () {
-    (await this.tooPrecise.exec(this.ctx)).should.equalDecimal(Decimal.from('0.44444444'));
+    (await this.tooPrecise.exec(this.ctx)).should.equalDecimal('0.44444444');
   });
 
   it('should be null for decimal that is above max decimal value', async function () {
@@ -384,7 +384,7 @@ describe('ToDecimal', () => {
   });
 
   it('should accept an integer-form Decimal string', async function () {
-    (await this.integerFormat.exec(this.ctx)).should.equalDecimal(Decimal.from(1));
+    (await this.integerFormat.exec(this.ctx)).should.equalDecimal(1);
   });
 
   it('should format Decimals in fixed-point notation', async function () {
@@ -576,17 +576,17 @@ describe('ToRatio', () => {
 
   it('should be valid given quantities with custom UCUM units', async function () {
     const ratio = await this.isValidWithCustomUCUM.exec(this.ctx);
-    ratio.numerator.value.should.equalDecimal(Decimal.from(1.0));
+    ratio.numerator.value.should.equalDecimal(1.0);
     ratio.numerator.unit.should.eql('{foo:bar}');
-    ratio.denominator.value.should.equalDecimal(Decimal.from(2.0));
+    ratio.denominator.value.should.equalDecimal(2.0);
     ratio.denominator.unit.should.eql('mg');
   });
 
   it('should create valid ratio', async function () {
     const ratio = await this.isValid.exec(this.ctx);
-    ratio.numerator.value.should.equalDecimal(Decimal.from(1.0));
+    ratio.numerator.value.should.equalDecimal(1.0);
     ratio.numerator.unit.should.eql('mg');
-    ratio.denominator.value.should.equalDecimal(Decimal.from(2.0));
+    ratio.denominator.value.should.equalDecimal(2.0);
     ratio.denominator.unit.should.eql('mg');
   });
 });
diff --git a/test/elm/datetime/datetime-test.ts b/test/elm/datetime/datetime-test.ts
index 95c449818..bc35d166e 100644
--- a/test/elm/datetime/datetime-test.ts
+++ b/test/elm/datetime/datetime-test.ts
@@ -100,7 +100,7 @@ describe('DateTime', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.equalDecimal(Decimal.from(-8));
+    d.timezoneOffset.should.equalDecimal(-8);
   });
 });
 
@@ -239,7 +239,7 @@ describe('Now', () => {
     should.exist(now.minute);
     should.exist(now.second);
     should.exist(now.millisecond);
-    now.timezoneOffset.should.equalDecimal(Decimal.from(0));
+    now.timezoneOffset.should.equalDecimal(0);
   });
 
   it('should return all date components representing now using a passed in timezone using a child context', async function () {
@@ -261,7 +261,7 @@ describe('Now', () => {
     should.exist(now.second);
     should.exist(now.millisecond);
     now.timezoneOffset.should.equalDecimal(this.child_ctx.getTimezoneOffset());
-    now.timezoneOffset.should.equalDecimal(Decimal.from(0));
+    now.timezoneOffset.should.equalDecimal(0);
   });
 });
 
@@ -409,13 +409,13 @@ describe('TimezoneOffsetFrom', () => {
   });
 
   it('should return the timezoneoffset from a fully defined DateTime', async function () {
-    (await this.centralEuropean.exec(this.ctx)).should.equalDecimal(Decimal.from(1));
-    (await this.easternStandard.exec(this.ctx)).should.equalDecimal(Decimal.from(-5));
+    (await this.centralEuropean.exec(this.ctx)).should.equalDecimal(1);
+    (await this.easternStandard.exec(this.ctx)).should.equalDecimal(-5);
   });
 
   it('should return the default timezone when not specified', async function () {
     (await this.defaultTimezone.exec(this.ctx)).should.equalDecimal(
-      Decimal.from((new Date().getTimezoneOffset() / 60) * -1)
+      (new Date().getTimezoneOffset() / 60) * -1
     );
   });
 
diff --git a/test/elm/interval/interval-test.ts b/test/elm/interval/interval-test.ts
index 207073d11..0be46dff7 100644
--- a/test/elm/interval/interval-test.ts
+++ b/test/elm/interval/interval-test.ts
@@ -4,7 +4,7 @@ const data = require('./data');
 import { Interval } from '../../../src/datatypes/interval';
 import { DateTime, MIN_DATETIME_VALUE, MAX_DATETIME_VALUE } from '../../../src/datatypes/datetime';
 import { Uncertainty } from '../../../src/datatypes/uncertainty';
-import { Decimal, MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
+import { MAX_DECIMAL_VALUE, MIN_DECIMAL_VALUE } from '../../../src/datatypes/decimal';
 import {
   MIN_INT_VALUE,
   MAX_INT_VALUE,
@@ -1618,10 +1618,10 @@ describe('Width', () => {
 
   it('should calculate the width of real intervals', async function () {
     // define RealWidth: width of Interval[1.23, 4.56]
-    (await this.realWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.33));
+    (await this.realWidth.exec(this.ctx)).should.equalDecimal(3.33);
     // define RealOpenWidth: width of Interval(1.23, 4.56)
     // width of Interval(1.23, 4.56) = predecessor(4.56) - successor (1.23) = 4.55 - 1.24 = 3.31
-    (await this.realOpenWidth.exec(this.ctx)).should.equalDecimal(Decimal.from(3.31));
+    (await this.realOpenWidth.exec(this.ctx)).should.equalDecimal(3.31);
   });
 
   it('should calculate the width of infinite intervals', async function () {
@@ -1645,7 +1645,7 @@ describe('Width', () => {
   it('should calculate the width of interval of quantities', async function () {
     // define WidthOfQuantityInterval: width of Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}]
     const width = await this.widthOfQuantityInterval.exec(this.ctx);
-    width.value.should.equalDecimal(Decimal.from(9));
+    width.value.should.equalDecimal(9);
     width.unit.should.equal('mm');
   });
 
@@ -1686,10 +1686,10 @@ describe('Size', () => {
 
   it('should calculate the size of real intervals', async function () {
     // define RealSize: Size(Interval[1.23, 4.56])
-    (await this.realSize.exec(this.ctx)).should.equalDecimal(Decimal.from('3.33000001'));
+    (await this.realSize.exec(this.ctx)).should.equalDecimal('3.33000001');
     // define RealOpenSize: Size(Interval(1.23, 4.56))
     // (1.23, 4.56) --> [1.24, 4.55], 4.55 - 1.24 = 3.31
-    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal(Decimal.from('3.31000001'));
+    (await this.realOpenSize.exec(this.ctx)).should.equalDecimal('3.31000001');
   });
 
   it('should calculate the size of infinite intervals', async function () {
@@ -1723,7 +1723,7 @@ describe('Size', () => {
   it('should calculate size of interval of quantities', async function () {
     // define SizeOfQuantityInterval: Size(Interval[Quantity{value: 1, unit: 'mm'}, Quantity{value: 10, unit: 'mm'}])
     const size = await this.sizeOfQuantityInterval.exec(this.ctx);
-    size.value.should.equalDecimal(Decimal.from(9.00000001));
+    size.value.should.equalDecimal(9.00000001);
     size.unit.should.equal('mm');
   });
 
@@ -1759,9 +1759,7 @@ describe('Start', () => {
   it('should return the minimum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(
-      Decimal.from(5)
-    );
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(5);
   });
 
   it('should return the minimum possible Integer', async function () {
@@ -1811,9 +1809,7 @@ describe('End', () => {
   it('should return the maximum possible DateTime in timzoneOffset of context', async function () {
     // set execution timestamp to be +5
     this.ctx.executionDateTime = new DateTime(2019, 10, 1, 12, 31, 31, 2, 5);
-    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(
-      Decimal.from(5)
-    );
+    (await this.closedNullDateTime.exec(this.ctx)).timezoneOffset.should.equalDecimal(5);
   });
 
   it('should return the maximum possible Integer', async function () {
diff --git a/test/elm/literal/literal-test.ts b/test/elm/literal/literal-test.ts
index c409a696d..fc0813845 100644
--- a/test/elm/literal/literal-test.ts
+++ b/test/elm/literal/literal-test.ts
@@ -1,6 +1,5 @@
 import should from 'should';
 import setup from '../../setup';
-import { Decimal } from '../../../src/datatypes/decimal';
 const data = require('./data');
 
 describe('Literal', () => {
@@ -41,11 +40,11 @@ describe('Literal', () => {
   });
 
   it('should convert .1 to decimal .1', function () {
-    this.decimalTenth.value.should.equalDecimal(Decimal.from(0.1));
+    this.decimalTenth.value.should.equalDecimal(0.1);
   });
 
   it('should execute .1 as .1', async function () {
-    (await this.decimalTenth.exec(this.ctx)).should.equalDecimal(Decimal.from(0.1));
+    (await this.decimalTenth.exec(this.ctx)).should.equalDecimal(0.1);
   });
 
   it("should convert 'true' to string 'true'", function () {
@@ -66,7 +65,7 @@ describe('Literal', () => {
     d.minute.should.equal(10);
     d.second.should.equal(59);
     d.millisecond.should.equal(456);
-    d.timezoneOffset.should.equalDecimal(Decimal.from(0));
+    d.timezoneOffset.should.equalDecimal(0);
   });
 
   it("should execute '' as correct Time", async function () {
diff --git a/test/elm/message/message-test.ts b/test/elm/message/message-test.ts
index 67d1243c0..c52f4851f 100644
--- a/test/elm/message/message-test.ts
+++ b/test/elm/message/message-test.ts
@@ -2,7 +2,6 @@ import should from 'should';
 import setup from '../../setup';
 const data = require('./data');
 import { Repository } from '../../../src/cql';
-import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('Message', () => {
   let messageCollector: any;
@@ -14,7 +13,7 @@ describe('Message', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(0.5));
+    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(0.5);
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
@@ -40,7 +39,7 @@ describe('Retrieve', () => {
   });
 
   it('should always return the first argument as-is', async function () {
-    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(Decimal.from(0.5));
+    (await this.oneOverTwo.exec(this.ctx)).should.equalDecimal(0.5);
     should(await this.oneOverZero.exec(this.ctx)).be.null();
   });
 
diff --git a/test/elm/parameters/parameters-test.ts b/test/elm/parameters/parameters-test.ts
index b450a217e..82ae5eb38 100644
--- a/test/elm/parameters/parameters-test.ts
+++ b/test/elm/parameters/parameters-test.ts
@@ -101,7 +101,7 @@ describe('DecimalParameterTypes', () => {
 
   it('should execute to provided valid value', async function () {
     (await this.foo.exec(this.ctx.withParameters({ FooP: Decimal.from(3.0) }))).should.equalDecimal(
-      Decimal.from(3.0)
+      3.0
     );
   });
 
@@ -110,13 +110,13 @@ describe('DecimalParameterTypes', () => {
   });
 
   it('should execute to default value', async function () {
-    (await this.foo2.exec(this.ctx)).should.equalDecimal(Decimal.from(1.5));
+    (await this.foo2.exec(this.ctx)).should.equalDecimal(1.5);
   });
 
   it('should execute to overriding valid value', async function () {
     (
       await this.foo2.exec(this.ctx.withParameters({ FooDP: Decimal.from(3.0) }))
-    ).should.equalDecimal(Decimal.from(3.0));
+    ).should.equalDecimal(3.0);
   });
 
   it('should throw when overriding value is wrong type', function () {
diff --git a/test/elm/quantity/quantity-test.ts b/test/elm/quantity/quantity-test.ts
index 81a4afb99..74817d03c 100644
--- a/test/elm/quantity/quantity-test.ts
+++ b/test/elm/quantity/quantity-test.ts
@@ -6,7 +6,6 @@ import {
   doSubtraction,
   Quantity
 } from '../../../src/datatypes/quantity';
-import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('Quantity', () => {
   it('should allow creation of Quantity with valid ucum units', () =>
@@ -63,7 +62,7 @@ describe('Quantity', () => {
     const denominator = new Quantity(2.0, 'mg');
     const result = numerator.dividedBy(denominator);
     result.unit.should.equal('1');
-    result.value.should.equalDecimal(Decimal.from(-2.75));
+    result.value.should.equalDecimal(-2.75);
   });
 
   it('should allow for singular time units', () => {
diff --git a/test/elm/query/query-test.ts b/test/elm/query/query-test.ts
index cc25054c5..7a237d8eb 100644
--- a/test/elm/query/query-test.ts
+++ b/test/elm/query/query-test.ts
@@ -7,7 +7,6 @@ import { Interval } from '../../../src/datatypes/interval';
 import { DateTime } from '../../../src/datatypes/datetime';
 import { Quantity } from '../../../src/datatypes/quantity';
 import { getLocalIdByPath } from '../../testHelpers';
-import { Decimal } from '../../../src/datatypes/decimal';
 
 describe('DateRangeOptimizedQuery', () => {
   beforeEach(function () {
@@ -197,12 +196,12 @@ describe('Sorting', () => {
   it('should correctly sort quantities asc', async function () {
     const e = await this.quantityListAsc.exec(this.ctx);
     e.should.have.length(2);
-    e[0]['value'].should.equalDecimal(Decimal.from(2));
+    e[0]['value'].should.equalDecimal(2);
   });
 
   it('should correctly sort quantities', async function () {
     const e = await this.quantityListSort.exec(this.ctx);
-    e[0]['N']['value'].should.equalDecimal(Decimal.from(2));
+    e[0]['N']['value'].should.equalDecimal(2);
   });
 
   it('should be able to sort by a tuple field asc', async function () {
diff --git a/test/util/math-test.ts b/test/util/math-test.ts
index 2576d29e1..11a411043 100644
--- a/test/util/math-test.ts
+++ b/test/util/math-test.ts
@@ -12,8 +12,8 @@ describe('successor', () => {
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from('1.0'), Decimal.from('2.0')));
-    result.low.should.equalDecimal(Decimal.from('1.1'));
-    result.high.should.equalDecimal(Decimal.from('2.1'));
+    result.low.should.equalDecimal('1.1');
+    result.high.should.equalDecimal('2.1');
   });
 
   it('should leave the uncertainty high unchanged when it overflows', () => {
@@ -31,8 +31,8 @@ describe('predecessor', () => {
 
   it('should preserve decimals in an Uncertainty', () => {
     const result = successor(new Uncertainty(Decimal.from('1.0'), Decimal.from('2.0')));
-    result.low.should.equalDecimal(Decimal.from('1.1'));
-    result.high.should.equalDecimal(Decimal.from('2.1'));
+    result.low.should.equalDecimal('1.1');
+    result.high.should.equalDecimal('2.1');
   });
 
   it('should leave the uncertainty low unchanged when it underflows', () => {
@@ -45,7 +45,7 @@ describe('finalizeNumericResult', () => {
   it('should normalize Decimal results to eight places using the implicit rounding mode', () => {
     const result = finalizeNumericResult(Decimal.from('1.234567895'));
 
-    result.should.equalDecimal(Decimal.from('1.23456790'));
+    result.should.equalDecimal('1.23456790');
   });
 
   it('should return a new normalized Uncertainty without modifying the input', () => {
@@ -53,9 +53,9 @@ describe('finalizeNumericResult', () => {
     const result = finalizeNumericResult(input);
 
     result.should.not.equal(input);
-    input.low.should.equalDecimal(Decimal.from('1.234567895'));
-    input.high.should.equalDecimal(Decimal.from('2.345678995'));
-    result.low.should.equalDecimal(Decimal.from('1.23456790'));
-    result.high.should.equalDecimal(Decimal.from('2.34567900'));
+    input.low.should.equalDecimal('1.234567895');
+    input.high.should.equalDecimal('2.345678995');
+    result.low.should.equalDecimal('1.23456790');
+    result.high.should.equalDecimal('2.34567900');
   });
 });
diff --git a/test/util/units-test.ts b/test/util/units-test.ts
index 21c8771c9..670ad1dd9 100644
--- a/test/util/units-test.ts
+++ b/test/util/units-test.ts
@@ -109,30 +109,30 @@ describe('checkUnit', () => {
 
 describe('convertUnit', () => {
   it('should convert compatible units', () => {
-    convertUnit(Decimal.from(18), '[in_i]', '[ft_i]').should.equalDecimal(Decimal.from(1.5));
+    convertUnit(Decimal.from(18), '[in_i]', '[ft_i]').should.equalDecimal(1.5);
   });
 
   it('should return same value for same units', () => {
-    convertUnit(Decimal.from(18), '[in_i]', '[in_i]').should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(18), '[in_i]', '[in_i]').should.equalDecimal(18);
   });
 
   it('should consider empty as 1 during conversion', () => {
-    convertUnit(Decimal.from(18), '', '').should.equalDecimal(Decimal.from(18));
-    convertUnit(Decimal.from(18), null, null).should.equalDecimal(Decimal.from(18));
-    convertUnit(Decimal.from(18), '', null).should.equalDecimal(Decimal.from(18));
-    convertUnit(Decimal.from(18), null, '').should.equalDecimal(Decimal.from(18));
+    convertUnit(Decimal.from(18), '', '').should.equalDecimal(18);
+    convertUnit(Decimal.from(18), null, null).should.equalDecimal(18);
+    convertUnit(Decimal.from(18), '', null).should.equalDecimal(18);
+    convertUnit(Decimal.from(18), null, '').should.equalDecimal(18);
   });
 
   it('should support CQL date units during conversion', () => {
-    convertUnit(Decimal.from(18), 'months', 'years').should.equalDecimal(Decimal.from(1.5));
-    convertUnit(Decimal.from(1.5), 'years', 'months').should.equalDecimal(Decimal.from(18));
-    convertUnit(Decimal.from(2), 'seconds', 'milliseconds').should.equalDecimal(Decimal.from(2000));
-    convertUnit(Decimal.from(2000), 'milliseconds', 'seconds').should.equalDecimal(Decimal.from(2));
+    convertUnit(Decimal.from(18), 'months', 'years').should.equalDecimal(1.5);
+    convertUnit(Decimal.from(1.5), 'years', 'months').should.equalDecimal(18);
+    convertUnit(Decimal.from(2), 'seconds', 'milliseconds').should.equalDecimal(2000);
+    convertUnit(Decimal.from(2000), 'milliseconds', 'seconds').should.equalDecimal(2);
   });
 
   it('should truncate precision to 8 decimals by default', () => {
     const result = convertUnit(Decimal.from(1), '[ft_i]', '[mi_i]');
-    result.should.equalDecimal(Decimal.from('0.00018939'));
+    result.should.equalDecimal('0.00018939');
   });
 
   it('should return undefined for incompatible units', () => {

From 4a7f549dbb8c8aa24bdde48a94afa70386dfc743 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 14:50:35 -0400
Subject: [PATCH 41/62] bump dependency, add csv-parse override to pass npm
 audit

---
 package-lock.json | 12 ++++++------
 package.json      |  3 ++-
 2 files changed, 8 insertions(+), 7 deletions(-)

diff --git a/package-lock.json b/package-lock.json
index 4e391eb81..c80f83831 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -793,9 +793,9 @@
       }
     },
     "node_modules/@istanbuljs/load-nyc-config/node_modules/js-yaml": {
-      "version": "3.15.1",
-      "resolved": "https://registry.npmjs.org/js-yaml/-/js-yaml-3.15.1.tgz",
-      "integrity": "sha512-S99WuO3HlhO3XN41EtYUNl9zzXjoJx7QvmipxsJVxtCBT0YHEFy+iOJhjSvrmV12nYhWpZaM8lPHkJm0yUMbag==",
+      "version": "3.15.2",
+      "resolved": "https://registry.npmjs.org/js-yaml/-/js-yaml-3.15.2.tgz",
+      "integrity": "sha512-6EuL879VkRA+1Cz578mKMiKvjPNEuk6+r1JaFzoSWejZmtf7xWbIyw1e3KkxlkzTIt9Taw6JBhEppG7utc1P+w==",
       "dev": true,
       "license": "MIT",
       "dependencies": {
@@ -2027,9 +2027,9 @@
       }
     },
     "node_modules/csv-parse": {
-      "version": "4.16.3",
-      "resolved": "https://registry.npmjs.org/csv-parse/-/csv-parse-4.16.3.tgz",
-      "integrity": "sha512-cO1I/zmz4w2dcKHVvpCr7JVRu8/FymG5OEpmvsZYlccYolPBLoVGKUHgNoc4ZGkFeFlWGEDmMyBM+TTqRdW/wg==",
+      "version": "7.0.2",
+      "resolved": "https://registry.npmjs.org/csv-parse/-/csv-parse-7.0.2.tgz",
+      "integrity": "sha512-uKZghv9UmPkMVLYy//KZ9HFAIJsl7wkhoEdIL0+rhuSY9pZQlhaeGEDPIe+/w7eh81MOql8Q/9+inAGWG6ZHYA==",
       "license": "MIT"
     },
     "node_modules/csv-stringify": {
diff --git a/package.json b/package.json
index c06af919c..cc350928a 100644
--- a/package.json
+++ b/package.json
@@ -94,7 +94,8 @@
   "overrides": {
     "mocha": {
       "serialize-javascript": "^7.0.3"
-    }
+    },
+    "csv-parse": "^7.0.2"
   },
   "main": "lib/cql",
   "types": "lib/cql.d.ts",

From b3a28d875cd1c08395fc3c4fe3994031783ccc6e Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 15:08:32 -0400
Subject: [PATCH 42/62] quick test cleanup

---
 test/elm/arithmetic/arithmetic-test.ts | 6 ++----
 1 file changed, 2 insertions(+), 4 deletions(-)

diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 67f80f136..80780898f 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -565,13 +565,11 @@ describe('Ln', () => {
   });
 
   it('should be able to return the natural log of a number', async function () {
-    const log4 = Decimal.from('1.3862943611198906').normalized();
-    (await this.ln.exec(this.ctx)).should.equalDecimal(log4);
+    (await this.ln.exec(this.ctx)).should.equalDecimal('1.38629436'); // 1.3862943611198906 to 8 decimal places
   });
 
   it('should be able to return the natural log of a long', async function () {
-    const log4 = Decimal.from('1.3862943611198906').normalized();
-    (await this.lnFourLong.exec(this.ctx)).should.equalDecimal(log4);
+    (await this.lnFourLong.exec(this.ctx)).should.equalDecimal('1.38629436');
   });
 });
 

From f189a0dceb64f3f427cb2ea6d28b5cfe14a7d353 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 15:23:55 -0400
Subject: [PATCH 43/62] add number type option to Date.getDateTime parameter

---
 src/datatypes/datetime.ts   | 2 +-
 test/datatypes/date-test.ts | 3 +--
 2 files changed, 2 insertions(+), 3 deletions(-)

diff --git a/src/datatypes/datetime.ts b/src/datatypes/datetime.ts
index b406d704b..aac32cc77 100644
--- a/src/datatypes/datetime.ts
+++ b/src/datatypes/datetime.ts
@@ -1213,7 +1213,7 @@ export class Date extends AbstractDate {
     return str;
   }
 
-  getDateTime(timeZoneOffset?: Decimal | null) {
+  getDateTime(timeZoneOffset?: Decimal | number | null) {
     // from the spec: the result will be a DateTime with the time components unspecified,
     // except for the timezone offset, which will be set to the timezone offset of the evaluation
     // request timestamp. (this last part is achieved by passing in the timeZoneOffset from the context)
diff --git a/test/datatypes/date-test.ts b/test/datatypes/date-test.ts
index c4e433b52..e2d1bb8f6 100644
--- a/test/datatypes/date-test.ts
+++ b/test/datatypes/date-test.ts
@@ -3,7 +3,6 @@ import should from 'should';
 import { Date, DateTime, MAX_DATE_VALUE, MIN_DATE_VALUE } from '../../src/datatypes/datetime';
 import { Uncertainty } from '../../src/datatypes/uncertainty';
 import { jsDate } from '../../src/util/util';
-import { Decimal } from '../../src/datatypes/decimal';
 
 describe('Date', () => {
   it('should properly set all properties when constructed', () => {
@@ -885,7 +884,7 @@ describe('Date.getPrecisionValue', () => {
 describe('Date.getDateTime', () => {
   it('should return a DateTime that has the passed in timeZoneOffset', () => {
     const d = new Date(2000, 12, 1);
-    const dateTime = d.getDateTime(Decimal.from(2));
+    const dateTime = d.getDateTime(2);
     dateTime.year.should.equal(2000);
     dateTime.month.should.equal(12);
     dateTime.day.should.equal(1);

From 405bd94c0a9e2d5db77de28689c8c2f8e98b5757 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Wed, 9 Sep 2026 15:36:49 -0400
Subject: [PATCH 44/62] make edge case tests more clearly edge cases

---
 test/elm/aggregate/data.cql |   8 +-
 test/elm/aggregate/data.js  | 327 +++++++++++++++++++-----------------
 2 files changed, 177 insertions(+), 158 deletions(-)

diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index 60fa73630..1ab8bb24b 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -17,18 +17,18 @@ define longs_at_min_value: Sum({-1L,-2L,-9223372036854775805L}) // -922337203685
 define longs_below_min_value: Sum({-1L,-2L,-9223372036854775806L}) //-9223372036854775809
 define decimals: Sum({1.1,2.2,3.3,4.4,5.5})
 define decimals_at_max_value: Sum({99999999999999999999.99999999})
-define decimals_above_max_value: Sum({99999999999999999999.99999999, 99999999999999999999.99999999})
+define decimals_above_max_value: Sum({99999999999999999999.99999999, 0.00000001})
 define decimals_at_min_value: Sum({-99999999999999999999.99999999})
-define decimals_below_min_value: Sum({-99999999999999999999.99999999, -99999999999999999999.99999999})
+define decimals_below_min_value: Sum({-99999999999999999999.99999999, -0.00000001})
 define quantities: Sum({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 // Max/Min-valued quantities are described using the "maximum" and "minimum" operators
 // to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
 define MaxValueMLQuantity: Quantity { value: maximum Decimal, unit: 'ml' }
 define MinValueMLQuantity: Quantity { value: minimum Decimal, unit: 'ml' }
 define quantities_at_max_value: Sum({MaxValueMLQuantity})
-define quantities_above_max_value: Sum({MaxValueMLQuantity, MaxValueMLQuantity})
+define quantities_above_max_value: Sum({MaxValueMLQuantity, 0.00000001'ml' })
 define quantities_at_min_value: Sum({MinValueMLQuantity})
-define quantities_below_min_value: Sum({MinValueMLQuantity, MinValueMLQuantity})
+define quantities_below_min_value: Sum({MinValueMLQuantity, -0.00000001'ml'})
 define has_null: Sum({1,null,null,null,2})
 define has_null_q: Sum({1 'ml',null,null,null,2 'ml'})
 define unmatched_units_q: Min({1 'ml',2 'm',3 'ml',4 'ml',5 'ml',0 'ml'})
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index 7173f9b42..e1ef717a5 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -495,18 +495,18 @@ define longs_at_min_value: Sum({-1L,-2L,-9223372036854775805L}) // -922337203685
 define longs_below_min_value: Sum({-1L,-2L,-9223372036854775806L}) //-9223372036854775809
 define decimals: Sum({1.1,2.2,3.3,4.4,5.5})
 define decimals_at_max_value: Sum({99999999999999999999.99999999})
-define decimals_above_max_value: Sum({99999999999999999999.99999999, 99999999999999999999.99999999})
+define decimals_above_max_value: Sum({99999999999999999999.99999999, 0.00000001})
 define decimals_at_min_value: Sum({-99999999999999999999.99999999})
-define decimals_below_min_value: Sum({-99999999999999999999.99999999, -99999999999999999999.99999999})
+define decimals_below_min_value: Sum({-99999999999999999999.99999999, -0.00000001})
 define quantities: Sum({1 'ml',2 'ml',3 'ml',4 'ml',5 'ml'})
 // Max/Min-valued quantities are described using the "maximum" and "minimum" operators
 // to avoid the translator rounding them to +/-1.0e20, which is not a legal Decimal
 define MaxValueMLQuantity: Quantity { value: maximum Decimal, unit: 'ml' }
 define MinValueMLQuantity: Quantity { value: minimum Decimal, unit: 'ml' }
 define quantities_at_max_value: Sum({MaxValueMLQuantity})
-define quantities_above_max_value: Sum({MaxValueMLQuantity, MaxValueMLQuantity})
+define quantities_above_max_value: Sum({MaxValueMLQuantity, 0.00000001'ml' })
 define quantities_at_min_value: Sum({MinValueMLQuantity})
-define quantities_below_min_value: Sum({MinValueMLQuantity, MinValueMLQuantity})
+define quantities_below_min_value: Sum({MinValueMLQuantity, -0.00000001'ml'})
 define has_null: Sum({1,null,null,null,2})
 define has_null_q: Sum({1 'ml',null,null,null,2 'ml'})
 define unmatched_units_q: Min({1 'ml',2 'm',3 'ml',4 'ml',5 'ml',0 'ml'})
@@ -528,7 +528,7 @@ module.exports['Sum'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "694",
+        "r" : "696",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -1893,7 +1893,7 @@ module.exports['Sum'] = {
                 "r" : "435",
                 "s" : [ {
                   "r" : "436",
-                  "value" : [ "{", "99999999999999999999.99999999", ", ", "99999999999999999999.99999999", "}" ]
+                  "value" : [ "{", "99999999999999999999.99999999", ", ", "0.00000001", "}" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -1944,7 +1944,7 @@ module.exports['Sum'] = {
               "localId" : "437",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "99999999999999999999.99999999",
+              "value" : "0.00000001",
               "annotation" : [ ]
             } ]
           }
@@ -2071,7 +2071,7 @@ module.exports['Sum'] = {
                   "r" : "470",
                   "s" : [ {
                     "r" : "471",
-                    "value" : [ "-", "99999999999999999999.99999999" ]
+                    "value" : [ "-", "0.00000001" ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2148,7 +2148,7 @@ module.exports['Sum'] = {
                 "localId" : "471",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-                "value" : "99999999999999999999.99999999",
+                "value" : "0.00000001",
                 "annotation" : [ ]
               }
             } ]
@@ -2542,10 +2542,10 @@ module.exports['Sum'] = {
                 }, {
                   "r" : "537",
                   "s" : [ {
-                    "value" : [ "MaxValueMLQuantity" ]
+                    "value" : [ "0.00000001", "'ml'" ]
                   } ]
                 }, {
-                  "value" : [ "}" ]
+                  "value" : [ " }" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -2591,10 +2591,11 @@ module.exports['Sum'] = {
               "name" : "MaxValueMLQuantity",
               "annotation" : [ ]
             }, {
-              "type" : "ExpressionRef",
+              "type" : "Quantity",
               "localId" : "537",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "name" : "MaxValueMLQuantity",
+              "value" : 1.0E-8,
+              "unit" : "ml",
               "annotation" : [ ]
             } ]
           }
@@ -2688,7 +2689,7 @@ module.exports['Sum'] = {
             "s" : [ {
               "value" : [ "", "define ", "quantities_below_min_value", ": " ]
             }, {
-              "r" : "573",
+              "r" : "575",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
@@ -2705,7 +2706,12 @@ module.exports['Sum'] = {
                 }, {
                   "r" : "566",
                   "s" : [ {
-                    "value" : [ "MinValueMLQuantity" ]
+                    "value" : [ "-" ]
+                  }, {
+                    "r" : "567",
+                    "s" : [ {
+                      "value" : [ "0.00000001", "'ml'" ]
+                    } ]
                   } ]
                 }, {
                   "value" : [ "}" ]
@@ -2718,16 +2724,16 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "573",
+          "localId" : "575",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "574",
+            "localId" : "576",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "575",
+              "localId" : "577",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
@@ -2738,11 +2744,11 @@ module.exports['Sum'] = {
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "567",
+              "localId" : "569",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "568",
+                "localId" : "570",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
@@ -2754,16 +2760,29 @@ module.exports['Sum'] = {
               "name" : "MinValueMLQuantity",
               "annotation" : [ ]
             }, {
-              "type" : "ExpressionRef",
+              "type" : "Negate",
               "localId" : "566",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
-              "name" : "MinValueMLQuantity",
-              "annotation" : [ ]
+              "annotation" : [ ],
+              "signature" : [ {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "568",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              } ],
+              "operand" : {
+                "type" : "Quantity",
+                "localId" : "567",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "value" : 1.0E-8,
+                "unit" : "ml",
+                "annotation" : [ ]
+              }
             } ]
           }
         }
       }, {
-        "localId" : "578",
+        "localId" : "580",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "has_null",
         "context" : "Patient",
@@ -2772,17 +2791,17 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "578",
+            "r" : "580",
             "s" : [ {
               "value" : [ "", "define ", "has_null", ": " ]
             }, {
-              "r" : "594",
+              "r" : "596",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "579",
+                "r" : "581",
                 "s" : [ {
-                  "r" : "580",
+                  "r" : "582",
                   "value" : [ "{", "1", ",", "null", ",", "null", ",", "null", ",", "2", "}" ]
                 } ]
               }, {
@@ -2793,81 +2812,81 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "594",
+          "localId" : "596",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "595",
+            "localId" : "597",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "596",
+              "localId" : "598",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "579",
+            "localId" : "581",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "588",
+              "localId" : "590",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "589",
+                "localId" : "591",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Literal",
-              "localId" : "580",
+              "localId" : "582",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "1",
               "annotation" : [ ]
             }, {
               "type" : "As",
-              "localId" : "585",
+              "localId" : "587",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "581",
+                "localId" : "583",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "586",
+              "localId" : "588",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "582",
+                "localId" : "584",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "587",
+              "localId" : "589",
               "asType" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "583",
+                "localId" : "585",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "Literal",
-              "localId" : "584",
+              "localId" : "586",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
               "value" : "2",
@@ -2876,7 +2895,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "599",
+        "localId" : "601",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "has_null_q",
         "context" : "Patient",
@@ -2885,27 +2904,27 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "599",
+            "r" : "601",
             "s" : [ {
               "value" : [ "", "define ", "has_null_q", ": " ]
             }, {
-              "r" : "615",
+              "r" : "617",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "600",
+                "r" : "602",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "601",
+                  "r" : "603",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
-                  "r" : "602",
+                  "r" : "604",
                   "value" : [ ",", "null", ",", "null", ",", "null", "," ]
                 }, {
-                  "r" : "605",
+                  "r" : "607",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
@@ -2920,81 +2939,81 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "615",
+          "localId" : "617",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "616",
+            "localId" : "618",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "617",
+              "localId" : "619",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "600",
+            "localId" : "602",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "609",
+              "localId" : "611",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "610",
+                "localId" : "612",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "601",
+              "localId" : "603",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "As",
-              "localId" : "606",
+              "localId" : "608",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "602",
+                "localId" : "604",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "607",
+              "localId" : "609",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "603",
+                "localId" : "605",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "As",
-              "localId" : "608",
+              "localId" : "610",
               "asType" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ],
               "signature" : [ ],
               "operand" : {
                 "type" : "Null",
-                "localId" : "604",
+                "localId" : "606",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
                 "annotation" : [ ]
               }
             }, {
               "type" : "Quantity",
-              "localId" : "605",
+              "localId" : "607",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
@@ -3003,7 +3022,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "620",
+        "localId" : "622",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "unmatched_units_q",
         "context" : "Patient",
@@ -3012,54 +3031,54 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "620",
+            "r" : "622",
             "s" : [ {
               "value" : [ "", "define ", "unmatched_units_q", ": " ]
             }, {
-              "r" : "634",
+              "r" : "636",
               "s" : [ {
                 "value" : [ "Min", "(" ]
               }, {
-                "r" : "621",
+                "r" : "623",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "622",
+                  "r" : "624",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "623",
+                  "r" : "625",
                   "s" : [ {
                     "value" : [ "2 ", "'m'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "624",
+                  "r" : "626",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "625",
+                  "r" : "627",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "626",
+                  "r" : "628",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "627",
+                  "r" : "629",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -3074,73 +3093,73 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Min",
-          "localId" : "634",
+          "localId" : "636",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "635",
+            "localId" : "637",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "636",
+              "localId" : "638",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "621",
+            "localId" : "623",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "628",
+              "localId" : "630",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "629",
+                "localId" : "631",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "622",
+              "localId" : "624",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "623",
+              "localId" : "625",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "m",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "624",
+              "localId" : "626",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "625",
+              "localId" : "627",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "626",
+              "localId" : "628",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "627",
+              "localId" : "629",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -3149,7 +3168,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "639",
+        "localId" : "641",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
         "name" : "empty",
         "context" : "Patient",
@@ -3158,19 +3177,19 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "639",
+            "r" : "641",
             "s" : [ {
               "value" : [ "", "define ", "empty", ": " ]
             }, {
-              "r" : "649",
+              "r" : "651",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "641",
+                "r" : "643",
                 "s" : [ {
                   "value" : [ "List<" ]
                 }, {
-                  "r" : "640",
+                  "r" : "642",
                   "s" : [ {
                     "value" : [ "Integer" ]
                   } ]
@@ -3185,31 +3204,31 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "649",
+          "localId" : "651",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "650",
+            "localId" : "652",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "651",
+              "localId" : "653",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "641",
+            "localId" : "643",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "643",
+              "localId" : "645",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "644",
+                "localId" : "646",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               }
@@ -3218,7 +3237,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "654",
+        "localId" : "656",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "q_diff_units",
         "context" : "Patient",
@@ -3227,47 +3246,47 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "654",
+            "r" : "656",
             "s" : [ {
               "value" : [ "", "define ", "q_diff_units", ": " ]
             }, {
-              "r" : "667",
+              "r" : "669",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "655",
+                "r" : "657",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "656",
+                  "r" : "658",
                   "s" : [ {
                     "value" : [ "1 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "657",
+                  "r" : "659",
                   "s" : [ {
                     "value" : [ "0.002 ", "'l'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "658",
+                  "r" : "660",
                   "s" : [ {
                     "value" : [ "0.03 ", "'dl'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "659",
+                  "r" : "661",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "660",
+                  "r" : "662",
                   "s" : [ {
                     "value" : [ "0.005 ", "'l'" ]
                   } ]
@@ -3282,66 +3301,66 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "667",
+          "localId" : "669",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "668",
+            "localId" : "670",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "669",
+              "localId" : "671",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "655",
+            "localId" : "657",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "661",
+              "localId" : "663",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "662",
+                "localId" : "664",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "656",
+              "localId" : "658",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "657",
+              "localId" : "659",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "l",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "658",
+              "localId" : "660",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.03,
               "unit" : "dl",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "659",
+              "localId" : "661",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "660",
+              "localId" : "662",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.005,
               "unit" : "l",
@@ -3350,7 +3369,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "672",
+        "localId" : "674",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "NumbersAndQuantities",
         "context" : "Patient",
@@ -3359,48 +3378,48 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "672",
+            "r" : "674",
             "s" : [ {
               "value" : [ "", "define ", "NumbersAndQuantities", ": " ]
             }, {
-              "r" : "689",
+              "r" : "691",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "673",
+                "r" : "675",
                 "s" : [ {
-                  "r" : "674",
+                  "r" : "676",
                   "value" : [ "{", "1", " ," ]
                 }, {
-                  "r" : "675",
+                  "r" : "677",
                   "s" : [ {
                     "value" : [ "2 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "676",
+                  "r" : "678",
                   "s" : [ {
                     "value" : [ "3 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "677",
+                  "r" : "679",
                   "s" : [ {
                     "value" : [ "4 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "678",
+                  "r" : "680",
                   "s" : [ {
                     "value" : [ "5 ", "'ml'" ]
                   } ]
                 }, {
                   "value" : [ "," ]
                 }, {
-                  "r" : "679",
+                  "r" : "681",
                   "s" : [ {
                     "value" : [ "0 ", "'ml'" ]
                   } ]
@@ -3415,48 +3434,48 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "689",
+          "localId" : "691",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "690",
+            "localId" : "692",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "691",
+              "localId" : "693",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "673",
+            "localId" : "675",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "683",
+              "localId" : "685",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "684",
+                "localId" : "686",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "ToQuantity",
-              "localId" : "681",
+              "localId" : "683",
               "annotation" : [ ],
               "signature" : [ {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "682",
+                "localId" : "684",
                 "name" : "{urn:hl7-org:elm-types:r1}Integer",
                 "annotation" : [ ]
               } ],
               "operand" : {
                 "type" : "Literal",
-                "localId" : "674",
+                "localId" : "676",
                 "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
                 "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
                 "value" : "1",
@@ -3464,35 +3483,35 @@ module.exports['Sum'] = {
               }
             }, {
               "type" : "Quantity",
-              "localId" : "675",
+              "localId" : "677",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 2,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "676",
+              "localId" : "678",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 3,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "677",
+              "localId" : "679",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 4,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "678",
+              "localId" : "680",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 5,
               "unit" : "ml",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "679",
+              "localId" : "681",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0,
               "unit" : "ml",
@@ -3501,7 +3520,7 @@ module.exports['Sum'] = {
           }
         }
       }, {
-        "localId" : "694",
+        "localId" : "696",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
         "name" : "IncompatibleUnitsNull",
         "context" : "Patient",
@@ -3510,26 +3529,26 @@ module.exports['Sum'] = {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "694",
+            "r" : "696",
             "s" : [ {
               "value" : [ "", "define ", "IncompatibleUnitsNull", ": " ]
             }, {
-              "r" : "704",
+              "r" : "706",
               "s" : [ {
                 "value" : [ "Sum", "(" ]
               }, {
-                "r" : "695",
+                "r" : "697",
                 "s" : [ {
                   "value" : [ "{" ]
                 }, {
-                  "r" : "696",
+                  "r" : "698",
                   "s" : [ {
                     "value" : [ "1 ", "'mg/d'" ]
                   } ]
                 }, {
                   "value" : [ ", " ]
                 }, {
-                  "r" : "697",
+                  "r" : "699",
                   "s" : [ {
                     "value" : [ "0.002 ", "'/d'" ]
                   } ]
@@ -3544,45 +3563,45 @@ module.exports['Sum'] = {
         } ],
         "expression" : {
           "type" : "Sum",
-          "localId" : "704",
+          "localId" : "706",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "ListTypeSpecifier",
-            "localId" : "705",
+            "localId" : "707",
             "annotation" : [ ],
             "elementType" : {
               "type" : "NamedTypeSpecifier",
-              "localId" : "706",
+              "localId" : "708",
               "name" : "{urn:hl7-org:elm-types:r1}Quantity",
               "annotation" : [ ]
             }
           } ],
           "source" : {
             "type" : "List",
-            "localId" : "695",
+            "localId" : "697",
             "annotation" : [ ],
             "resultTypeSpecifier" : {
               "type" : "ListTypeSpecifier",
-              "localId" : "698",
+              "localId" : "700",
               "annotation" : [ ],
               "elementType" : {
                 "type" : "NamedTypeSpecifier",
-                "localId" : "699",
+                "localId" : "701",
                 "name" : "{urn:hl7-org:elm-types:r1}Quantity",
                 "annotation" : [ ]
               }
             },
             "element" : [ {
               "type" : "Quantity",
-              "localId" : "696",
+              "localId" : "698",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 1,
               "unit" : "mg/d",
               "annotation" : [ ]
             }, {
               "type" : "Quantity",
-              "localId" : "697",
+              "localId" : "699",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
               "value" : 0.002,
               "unit" : "/d",

From 603a5c85a0b1fba50e0a9bed4004754493e9f9b3 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:28:30 -0400
Subject: [PATCH 45/62] create Decimal.truncatedDivideBy to ensure result is
 not rounded prior to truncation. add new flag to MathUtil.divide to specify
 truncated division

---
 src/datatypes/decimal.ts               |    7 +
 src/datatypes/quantity.ts              |    4 +-
 src/elm/arithmetic.ts                  |   15 +-
 src/util/math.ts                       |    9 +-
 test/datatypes/decimal-test.ts         |   11 +
 test/elm/arithmetic/arithmetic-test.ts |   20 +
 test/elm/arithmetic/data.cql           |    5 +
 test/elm/arithmetic/data.js            | 2461 ++++++++++++++++--------
 8 files changed, 1715 insertions(+), 817 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index b1edcf49f..c86e1ffc0 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -128,6 +128,13 @@ export class Decimal {
     return unscaledResult.withMinimumScale(preferredScale);
   }
 
+  truncatedDivideBy(other: DecimalInput) {
+    if (Decimal.from(other).equals(0)) {
+      throw new RangeError('Cannot divide a decimal by zero');
+    }
+    return this.applyWrapper(this.value.dividedToIntegerBy, other);
+  }
+
   modulo(other: DecimalInput) {
     if (Decimal.from(other).equals(0)) {
       throw new RangeError('Cannot calculate decimal modulo by zero');
diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index 77eab93db..433ddc2d4 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -116,7 +116,7 @@ export class Quantity {
     return new Quantity(value, toUnit);
   }
 
-  dividedBy(other: any) {
+  dividedBy(other: any, truncated?: boolean) {
     if (
       other == null ||
       other === 0 ||
@@ -134,7 +134,7 @@ export class Quantity {
       other.value,
       other.unit
     );
-    const resultValue = val1.divideBy(val2);
+    const resultValue = truncated ? val1.truncatedDivideBy(val2) : val1.divideBy(val2);
     const resultUnit = getQuotientOfUnits(unit1, unit2);
 
     // Check for invalid unit or value
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index bf39d8b4b..f100c5d03 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -164,20 +164,9 @@ export class TruncatedDivide extends Expression {
     const [x, y] = args;
     let quotient;
     if (x.isQuantity) {
-      quotient = x.dividedBy(y);
-      if (quotient instanceof Quantity) {
-        quotient = new Quantity(quotient.value.truncated(), quotient.unit);
-      }
+      quotient = x.dividedBy(y, true);
     } else {
-      quotient = MathUtil.divide(x, y);
-
-      // MathUtil.divide performs truncated division for Integers and Longs implicitly
-      if (
-        quotient != null &&
-        (x.isDecimal || y.isDecimal || this.resultTypeName === ELM_DECIMAL_TYPE)
-      ) {
-        quotient = (quotient as Decimal).truncated();
-      }
+      quotient = MathUtil.divide(x, y, true);
     }
 
     return finalizeArithmeticResult(quotient);
diff --git a/src/util/math.ts b/src/util/math.ts
index 934fe48eb..9d794381b 100644
--- a/src/util/math.ts
+++ b/src/util/math.ts
@@ -202,13 +202,14 @@ export function multiply(a: any, b: any) {
   throw new Error('Unsupported argument types.');
 }
 
-export function divide(a: any, b: any) {
+export function divide(a: any, b: any, truncated?: boolean) {
   if (a.isDecimal || b.isDecimal) {
-    b = Decimal.from(b);
-    if (b.equals(0)) {
+    const bDecimal = Decimal.from(b);
+    if (bDecimal.equals(0)) {
       return null;
     }
-    const quotient = Decimal.from(a).divideBy(b);
+    const aDecimal = Decimal.from(a);
+    const quotient = truncated ? aDecimal.truncatedDivideBy(b) : aDecimal.divideBy(b);
     return overflowsOrUnderflows(quotient) ? null : quotient;
   }
   if (typeof a === 'bigint' || typeof b === 'bigint') {
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index f4511ae45..22072574b 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -95,6 +95,17 @@ describe('Decimal', () => {
     });
   });
 
+  describe('truncatedDivideBy', () => {
+    it('should truncate without rounding', () => {
+      Decimal.from('1.00000').truncatedDivideBy('2.0').should.equalDecimal('0');
+      Decimal.from('1.99999999').truncatedDivideBy('2.0').should.equalDecimal('0');
+    });
+
+    it('should reject a zero divisor', () => {
+      (() => Decimal.from(1).truncatedDivideBy(0)).should.throw(RangeError);
+    });
+  });
+
   describe('modulo', () => {
     it('should calculate a remainder', () => {
       Decimal.from('5.5').modulo(2).should.equalDecimal('1.5');
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 80780898f..ab9279190 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -503,6 +503,26 @@ describe('TruncatedDivide', () => {
   it('should truncate quantity division results', async function () {
     validateQuantity(await this.quantityTruncatedDivide.exec(this.ctx), 5, '1');
   });
+
+  it('should truncate Decimal division results', async function () {
+    (await this.truncatedDivideDecimalJustAboveOne.exec(this.ctx)).should.equalDecimal(1);
+  });
+
+  it('should provide precise results above JS safe numbers', async function () {
+    (await this.truncatedDivideLargePositiveDecimal.exec(this.ctx)).should.equalDecimal(
+      '9007199254740993.0'
+    );
+    validateQuantity(
+      await this.truncatedDivideLargePositiveQuantity.exec(this.ctx),
+      Decimal.from('9007199254740993.0'),
+      '1'
+    );
+  });
+
+  it('should truncate before rounding the quotient', async function () {
+    (await this.truncatedDivideDecimalJustBelowOne.exec(this.ctx)).should.equalDecimal(0);
+    validateQuantity(await this.truncatedDivideQuantityJustBelowOne.exec(this.ctx), 0, '1');
+  });
 });
 
 describe('Truncate', () => {
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 6812f7c04..0e0512ec2 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -109,6 +109,11 @@ define TenDivThreeLong: 10L div 3L
 define TenDivThreeMixed: 10 div 3L
 define TenDivThreeReverseMixed: 10L div 3
 define QuantityTruncatedDivide: 10.5 'g' div 2.0 'g'
+define TruncatedDivideLargePositiveDecimal: 9007199254740993.0 div 1.0
+define TruncatedDivideDecimalJustBelowOne: 1.99999999 div 2.0
+define TruncatedDivideDecimalJustAboveOne: 2.00000001 div 2.0
+define TruncatedDivideLargePositiveQuantity: Quantity { value: 9007199254740993.0, unit: 'g' } div Quantity { value: 1.0, unit: 'g' }
+define TruncatedDivideQuantityJustBelowOne: Quantity { value: 1.99999999, unit: 'g' } div Quantity { value: 2.0, unit: 'g' }
 
 // @Test: Modulo
 define Mod: 3 mod 2
diff --git a/test/elm/arithmetic/data.js b/test/elm/arithmetic/data.js
index b94eb9583..192282700 100644
--- a/test/elm/arithmetic/data.js
+++ b/test/elm/arithmetic/data.js
@@ -6809,6 +6809,11 @@ define TenDivThreeLong: 10L div 3L
 define TenDivThreeMixed: 10 div 3L
 define TenDivThreeReverseMixed: 10L div 3
 define QuantityTruncatedDivide: 10.5 'g' div 2.0 'g'
+define TruncatedDivideLargePositiveDecimal: 9007199254740993.0 div 1.0
+define TruncatedDivideDecimalJustBelowOne: 1.99999999 div 2.0
+define TruncatedDivideDecimalJustAboveOne: 2.00000001 div 2.0
+define TruncatedDivideLargePositiveQuantity: Quantity { value: 9007199254740993.0, unit: 'g' } div Quantity { value: 1.0, unit: 'g' }
+define TruncatedDivideQuantityJustBelowOne: Quantity { value: 1.99999999, unit: 'g' } div Quantity { value: 2.0, unit: 'g' }
 */
 
 module.exports['TruncatedDivide'] = {
@@ -6823,7 +6828,7 @@ module.exports['TruncatedDivide'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "260",
+        "r" : "308",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -7250,524 +7255,1253 @@ module.exports['TruncatedDivide'] = {
             "annotation" : [ ]
           } ]
         }
-      } ]
-    }
-  }
-}
-
-/* Modulo
-library TestSnippet version '1'
-using Simple version '1.0.0'
-context Patient
-define Mod: 3 mod 2
-define ThreeModZero: 3 mod 0
-define ThreeModTwoLong: 3L mod 2L
-define ThreeModTwoMixed: 3 mod 2L
-define ThreeModTwoReverseMixed: 3L mod 2
-define ThreeModZeroLong: 3L mod 0L
-define ThreeModZeroDecimal: 3.0 mod 0.0
-*/
-
-module.exports['Modulo'] = {
-  "library" : {
-    "localId" : "0",
-    "annotation" : [ {
-      "type" : "CqlToElmInfo",
-      "translatorVersion" : "4.2.0",
-      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
-      "signatureLevel" : "All"
-    }, {
-      "type" : "Annotation",
-      "t" : [ ],
-      "s" : {
-        "r" : "268",
-        "s" : [ {
-          "value" : [ "", "library TestSnippet version '1'" ]
-        } ]
-      }
-    } ],
-    "identifier" : {
-      "id" : "TestSnippet",
-      "version" : "1"
-    },
-    "schemaIdentifier" : {
-      "id" : "urn:hl7-org:elm",
-      "version" : "r1"
-    },
-    "usings" : {
-      "def" : [ {
-        "localId" : "1",
-        "localIdentifier" : "System",
-        "uri" : "urn:hl7-org:elm-types:r1",
-        "annotation" : [ ]
-      }, {
-        "localId" : "206",
-        "localIdentifier" : "Simple",
-        "uri" : "https://github.com/cqframework/cql-execution/simple",
-        "version" : "1.0.0",
-        "annotation" : [ {
-          "type" : "Annotation",
-          "t" : [ ],
-          "s" : {
-            "r" : "206",
-            "s" : [ {
-              "value" : [ "", "using " ]
-            }, {
-              "s" : [ {
-                "value" : [ "Simple" ]
-              } ]
-            }, {
-              "value" : [ " version '1.0.0'" ]
-            } ]
-          }
-        } ]
-      } ]
-    },
-    "contexts" : {
-      "def" : [ {
-        "localId" : "211",
-        "name" : "Patient",
-        "annotation" : [ ]
-      } ]
-    },
-    "statements" : {
-      "def" : [ {
-        "localId" : "209",
-        "name" : "Patient",
-        "context" : "Patient",
-        "annotation" : [ ],
-        "expression" : {
-          "type" : "SingletonFrom",
-          "localId" : "210",
-          "annotation" : [ ],
-          "signature" : [ ],
-          "operand" : {
-            "type" : "Retrieve",
-            "localId" : "208",
-            "dataType" : "{https://github.com/cqframework/cql-execution/simple}Patient",
-            "annotation" : [ ],
-            "include" : [ ],
-            "codeFilter" : [ ],
-            "dateFilter" : [ ],
-            "otherFilter" : [ ]
-          }
-        }
       }, {
-        "localId" : "214",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Mod",
+        "localId" : "268",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "TruncatedDivideLargePositiveDecimal",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "214",
+            "r" : "268",
             "s" : [ {
-              "value" : [ "", "define ", "Mod", ": " ]
+              "value" : [ "", "define ", "TruncatedDivideLargePositiveDecimal", ": " ]
             }, {
-              "r" : "215",
+              "r" : "269",
               "s" : [ {
-                "r" : "216",
-                "value" : [ "3", " mod ", "2" ]
+                "r" : "270",
+                "value" : [ "9007199254740993.0", " div ", "1.0" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "215",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "TruncatedDivide",
+          "localId" : "269",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "218",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "localId" : "272",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           }, {
             "type" : "NamedTypeSpecifier",
-            "localId" : "219",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "localId" : "273",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : [ {
             "type" : "Literal",
-            "localId" : "216",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "3",
+            "localId" : "270",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "9007199254740993.0",
             "annotation" : [ ]
           }, {
             "type" : "Literal",
-            "localId" : "217",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "2",
+            "localId" : "271",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "1.0",
             "annotation" : [ ]
           } ]
         }
       }, {
-        "localId" : "222",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "ThreeModZero",
+        "localId" : "276",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "TruncatedDivideDecimalJustBelowOne",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "222",
+            "r" : "276",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModZero", ": " ]
+              "value" : [ "", "define ", "TruncatedDivideDecimalJustBelowOne", ": " ]
             }, {
-              "r" : "223",
+              "r" : "277",
               "s" : [ {
-                "r" : "224",
-                "value" : [ "3", " mod ", "0" ]
+                "r" : "278",
+                "value" : [ "1.99999999", " div ", "2.0" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "223",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "TruncatedDivide",
+          "localId" : "277",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "226",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "localId" : "280",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           }, {
             "type" : "NamedTypeSpecifier",
-            "localId" : "227",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "localId" : "281",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : [ {
             "type" : "Literal",
-            "localId" : "224",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "3",
+            "localId" : "278",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "1.99999999",
             "annotation" : [ ]
           }, {
             "type" : "Literal",
-            "localId" : "225",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "0",
+            "localId" : "279",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2.0",
             "annotation" : [ ]
           } ]
         }
       }, {
-        "localId" : "230",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "ThreeModTwoLong",
+        "localId" : "284",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "TruncatedDivideDecimalJustAboveOne",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "230",
+            "r" : "284",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModTwoLong", ": " ]
+              "value" : [ "", "define ", "TruncatedDivideDecimalJustAboveOne", ": " ]
             }, {
-              "r" : "231",
+              "r" : "285",
               "s" : [ {
-                "r" : "232",
-                "value" : [ "3L", " mod ", "2L" ]
+                "r" : "286",
+                "value" : [ "2.00000001", " div ", "2.0" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "231",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "type" : "TruncatedDivide",
+          "localId" : "285",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "234",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "288",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           }, {
             "type" : "NamedTypeSpecifier",
-            "localId" : "235",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "289",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : [ {
             "type" : "Literal",
-            "localId" : "232",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "3",
+            "localId" : "286",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2.00000001",
             "annotation" : [ ]
           }, {
             "type" : "Literal",
-            "localId" : "233",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "2",
+            "localId" : "287",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2.0",
             "annotation" : [ ]
           } ]
         }
       }, {
-        "localId" : "238",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "ThreeModTwoMixed",
+        "localId" : "292",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "TruncatedDivideLargePositiveQuantity",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "238",
+            "r" : "292",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModTwoMixed", ": " ]
+              "value" : [ "", "define ", "TruncatedDivideLargePositiveQuantity", ": " ]
             }, {
-              "r" : "239",
+              "r" : "293",
               "s" : [ {
-                "r" : "240",
-                "value" : [ "3", " mod ", "2L" ]
-              } ]
-            } ]
-          }
-        } ],
-        "expression" : {
-          "type" : "Modulo",
-          "localId" : "239",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-          "annotation" : [ ],
-          "signature" : [ {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "245",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
-            "annotation" : [ ]
-          }, {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "246",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
-            "annotation" : [ ]
-          } ],
-          "operand" : [ {
+                "r" : "294",
+                "s" : [ {
+                  "value" : [ "Quantity", " { " ]
+                }, {
+                  "s" : [ {
+                    "r" : "296",
+                    "value" : [ "value", ": ", "9007199254740993.0" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "s" : [ {
+                    "value" : [ "unit", ": " ]
+                  }, {
+                    "r" : "297",
+                    "s" : [ {
+                      "value" : [ "'g'" ]
+                    } ]
+                  } ]
+                }, {
+                  "value" : [ " }" ]
+                } ]
+              }, {
+                "value" : [ " div " ]
+              }, {
+                "r" : "299",
+                "s" : [ {
+                  "value" : [ "Quantity", " { " ]
+                }, {
+                  "s" : [ {
+                    "r" : "301",
+                    "value" : [ "value", ": ", "1.0" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "s" : [ {
+                    "value" : [ "unit", ": " ]
+                  }, {
+                    "r" : "302",
+                    "s" : [ {
+                      "value" : [ "'g'" ]
+                    } ]
+                  } ]
+                }, {
+                  "value" : [ " }" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "TruncatedDivide",
+          "localId" : "293",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "304",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "305",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Instance",
+            "localId" : "294",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ],
+            "element" : [ {
+              "name" : "value",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "296",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "value" : "9007199254740993.0",
+                "annotation" : [ ]
+              }
+            }, {
+              "name" : "unit",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "297",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                "value" : "g",
+                "annotation" : [ ]
+              }
+            } ]
+          }, {
+            "type" : "Instance",
+            "localId" : "299",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ],
+            "element" : [ {
+              "name" : "value",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "301",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "value" : "1.0",
+                "annotation" : [ ]
+              }
+            }, {
+              "name" : "unit",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "302",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                "value" : "g",
+                "annotation" : [ ]
+              }
+            } ]
+          } ]
+        }
+      }, {
+        "localId" : "308",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "TruncatedDivideQuantityJustBelowOne",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "308",
+            "s" : [ {
+              "value" : [ "", "define ", "TruncatedDivideQuantityJustBelowOne", ": " ]
+            }, {
+              "r" : "309",
+              "s" : [ {
+                "r" : "310",
+                "s" : [ {
+                  "value" : [ "Quantity", " { " ]
+                }, {
+                  "s" : [ {
+                    "r" : "312",
+                    "value" : [ "value", ": ", "1.99999999" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "s" : [ {
+                    "value" : [ "unit", ": " ]
+                  }, {
+                    "r" : "313",
+                    "s" : [ {
+                      "value" : [ "'g'" ]
+                    } ]
+                  } ]
+                }, {
+                  "value" : [ " }" ]
+                } ]
+              }, {
+                "value" : [ " div " ]
+              }, {
+                "r" : "315",
+                "s" : [ {
+                  "value" : [ "Quantity", " { " ]
+                }, {
+                  "s" : [ {
+                    "r" : "317",
+                    "value" : [ "value", ": ", "2.0" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "s" : [ {
+                    "value" : [ "unit", ": " ]
+                  }, {
+                    "r" : "318",
+                    "s" : [ {
+                      "value" : [ "'g'" ]
+                    } ]
+                  } ]
+                }, {
+                  "value" : [ " }" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "TruncatedDivide",
+          "localId" : "309",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "320",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "321",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Instance",
+            "localId" : "310",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ],
+            "element" : [ {
+              "name" : "value",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "312",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "value" : "1.99999999",
+                "annotation" : [ ]
+              }
+            }, {
+              "name" : "unit",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "313",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                "value" : "g",
+                "annotation" : [ ]
+              }
+            } ]
+          }, {
+            "type" : "Instance",
+            "localId" : "315",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ],
+            "element" : [ {
+              "name" : "value",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "317",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "value" : "2.0",
+                "annotation" : [ ]
+              }
+            }, {
+              "name" : "unit",
+              "value" : {
+                "type" : "Literal",
+                "localId" : "318",
+                "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                "value" : "g",
+                "annotation" : [ ]
+              }
+            } ]
+          } ]
+        }
+      } ]
+    }
+  }
+}
+
+/* Modulo
+library TestSnippet version '1'
+using Simple version '1.0.0'
+context Patient
+define Mod: 3 mod 2
+define ThreeModZero: 3 mod 0
+define ThreeModTwoLong: 3L mod 2L
+define ThreeModTwoMixed: 3 mod 2L
+define ThreeModTwoReverseMixed: 3L mod 2
+define ThreeModZeroLong: 3L mod 0L
+define ThreeModZeroDecimal: 3.0 mod 0.0
+*/
+
+module.exports['Modulo'] = {
+  "library" : {
+    "localId" : "0",
+    "annotation" : [ {
+      "type" : "CqlToElmInfo",
+      "translatorVersion" : "4.2.0",
+      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
+      "signatureLevel" : "All"
+    }, {
+      "type" : "Annotation",
+      "t" : [ ],
+      "s" : {
+        "r" : "268",
+        "s" : [ {
+          "value" : [ "", "library TestSnippet version '1'" ]
+        } ]
+      }
+    } ],
+    "identifier" : {
+      "id" : "TestSnippet",
+      "version" : "1"
+    },
+    "schemaIdentifier" : {
+      "id" : "urn:hl7-org:elm",
+      "version" : "r1"
+    },
+    "usings" : {
+      "def" : [ {
+        "localId" : "1",
+        "localIdentifier" : "System",
+        "uri" : "urn:hl7-org:elm-types:r1",
+        "annotation" : [ ]
+      }, {
+        "localId" : "206",
+        "localIdentifier" : "Simple",
+        "uri" : "https://github.com/cqframework/cql-execution/simple",
+        "version" : "1.0.0",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "206",
+            "s" : [ {
+              "value" : [ "", "using " ]
+            }, {
+              "s" : [ {
+                "value" : [ "Simple" ]
+              } ]
+            }, {
+              "value" : [ " version '1.0.0'" ]
+            } ]
+          }
+        } ]
+      } ]
+    },
+    "contexts" : {
+      "def" : [ {
+        "localId" : "211",
+        "name" : "Patient",
+        "annotation" : [ ]
+      } ]
+    },
+    "statements" : {
+      "def" : [ {
+        "localId" : "209",
+        "name" : "Patient",
+        "context" : "Patient",
+        "annotation" : [ ],
+        "expression" : {
+          "type" : "SingletonFrom",
+          "localId" : "210",
+          "annotation" : [ ],
+          "signature" : [ ],
+          "operand" : {
+            "type" : "Retrieve",
+            "localId" : "208",
+            "dataType" : "{https://github.com/cqframework/cql-execution/simple}Patient",
+            "annotation" : [ ],
+            "include" : [ ],
+            "codeFilter" : [ ],
+            "dateFilter" : [ ],
+            "otherFilter" : [ ]
+          }
+        }
+      }, {
+        "localId" : "214",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "Mod",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "214",
+            "s" : [ {
+              "value" : [ "", "define ", "Mod", ": " ]
+            }, {
+              "r" : "215",
+              "s" : [ {
+                "r" : "216",
+                "value" : [ "3", " mod ", "2" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "215",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "218",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "219",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "216",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "3",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "217",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "2",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "222",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "ThreeModZero",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "222",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModZero", ": " ]
+            }, {
+              "r" : "223",
+              "s" : [ {
+                "r" : "224",
+                "value" : [ "3", " mod ", "0" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "223",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "226",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "227",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "224",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "3",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "225",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "0",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "230",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "ThreeModTwoLong",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "230",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModTwoLong", ": " ]
+            }, {
+              "r" : "231",
+              "s" : [ {
+                "r" : "232",
+                "value" : [ "3L", " mod ", "2L" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "231",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "234",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "235",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "232",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "3",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "233",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "2",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "238",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "ThreeModTwoMixed",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "238",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModTwoMixed", ": " ]
+            }, {
+              "r" : "239",
+              "s" : [ {
+                "r" : "240",
+                "value" : [ "3", " mod ", "2L" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "239",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "245",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "246",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "ToLong",
+            "localId" : "243",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "244",
+              "name" : "{urn:hl7-org:elm-types:r1}Integer",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "240",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+              "value" : "3",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "Literal",
+            "localId" : "241",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "2",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "249",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "ThreeModTwoReverseMixed",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "249",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModTwoReverseMixed", ": " ]
+            }, {
+              "r" : "250",
+              "s" : [ {
+                "r" : "251",
+                "value" : [ "3L", " mod ", "2" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "250",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "256",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "257",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "251",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "3",
+            "annotation" : [ ]
+          }, {
             "type" : "ToLong",
-            "localId" : "243",
+            "localId" : "254",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "255",
+              "name" : "{urn:hl7-org:elm-types:r1}Integer",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "252",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+              "value" : "2",
+              "annotation" : [ ]
+            }
+          } ]
+        }
+      }, {
+        "localId" : "260",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "ThreeModZeroLong",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "260",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModZeroLong", ": " ]
+            }, {
+              "r" : "261",
+              "s" : [ {
+                "r" : "262",
+                "value" : [ "3L", " mod ", "0L" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "261",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "264",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "265",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "262",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "3",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "263",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "value" : "0",
+            "annotation" : [ ]
+          } ]
+        }
+      }, {
+        "localId" : "268",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "ThreeModZeroDecimal",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "268",
+            "s" : [ {
+              "value" : [ "", "define ", "ThreeModZeroDecimal", ": " ]
+            }, {
+              "r" : "269",
+              "s" : [ {
+                "r" : "270",
+                "value" : [ "3.0", " mod ", "0.0" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Modulo",
+          "localId" : "269",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "272",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "273",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Literal",
+            "localId" : "270",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "3.0",
+            "annotation" : [ ]
+          }, {
+            "type" : "Literal",
+            "localId" : "271",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "0.0",
+            "annotation" : [ ]
+          } ]
+        }
+      } ]
+    }
+  }
+}
+
+/* Ceiling
+library TestSnippet version '1'
+using Simple version '1.0.0'
+context Patient
+define Ceil: Ceiling(10.1)
+define Even: Ceiling(10)
+define CeilTenLong: Ceiling(10L)
+define CeilingOverflow: Ceiling(2147483647.1)
+*/
+
+module.exports['Ceiling'] = {
+  "library" : {
+    "localId" : "0",
+    "annotation" : [ {
+      "type" : "CqlToElmInfo",
+      "translatorVersion" : "4.2.0",
+      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
+      "signatureLevel" : "All"
+    }, {
+      "type" : "Annotation",
+      "t" : [ ],
+      "s" : {
+        "r" : "253",
+        "s" : [ {
+          "value" : [ "", "library TestSnippet version '1'" ]
+        } ]
+      }
+    } ],
+    "identifier" : {
+      "id" : "TestSnippet",
+      "version" : "1"
+    },
+    "schemaIdentifier" : {
+      "id" : "urn:hl7-org:elm",
+      "version" : "r1"
+    },
+    "usings" : {
+      "def" : [ {
+        "localId" : "1",
+        "localIdentifier" : "System",
+        "uri" : "urn:hl7-org:elm-types:r1",
+        "annotation" : [ ]
+      }, {
+        "localId" : "206",
+        "localIdentifier" : "Simple",
+        "uri" : "https://github.com/cqframework/cql-execution/simple",
+        "version" : "1.0.0",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "206",
+            "s" : [ {
+              "value" : [ "", "using " ]
+            }, {
+              "s" : [ {
+                "value" : [ "Simple" ]
+              } ]
+            }, {
+              "value" : [ " version '1.0.0'" ]
+            } ]
+          }
+        } ]
+      } ]
+    },
+    "contexts" : {
+      "def" : [ {
+        "localId" : "211",
+        "name" : "Patient",
+        "annotation" : [ ]
+      } ]
+    },
+    "statements" : {
+      "def" : [ {
+        "localId" : "209",
+        "name" : "Patient",
+        "context" : "Patient",
+        "annotation" : [ ],
+        "expression" : {
+          "type" : "SingletonFrom",
+          "localId" : "210",
+          "annotation" : [ ],
+          "signature" : [ ],
+          "operand" : {
+            "type" : "Retrieve",
+            "localId" : "208",
+            "dataType" : "{https://github.com/cqframework/cql-execution/simple}Patient",
             "annotation" : [ ],
-            "signature" : [ {
-              "type" : "NamedTypeSpecifier",
-              "localId" : "244",
-              "name" : "{urn:hl7-org:elm-types:r1}Integer",
-              "annotation" : [ ]
-            } ],
-            "operand" : {
-              "type" : "Literal",
-              "localId" : "240",
-              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-              "value" : "3",
-              "annotation" : [ ]
-            }
-          }, {
-            "type" : "Literal",
-            "localId" : "241",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "2",
-            "annotation" : [ ]
-          } ]
+            "include" : [ ],
+            "codeFilter" : [ ],
+            "dateFilter" : [ ],
+            "otherFilter" : [ ]
+          }
         }
       }, {
-        "localId" : "249",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "ThreeModTwoReverseMixed",
+        "localId" : "214",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "Ceil",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "249",
+            "r" : "214",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModTwoReverseMixed", ": " ]
+              "value" : [ "", "define ", "Ceil", ": " ]
             }, {
-              "r" : "250",
+              "r" : "219",
               "s" : [ {
-                "r" : "251",
-                "value" : [ "3L", " mod ", "2" ]
+                "r" : "215",
+                "value" : [ "Ceiling", "(", "10.1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "250",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "type" : "Ceiling",
+          "localId" : "219",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "256",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
-            "annotation" : [ ]
-          }, {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "257",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "220",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
-          "operand" : [ {
+          "operand" : {
             "type" : "Literal",
-            "localId" : "251",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "3",
+            "localId" : "215",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "10.1",
             "annotation" : [ ]
-          }, {
-            "type" : "ToLong",
-            "localId" : "254",
+          }
+        }
+      }, {
+        "localId" : "223",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "Even",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "223",
+            "s" : [ {
+              "value" : [ "", "define ", "Even", ": " ]
+            }, {
+              "r" : "231",
+              "s" : [ {
+                "r" : "224",
+                "value" : [ "Ceiling", "(", "10", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Ceiling",
+          "localId" : "231",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "235",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "ToDecimal",
+            "localId" : "233",
             "annotation" : [ ],
             "signature" : [ {
               "type" : "NamedTypeSpecifier",
-              "localId" : "255",
+              "localId" : "234",
               "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             } ],
             "operand" : {
               "type" : "Literal",
-              "localId" : "252",
+              "localId" : "224",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
               "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-              "value" : "2",
+              "value" : "10",
               "annotation" : [ ]
             }
-          } ]
+          }
         }
       }, {
-        "localId" : "260",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "ThreeModZeroLong",
+        "localId" : "238",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "CeilTenLong",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "260",
+            "r" : "238",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModZeroLong", ": " ]
+              "value" : [ "", "define ", "CeilTenLong", ": " ]
             }, {
-              "r" : "261",
+              "r" : "246",
               "s" : [ {
-                "r" : "262",
-                "value" : [ "3L", " mod ", "0L" ]
+                "r" : "239",
+                "value" : [ "Ceiling", "(", "10L", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "261",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "type" : "Ceiling",
+          "localId" : "246",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "264",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
-            "annotation" : [ ]
-          }, {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "265",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "250",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
-          "operand" : [ {
-            "type" : "Literal",
-            "localId" : "262",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "3",
-            "annotation" : [ ]
-          }, {
-            "type" : "Literal",
-            "localId" : "263",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-            "value" : "0",
-            "annotation" : [ ]
-          } ]
+          "operand" : {
+            "type" : "ToDecimal",
+            "localId" : "248",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "249",
+              "name" : "{urn:hl7-org:elm-types:r1}Long",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "239",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+              "value" : "10",
+              "annotation" : [ ]
+            }
+          }
         }
       }, {
-        "localId" : "268",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "ThreeModZeroDecimal",
+        "localId" : "253",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "CeilingOverflow",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "268",
+            "r" : "253",
             "s" : [ {
-              "value" : [ "", "define ", "ThreeModZeroDecimal", ": " ]
+              "value" : [ "", "define ", "CeilingOverflow", ": " ]
             }, {
-              "r" : "269",
+              "r" : "258",
               "s" : [ {
-                "r" : "270",
-                "value" : [ "3.0", " mod ", "0.0" ]
+                "r" : "254",
+                "value" : [ "Ceiling", "(", "2147483647.1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Modulo",
-          "localId" : "269",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "type" : "Ceiling",
+          "localId" : "258",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "272",
-            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "annotation" : [ ]
-          }, {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "273",
+            "localId" : "259",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
-          "operand" : [ {
-            "type" : "Literal",
-            "localId" : "270",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "3.0",
-            "annotation" : [ ]
-          }, {
+          "operand" : {
             "type" : "Literal",
-            "localId" : "271",
+            "localId" : "254",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "0.0",
+            "value" : "2147483647.1",
             "annotation" : [ ]
-          } ]
+          }
         }
       } ]
     }
   }
 }
 
-/* Ceiling
+/* Floor
 library TestSnippet version '1'
 using Simple version '1.0.0'
 context Patient
-define Ceil: Ceiling(10.1)
-define Even: Ceiling(10)
-define CeilTenLong: Ceiling(10L)
-define CeilingOverflow: Ceiling(2147483647.1)
+define flr: Floor(10.1)
+define Even: Floor(10)
+define FloorTenLong: Floor(10L)
+define FloorUnderflow: Floor(-2147483648.1)
 */
 
-module.exports['Ceiling'] = {
+module.exports['Floor'] = {
   "library" : {
     "localId" : "0",
     "annotation" : [ {
@@ -7854,7 +8588,7 @@ module.exports['Ceiling'] = {
       }, {
         "localId" : "214",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Ceil",
+        "name" : "flr",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -7863,18 +8597,18 @@ module.exports['Ceiling'] = {
           "s" : {
             "r" : "214",
             "s" : [ {
-              "value" : [ "", "define ", "Ceil", ": " ]
+              "value" : [ "", "define ", "flr", ": " ]
             }, {
               "r" : "219",
               "s" : [ {
                 "r" : "215",
-                "value" : [ "Ceiling", "(", "10.1", ")" ]
+                "value" : [ "Floor", "(", "10.1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Ceiling",
+          "type" : "Floor",
           "localId" : "219",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -7910,13 +8644,13 @@ module.exports['Ceiling'] = {
               "r" : "231",
               "s" : [ {
                 "r" : "224",
-                "value" : [ "Ceiling", "(", "10", ")" ]
+                "value" : [ "Floor", "(", "10", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Ceiling",
+          "type" : "Floor",
           "localId" : "231",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -7949,7 +8683,7 @@ module.exports['Ceiling'] = {
       }, {
         "localId" : "238",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "CeilTenLong",
+        "name" : "FloorTenLong",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -7958,18 +8692,18 @@ module.exports['Ceiling'] = {
           "s" : {
             "r" : "238",
             "s" : [ {
-              "value" : [ "", "define ", "CeilTenLong", ": " ]
+              "value" : [ "", "define ", "FloorTenLong", ": " ]
             }, {
               "r" : "246",
               "s" : [ {
                 "r" : "239",
-                "value" : [ "Ceiling", "(", "10L", ")" ]
+                "value" : [ "Floor", "(", "10L", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Ceiling",
+          "type" : "Floor",
           "localId" : "246",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -8002,7 +8736,7 @@ module.exports['Ceiling'] = {
       }, {
         "localId" : "253",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "CeilingOverflow",
+        "name" : "FloorUnderflow",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8011,34 +8745,53 @@ module.exports['Ceiling'] = {
           "s" : {
             "r" : "253",
             "s" : [ {
-              "value" : [ "", "define ", "CeilingOverflow", ": " ]
+              "value" : [ "", "define ", "FloorUnderflow", ": " ]
             }, {
-              "r" : "258",
+              "r" : "260",
               "s" : [ {
+                "value" : [ "Floor", "(" ]
+              }, {
                 "r" : "254",
-                "value" : [ "Ceiling", "(", "2147483647.1", ")" ]
+                "s" : [ {
+                  "r" : "255",
+                  "value" : [ "-", "2147483648.1" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Ceiling",
-          "localId" : "258",
+          "type" : "Floor",
+          "localId" : "260",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "259",
+            "localId" : "261",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "Literal",
+            "type" : "Negate",
             "localId" : "254",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "2147483647.1",
-            "annotation" : [ ]
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "256",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "255",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2147483648.1",
+              "annotation" : [ ]
+            }
           }
         }
       } ]
@@ -8046,17 +8799,17 @@ module.exports['Ceiling'] = {
   }
 }
 
-/* Floor
+/* Truncate
 library TestSnippet version '1'
 using Simple version '1.0.0'
 context Patient
-define flr: Floor(10.1)
-define Even: Floor(10)
-define FloorTenLong: Floor(10L)
-define FloorUnderflow: Floor(-2147483648.1)
+define Trunc: Truncate(10.1)
+define Even: Truncate(10)
+define TruncTenLong: Truncate(10L)
+define TruncateOverflow: Truncate(2147483648.0)
 */
 
-module.exports['Floor'] = {
+module.exports['Truncate'] = {
   "library" : {
     "localId" : "0",
     "annotation" : [ {
@@ -8143,7 +8896,7 @@ module.exports['Floor'] = {
       }, {
         "localId" : "214",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "flr",
+        "name" : "Trunc",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8152,18 +8905,18 @@ module.exports['Floor'] = {
           "s" : {
             "r" : "214",
             "s" : [ {
-              "value" : [ "", "define ", "flr", ": " ]
+              "value" : [ "", "define ", "Trunc", ": " ]
             }, {
               "r" : "219",
               "s" : [ {
                 "r" : "215",
-                "value" : [ "Floor", "(", "10.1", ")" ]
+                "value" : [ "Truncate", "(", "10.1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Floor",
+          "type" : "Truncate",
           "localId" : "219",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -8199,13 +8952,13 @@ module.exports['Floor'] = {
               "r" : "231",
               "s" : [ {
                 "r" : "224",
-                "value" : [ "Floor", "(", "10", ")" ]
+                "value" : [ "Truncate", "(", "10", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Floor",
+          "type" : "Truncate",
           "localId" : "231",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -8238,7 +8991,7 @@ module.exports['Floor'] = {
       }, {
         "localId" : "238",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "FloorTenLong",
+        "name" : "TruncTenLong",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8247,18 +9000,18 @@ module.exports['Floor'] = {
           "s" : {
             "r" : "238",
             "s" : [ {
-              "value" : [ "", "define ", "FloorTenLong", ": " ]
+              "value" : [ "", "define ", "TruncTenLong", ": " ]
             }, {
               "r" : "246",
               "s" : [ {
                 "r" : "239",
-                "value" : [ "Floor", "(", "10L", ")" ]
+                "value" : [ "Truncate", "(", "10L", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Floor",
+          "type" : "Truncate",
           "localId" : "246",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
@@ -8291,7 +9044,7 @@ module.exports['Floor'] = {
       }, {
         "localId" : "253",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "FloorUnderflow",
+        "name" : "TruncateOverflow",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8300,53 +9053,34 @@ module.exports['Floor'] = {
           "s" : {
             "r" : "253",
             "s" : [ {
-              "value" : [ "", "define ", "FloorUnderflow", ": " ]
+              "value" : [ "", "define ", "TruncateOverflow", ": " ]
             }, {
-              "r" : "260",
+              "r" : "258",
               "s" : [ {
-                "value" : [ "Floor", "(" ]
-              }, {
                 "r" : "254",
-                "s" : [ {
-                  "r" : "255",
-                  "value" : [ "-", "2147483648.1" ]
-                } ]
-              }, {
-                "value" : [ ")" ]
+                "value" : [ "Truncate", "(", "2147483648.0", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Floor",
-          "localId" : "260",
+          "type" : "Truncate",
+          "localId" : "258",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "261",
+            "localId" : "259",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "Negate",
+            "type" : "Literal",
             "localId" : "254",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "annotation" : [ ],
-            "signature" : [ {
-              "type" : "NamedTypeSpecifier",
-              "localId" : "256",
-              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "annotation" : [ ]
-            } ],
-            "operand" : {
-              "type" : "Literal",
-              "localId" : "255",
-              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "2147483648.1",
-              "annotation" : [ ]
-            }
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "2147483648.0",
+            "annotation" : [ ]
           }
         }
       } ]
@@ -8354,17 +9088,19 @@ module.exports['Floor'] = {
   }
 }
 
-/* Truncate
+/* Abs
 library TestSnippet version '1'
 using Simple version '1.0.0'
 context Patient
-define Trunc: Truncate(10.1)
-define Even: Truncate(10)
-define TruncTenLong: Truncate(10L)
-define TruncateOverflow: Truncate(2147483648.0)
+define Pos: Abs(10)
+define Neg: Abs(-10)
+define Zero: Abs(0)
+define AbsMinInteger: Abs(minimum Integer)
+define AbsNegTenLong: Abs(-10L)
+define AbsMinLong: Abs(minimum Long)
 */
 
-module.exports['Truncate'] = {
+module.exports['Abs'] = {
   "library" : {
     "localId" : "0",
     "annotation" : [ {
@@ -8376,7 +9112,7 @@ module.exports['Truncate'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "253",
+        "r" : "264",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8451,7 +9187,7 @@ module.exports['Truncate'] = {
       }, {
         "localId" : "214",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Trunc",
+        "name" : "Pos",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8460,135 +9196,245 @@ module.exports['Truncate'] = {
           "s" : {
             "r" : "214",
             "s" : [ {
-              "value" : [ "", "define ", "Trunc", ": " ]
+              "value" : [ "", "define ", "Pos", ": " ]
             }, {
               "r" : "219",
               "s" : [ {
                 "r" : "215",
-                "value" : [ "Truncate", "(", "10.1", ")" ]
+                "value" : [ "Abs", "(", "10", ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Abs",
+          "localId" : "219",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "220",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Literal",
+            "localId" : "215",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "10",
+            "annotation" : [ ]
+          }
+        }
+      }, {
+        "localId" : "223",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "Neg",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "223",
+            "s" : [ {
+              "value" : [ "", "define ", "Neg", ": " ]
+            }, {
+              "r" : "230",
+              "s" : [ {
+                "value" : [ "Abs", "(" ]
+              }, {
+                "r" : "224",
+                "s" : [ {
+                  "r" : "225",
+                  "value" : [ "-", "10" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Abs",
+          "localId" : "230",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "231",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
+          } ],
+          "operand" : {
+            "type" : "Negate",
+            "localId" : "224",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "226",
+              "name" : "{urn:hl7-org:elm-types:r1}Integer",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "225",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+              "value" : "10",
+              "annotation" : [ ]
+            }
+          }
+        }
+      }, {
+        "localId" : "234",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+        "name" : "Zero",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "234",
+            "s" : [ {
+              "value" : [ "", "define ", "Zero", ": " ]
+            }, {
+              "r" : "239",
+              "s" : [ {
+                "r" : "235",
+                "value" : [ "Abs", "(", "0", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Truncate",
-          "localId" : "219",
+          "type" : "Abs",
+          "localId" : "239",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "220",
-            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "localId" : "240",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
-            "localId" : "215",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "10.1",
+            "localId" : "235",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "0",
             "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "223",
+        "localId" : "243",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Even",
+        "name" : "AbsMinInteger",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "223",
+            "r" : "243",
             "s" : [ {
-              "value" : [ "", "define ", "Even", ": " ]
+              "value" : [ "", "define ", "AbsMinInteger", ": " ]
             }, {
-              "r" : "231",
+              "r" : "249",
               "s" : [ {
-                "r" : "224",
-                "value" : [ "Truncate", "(", "10", ")" ]
+                "value" : [ "Abs", "(" ]
+              }, {
+                "r" : "245",
+                "s" : [ {
+                  "value" : [ "minimum", " " ]
+                }, {
+                  "r" : "244",
+                  "s" : [ {
+                    "value" : [ "Integer" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Truncate",
-          "localId" : "231",
+          "type" : "Abs",
+          "localId" : "249",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "235",
-            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "localId" : "250",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "ToDecimal",
-            "localId" : "233",
-            "annotation" : [ ],
-            "signature" : [ {
-              "type" : "NamedTypeSpecifier",
-              "localId" : "234",
-              "name" : "{urn:hl7-org:elm-types:r1}Integer",
-              "annotation" : [ ]
-            } ],
-            "operand" : {
-              "type" : "Literal",
-              "localId" : "224",
-              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-              "value" : "10",
-              "annotation" : [ ]
-            }
+            "type" : "MinValue",
+            "localId" : "245",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "238",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "TruncTenLong",
+        "localId" : "253",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "AbsNegTenLong",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "238",
+            "r" : "253",
             "s" : [ {
-              "value" : [ "", "define ", "TruncTenLong", ": " ]
+              "value" : [ "", "define ", "AbsNegTenLong", ": " ]
             }, {
-              "r" : "246",
+              "r" : "260",
               "s" : [ {
-                "r" : "239",
-                "value" : [ "Truncate", "(", "10L", ")" ]
+                "value" : [ "Abs", "(" ]
+              }, {
+                "r" : "254",
+                "s" : [ {
+                  "r" : "255",
+                  "value" : [ "-", "10L" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Truncate",
-          "localId" : "246",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "Abs",
+          "localId" : "260",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "250",
-            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "localId" : "261",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "ToDecimal",
-            "localId" : "248",
+            "type" : "Negate",
+            "localId" : "254",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
             "annotation" : [ ],
             "signature" : [ {
               "type" : "NamedTypeSpecifier",
-              "localId" : "249",
+              "localId" : "256",
               "name" : "{urn:hl7-org:elm-types:r1}Long",
               "annotation" : [ ]
             } ],
             "operand" : {
               "type" : "Literal",
-              "localId" : "239",
+              "localId" : "255",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
               "valueType" : "{urn:hl7-org:elm-types:r1}Long",
               "value" : "10",
@@ -8597,44 +9443,54 @@ module.exports['Truncate'] = {
           }
         }
       }, {
-        "localId" : "253",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "TruncateOverflow",
+        "localId" : "264",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+        "name" : "AbsMinLong",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "253",
+            "r" : "264",
             "s" : [ {
-              "value" : [ "", "define ", "TruncateOverflow", ": " ]
+              "value" : [ "", "define ", "AbsMinLong", ": " ]
             }, {
-              "r" : "258",
+              "r" : "270",
               "s" : [ {
-                "r" : "254",
-                "value" : [ "Truncate", "(", "2147483648.0", ")" ]
+                "value" : [ "Abs", "(" ]
+              }, {
+                "r" : "266",
+                "s" : [ {
+                  "value" : [ "minimum", " " ]
+                }, {
+                  "r" : "265",
+                  "s" : [ {
+                    "value" : [ "Long" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Truncate",
-          "localId" : "258",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "Abs",
+          "localId" : "270",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "259",
-            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "localId" : "271",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "Literal",
-            "localId" : "254",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "2147483648.0",
+            "type" : "MinValue",
+            "localId" : "266",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
             "annotation" : [ ]
           }
         }
@@ -8643,19 +9499,25 @@ module.exports['Truncate'] = {
   }
 }
 
-/* Abs
+/* Round
 library TestSnippet version '1'
 using Simple version '1.0.0'
 context Patient
-define Pos: Abs(10)
-define Neg: Abs(-10)
-define Zero: Abs(0)
-define AbsMinInteger: Abs(minimum Integer)
-define AbsNegTenLong: Abs(-10L)
-define AbsMinLong: Abs(minimum Long)
+define Up: Round(4.56)
+define Up_percent: Round(4.56,1)
+define Down: Round(4.49)
+define Down_percent: Round(4.43,1)
+define NegativeHalf: Round(-0.5)
+define NegativeOnePointFive: Round(-1.5)
+define RoundPositiveHalfOmittedPrecision: Round(1.5)
+define RoundPositiveHalfNullPrecision: Round(1.5, null as Integer)
+define RoundPositiveHalfZeroPrecision: Round(1.5, 0)
+define RoundNegativeHalfOmittedPrecision: Round(-1.5)
+define RoundNegativeHalfNullPrecision: Round(-1.5, null as Integer)
+define RoundNegativeHalfZeroPrecision: Round(-1.5, 0)
 */
 
-module.exports['Abs'] = {
+module.exports['Round'] = {
   "library" : {
     "localId" : "0",
     "annotation" : [ {
@@ -8667,7 +9529,7 @@ module.exports['Abs'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "264",
+        "r" : "340",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8741,8 +9603,8 @@ module.exports['Abs'] = {
         }
       }, {
         "localId" : "214",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Pos",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "Up",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8751,40 +9613,40 @@ module.exports['Abs'] = {
           "s" : {
             "r" : "214",
             "s" : [ {
-              "value" : [ "", "define ", "Pos", ": " ]
+              "value" : [ "", "define ", "Up", ": " ]
             }, {
               "r" : "219",
               "s" : [ {
                 "r" : "215",
-                "value" : [ "Abs", "(", "10", ")" ]
+                "value" : [ "Round", "(", "4.56", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Abs",
+          "type" : "Round",
           "localId" : "219",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
             "localId" : "220",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
             "localId" : "215",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "10",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "4.56",
             "annotation" : [ ]
           }
         }
       }, {
         "localId" : "223",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Neg",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "Up_percent",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
@@ -8793,171 +9655,168 @@ module.exports['Abs'] = {
           "s" : {
             "r" : "223",
             "s" : [ {
-              "value" : [ "", "define ", "Neg", ": " ]
+              "value" : [ "", "define ", "Up_percent", ": " ]
             }, {
               "r" : "230",
               "s" : [ {
-                "value" : [ "Abs", "(" ]
-              }, {
                 "r" : "224",
-                "s" : [ {
-                  "r" : "225",
-                  "value" : [ "-", "10" ]
-                } ]
-              }, {
-                "value" : [ ")" ]
+                "value" : [ "Round", "(", "4.56", ",", "1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Abs",
+          "type" : "Round",
           "localId" : "230",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
             "localId" : "231",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "232",
             "name" : "{urn:hl7-org:elm-types:r1}Integer",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "Negate",
+            "type" : "Literal",
             "localId" : "224",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "4.56",
+            "annotation" : [ ]
+          },
+          "precision" : {
+            "type" : "Literal",
+            "localId" : "225",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "annotation" : [ ],
-            "signature" : [ {
-              "type" : "NamedTypeSpecifier",
-              "localId" : "226",
-              "name" : "{urn:hl7-org:elm-types:r1}Integer",
-              "annotation" : [ ]
-            } ],
-            "operand" : {
-              "type" : "Literal",
-              "localId" : "225",
-              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-              "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-              "value" : "10",
-              "annotation" : [ ]
-            }
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "1",
+            "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "234",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "Zero",
+        "localId" : "235",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "Down",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "234",
+            "r" : "235",
             "s" : [ {
-              "value" : [ "", "define ", "Zero", ": " ]
+              "value" : [ "", "define ", "Down", ": " ]
             }, {
-              "r" : "239",
+              "r" : "240",
               "s" : [ {
-                "r" : "235",
-                "value" : [ "Abs", "(", "0", ")" ]
+                "r" : "236",
+                "value" : [ "Round", "(", "4.49", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Abs",
-          "localId" : "239",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "Round",
+          "localId" : "240",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "240",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "localId" : "241",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
-            "localId" : "235",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "0",
+            "localId" : "236",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "4.49",
             "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "243",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-        "name" : "AbsMinInteger",
+        "localId" : "244",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "Down_percent",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "243",
+            "r" : "244",
             "s" : [ {
-              "value" : [ "", "define ", "AbsMinInteger", ": " ]
+              "value" : [ "", "define ", "Down_percent", ": " ]
             }, {
-              "r" : "249",
+              "r" : "251",
               "s" : [ {
-                "value" : [ "Abs", "(" ]
-              }, {
                 "r" : "245",
-                "s" : [ {
-                  "value" : [ "minimum", " " ]
-                }, {
-                  "r" : "244",
-                  "s" : [ {
-                    "value" : [ "Integer" ]
-                  } ]
-                } ]
-              }, {
-                "value" : [ ")" ]
+                "value" : [ "Round", "(", "4.43", ",", "1", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
-          "type" : "Abs",
-          "localId" : "249",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+          "type" : "Round",
+          "localId" : "251",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "250",
+            "localId" : "252",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "253",
             "name" : "{urn:hl7-org:elm-types:r1}Integer",
             "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "MinValue",
+            "type" : "Literal",
             "localId" : "245",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "value" : "4.43",
+            "annotation" : [ ]
+          },
+          "precision" : {
+            "type" : "Literal",
+            "localId" : "246",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
             "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "1",
             "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "253",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "AbsNegTenLong",
+        "localId" : "256",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "NegativeHalf",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "253",
+            "r" : "256",
             "s" : [ {
-              "value" : [ "", "define ", "AbsNegTenLong", ": " ]
+              "value" : [ "", "define ", "NegativeHalf", ": " ]
             }, {
-              "r" : "260",
+              "r" : "263",
               "s" : [ {
-                "value" : [ "Abs", "(" ]
+                "value" : [ "Round", "(" ]
               }, {
-                "r" : "254",
+                "r" : "257",
                 "s" : [ {
-                  "r" : "255",
-                  "value" : [ "-", "10L" ]
+                  "r" : "258",
+                  "value" : [ "-", "0.5" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -8966,63 +9825,59 @@ module.exports['Abs'] = {
           }
         } ],
         "expression" : {
-          "type" : "Abs",
-          "localId" : "260",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "type" : "Round",
+          "localId" : "263",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "261",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "264",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Negate",
-            "localId" : "254",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "257",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ],
             "signature" : [ {
               "type" : "NamedTypeSpecifier",
-              "localId" : "256",
-              "name" : "{urn:hl7-org:elm-types:r1}Long",
+              "localId" : "259",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
               "annotation" : [ ]
             } ],
             "operand" : {
               "type" : "Literal",
-              "localId" : "255",
-              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-              "valueType" : "{urn:hl7-org:elm-types:r1}Long",
-              "value" : "10",
+              "localId" : "258",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "0.5",
               "annotation" : [ ]
             }
           }
         }
       }, {
-        "localId" : "264",
-        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-        "name" : "AbsMinLong",
+        "localId" : "267",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "NegativeOnePointFive",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "264",
+            "r" : "267",
             "s" : [ {
-              "value" : [ "", "define ", "AbsMinLong", ": " ]
+              "value" : [ "", "define ", "NegativeOnePointFive", ": " ]
             }, {
-              "r" : "270",
+              "r" : "274",
               "s" : [ {
-                "value" : [ "Abs", "(" ]
+                "value" : [ "Round", "(" ]
               }, {
-                "r" : "266",
+                "r" : "268",
                 "s" : [ {
-                  "value" : [ "minimum", " " ]
-                }, {
-                  "r" : "265",
-                  "s" : [ {
-                    "value" : [ "Long" ]
-                  } ]
+                  "r" : "269",
+                  "value" : [ "-", "1.5" ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -9031,341 +9886,311 @@ module.exports['Abs'] = {
           }
         } ],
         "expression" : {
-          "type" : "Abs",
-          "localId" : "270",
-          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+          "type" : "Round",
+          "localId" : "274",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "271",
-            "name" : "{urn:hl7-org:elm-types:r1}Long",
-            "annotation" : [ ]
-          } ],
-          "operand" : {
-            "type" : "MinValue",
-            "localId" : "266",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+            "localId" : "275",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
-          }
-        }
-      } ]
-    }
-  }
-}
-
-/* Round
-library TestSnippet version '1'
-using Simple version '1.0.0'
-context Patient
-define Up: Round(4.56)
-define Up_percent: Round(4.56,1)
-define Down: Round(4.49)
-define Down_percent: Round(4.43,1)
-define NegativeHalf: Round(-0.5)
-define NegativeOnePointFive: Round(-1.5)
-*/
-
-module.exports['Round'] = {
-  "library" : {
-    "localId" : "0",
-    "annotation" : [ {
-      "type" : "CqlToElmInfo",
-      "translatorVersion" : "4.2.0",
-      "translatorOptions" : "EnableDateRangeOptimization,EnableAnnotations,EnableResultTypes",
-      "signatureLevel" : "All"
-    }, {
-      "type" : "Annotation",
-      "t" : [ ],
-      "s" : {
-        "r" : "267",
-        "s" : [ {
-          "value" : [ "", "library TestSnippet version '1'" ]
-        } ]
-      }
-    } ],
-    "identifier" : {
-      "id" : "TestSnippet",
-      "version" : "1"
-    },
-    "schemaIdentifier" : {
-      "id" : "urn:hl7-org:elm",
-      "version" : "r1"
-    },
-    "usings" : {
-      "def" : [ {
-        "localId" : "1",
-        "localIdentifier" : "System",
-        "uri" : "urn:hl7-org:elm-types:r1",
-        "annotation" : [ ]
-      }, {
-        "localId" : "206",
-        "localIdentifier" : "Simple",
-        "uri" : "https://github.com/cqframework/cql-execution/simple",
-        "version" : "1.0.0",
-        "annotation" : [ {
-          "type" : "Annotation",
-          "t" : [ ],
-          "s" : {
-            "r" : "206",
-            "s" : [ {
-              "value" : [ "", "using " ]
-            }, {
-              "s" : [ {
-                "value" : [ "Simple" ]
-              } ]
-            }, {
-              "value" : [ " version '1.0.0'" ]
-            } ]
-          }
-        } ]
-      } ]
-    },
-    "contexts" : {
-      "def" : [ {
-        "localId" : "211",
-        "name" : "Patient",
-        "annotation" : [ ]
-      } ]
-    },
-    "statements" : {
-      "def" : [ {
-        "localId" : "209",
-        "name" : "Patient",
-        "context" : "Patient",
-        "annotation" : [ ],
-        "expression" : {
-          "type" : "SingletonFrom",
-          "localId" : "210",
-          "annotation" : [ ],
-          "signature" : [ ],
+          } ],
           "operand" : {
-            "type" : "Retrieve",
-            "localId" : "208",
-            "dataType" : "{https://github.com/cqframework/cql-execution/simple}Patient",
+            "type" : "Negate",
+            "localId" : "268",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ],
-            "include" : [ ],
-            "codeFilter" : [ ],
-            "dateFilter" : [ ],
-            "otherFilter" : [ ]
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "270",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "269",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.5",
+              "annotation" : [ ]
+            }
           }
         }
       }, {
-        "localId" : "214",
+        "localId" : "278",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "Up",
+        "name" : "RoundPositiveHalfOmittedPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "214",
+            "r" : "278",
             "s" : [ {
-              "value" : [ "", "define ", "Up", ": " ]
+              "value" : [ "", "define ", "RoundPositiveHalfOmittedPrecision", ": " ]
             }, {
-              "r" : "219",
+              "r" : "283",
               "s" : [ {
-                "r" : "215",
-                "value" : [ "Round", "(", "4.56", ")" ]
+                "r" : "279",
+                "value" : [ "Round", "(", "1.5", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "219",
+          "localId" : "283",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "220",
+            "localId" : "284",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
-            "localId" : "215",
+            "localId" : "279",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "4.56",
+            "value" : "1.5",
             "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "223",
+        "localId" : "287",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "Up_percent",
+        "name" : "RoundPositiveHalfNullPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "223",
+            "r" : "287",
             "s" : [ {
-              "value" : [ "", "define ", "Up_percent", ": " ]
+              "value" : [ "", "define ", "RoundPositiveHalfNullPrecision", ": " ]
             }, {
-              "r" : "230",
+              "r" : "296",
               "s" : [ {
-                "r" : "224",
-                "value" : [ "Round", "(", "4.56", ",", "1", ")" ]
+                "r" : "288",
+                "value" : [ "Round", "(", "1.5", ", " ]
+              }, {
+                "r" : "289",
+                "s" : [ {
+                  "r" : "290",
+                  "value" : [ "null", " as " ]
+                }, {
+                  "r" : "291",
+                  "s" : [ {
+                    "value" : [ "Integer" ]
+                  } ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "230",
+          "localId" : "296",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "231",
+            "localId" : "297",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
           }, {
             "type" : "NamedTypeSpecifier",
-            "localId" : "232",
+            "localId" : "298",
             "name" : "{urn:hl7-org:elm-types:r1}Integer",
             "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
-            "localId" : "224",
+            "localId" : "288",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "4.56",
+            "value" : "1.5",
             "annotation" : [ ]
           },
           "precision" : {
-            "type" : "Literal",
-            "localId" : "225",
+            "type" : "As",
+            "localId" : "289",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "1",
-            "annotation" : [ ]
+            "strict" : false,
+            "annotation" : [ ],
+            "signature" : [ ],
+            "operand" : {
+              "type" : "Null",
+              "localId" : "290",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
+              "annotation" : [ ]
+            },
+            "asTypeSpecifier" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "291",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+              "name" : "{urn:hl7-org:elm-types:r1}Integer",
+              "annotation" : [ ]
+            }
           }
         }
       }, {
-        "localId" : "235",
+        "localId" : "301",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "Down",
+        "name" : "RoundPositiveHalfZeroPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "235",
+            "r" : "301",
             "s" : [ {
-              "value" : [ "", "define ", "Down", ": " ]
+              "value" : [ "", "define ", "RoundPositiveHalfZeroPrecision", ": " ]
             }, {
-              "r" : "240",
+              "r" : "308",
               "s" : [ {
-                "r" : "236",
-                "value" : [ "Round", "(", "4.49", ")" ]
+                "r" : "302",
+                "value" : [ "Round", "(", "1.5", ", ", "0", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "240",
+          "localId" : "308",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "241",
+            "localId" : "309",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "310",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Literal",
-            "localId" : "236",
+            "localId" : "302",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "4.49",
+            "value" : "1.5",
+            "annotation" : [ ]
+          },
+          "precision" : {
+            "type" : "Literal",
+            "localId" : "303",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "0",
             "annotation" : [ ]
           }
         }
       }, {
-        "localId" : "244",
+        "localId" : "313",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "Down_percent",
+        "name" : "RoundNegativeHalfOmittedPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "244",
+            "r" : "313",
             "s" : [ {
-              "value" : [ "", "define ", "Down_percent", ": " ]
+              "value" : [ "", "define ", "RoundNegativeHalfOmittedPrecision", ": " ]
             }, {
-              "r" : "251",
+              "r" : "320",
               "s" : [ {
-                "r" : "245",
-                "value" : [ "Round", "(", "4.43", ",", "1", ")" ]
+                "value" : [ "Round", "(" ]
+              }, {
+                "r" : "314",
+                "s" : [ {
+                  "r" : "315",
+                  "value" : [ "-", "1.5" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "251",
+          "localId" : "320",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "252",
+            "localId" : "321",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
-          }, {
-            "type" : "NamedTypeSpecifier",
-            "localId" : "253",
-            "name" : "{urn:hl7-org:elm-types:r1}Integer",
-            "annotation" : [ ]
           } ],
           "operand" : {
-            "type" : "Literal",
-            "localId" : "245",
+            "type" : "Negate",
+            "localId" : "314",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-            "value" : "4.43",
-            "annotation" : [ ]
-          },
-          "precision" : {
-            "type" : "Literal",
-            "localId" : "246",
-            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
-            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
-            "value" : "1",
-            "annotation" : [ ]
+            "annotation" : [ ],
+            "signature" : [ {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "316",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            } ],
+            "operand" : {
+              "type" : "Literal",
+              "localId" : "315",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.5",
+              "annotation" : [ ]
+            }
           }
         }
       }, {
-        "localId" : "256",
+        "localId" : "324",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "NegativeHalf",
+        "name" : "RoundNegativeHalfNullPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "256",
+            "r" : "324",
             "s" : [ {
-              "value" : [ "", "define ", "NegativeHalf", ": " ]
+              "value" : [ "", "define ", "RoundNegativeHalfNullPrecision", ": " ]
             }, {
-              "r" : "263",
+              "r" : "335",
               "s" : [ {
                 "value" : [ "Round", "(" ]
               }, {
-                "r" : "257",
+                "r" : "325",
                 "s" : [ {
-                  "r" : "258",
-                  "value" : [ "-", "0.5" ]
+                  "r" : "326",
+                  "value" : [ "-", "1.5" ]
+                } ]
+              }, {
+                "value" : [ ", " ]
+              }, {
+                "r" : "328",
+                "s" : [ {
+                  "r" : "329",
+                  "value" : [ "null", " as " ]
+                }, {
+                  "r" : "330",
+                  "s" : [ {
+                    "value" : [ "Integer" ]
+                  } ]
                 } ]
               }, {
                 "value" : [ ")" ]
@@ -9375,95 +10200,135 @@ module.exports['Round'] = {
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "263",
+          "localId" : "335",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "264",
+            "localId" : "336",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "337",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Negate",
-            "localId" : "257",
+            "localId" : "325",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ],
             "signature" : [ {
               "type" : "NamedTypeSpecifier",
-              "localId" : "259",
+              "localId" : "327",
               "name" : "{urn:hl7-org:elm-types:r1}Decimal",
               "annotation" : [ ]
             } ],
             "operand" : {
               "type" : "Literal",
-              "localId" : "258",
+              "localId" : "326",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
-              "value" : "0.5",
+              "value" : "1.5",
+              "annotation" : [ ]
+            }
+          },
+          "precision" : {
+            "type" : "As",
+            "localId" : "328",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "strict" : false,
+            "annotation" : [ ],
+            "signature" : [ ],
+            "operand" : {
+              "type" : "Null",
+              "localId" : "329",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Any",
+              "annotation" : [ ]
+            },
+            "asTypeSpecifier" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "330",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+              "name" : "{urn:hl7-org:elm-types:r1}Integer",
               "annotation" : [ ]
             }
           }
         }
       }, {
-        "localId" : "267",
+        "localId" : "340",
         "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
-        "name" : "NegativeOnePointFive",
+        "name" : "RoundNegativeHalfZeroPrecision",
         "context" : "Patient",
         "accessLevel" : "Public",
         "annotation" : [ {
           "type" : "Annotation",
           "t" : [ ],
           "s" : {
-            "r" : "267",
+            "r" : "340",
             "s" : [ {
-              "value" : [ "", "define ", "NegativeOnePointFive", ": " ]
+              "value" : [ "", "define ", "RoundNegativeHalfZeroPrecision", ": " ]
             }, {
-              "r" : "274",
+              "r" : "349",
               "s" : [ {
                 "value" : [ "Round", "(" ]
               }, {
-                "r" : "268",
+                "r" : "341",
                 "s" : [ {
-                  "r" : "269",
+                  "r" : "342",
                   "value" : [ "-", "1.5" ]
                 } ]
               }, {
-                "value" : [ ")" ]
+                "r" : "344",
+                "value" : [ ", ", "0", ")" ]
               } ]
             } ]
           }
         } ],
         "expression" : {
           "type" : "Round",
-          "localId" : "274",
+          "localId" : "349",
           "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
           "annotation" : [ ],
           "signature" : [ {
             "type" : "NamedTypeSpecifier",
-            "localId" : "275",
+            "localId" : "350",
             "name" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ]
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "351",
+            "name" : "{urn:hl7-org:elm-types:r1}Integer",
+            "annotation" : [ ]
           } ],
           "operand" : {
             "type" : "Negate",
-            "localId" : "268",
+            "localId" : "341",
             "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
             "annotation" : [ ],
             "signature" : [ {
               "type" : "NamedTypeSpecifier",
-              "localId" : "270",
+              "localId" : "343",
               "name" : "{urn:hl7-org:elm-types:r1}Decimal",
               "annotation" : [ ]
             } ],
             "operand" : {
               "type" : "Literal",
-              "localId" : "269",
+              "localId" : "342",
               "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
               "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
               "value" : "1.5",
               "annotation" : [ ]
             }
+          },
+          "precision" : {
+            "type" : "Literal",
+            "localId" : "344",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Integer",
+            "valueType" : "{urn:hl7-org:elm-types:r1}Integer",
+            "value" : "0",
+            "annotation" : [ ]
           }
         }
       } ]

From 0cf5efd1e4e13c3b1f234a73d5050456c77f4a71 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:32:27 -0400
Subject: [PATCH 46/62] Add Decimal.truncateToBigInt as Long counterpart to
 Integer Decimal.truncate

---
 src/datatypes/decimal.ts       | 6 +++++-
 src/elm/arithmetic.ts          | 3 +++
 src/elm/interval.ts            | 4 ++--
 test/datatypes/decimal-test.ts | 9 +++++++++
 4 files changed, 19 insertions(+), 3 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index c86e1ffc0..061f69e3c 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -212,13 +212,17 @@ export class Decimal {
     return this.value.truncated().toNumber();
   }
 
+  truncateToBigInt(): bigint {
+    return BigInt(this.value.truncated().toString());
+  }
+
   truncated(scale?: number): Decimal {
     // specifying a scale here allows for "truncating to a precision"
     // this is currently used in Interval.expand
 
     if (!scale) {
       // undefined or 0 both mean truncated to an integer
-      return new Decimal(this.truncate(), 0);
+      return new Decimal(this.value.truncated(), 0);
     }
 
     return this.withScale(scale, TRUNCATE_TO_PRECISION);
diff --git a/src/elm/arithmetic.ts b/src/elm/arithmetic.ts
index f100c5d03..e0db3a8e5 100644
--- a/src/elm/arithmetic.ts
+++ b/src/elm/arithmetic.ts
@@ -242,6 +242,9 @@ export class Truncate extends Expression {
 
     let truncated;
     if (arg.isDecimal) {
+      // Note that the CQL spec defines Truncate as returning an Integer,
+      // but the Decimal bounds are greater than allowed for Integer.
+      // If the spec changes, add another case here for truncating to Long.
       truncated = arg.truncate();
     } else if (arg >= 0) {
       truncated = Math.floor(arg);
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index a967726c2..b5090d5c1 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -655,7 +655,7 @@ export class Expand extends Expression {
       convertBound = d => d;
     } else if (typeof lowValue === 'bigint' || typeof highValue === 'bigint') {
       // the bounds were integral and the per was integral, so there should be no risk of non-integral values
-      convertBound = d => BigInt(d.truncate());
+      convertBound = d => d.truncateToBigInt();
     } else if (typeof lowValue === 'number' || typeof highValue === 'number') {
       convertBound = d => d.truncate();
     } else {
@@ -670,7 +670,7 @@ export class Expand extends Expression {
         high.lessThan(MIN_INT_VALUE) ||
         high.greaterThan(MAX_INT_VALUE)
       ) {
-        convertBound = d => BigInt(d.truncate());
+        convertBound = d => d.truncateToBigInt();
       } else {
         convertBound = d => d.truncate();
       }
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 22072574b..caa258636 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -201,10 +201,19 @@ describe('Decimal', () => {
 
   describe('truncate', () => {
     it('should return the integer component', () => {
+      Decimal.from('1.9').truncate().should.equal(1);
       Decimal.from('-1.9').truncate().should.equal(-1);
     });
   });
 
+  describe('truncateToBigInt', () => {
+    it('should return the integer component as a BigInt', () => {
+      Decimal.from('1.9').truncateToBigInt().should.equal(1n);
+      Decimal.from('-1.9').truncateToBigInt().should.equal(-1n);
+      Decimal.from('9007199254740992').truncateToBigInt().should.equal(9007199254740992n);
+    });
+  });
+
   describe('truncated', () => {
     it('should truncate to an optional decimal scale', () => {
       Decimal.from('-1.239').truncated(2).should.equalDecimal('-1.23');

From 802d918f359c0eef15702d76b8a8bdf772a01658 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:43:08 -0400
Subject: [PATCH 47/62] Add Decimal.nthRoot to try to preserve exact values
 where possible

---
 src/datatypes/decimal.ts       | 18 ++++++++++++++++++
 src/elm/aggregate.ts           |  3 +--
 test/datatypes/decimal-test.ts | 19 +++++++++++++++++++
 test/elm/aggregate/data.cql    |  2 ++
 4 files changed, 40 insertions(+), 2 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 061f69e3c..e67350702 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -244,6 +244,24 @@ export class Decimal {
     return this.applyWrapper(this.value.toPower, exponent);
   }
 
+  nthRoot(root: DecimalInput) {
+    // The goal of this method is to preserve exact values in common cases,
+    // by leveraging the decimal.js sqrt() and cubeRoot() methods for roots 2 and 3.
+    // For other roots, fall back to the power method with the inverse of the provided value.
+    // See docs on decimal.js pow, in particular the note about non-integer exponents:
+    // https://mikemcl.github.io/decimal.js/#pow
+    const rootAsDecimal = Decimal.from(root);
+    if (rootAsDecimal.equals(0)) {
+      throw new RangeError('Cannot take the zero-th root of a decimal');
+    } else if (rootAsDecimal.equals(2)) {
+      return this.sqrt();
+    } else if (rootAsDecimal.equals(3)) {
+      return new Decimal(this.value.cubeRoot()).withMinimumScale(this.scale);
+    } else {
+      return this.power(Decimal.from(1).divideBy(root));
+    }
+  }
+
   sqrt() {
     return new Decimal(this.value.sqrt()).withMinimumScale(this.scale);
   }
diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index caae0f591..3cd194279 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -417,8 +417,7 @@ export class GeometricMean extends AggregateExpression {
 
     try {
       const product = productOfDecimals(decimals);
-      const oneOverLength = Decimal.from(1).divideBy(items.length);
-      const geoMean = product.power(oneOverLength);
+      const geoMean = product.nthRoot(items.length);
       return finalizeAggregateResult(geoMean, items[0]);
     } catch {
       return null;
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index caa258636..0777bf71a 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -255,6 +255,25 @@ describe('Decimal', () => {
     });
   });
 
+  describe('nthRoot', () => {
+    it('should take the provided root', () => {
+      Decimal.from(8).nthRoot(3).should.equalDecimal('2.0');
+      Decimal.from(32).nthRoot(5).should.equalDecimal('2.0');
+      Decimal.from(65536).nthRoot(16).should.equalDecimal('2.0');
+      Decimal.from(4294967296).nthRoot(32).should.equalDecimal('2.0');
+
+      Decimal.from(9).nthRoot(2).should.equalDecimal('3.0');
+      Decimal.from(81).nthRoot(4).should.equalDecimal('3.0');
+      Decimal.from(243).nthRoot(5).should.equalDecimal('3.0');
+
+      Decimal.from(1).nthRoot(12345).should.equalDecimal('1.0');
+    });
+
+    it('should reject a zero divisor', () => {
+      (() => Decimal.from(1).nthRoot(0)).should.throw(RangeError);
+    });
+  });
+
   describe('sqrt', () => {
     it('should calculate square roots', () => {
       const result = Decimal.from('9.00').sqrt();
diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index 1ab8bb24b..feb508431 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -195,6 +195,8 @@ define null_geometric_mean: GeometricMean({1, 2, null})
 define all_nulls: GeometricMean({null, null, null})
 define also_null_geometric_mean: GeometricMean(null as List<Decimal>)
 define negative_geometric_mean: GeometricMean({-1.0, 4.0})
+define GeometricMeanThreeIdenticalDecimals: GeometricMean({2.0, 2.0, 2.0})
+define GeometricMeanExactCubeRoot: GeometricMean({2.0, 4.0, 8.0})
 
 // @Test: AllTrue
 define at: AllTrue({true,true,true,true})

From e81f5c0a8abf92d2ba191898b83c2c3792faab5e Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:44:27 -0400
Subject: [PATCH 48/62] Make Decimal.round parameter optional; unspecified or
 null = 0

---
 src/datatypes/decimal.ts               |  7 ++++++-
 test/elm/arithmetic/arithmetic-test.ts | 10 ++++++++++
 test/elm/arithmetic/data.cql           |  6 ++++++
 3 files changed, 22 insertions(+), 1 deletion(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index e67350702..05ad6e873 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -278,7 +278,12 @@ export class Decimal {
     return this.applyWrapper(this.value.log, base).withMinimumScale(this.scale);
   }
 
-  round(scale: number) {
+  round(scale?: number | null) {
+    // "If precision is not specified or null, 0 is assumed."
+    if (scale == null) {
+      scale = 0;
+    }
+
     // notes on rounding modes
     // ROUND_HALF_UP "Rounds towards nearest neighbour. If equidistant, rounds away from zero"
     // rounds 0.5 -> 1.0, -0.5 -> -1.0
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index ab9279190..7b437e295 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -684,6 +684,16 @@ describe('Round', () => {
     (await this.negativeHalf.exec(this.ctx)).should.equalDecimal(-1);
     (await this.negativeOnePointFive.exec(this.ctx)).should.equalDecimal(-2);
   });
+
+  it('should treat omitted or null precision as 0 precision', async function () {
+    (await this.roundPositiveHalfOmittedPrecision.exec(this.ctx)).should.equalDecimal(2.0);
+    (await this.roundPositiveHalfNullPrecision.exec(this.ctx)).should.equalDecimal(2.0);
+    (await this.roundPositiveHalfZeroPrecision.exec(this.ctx)).should.equalDecimal(2.0);
+
+    (await this.roundNegativeHalfOmittedPrecision.exec(this.ctx)).should.equalDecimal(-2.0);
+    (await this.roundNegativeHalfNullPrecision.exec(this.ctx)).should.equalDecimal(-2.0);
+    (await this.roundNegativeHalfZeroPrecision.exec(this.ctx)).should.equalDecimal(-2.0);
+  });
 });
 
 describe('Successor', () => {
diff --git a/test/elm/arithmetic/data.cql b/test/elm/arithmetic/data.cql
index 0e0512ec2..6ad986a88 100644
--- a/test/elm/arithmetic/data.cql
+++ b/test/elm/arithmetic/data.cql
@@ -158,6 +158,12 @@ define Down: Round(4.49)
 define Down_percent: Round(4.43,1)
 define NegativeHalf: Round(-0.5)
 define NegativeOnePointFive: Round(-1.5)
+define RoundPositiveHalfOmittedPrecision: Round(1.5)
+define RoundPositiveHalfNullPrecision: Round(1.5, null as Integer)
+define RoundPositiveHalfZeroPrecision: Round(1.5, 0)
+define RoundNegativeHalfOmittedPrecision: Round(-1.5)
+define RoundNegativeHalfNullPrecision: Round(-1.5, null as Integer)
+define RoundNegativeHalfZeroPrecision: Round(-1.5, 0)
 
 // @Test: Ln
 define ln: Ln(4)

From 2b1e02597d8b26353c57b620d57ad8b9fb4136da Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:46:02 -0400
Subject: [PATCH 49/62] Make sure aggregate operations like Mode, Except, etc,
 use value equality semantics (ignore trailing zeros)

---
 src/elm/aggregate.ts                 |   9 +-
 src/util/immutableUtil.ts            |   3 +-
 test/elm/aggregate/aggregate-test.ts |   8 +
 test/elm/aggregate/data.cql          |   2 +
 test/elm/aggregate/data.js           | 478 +++++++++++++++++++++++-
 test/elm/list/data.cql               |   4 +
 test/elm/list/data.js                | 537 ++++++++++++++++++++++++++-
 test/elm/list/list-test.ts           |  21 ++
 8 files changed, 1053 insertions(+), 9 deletions(-)

diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 3cd194279..97a1c9465 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -6,6 +6,8 @@ import { Context } from '../runtime/context';
 import { Exception } from '../datatypes/exception';
 import { greaterThan, lessThan } from '../util/comparison';
 import { build } from './builder';
+import { Map as ImmutableMap } from 'immutable';
+import { toNormalizedKey, NormalizedKey } from '../util/immutableUtil';
 import * as MathUtil from '../util/math';
 
 function finalizeAggregateResult(result: any, firstItem: any) {
@@ -263,10 +265,13 @@ export class Mode extends AggregateExpression {
 
   mode(arr: any[]) {
     let max = 0;
-    const counts: any = {};
+    // use ImmutableMap and NormalizedKeys, to compare objects using value equality
+    let counts = ImmutableMap<NormalizedKey, number>();
     let results: any[] = [];
     for (const elem of arr) {
-      const cnt = (counts[elem] = (counts[elem] != null ? counts[elem] : 0) + 1);
+      const key = toNormalizedKey(elem);
+      const cnt = (counts.get(key) ?? 0) + 1;
+      counts = counts.set(key, cnt); // note: set returns a new instance
       if (cnt === max && !results.includes(elem)) {
         results.push(elem);
       } else if (cnt > max) {
diff --git a/src/util/immutableUtil.ts b/src/util/immutableUtil.ts
index adeada848..6d174ecc1 100644
--- a/src/util/immutableUtil.ts
+++ b/src/util/immutableUtil.ts
@@ -77,7 +77,8 @@ export const toNormalizedKey = (js: any): NormalizedKey => {
 
     case Decimal:
       return ImmutableMap({
-        value: js.toString(),
+        // Decimal value equality ignores trailing zeros, so scale is essentially ignored
+        value: js.withoutTrailingZeros().toString(),
         __instance: js.constructor
       });
 
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 1f41fff0a..0498812f9 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -436,6 +436,14 @@ describe('Mode', () => {
   it('should be null if quantity units are not compatible', async function () {
     should(await this.incompatibleUnitsNull.exec(this.ctx)).be.null();
   });
+
+  it('should use value equality for Decimals (ignores trailing zeros)', async function () {
+    (await this.modeDecimalsAcrossScales.exec(this.ctx)).should.equalDecimal('1.0');
+  });
+
+  it('should use value equality for Quantities (ignores trailing zeros)', async function () {
+    validateQuantity(await this.modeDecimalQuantitiesAcrossScales.exec(this.ctx), '1.0', 'g');
+  });
 });
 
 describe('PopulationVariance', () => {
diff --git a/test/elm/aggregate/data.cql b/test/elm/aggregate/data.cql
index feb508431..799eaad39 100644
--- a/test/elm/aggregate/data.cql
+++ b/test/elm/aggregate/data.cql
@@ -116,6 +116,8 @@ define QuantitySingleMode: Mode({1.0 'g', 1.0 'g', 2.0 'g'})
 define QuantityBiModal: Mode({1.0 'g', 1.0 'g', 2.0 'g', 2.0 'g'})
 define NumbersAndQuantities: Mode({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Mode({1 'mg/d', 0.002 '/d'})
+define ModeDecimalsAcrossScales: Mode({1.0, 1.00, 2.0})
+define ModeDecimalQuantitiesAcrossScales: Mode({ Quantity { value: 1.0, unit: 'g' }, Quantity { value: 1.00, unit: 'g' }, Quantity { value: 2.0, unit: 'g' } })
 
 // @Test: Variance
 define v: Variance({1,2,3,4,5})
diff --git a/test/elm/aggregate/data.js b/test/elm/aggregate/data.js
index e1ef717a5..98ea55848 100644
--- a/test/elm/aggregate/data.js
+++ b/test/elm/aggregate/data.js
@@ -11444,6 +11444,8 @@ define QuantitySingleMode: Mode({1.0 'g', 1.0 'g', 2.0 'g'})
 define QuantityBiModal: Mode({1.0 'g', 1.0 'g', 2.0 'g', 2.0 'g'})
 define NumbersAndQuantities: Mode({1 ,2 'ml',3 'ml',4 'ml',5 'ml',0 'ml'})
 define IncompatibleUnitsNull: Mode({1 'mg/d', 0.002 '/d'})
+define ModeDecimalsAcrossScales: Mode({1.0, 1.00, 2.0})
+define ModeDecimalQuantitiesAcrossScales: Mode({ Quantity { value: 1.0, unit: 'g' }, Quantity { value: 1.00, unit: 'g' }, Quantity { value: 2.0, unit: 'g' } })
 */
 
 module.exports['Mode'] = {
@@ -11458,7 +11460,7 @@ module.exports['Mode'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "364",
+        "r" : "395",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -12507,6 +12509,308 @@ module.exports['Mode'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "379",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "ModeDecimalsAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "379",
+            "s" : [ {
+              "value" : [ "", "define ", "ModeDecimalsAcrossScales", ": " ]
+            }, {
+              "r" : "390",
+              "s" : [ {
+                "value" : [ "Mode", "(" ]
+              }, {
+                "r" : "380",
+                "s" : [ {
+                  "r" : "381",
+                  "value" : [ "{", "1.0", ", ", "1.00", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Mode",
+          "localId" : "390",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "391",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "392",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "380",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "384",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "385",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "381",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "382",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.00",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "383",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "395",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+        "name" : "ModeDecimalQuantitiesAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "395",
+            "s" : [ {
+              "value" : [ "", "define ", "ModeDecimalQuantitiesAcrossScales", ": " ]
+            }, {
+              "r" : "418",
+              "s" : [ {
+                "value" : [ "Mode", "(" ]
+              }, {
+                "r" : "396",
+                "s" : [ {
+                  "value" : [ "{ " ]
+                }, {
+                  "r" : "397",
+                  "s" : [ {
+                    "value" : [ "Quantity", " { " ]
+                  }, {
+                    "s" : [ {
+                      "r" : "399",
+                      "value" : [ "value", ": ", "1.0" ]
+                    } ]
+                  }, {
+                    "value" : [ ", " ]
+                  }, {
+                    "s" : [ {
+                      "value" : [ "unit", ": " ]
+                    }, {
+                      "r" : "400",
+                      "s" : [ {
+                        "value" : [ "'g'" ]
+                      } ]
+                    } ]
+                  }, {
+                    "value" : [ " }" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "402",
+                  "s" : [ {
+                    "value" : [ "Quantity", " { " ]
+                  }, {
+                    "s" : [ {
+                      "r" : "404",
+                      "value" : [ "value", ": ", "1.00" ]
+                    } ]
+                  }, {
+                    "value" : [ ", " ]
+                  }, {
+                    "s" : [ {
+                      "value" : [ "unit", ": " ]
+                    }, {
+                      "r" : "405",
+                      "s" : [ {
+                        "value" : [ "'g'" ]
+                      } ]
+                    } ]
+                  }, {
+                    "value" : [ " }" ]
+                  } ]
+                }, {
+                  "value" : [ ", " ]
+                }, {
+                  "r" : "407",
+                  "s" : [ {
+                    "value" : [ "Quantity", " { " ]
+                  }, {
+                    "s" : [ {
+                      "r" : "409",
+                      "value" : [ "value", ": ", "2.0" ]
+                    } ]
+                  }, {
+                    "value" : [ ", " ]
+                  }, {
+                    "s" : [ {
+                      "value" : [ "unit", ": " ]
+                    }, {
+                      "r" : "410",
+                      "s" : [ {
+                        "value" : [ "'g'" ]
+                      } ]
+                    } ]
+                  }, {
+                    "value" : [ " }" ]
+                  } ]
+                }, {
+                  "value" : [ " }" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "Mode",
+          "localId" : "418",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "419",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "420",
+              "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "396",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "412",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "413",
+                "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Instance",
+              "localId" : "397",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ],
+              "element" : [ {
+                "name" : "value",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "399",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "value" : "1.0",
+                  "annotation" : [ ]
+                }
+              }, {
+                "name" : "unit",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "400",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                  "value" : "g",
+                  "annotation" : [ ]
+                }
+              } ]
+            }, {
+              "type" : "Instance",
+              "localId" : "402",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ],
+              "element" : [ {
+                "name" : "value",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "404",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "value" : "1.00",
+                  "annotation" : [ ]
+                }
+              }, {
+                "name" : "unit",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "405",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                  "value" : "g",
+                  "annotation" : [ ]
+                }
+              } ]
+            }, {
+              "type" : "Instance",
+              "localId" : "407",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "classType" : "{urn:hl7-org:elm-types:r1}Quantity",
+              "annotation" : [ ],
+              "element" : [ {
+                "name" : "value",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "409",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+                  "value" : "2.0",
+                  "annotation" : [ ]
+                }
+              }, {
+                "name" : "unit",
+                "value" : {
+                  "type" : "Literal",
+                  "localId" : "410",
+                  "resultTypeName" : "{urn:hl7-org:elm-types:r1}String",
+                  "valueType" : "{urn:hl7-org:elm-types:r1}String",
+                  "value" : "g",
+                  "annotation" : [ ]
+                }
+              } ]
+            } ]
+          }
+        }
       } ]
     }
   }
@@ -18974,6 +19278,8 @@ define null_geometric_mean: GeometricMean({1, 2, null})
 define all_nulls: GeometricMean({null, null, null})
 define also_null_geometric_mean: GeometricMean(null as List<Decimal>)
 define negative_geometric_mean: GeometricMean({-1.0, 4.0})
+define GeometricMeanThreeIdenticalDecimals: GeometricMean({2.0, 2.0, 2.0})
+define GeometricMeanExactCubeRoot: GeometricMean({2.0, 4.0, 8.0})
 */
 
 module.exports['GeometricMean'] = {
@@ -18988,7 +19294,7 @@ module.exports['GeometricMean'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "325",
+        "r" : "358",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -19677,6 +19983,174 @@ module.exports['GeometricMean'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "342",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "GeometricMeanThreeIdenticalDecimals",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "342",
+            "s" : [ {
+              "value" : [ "", "define ", "GeometricMeanThreeIdenticalDecimals", ": " ]
+            }, {
+              "r" : "353",
+              "s" : [ {
+                "value" : [ "GeometricMean", "(" ]
+              }, {
+                "r" : "343",
+                "s" : [ {
+                  "r" : "344",
+                  "value" : [ "{", "2.0", ", ", "2.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "GeometricMean",
+          "localId" : "353",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "354",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "355",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "343",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "347",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "348",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "344",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "345",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "346",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
+      }, {
+        "localId" : "358",
+        "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+        "name" : "GeometricMeanExactCubeRoot",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "358",
+            "s" : [ {
+              "value" : [ "", "define ", "GeometricMeanExactCubeRoot", ": " ]
+            }, {
+              "r" : "369",
+              "s" : [ {
+                "value" : [ "GeometricMean", "(" ]
+              }, {
+                "r" : "359",
+                "s" : [ {
+                  "r" : "360",
+                  "value" : [ "{", "2.0", ", ", "4.0", ", ", "8.0", "}" ]
+                } ]
+              }, {
+                "value" : [ ")" ]
+              } ]
+            } ]
+          }
+        } ],
+        "expression" : {
+          "type" : "GeometricMean",
+          "localId" : "369",
+          "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+          "annotation" : [ ],
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "370",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "371",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "source" : {
+            "type" : "List",
+            "localId" : "359",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "363",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "364",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "360",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "361",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "4.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "362",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "8.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
diff --git a/test/elm/list/data.cql b/test/elm/list/data.cql
index cce588569..4d31b3fe5 100644
--- a/test/elm/list/data.cql
+++ b/test/elm/list/data.cql
@@ -53,6 +53,7 @@ define NestedToFifteen: {1, 2, 3} union {4, 5, 6} union {7 ,8 , 9} union {10, 11
 define NullUnion: null union {1, 2, 3}
 define UnionNull: {1, 2, 3} union null
 define nullUnionNull: (null as List<String>) union (null as List<String>)
+define UnionDecimalsAcrossScales: {1.0, 2.0} union {1.00, 3.0}
 
 
 // @Test: Except
@@ -69,6 +70,7 @@ define NothingExceptSomething: List<Integer>{} except {1, 2, 3, 4, 5}
 define ExceptTuples: {Tuple{a: 1}, Tuple{a: 2}, Tuple{a: 3}} except {Tuple{a: 2}}
 define ExceptNull: {1, 2, 3, 4, 5} except null
 define NullExcept: null except {1, 2, 3, 4, 5}
+define ExceptDecimalsAcrossScales: {1.0, 2.0} except {1.00, 3.0}
 
 // @Test: Intersect
 define NoIntersection: {1, 2, 2, 3} intersect {4, 5, 6}
@@ -82,6 +84,7 @@ define IntersectTuples: {Tuple{a:1, b:'d'}, Tuple{a:1, b:'c'}, Tuple{a:2, b:'c'}
 define NullIntersect: null intersect {1, 2, 3}
 define IntersectNull: {1, 2, 3} intersect null
 define MultipleNullInListIntersect: {1, 2, 3, null} intersect {null, 3}
+define IntersectDecimalsAcrossScales: {1.0, 2.0} intersect {1.00, 3.0}
 
 // @Test: IndexOf
 define IndexOfSecond: IndexOf({'a', 'b', 'c', 'd'}, 'b')
@@ -229,6 +232,7 @@ define NoDups: distinct {2, 4, 6, 8, 10}
 define DupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' }, Tuple{ hello: 'world' }, Tuple{ hello: 'dolly' } }
 define NoDupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' } }
 define DuplicateNulls: distinct {null, 1, 2, null, 3, 4, 5, null}
+define DistinctDecimalsAcrossScales: distinct {1.0, 1.00, 2.0}
 
 // @Test: First
 define Numbers: First({1, 2, 3, 4})
diff --git a/test/elm/list/data.js b/test/elm/list/data.js
index ba67b01e7..c2cbdf3bb 100644
--- a/test/elm/list/data.js
+++ b/test/elm/list/data.js
@@ -6292,6 +6292,7 @@ define NestedToFifteen: {1, 2, 3} union {4, 5, 6} union {7 ,8 , 9} union {10, 11
 define NullUnion: null union {1, 2, 3}
 define UnionNull: {1, 2, 3} union null
 define nullUnionNull: (null as List<String>) union (null as List<String>)
+define UnionDecimalsAcrossScales: {1.0, 2.0} union {1.00, 3.0}
 */
 
 module.exports['Union'] = {
@@ -6306,7 +6307,7 @@ module.exports['Union'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "455",
+        "r" : "487",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8092,6 +8093,147 @@ module.exports['Union'] = {
             }
           } ]
         }
+      }, {
+        "localId" : "487",
+        "name" : "UnionDecimalsAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "487",
+            "s" : [ {
+              "value" : [ "", "define ", "UnionDecimalsAcrossScales", ": " ]
+            }, {
+              "r" : "498",
+              "s" : [ {
+                "r" : "488",
+                "s" : [ {
+                  "r" : "489",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " union " ]
+              }, {
+                "r" : "493",
+                "s" : [ {
+                  "r" : "494",
+                  "value" : [ "{", "1.00", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "505",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "506",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Union",
+          "localId" : "498",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "503",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "504",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "499",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "500",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "501",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "502",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "488",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "491",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "492",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "489",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "490",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "493",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "496",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "497",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "494",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.00",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "495",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -8114,6 +8256,7 @@ define NothingExceptSomething: List<Integer>{} except {1, 2, 3, 4, 5}
 define ExceptTuples: {Tuple{a: 1}, Tuple{a: 2}, Tuple{a: 3}} except {Tuple{a: 2}}
 define ExceptNull: {1, 2, 3, 4, 5} except null
 define NullExcept: null except {1, 2, 3, 4, 5}
+define ExceptDecimalsAcrossScales: {1.0, 2.0} except {1.00, 3.0}
 */
 
 module.exports['Except'] = {
@@ -8128,7 +8271,7 @@ module.exports['Except'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "525",
+        "r" : "549",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -10369,6 +10512,147 @@ module.exports['Except'] = {
             } ]
           } ]
         }
+      }, {
+        "localId" : "549",
+        "name" : "ExceptDecimalsAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "549",
+            "s" : [ {
+              "value" : [ "", "define ", "ExceptDecimalsAcrossScales", ": " ]
+            }, {
+              "r" : "560",
+              "s" : [ {
+                "r" : "550",
+                "s" : [ {
+                  "r" : "551",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " except " ]
+              }, {
+                "r" : "555",
+                "s" : [ {
+                  "r" : "556",
+                  "value" : [ "{", "1.00", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "567",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "568",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Except",
+          "localId" : "560",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "565",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "566",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "561",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "562",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "563",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "564",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "550",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "553",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "554",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "551",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "552",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "555",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "558",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "559",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "556",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.00",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "557",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -10389,6 +10673,7 @@ define IntersectTuples: {Tuple{a:1, b:'d'}, Tuple{a:1, b:'c'}, Tuple{a:2, b:'c'}
 define NullIntersect: null intersect {1, 2, 3}
 define IntersectNull: {1, 2, 3} intersect null
 define MultipleNullInListIntersect: {1, 2, 3, null} intersect {null, 3}
+define IntersectDecimalsAcrossScales: {1.0, 2.0} intersect {1.00, 3.0}
 */
 
 module.exports['Intersect'] = {
@@ -10403,7 +10688,7 @@ module.exports['Intersect'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "593",
+        "r" : "619",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -13134,6 +13419,147 @@ module.exports['Intersect'] = {
             } ]
           } ]
         }
+      }, {
+        "localId" : "619",
+        "name" : "IntersectDecimalsAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "619",
+            "s" : [ {
+              "value" : [ "", "define ", "IntersectDecimalsAcrossScales", ": " ]
+            }, {
+              "r" : "630",
+              "s" : [ {
+                "r" : "620",
+                "s" : [ {
+                  "r" : "621",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " intersect " ]
+              }, {
+                "r" : "625",
+                "s" : [ {
+                  "r" : "626",
+                  "value" : [ "{", "1.00", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "637",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "638",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Intersect",
+          "localId" : "630",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "635",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "636",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "631",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "632",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "633",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "634",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "620",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "623",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "624",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "621",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "622",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "625",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "628",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "629",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "626",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.00",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "627",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -37225,6 +37651,7 @@ define NoDups: distinct {2, 4, 6, 8, 10}
 define DupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' }, Tuple{ hello: 'world' }, Tuple{ hello: 'dolly' } }
 define NoDupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' } }
 define DuplicateNulls: distinct {null, 1, 2, null, 3, 4, 5, null}
+define DistinctDecimalsAcrossScales: distinct {1.0, 1.00, 2.0}
 */
 
 module.exports['Distinct'] = {
@@ -37239,7 +37666,7 @@ module.exports['Distinct'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "374",
+        "r" : "398",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -38541,6 +38968,108 @@ module.exports['Distinct'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "398",
+        "name" : "DistinctDecimalsAcrossScales",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "398",
+            "s" : [ {
+              "value" : [ "", "define ", "DistinctDecimalsAcrossScales", ": " ]
+            }, {
+              "r" : "399",
+              "s" : [ {
+                "value" : [ "distinct " ]
+              }, {
+                "r" : "400",
+                "s" : [ {
+                  "r" : "401",
+                  "value" : [ "{", "1.0", ", ", "1.00", ", ", "2.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "410",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "411",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Distinct",
+          "localId" : "399",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "408",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "409",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "406",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "407",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : {
+            "type" : "List",
+            "localId" : "400",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "404",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "405",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "401",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "402",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.00",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "403",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
diff --git a/test/elm/list/list-test.ts b/test/elm/list/list-test.ts
index fba739f4b..eb9b7a36b 100644
--- a/test/elm/list/list-test.ts
+++ b/test/elm/list/list-test.ts
@@ -1,6 +1,7 @@
 import should from 'should';
 import setup from '../../setup';
 import { getLocalIdByPath } from '../../testHelpers';
+import { Decimal } from '../../../src/datatypes/decimal';
 const data = require('./data');
 
 describe('List', () => {
@@ -203,6 +204,11 @@ describe('Union', () => {
   it('should return an empty list if both args are null but expected to be lists', async function () {
     (await this.nullUnionNull.exec(this.ctx)).should.be.eql([]);
   });
+
+  it('should use equality semantics for Decimal (ignores scale)', async function () {
+    const expected = ['1.0', '2.0', '3.0'].map(Decimal.from);
+    should(await this.unionDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('Except', () => {
@@ -257,6 +263,11 @@ describe('Except', () => {
   it('should return first arg if second arg is null', async function () {
     (await this.exceptNull.exec(this.ctx)).should.eql([1, 2, 3, 4, 5]);
   });
+
+  it('should use equality semantics for Decimal (ignores scale)', async function () {
+    const expected = [Decimal.from('2.0')];
+    should(await this.exceptDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('Intersect', () => {
@@ -307,6 +318,11 @@ describe('Intersect', () => {
   it('should intersect two lists that contain null', async function () {
     (await this.multipleNullInListIntersect.exec(this.ctx)).should.eql([3, null]);
   });
+
+  it('should use equality semantics for Decimal (ignores scale)', async function () {
+    const expected = [Decimal.from('1.0')];
+    should(await this.intersectDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('IndexOf', () => {
@@ -847,6 +863,11 @@ describe('Distinct', () => {
     // define DuplicateNulls: distinct {null, 1, 2, null, 3, 4, 5, null}
     (await this.duplicateNulls.exec(this.ctx)).should.eql([null, 1, 2, 3, 4, 5]);
   });
+
+  it('should use equality semantics for Decimal (ignores scale)', async function () {
+    const expected = [Decimal.from('1.0'), Decimal.from('2.0')];
+    should(await this.distinctDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('First', () => {

From 7615e7fd23d364a1f7cbdb530db2748359be5844 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Thu, 10 Sep 2026 12:46:29 -0400
Subject: [PATCH 50/62] More interval expand examples

---
 test/elm/interval/data.cql |   2 +
 test/elm/interval/data.js  | 226 ++++++++++++++++++++++++++++++++++++-
 2 files changed, 226 insertions(+), 2 deletions(-)

diff --git a/test/elm/interval/data.cql b/test/elm/interval/data.cql
index a0f21523c..d340dfcfc 100644
--- a/test/elm/interval/data.cql
+++ b/test/elm/interval/data.cql
@@ -1633,6 +1633,7 @@ define LongNullBoth: expand { Interval[null, null] } per 1 '1'
 define LongBadPerMinute: expand { Interval(2L, 4L] } per 1 minute
 
 define LongPerDecimalMorePrecise: expand { Interval[10L, 10L] } per 0.1
+define ExpandLargePositiveLongInterval: expand Interval[9007199254740993L, 9007199254740995L]
 
 // @Test: DecimalIntervalExpand
 define ClosedSingle: expand { Interval[2, 5] } per 1.5 '1'
@@ -1656,6 +1657,7 @@ define NullOpen: expand { Interval[null, 4] } per 1.5 '1'
 define NullClose: expand { Interval[2, null] } per 1.5 '1'
 define NullBoth: expand { Interval[null, null] } per 1.5 '1'
 define BadPerMinute: expand { Interval(2.1, 4.1] } per 0.5 minute
+define ExpandLargeDecimalIntervalFractionalStep: expand Interval[9007199254740993.0, 9007199254740993.3] per 0.1
 
 // @Test: SameAs
 define NullBoth: Interval[null as DateTime, null as DateTime] same as Interval[null as DateTime, null as DateTime]
diff --git a/test/elm/interval/data.js b/test/elm/interval/data.js
index 4ad13753e..fe5b3d0bc 100644
--- a/test/elm/interval/data.js
+++ b/test/elm/interval/data.js
@@ -289729,6 +289729,7 @@ define LongNullBoth: expand { Interval[null, null] } per 1 '1'
 define LongBadPerMinute: expand { Interval(2L, 4L] } per 1 minute
 
 define LongPerDecimalMorePrecise: expand { Interval[10L, 10L] } per 0.1
+define ExpandLargePositiveLongInterval: expand Interval[9007199254740993L, 9007199254740995L]
 */
 
 module.exports['LongIntervalExpand'] = {
@@ -289743,7 +289744,7 @@ module.exports['LongIntervalExpand'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "652",
+        "r" : "678",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -292750,6 +292751,114 @@ module.exports['LongIntervalExpand'] = {
             "annotation" : [ ]
           } ]
         }
+      }, {
+        "localId" : "678",
+        "name" : "ExpandLargePositiveLongInterval",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "678",
+            "s" : [ {
+              "value" : [ "", "define ", "ExpandLargePositiveLongInterval", ": " ]
+            }, {
+              "r" : "685",
+              "s" : [ {
+                "value" : [ "expand " ]
+              }, {
+                "r" : "681",
+                "s" : [ {
+                  "r" : "679",
+                  "value" : [ "Interval[", "9007199254740993L", ", ", "9007199254740995L", "]" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "691",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "692",
+            "name" : "{urn:hl7-org:elm-types:r1}Long",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Expand",
+          "localId" : "685",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "689",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "690",
+              "name" : "{urn:hl7-org:elm-types:r1}Long",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "IntervalTypeSpecifier",
+            "localId" : "686",
+            "annotation" : [ ],
+            "pointType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "687",
+              "name" : "{urn:hl7-org:elm-types:r1}Long",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "688",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Interval",
+            "localId" : "681",
+            "lowClosed" : true,
+            "highClosed" : true,
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "IntervalTypeSpecifier",
+              "localId" : "682",
+              "annotation" : [ ],
+              "pointType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "683",
+                "name" : "{urn:hl7-org:elm-types:r1}Long",
+                "annotation" : [ ]
+              }
+            },
+            "low" : {
+              "type" : "Literal",
+              "localId" : "679",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+              "value" : "9007199254740993",
+              "annotation" : [ ]
+            },
+            "high" : {
+              "type" : "Literal",
+              "localId" : "680",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Long",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Long",
+              "value" : "9007199254740995",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "Null",
+            "localId" : "684",
+            "resultTypeName" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ]
+        }
       } ]
     }
   }
@@ -292780,6 +292889,7 @@ define NullOpen: expand { Interval[null, 4] } per 1.5 '1'
 define NullClose: expand { Interval[2, null] } per 1.5 '1'
 define NullBoth: expand { Interval[null, null] } per 1.5 '1'
 define BadPerMinute: expand { Interval(2.1, 4.1] } per 0.5 minute
+define ExpandLargeDecimalIntervalFractionalStep: expand Interval[9007199254740993.0, 9007199254740993.3] per 0.1
 */
 
 module.exports['DecimalIntervalExpand'] = {
@@ -292794,7 +292904,7 @@ module.exports['DecimalIntervalExpand'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "633",
+        "r" : "658",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -295668,6 +295778,118 @@ module.exports['DecimalIntervalExpand'] = {
             "annotation" : [ ]
           } ]
         }
+      }, {
+        "localId" : "658",
+        "name" : "ExpandLargeDecimalIntervalFractionalStep",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "658",
+            "s" : [ {
+              "value" : [ "", "define ", "ExpandLargeDecimalIntervalFractionalStep", ": " ]
+            }, {
+              "r" : "667",
+              "s" : [ {
+                "value" : [ "expand " ]
+              }, {
+                "r" : "661",
+                "s" : [ {
+                  "r" : "659",
+                  "value" : [ "Interval[", "9007199254740993.0", ", ", "9007199254740993.3", "]" ]
+                } ]
+              }, {
+                "r" : "665",
+                "value" : [ " per ", "0.1" ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "673",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "674",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Expand",
+          "localId" : "667",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "671",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "672",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "IntervalTypeSpecifier",
+            "localId" : "668",
+            "annotation" : [ ],
+            "pointType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "669",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "670",
+            "name" : "{urn:hl7-org:elm-types:r1}Quantity",
+            "annotation" : [ ]
+          } ],
+          "operand" : [ {
+            "type" : "Interval",
+            "localId" : "661",
+            "lowClosed" : true,
+            "highClosed" : true,
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "IntervalTypeSpecifier",
+              "localId" : "662",
+              "annotation" : [ ],
+              "pointType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "663",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "low" : {
+              "type" : "Literal",
+              "localId" : "659",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "9007199254740993.0",
+              "annotation" : [ ]
+            },
+            "high" : {
+              "type" : "Literal",
+              "localId" : "660",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "9007199254740993.3",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "Quantity",
+            "localId" : "666",
+            "value" : 0.1,
+            "unit" : "1",
+            "annotation" : [ ]
+          } ]
+        }
       } ]
     }
   }

From 991acc52e8b00e109492443ea426832ef340e2d9 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Fri, 11 Sep 2026 09:37:43 -0400
Subject: [PATCH 51/62] remove Quantity do(+,-,/) helper functions. Point
 existing tests at MathUtil for now

---
 src/datatypes/quantity.ts              | 16 +--------
 test/elm/arithmetic/arithmetic-test.ts | 16 +++------
 test/elm/quantity/quantity-test.ts     | 48 ++++++++++++++------------
 3 files changed, 32 insertions(+), 48 deletions(-)

diff --git a/src/datatypes/quantity.ts b/src/datatypes/quantity.ts
index 433ddc2d4..ee7926436 100644
--- a/src/datatypes/quantity.ts
+++ b/src/datatypes/quantity.ts
@@ -1,4 +1,4 @@
-import { add, subtract, isValidDecimal, overflowsOrUnderflows } from '../util/math';
+import { isValidDecimal, overflowsOrUnderflows } from '../util/math';
 import { Decimal } from './decimal';
 import {
   checkUnit,
@@ -188,20 +188,6 @@ export function parseQuantity(str: string) {
   }
 }
 
-export function doAddition(a: any, b: any) {
-  return add(a, b);
-}
-
-export function doSubtraction(a: any, b: any) {
-  return subtract(a, b);
-}
-
-export function doDivision(a: any, b: any) {
-  if (a != null && a.isQuantity) {
-    return a.dividedBy(b);
-  }
-}
-
 export function doMultiplication(a: any, b: any) {
   if (a != null && a.isQuantity) {
     return a.multiplyBy(b);
diff --git a/test/elm/arithmetic/arithmetic-test.ts b/test/elm/arithmetic/arithmetic-test.ts
index 7b437e295..f0e50f9ef 100644
--- a/test/elm/arithmetic/arithmetic-test.ts
+++ b/test/elm/arithmetic/arithmetic-test.ts
@@ -1,12 +1,6 @@
 import should from 'should';
-import {
-  doAddition,
-  doDivision,
-  doMultiplication,
-  doSubtraction,
-  parseQuantity,
-  Quantity
-} from '../../../src/datatypes/quantity';
+import { doMultiplication, parseQuantity, Quantity } from '../../../src/datatypes/quantity';
+import * as MathUtil from '../../../src/util/math';
 import setup from '../../setup';
 import {
   MAX_INT_VALUE,
@@ -41,11 +35,11 @@ const doQuantityMathTests = function (tests: string[][], operator: string) {
   if (operator === '*') {
     func = doMultiplication;
   } else if (operator === '/') {
-    func = doDivision;
+    func = (a: Quantity, b: Quantity) => a.dividedBy(b);
   } else if (operator === '+') {
-    func = doAddition;
+    func = MathUtil.add;
   } else if (operator === '-') {
-    func = doSubtraction;
+    func = MathUtil.subtract;
   }
 
   for (const t of tests) {
diff --git a/test/elm/quantity/quantity-test.ts b/test/elm/quantity/quantity-test.ts
index 74817d03c..1b887a38e 100644
--- a/test/elm/quantity/quantity-test.ts
+++ b/test/elm/quantity/quantity-test.ts
@@ -1,11 +1,6 @@
 import should from 'should';
-import {
-  doAddition,
-  doDivision,
-  doMultiplication,
-  doSubtraction,
-  Quantity
-} from '../../../src/datatypes/quantity';
+import { doMultiplication, Quantity } from '../../../src/datatypes/quantity';
+import * as MathUtil from '../../../src/util/math';
 
 describe('Quantity', () => {
   it('should allow creation of Quantity with valid ucum units', () =>
@@ -86,14 +81,14 @@ describe('Quantity', () => {
     const quantity1 = new Quantity(2, 'm');
     const quantity2 = new Quantity(2, 'm');
     quantity2.unit = 'fakeUnit';
-    should(doAddition(quantity1, quantity2)).be.null();
+    should(MathUtil.add(quantity1, quantity2)).be.null();
   });
 
   it('subtracted from Quantity with invalid ucum units results in null', () => {
     const quantity1 = new Quantity(2, 'm');
     const quantity2 = new Quantity(2, 'm');
     quantity2.unit = 'fakeUnit';
-    should(doSubtraction(quantity1, quantity2)).be.null();
+    should(MathUtil.subtract(quantity1, quantity2)).be.null();
   });
 
   it('multiplied by Quantity with invalid ucum units results in null', () => {
@@ -107,7 +102,7 @@ describe('Quantity', () => {
     const quantity1 = new Quantity(2, 'm');
     const quantity2 = new Quantity(2, 'm');
     quantity2.unit = 'fakeUnit';
-    should(doDivision(quantity1, quantity2)).be.null();
+    should(quantity1.dividedBy(quantity2)).be.null();
   });
 
   it('should convert units when possible to perform arithmetic', () => {
@@ -115,16 +110,16 @@ describe('Quantity', () => {
     divide.equals(new Quantity(16, '1')).should.be.true();
     const multiply = new Quantity(8, 'cm').multiplyBy(new Quantity(2, 'm'));
     multiply.equals(new Quantity(0.16, 'm2')).should.be.true();
-    const add = doAddition(new Quantity(8, 'cm'), new Quantity(2, 'm'));
+    const add = MathUtil.add(new Quantity(8, 'cm'), new Quantity(2, 'm'));
     add.equals(new Quantity(2.08, 'm')).should.be.true();
-    const subtract = doSubtraction(new Quantity(150, 'cm'), new Quantity(1, 'm'));
+    const subtract = MathUtil.subtract(new Quantity(150, 'cm'), new Quantity(1, 'm'));
     subtract.equals(new Quantity(0.5, 'm')).should.be.true();
   });
 
   it('should return null when units are mismatched and cannot be converted', () => {
-    const add = doAddition(new Quantity(8, 'cm'), new Quantity(2, 'g'));
+    const add = MathUtil.add(new Quantity(8, 'cm'), new Quantity(2, 'g'));
     should.not.exist(add);
-    const subtract = doSubtraction(new Quantity(150, 'cm'), new Quantity(1, 'mg'));
+    const subtract = MathUtil.subtract(new Quantity(150, 'cm'), new Quantity(1, 'mg'));
     should.not.exist(subtract);
   });
 
@@ -138,11 +133,17 @@ describe('Quantity', () => {
         const multiplyWithOneOnRight = new Quantity(8, 'm').multiplyBy(new Quantity(2, '1'));
         const multiplyWithNullOnRight = new Quantity(8, 'm').multiplyBy(new Quantity(2, unit));
         multiplyWithOneOnRight.should.deepEqual(multiplyWithNullOnRight);
-        const addWithOneOnRight = doAddition(new Quantity(8, '1'), new Quantity(2, '1'));
-        const addWithNullOnRight = doAddition(new Quantity(8, '1'), new Quantity(2, unit));
+        const addWithOneOnRight = MathUtil.add(new Quantity(8, '1'), new Quantity(2, '1'));
+        const addWithNullOnRight = MathUtil.add(new Quantity(8, '1'), new Quantity(2, unit));
         addWithOneOnRight.should.deepEqual(addWithNullOnRight);
-        const subtractWithOneOnRight = doSubtraction(new Quantity(8, '1'), new Quantity(2, '1'));
-        const subtractWithNullOnRight = doSubtraction(new Quantity(8, '1'), new Quantity(2, unit));
+        const subtractWithOneOnRight = MathUtil.subtract(
+          new Quantity(8, '1'),
+          new Quantity(2, '1')
+        );
+        const subtractWithNullOnRight = MathUtil.subtract(
+          new Quantity(8, '1'),
+          new Quantity(2, unit)
+        );
         subtractWithOneOnRight.should.deepEqual(subtractWithNullOnRight);
 
         const divideWithOneOnLeft = new Quantity(8, '1').dividedBy(new Quantity(2, 'm'));
@@ -151,11 +152,14 @@ describe('Quantity', () => {
         const multiplyWithOneOnLeft = new Quantity(8, '1').multiplyBy(new Quantity(2, 'm'));
         const multiplyWithNullOnLeft = new Quantity(8, unit).multiplyBy(new Quantity(2, 'm'));
         multiplyWithOneOnLeft.should.deepEqual(multiplyWithNullOnLeft);
-        const addWithOneOnLeft = doAddition(new Quantity(8, '1'), new Quantity(2, '1'));
-        const addWithNullOnLeft = doAddition(new Quantity(8, unit), new Quantity(2, '1'));
+        const addWithOneOnLeft = MathUtil.add(new Quantity(8, '1'), new Quantity(2, '1'));
+        const addWithNullOnLeft = MathUtil.add(new Quantity(8, unit), new Quantity(2, '1'));
         addWithOneOnLeft.should.deepEqual(addWithNullOnLeft);
-        const subtractWithOneOnLeft = doSubtraction(new Quantity(8, '1'), new Quantity(2, '1'));
-        const subtractWithNullOnLeft = doSubtraction(new Quantity(8, unit), new Quantity(2, '1'));
+        const subtractWithOneOnLeft = MathUtil.subtract(new Quantity(8, '1'), new Quantity(2, '1'));
+        const subtractWithNullOnLeft = MathUtil.subtract(
+          new Quantity(8, unit),
+          new Quantity(2, '1')
+        );
         subtractWithOneOnLeft.should.deepEqual(subtractWithNullOnLeft);
       });
     })(unit);

From 7574ce1daa0f05cdaf1e1106bc667fa5da9c9d1b Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Fri, 11 Sep 2026 10:51:42 -0400
Subject: [PATCH 52/62] simplify units logic, remove division factor

---
 src/util/units.ts | 18 +++---------------
 1 file changed, 3 insertions(+), 15 deletions(-)

diff --git a/src/util/units.ts b/src/util/units.ts
index 0a539c194..782b52351 100644
--- a/src/util/units.ts
+++ b/src/util/units.ts
@@ -79,7 +79,6 @@ export function convertUnit(fromVal: Decimal, fromUnit: any, toUnit: any) {
   // First though, make sure the units can be safely converted by simple scalar factor.
   // Units that cannot because they require a special function, such as C <--> F,
   // fall back to calling the UCUM library directly.
-
   const testFrom = utils.convertToBaseUnits(fromUnit, 1);
   const testTo = utils.convertToBaseUnits(toUnit, 1);
 
@@ -89,23 +88,12 @@ export function convertUnit(fromVal: Decimal, fromUnit: any, toUnit: any) {
 
   let rawResult: Decimal;
   if (testFrom.fromUnitIsSpecial === false && testTo.fromUnitIsSpecial === false) {
-    // try both directions to see if one is more exact,
-    // eg, days to weeks is * 0.142857... but weeks to days is * 7, so days to weeks could be / 7 instead
-    const fromToTo = utils.convertUnitTo(fromUnit, 1, toUnit);
-    const toToFrom = utils.convertUnitTo(toUnit, 1, fromUnit);
-    if (fromToTo.status !== 'succeeded' || toToFrom.status !== 'succeeded') {
+    const conversion = utils.convertUnitTo(fromUnit, 1, toUnit);
+    if (conversion.status !== 'succeeded') {
       return;
     }
-
-    const multFactor = fromToTo.toVal;
-    const divFactor = toToFrom.toVal;
     // NOTE: conversion factor is a JS number and can itself be imprecise, eg, inches to m is 0.025400000000000002
-    if (Number.isInteger(divFactor)) {
-      rawResult = fromVal.divideBy(divFactor);
-    } else {
-      // We could consider more heuristics here, but for now just fall back to the multiplication factor
-      rawResult = fromVal.multiplyBy(multFactor);
-    }
+    rawResult = fromVal.multiplyBy(conversion.toVal);
   } else {
     // units are special, so call the library with the exact value
     const result = utils.convertUnitTo(fromUnit, fromVal.toNumber(), toUnit);

From 8d7354aa80a7ce396e27d22e1fdce5d7dc2447d8 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 07:24:56 -0400
Subject: [PATCH 53/62] remove Decimal.truncated, export TRUNCATE_TO_PRECISION
 rounding mode

---
 src/datatypes/decimal.ts       | 16 ++--------------
 src/elm/interval.ts            |  6 +++---
 test/datatypes/decimal-test.ts | 24 +++++++++---------------
 3 files changed, 14 insertions(+), 32 deletions(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index 05ad6e873..ca927e657 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -12,8 +12,8 @@ export type DecimalInput = Decimal | string | number | bigint;
 export type DecimalRoundingMode = DecimalJS.Rounding;
 
 const CQL_IMPLICIT_SCALE = 8;
-const CQL_IMPLICIT_ROUNDING = CQLDecimalJS.ROUND_HALF_UP;
-const TRUNCATE_TO_PRECISION = CQLDecimalJS.ROUND_DOWN;
+export const CQL_IMPLICIT_ROUNDING = CQLDecimalJS.ROUND_HALF_UP;
+export const TRUNCATE_TO_PRECISION = CQLDecimalJS.ROUND_DOWN;
 
 export class Decimal {
   private readonly value: DecimalJS;
@@ -216,18 +216,6 @@ export class Decimal {
     return BigInt(this.value.truncated().toString());
   }
 
-  truncated(scale?: number): Decimal {
-    // specifying a scale here allows for "truncating to a precision"
-    // this is currently used in Interval.expand
-
-    if (!scale) {
-      // undefined or 0 both mean truncated to an integer
-      return new Decimal(this.value.truncated(), 0);
-    }
-
-    return this.withScale(scale, TRUNCATE_TO_PRECISION);
-  }
-
   ceil(): number {
     return this.value.ceil().toNumber();
   }
diff --git a/src/elm/interval.ts b/src/elm/interval.ts
index b5090d5c1..5074262d9 100644
--- a/src/elm/interval.ts
+++ b/src/elm/interval.ts
@@ -9,7 +9,7 @@ import { Context } from '../runtime/context';
 import { build } from './builder';
 import { IntervalTypeSpecifier, NamedTypeSpecifier } from '../types/type-specifiers.interfaces';
 import { ELM_ANY_TYPE, ELM_NAMED_TYPE_SPECIFIER } from '../util/elmTypes';
-import { Decimal } from '../datatypes/decimal';
+import { Decimal, TRUNCATE_TO_PRECISION } from '../datatypes/decimal';
 import { MAX_INT_VALUE, MIN_INT_VALUE } from '../util/limits';
 
 export class Interval extends Expression {
@@ -682,8 +682,8 @@ export class Expand extends Expression {
     // If the interval boundaries are more precise than the per quantity, the
     // more precise values will be truncated to the precision specified by the
     // per quantity.
-    low = low.truncated(perValue.scale);
-    high = high.truncated(perValue.scale);
+    low = low.withScale(perValue.scale, TRUNCATE_TO_PRECISION);
+    high = high.withScale(perValue.scale, TRUNCATE_TO_PRECISION);
 
     const perUnitSize = perIsIntegral ? 1 : 0.00000001;
     // NOTE: This is based on the size of an interval being based on the point-size of the type.
diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 0777bf71a..9fce2b2ee 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -1,4 +1,4 @@
-import { Decimal } from '../../src/datatypes/decimal';
+import { Decimal, TRUNCATE_TO_PRECISION } from '../../src/datatypes/decimal';
 
 describe('Decimal', () => {
   describe('from', () => {
@@ -214,19 +214,6 @@ describe('Decimal', () => {
     });
   });
 
-  describe('truncated', () => {
-    it('should truncate to an optional decimal scale', () => {
-      Decimal.from('-1.239').truncated(2).should.equalDecimal('-1.23');
-      Decimal.from('1.9').truncated().should.equalDecimal('1.0');
-    });
-
-    it('should treat scale zero as integer truncation', () => {
-      const result = Decimal.from('1.99').truncated(0);
-      result.should.equalDecimal('1.0');
-      result.scale.should.equal(0);
-    });
-  });
-
   describe('ceil', () => {
     it('should return the smallest integer not less than the value', () => {
       Decimal.from('1.1').ceil().should.equal(2);
@@ -310,11 +297,18 @@ describe('Decimal', () => {
   });
 
   describe('withScale', () => {
-    it('should use CQL half-up rounding', () => {
+    it('should use CQL half-up rounding if no rounding mode specified', () => {
       Decimal.from('-0.5').withScale(0).should.equalDecimal('-1.0');
       Decimal.from('0.444444444').withScale(8).should.equalDecimal('0.44444444');
     });
 
+    it('should truncate to precision when specified', () => {
+      Decimal.from('-0.5').withScale(0, TRUNCATE_TO_PRECISION).should.equalDecimal('0');
+      Decimal.from('1.777').withScale(0, TRUNCATE_TO_PRECISION).should.equalDecimal('1');
+      Decimal.from('1.777').withScale(1, TRUNCATE_TO_PRECISION).should.equalDecimal('1.7');
+      Decimal.from('1.777').withScale(2, TRUNCATE_TO_PRECISION).should.equalDecimal('1.77');
+    });
+
     it('should reject invalid scales', () => {
       (() => Decimal.from(1).withScale(-1)).should.throw(RangeError);
       (() => Decimal.from(1).withScale(1.5)).should.throw(RangeError);

From 06e8c845d635223e8c1b90d62b9e2791ac3cbd05 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 07:49:29 -0400
Subject: [PATCH 54/62] update cql-tests to the latest

---
 .../cql/CqlArithmeticFunctionsTest.cql        |  50 +-
 .../cql/CqlArithmeticFunctionsTest.json       | 790 +++++++++++++++++-
 .../cql/CqlDateTimeOperatorsTest.cql          |   8 +
 .../cql/CqlDateTimeOperatorsTest.json         | 354 ++++++++
 test/spec-tests/skip-list.txt                 |  21 +-
 .../xml/CqlArithmeticFunctionsTest.xml        |  37 +-
 .../xml/CqlDateTimeOperatorsTest.xml          |  10 +
 7 files changed, 1189 insertions(+), 81 deletions(-)

diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
index 624ae2173..b57c1a44b 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
@@ -694,23 +694,37 @@ define "Predecessor": Tuple{
     output: 0L
   },
   "PredecessorOf1D": Tuple{
-    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147'
+    skipped: 'Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware.'
     /*
     expression: predecessor of 1.0,
     output: 0.99999999
     */  },
   "PredecessorOf101D": Tuple{
-    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    skipped: 'Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware'
     /*
     expression: predecessor of 1.01,
     output: 1.00999999
     */  },
+  "PredecessorOf1DPrecision": Tuple{
+    expression: predecessor of 1.0,
+    output: 0.9
+  },
+  "PredecessorOf101DPrecision": Tuple{
+    expression: predecessor of 1.01,
+    output: 1.00
+  },
   "PredecessorOf1QCM": Tuple{
-    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    skipped: 'Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware'
     /*
     expression: predecessor of 1.0 'cm',
     output: 0.99999999'cm'
     */  },
+  "PredecessorOf1QCMPrecision": Tuple{
+    skipped: 'Wrong answer: Translator loses Decimal in ELM representation of Quantity literal.'
+    /*
+    expression: predecessor of 1.0 'cm',
+    output: 0.9'cm'
+    */  },
   "PredecessorOfJan12000": Tuple{
     expression: predecessor of DateTime(2000,1,1),
     output: @1999-12-31T
@@ -896,17 +910,25 @@ define "Successor": Tuple{
     output: 2L
   },
   "SuccessorOf1D": Tuple{
-    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    skipped: 'Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware'
     /*
     expression: successor of 1.0,
     output: 1.00000001
     */  },
   "SuccessorOf101D": Tuple{
-    skipped: 'Wrong output: As of 2.0 Successor of Decimal should be precision-aware'
+    skipped: 'Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware'
     /*
     expression: successor of 1.01,
     output: 1.01000001
     */  },
+  "SuccessorOf1DPrecision": Tuple{
+    expression: successor of 1.0,
+    output: 1.1
+  },
+  "SuccessorOf101DPrecision": Tuple{
+    expression: successor of 1.01,
+    output: 1.02
+  },
   "SuccessorOfJan12000": Tuple{
     expression: successor of DateTime(2000,1,1),
     output: @2000-01-02T
@@ -1050,23 +1072,17 @@ define "Truncated Divide": Tuple{
     output: 2.0
   },
   "TruncatedDivide10d1ByNeg3D1Quantity": Tuple{
-    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit; \'g\' / \'g\' should be \'1\', not \'g\'. See https://github.com/cqframework/cql-tests/pull/148'
-    /*
     expression: 10.1 'cm' div -3.1 'cm',
-    output: -3.0 'cm'
-    */  },
+    output: -3.0 '1'
+  },
   "TruncatedDivide10By5DQuantity": Tuple{
-    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit'
-    /*
     expression: 10.0 'g' div 5.0 'g',
-    output: 2.0 'g'
-    */  },
+    output: 2.0 '1'
+  },
   "TruncatedDivide414By206DQuantity": Tuple{
-    skipped: 'Wrong output: The resulting Quantity should have an appropriate unit'
-    /*
     expression: 4.14 'm' div 2.06 'm',
-    output: 2.0 'm'
-    */  },
+    output: 2.0 '1'
+  },
   "TruncatedDivide10By0DQuantity": Tuple{
     expression: 10.0 'g' div 0.0 'g',
     output: null
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
index 82e90b7ee..2bb93b119 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
@@ -18342,6 +18342,62 @@
                   ]
                 }
               },
+              {
+                "name": "PredecessorOf1DPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "PredecessorOf101DPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "PredecessorOf1QCM",
                 "annotation": [],
@@ -18361,6 +18417,25 @@
                   ]
                 }
               },
+              {
+                "name": "PredecessorOf1QCMPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "PredecessorOfJan12000",
                 "annotation": [],
@@ -18632,6 +18707,62 @@
                     ]
                   }
                 },
+                {
+                  "name": "PredecessorOf1DPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "PredecessorOf101DPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "PredecessorOf1QCM",
                   "annotation": [],
@@ -18651,6 +18782,25 @@
                     ]
                   }
                 },
+                {
+                  "name": "PredecessorOf1QCMPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "PredecessorOfJan12000",
                   "annotation": [],
@@ -19044,7 +19194,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147",
+                        "value": "Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware.",
                         "annotation": []
                       }
                     }
@@ -19078,7 +19228,125 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
+                        "value": "Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "PredecessorOf1DPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Predecessor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "0.9",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "PredecessorOf101DPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Predecessor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.01",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.00",
                         "annotation": []
                       }
                     }
@@ -19112,7 +19380,41 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
+                        "value": "Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "PredecessorOf1QCMPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Wrong answer: Translator loses Decimal in ELM representation of Quantity literal.",
                         "annotation": []
                       }
                     }
@@ -23480,6 +23782,62 @@
                   ]
                 }
               },
+              {
+                "name": "SuccessorOf1DPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SuccessorOf101DPrecision",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "SuccessorOfJan12000",
                 "annotation": [],
@@ -23751,6 +24109,62 @@
                     ]
                   }
                 },
+                {
+                  "name": "SuccessorOf1DPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "SuccessorOf101DPrecision",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "SuccessorOfJan12000",
                   "annotation": [],
@@ -24138,7 +24552,100 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
+                        "value": "Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SuccessorOf101D",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "skipped",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "skipped",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
+                        "valueType": "{urn:hl7-org:elm-types:r1}String",
+                        "value": "Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "SuccessorOf1DPrecision",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "Successor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.0",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.1",
                         "annotation": []
                       }
                     }
@@ -24146,7 +24653,7 @@
                 }
               },
               {
-                "name": "SuccessorOf101D",
+                "name": "SuccessorOf101DPrecision",
                 "value": {
                   "type": "Tuple",
                   "annotation": [],
@@ -24155,11 +24662,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Decimal",
                           "annotation": []
                         }
                       }
@@ -24167,12 +24683,28 @@
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
+                      "value": {
+                        "type": "Successor",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Literal",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                          "value": "1.01",
+                          "annotation": []
+                        }
+                      }
+                    },
+                    {
+                      "name": "output",
                       "value": {
                         "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: As of 2.0 Successor of Decimal should be precision-aware",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Decimal",
+                        "value": "1.02",
                         "annotation": []
                       }
                     }
@@ -26569,11 +27101,20 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": []
                       }
                     }
@@ -26588,11 +27129,20 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": []
                       }
                     }
@@ -26607,11 +27157,20 @@
                   "annotation": [],
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "annotation": [],
                       "elementType": {
                         "type": "NamedTypeSpecifier",
-                        "name": "{urn:hl7-org:elm-types:r1}String",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Quantity",
                         "annotation": []
                       }
                     }
@@ -27167,11 +27726,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -27186,11 +27754,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -27205,11 +27782,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -28608,11 +29194,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -28620,13 +29215,50 @@
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See https://github.com/cqframework/cql-tests/pull/148",
-                        "annotation": []
+                        "type": "TruncatedDivide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 10.1,
+                            "unit": "cm",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Negate",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "annotation": [],
+                            "signature": [],
+                            "operand": {
+                              "type": "Quantity",
+                              "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                              "value": 3.1,
+                              "unit": "cm",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Negate",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": {
+                          "type": "Quantity",
+                          "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "value": 3,
+                          "unit": "1",
+                          "annotation": []
+                        }
                       }
                     }
                   ]
@@ -28642,11 +29274,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -28654,12 +29295,37 @@
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: The resulting Quantity should have an appropriate unit",
+                        "type": "TruncatedDivide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 10,
+                            "unit": "g",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 5,
+                            "unit": "g",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 2,
+                        "unit": "1",
                         "annotation": []
                       }
                     }
@@ -28676,11 +29342,20 @@
                     "annotation": [],
                     "element": [
                       {
-                        "name": "skipped",
+                        "name": "expression",
                         "annotation": [],
                         "elementType": {
                           "type": "NamedTypeSpecifier",
-                          "name": "{urn:hl7-org:elm-types:r1}String",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Quantity",
                           "annotation": []
                         }
                       }
@@ -28688,12 +29363,37 @@
                   },
                   "element": [
                     {
-                      "name": "skipped",
+                      "name": "expression",
                       "value": {
-                        "type": "Literal",
-                        "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
-                        "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: The resulting Quantity should have an appropriate unit",
+                        "type": "TruncatedDivide",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 4.14,
+                            "unit": "m",
+                            "annotation": []
+                          },
+                          {
+                            "type": "Quantity",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                            "value": 2.06,
+                            "unit": "m",
+                            "annotation": []
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Quantity",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Quantity",
+                        "value": 2,
+                        "unit": "1",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
index ce21523b5..42f483d6b 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
@@ -606,6 +606,14 @@ define "Duration": Tuple{
     expression: years between DateTime(2005, 5) and DateTime(2010, 4),
     output: 4
   },
+  "YearsBetweenLeapYearDatesEquals2": Tuple{
+    expression: years between @2012-02-29 and @2014-02-28,
+    output: 2
+  },
+  "YearsBetweenLeapYearDateTimesEquals2": Tuple{
+    expression: years between @2012-02-29T12:34:56 and @2014-02-28T12:34:56,
+    output: 2
+  },
   "DateTimeDurationBetweenMonth": Tuple{
     expression: months between @2014-01-31 and @2014-02-01,
     output: 0
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
index 6ab5a5c2d..4b9b7ed6e 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
@@ -25696,6 +25696,62 @@
                   ]
                 }
               },
+              {
+                "name": "YearsBetweenLeapYearDatesEquals2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "YearsBetweenLeapYearDateTimesEquals2",
+                "annotation": [],
+                "elementType": {
+                  "type": "TupleTypeSpecifier",
+                  "annotation": [],
+                  "element": [
+                    {
+                      "name": "expression",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "annotation": [],
+                      "elementType": {
+                        "type": "NamedTypeSpecifier",
+                        "name": "{urn:hl7-org:elm-types:r1}Integer",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "DateTimeDurationBetweenMonth",
                 "annotation": [],
@@ -25821,6 +25877,62 @@
                     ]
                   }
                 },
+                {
+                  "name": "YearsBetweenLeapYearDatesEquals2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
+                {
+                  "name": "YearsBetweenLeapYearDateTimesEquals2",
+                  "annotation": [],
+                  "elementType": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  }
+                },
                 {
                   "name": "DateTimeDurationBetweenMonth",
                   "annotation": [],
@@ -26082,6 +26194,248 @@
                   ]
                 }
               },
+              {
+                "name": "YearsBetweenLeapYearDatesEquals2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "29",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "Date",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}Date",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "28",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
+              {
+                "name": "YearsBetweenLeapYearDateTimesEquals2",
+                "value": {
+                  "type": "Tuple",
+                  "annotation": [],
+                  "resultTypeSpecifier": {
+                    "type": "TupleTypeSpecifier",
+                    "annotation": [],
+                    "element": [
+                      {
+                        "name": "expression",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      },
+                      {
+                        "name": "output",
+                        "annotation": [],
+                        "elementType": {
+                          "type": "NamedTypeSpecifier",
+                          "name": "{urn:hl7-org:elm-types:r1}Integer",
+                          "annotation": []
+                        }
+                      }
+                    ]
+                  },
+                  "element": [
+                    {
+                      "name": "expression",
+                      "value": {
+                        "type": "DurationBetween",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "precision": "Year",
+                        "annotation": [],
+                        "signature": [],
+                        "operand": [
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2012",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "29",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "34",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "56",
+                              "annotation": []
+                            }
+                          },
+                          {
+                            "type": "DateTime",
+                            "resultTypeName": "{urn:hl7-org:elm-types:r1}DateTime",
+                            "annotation": [],
+                            "signature": [],
+                            "year": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2014",
+                              "annotation": []
+                            },
+                            "month": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "2",
+                              "annotation": []
+                            },
+                            "day": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "28",
+                              "annotation": []
+                            },
+                            "hour": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "12",
+                              "annotation": []
+                            },
+                            "minute": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "34",
+                              "annotation": []
+                            },
+                            "second": {
+                              "type": "Literal",
+                              "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                              "value": "56",
+                              "annotation": []
+                            }
+                          }
+                        ]
+                      }
+                    },
+                    {
+                      "name": "output",
+                      "value": {
+                        "type": "Literal",
+                        "resultTypeName": "{urn:hl7-org:elm-types:r1}Integer",
+                        "valueType": "{urn:hl7-org:elm-types:r1}Integer",
+                        "value": "2",
+                        "annotation": []
+                      }
+                    }
+                  ]
+                }
+              },
               {
                 "name": "DateTimeDurationBetweenMonth",
                 "value": {
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index 1c8fbd74d..db6ab0f55 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -3,7 +3,6 @@ CqlTypesTest.Time.TimeUpperBoundHours       Intentional Translator error: Invali
 CqlTypesTest.Time.TimeUpperBoundMinutes     Translator error: Invalid time input[...]
 CqlTypesTest.Time.TimeUpperBoundSeconds     Translator error: Invalid time input[...]
 "CqlDateTimeOperatorsTest.Uncertainty tests.TimeDurationBetweenHourDiffPrecision"       Translator error: Syntax error at Z
-CqlDateTimeOperatorsTest.DateTimeComponentFrom.DateTimeComponentFromTimezoneOffset      Translator error: Timezone keyword is only valid in 1.3 or lower
 
 # Invalid Translation (translates, but translates wrong)
 CqlAggregateTest.AggregateTests.RolledOutIntervals  CQL adds an integer to a date ("S + duration in days of X"). Should be "S + Quantity{ value: duration in days of X, unit: 'days' }". Translator translates it, but probably shouldn't.
@@ -23,15 +22,7 @@ CqlListOperatorsTest.Equal.EqualNullNull                        Wrong output: Ac
 CqlListOperatorsTest.Sort.simpleSortAsc                         Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlListOperatorsTest.Sort.simpleSortDesc                        Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: Interval[null, null] is not a unit interval, nor is it null
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10d1ByNeg3D1Quantity"     Wrong output: The resulting Quantity should have an appropriate unit; 'g' / 'g' should be '1', not 'g'. See https://github.com/cqframework/cql-tests/pull/148
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide10By5DQuantity"           Wrong output: The resulting Quantity should have an appropriate unit
-"CqlArithmeticFunctionsTest.Truncated Divide.TruncatedDivide414By206DQuantity"        Wrong output: The resulting Quantity should have an appropriate unit
 "CqlStringOperatorsTest.toString tests.QuantityToString"        Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side
-CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1D          Wrong output: As of 2.0 Successor of Decimal should be precision-aware. See https://github.com/cqframework/cql-tests/pull/147
-CqlArithmeticFunctionsTest.Predecessor.PredecessorOf101D        Wrong output: As of 2.0 Successor of Decimal should be precision-aware
-CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCM        Wrong output: As of 2.0 Successor of Decimal should be precision-aware
-CqlArithmeticFunctionsTest.Successor.SuccessorOf1D              Wrong output: As of 2.0 Successor of Decimal should be precision-aware
-CqlArithmeticFunctionsTest.Successor.SuccessorOf101D            Wrong output: As of 2.0 Successor of Decimal should be precision-aware
 CqlArithmeticFunctionsTest.Power.Power0To0                      Wrong output: As of CQL 2.0, Power always returns Decimal
 CqlArithmeticFunctionsTest.Power.Power2To2                      Wrong output: As of CQL 2.0, Power always returns Decimal
 CqlArithmeticFunctionsTest.Power.PowerNeg2To2                   Wrong output: As of CQL 2.0, Power always returns Decimal
@@ -84,7 +75,7 @@ ValueLiteralsAndSelectors.Decimal.DecimalPos10Pow28ToZeroOneStepDecimalMaxValue
 CqlDateTimeOperatorsTest.Subtract.DateTimeSubtract1YearInSeconds                        Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05
 CqlTypesTest.DateTime.DateTimeNull                                                      Wrong answer: null vs DateTime with null components
 CqlTypesTest.Time.TimeMillisParsing                                                     Wrong answer: @T23:59:59.100 vs @T23:59:59.10000
-
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCMPrecision          Wrong answer: Translator loses Decimal precision (trailing zeros) in ELM representation of Quantity literal
 
 # Unimplemented
 CqlArithmeticFunctionsTest.HighBoundary                 HighBoundary not implemented
@@ -97,4 +88,12 @@ CqlArithmeticFunctionsTest.Modulo.ModuloQuantity                      Modulo not
 CqlArithmeticFunctionsTest.Modulo.Modulo10By3Quantity                 Modulo not implemented for Quantity
 
 # Unimplemented (New in CQL 2.0)
-CqlListOperatorsTest.Slice                              Slice not implemented
\ No newline at end of file
+CqlListOperatorsTest.Slice                              Slice not implemented
+
+# Legacy Behavior (Test targets an earlier version of CQL)
+CqlDateTimeOperatorsTest.DateTimeComponentFrom.DateTimeComponentFromTimezoneOffset      Translator error: Timezone keyword is only valid in 1.3 or lower
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1D          Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware.
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf101D        Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware
+CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCM        Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware
+CqlArithmeticFunctionsTest.Successor.SuccessorOf1D              Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware
+CqlArithmeticFunctionsTest.Successor.SuccessorOf101D            Test targets <= 1.5.3. As of 2.0 Successor of Decimal is precision-aware
\ No newline at end of file
diff --git a/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml b/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
index 72e3d73c0..f10620f70 100644
--- a/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
+++ b/test/spec-tests/xml/CqlArithmeticFunctionsTest.xml
@@ -725,19 +725,32 @@
 			<expression>predecessor of 1L</expression>
 			<output>0L</output>
 		</test>
-		<test name="PredecessorOf1D" version="1.0">
+		<test name="PredecessorOf1D" version="1.0" versionTo="1.5.3">
 			<expression>predecessor of 1.0</expression>
 			<output>0.99999999</output>
 		</test>
-		<test name="PredecessorOf101D" version="1.0">
+		<test name="PredecessorOf101D" version="1.0" versionTo="1.5.3">
 			<expression>predecessor of 1.01</expression>
 			<output>1.00999999</output>
 		</test>
-		<test name="PredecessorOf1QCM" version="1.0">
+		<test name="PredecessorOf1DPrecision" version="2.0">
+			<expression>predecessor of 1.0</expression>
+			<output>0.9</output>
+		</test>
+		<test name="PredecessorOf101DPrecision" version="2.0">
+			<expression>predecessor of 1.01</expression>
+			<output>1.00</output>
+		</test>
+		<test name="PredecessorOf1QCM" version="1.0" versionTo="1.5.3">
 			<capability code="ucum-unit-conversion-support"/>
 			<expression>predecessor of 1.0 'cm'</expression>
 			<output>0.99999999'cm'</output>
 		</test>
+		<test name="PredecessorOf1QCMPrecision" version="2.0">
+			<capability code="ucum-unit-conversion-support"/>
+			<expression>predecessor of 1.0 'cm'</expression>
+			<output>0.9'cm'</output>
+		</test>
 		<test name="PredecessorOfJan12000" version="1.0">
 			<expression>predecessor of DateTime(2000,1,1)</expression>
 			<output>@1999-12-31T</output>
@@ -916,14 +929,22 @@
 			<expression>successor of 1L</expression>
 			<output>2L</output>
 		</test>
-		<test name="SuccessorOf1D" version="1.0">
+		<test name="SuccessorOf1D" version="1.0" versionTo="1.5.3">
 			<expression>successor of 1.0</expression>
 			<output>1.00000001</output>
 		</test>
-		<test name="SuccessorOf101D" version="1.0">
+		<test name="SuccessorOf101D" version="1.0" versionTo="1.5.3">
 			<expression>successor of 1.01</expression>
 			<output>1.01000001</output>
 		</test>
+		<test name="SuccessorOf1DPrecision" version="2.0">
+			<expression>successor of 1.0</expression>
+			<output>1.1</output>
+		</test>
+		<test name="SuccessorOf101DPrecision" version="2.0">
+			<expression>successor of 1.01</expression>
+			<output>1.02</output>
+		</test>
 		<test name="SuccessorOfJan12000" version="1.0">
 			<expression>successor of DateTime(2000,1,1)</expression>
 			<output>@2000-01-02T</output>
@@ -1071,17 +1092,17 @@
 		<test name="TruncatedDivide10d1ByNeg3D1Quantity" version="1.0">
 			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.1 'cm' div -3.1 'cm'</expression>
-			<output>-3.0 'cm'</output>
+			<output>-3.0 '1'</output>
 		</test>
 		<test name="TruncatedDivide10By5DQuantity" version="1.0">
 			<capability code="ucum-unit-conversion-support"/>
 			<expression>10.0 'g' div 5.0 'g'</expression>
-			<output>2.0 'g'</output>
+			<output>2.0 '1'</output>
 		</test>
 		<test name="TruncatedDivide414By206DQuantity" version="1.0">
 			<capability code="ucum-unit-conversion-support"/>
 			<expression>4.14 'm' div 2.06 'm'</expression>
-			<output>2.0 'm'</output>
+			<output>2.0 '1'</output>
 		</test>
 		<test name="TruncatedDivide10By0DQuantity" version="1.0">
 			<capability code="ucum-unit-conversion-support"/>
diff --git a/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml b/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
index 193a3903e..da3d69478 100644
--- a/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
+++ b/test/spec-tests/xml/CqlDateTimeOperatorsTest.xml
@@ -821,6 +821,16 @@
 			<expression>years between DateTime(2005, 5) and DateTime(2010, 4)</expression>
 			<output>4</output>
 		</test>
+		<test name="YearsBetweenLeapYearDatesEquals2" version="1.4">
+			<capability code="duration-between"/>
+			<expression>years between @2012-02-29 and @2014-02-28</expression>
+			<output>2</output>
+		</test>
+		<test name="YearsBetweenLeapYearDateTimesEquals2" version="1.4">
+			<capability code="duration-between"/>
+			<expression>years between @2012-02-29T12:34:56 and @2014-02-28T12:34:56</expression>
+			<output>2</output>
+		</test>
 		<test name="DateTimeDurationBetweenMonth" version="1.4">
 		  	<capability code="duration-between"/>
 			<expression>months between @2014-01-31 and @2014-02-01</expression>

From 2a4927bb3d1638f98b60bd9f623de515196f8161 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 09:29:45 -0400
Subject: [PATCH 55/62] Return only one value from Mode, even in case of ties

---
 src/elm/aggregate.ts                 | 12 ++++++++++--
 test/elm/aggregate/aggregate-test.ts | 14 ++++++++++----
 2 files changed, 20 insertions(+), 6 deletions(-)

diff --git a/src/elm/aggregate.ts b/src/elm/aggregate.ts
index 97a1c9465..648ac83eb 100644
--- a/src/elm/aggregate.ts
+++ b/src/elm/aggregate.ts
@@ -251,14 +251,22 @@ export class Mode extends AggregateExpression {
       if (mode.length === 1) {
         return new Quantity(mode[0], items[0].unit);
       } else {
-        return mode.map(m => new Quantity(m, items[0].unit));
+        // TODO: The spec does not currently support returning multiple modes in case of a tie,
+        // the method signature is `Mode(argument List<T>) T`.
+        // To avoid returning something unexpected that will cause errors in followup expressions,
+        // just return the first result here. (See also the non-Quantity branch below)
+        // See: https://jira.hl7.org/browse/FHIR-58745
+        // return mode.map(m => new Quantity(m, items[0].unit));
+        return new Quantity(mode[0], items[0].unit);
       }
     } else {
       const mode = this.mode(filtered);
       if (mode.length === 1) {
         return mode[0];
       } else {
-        return mode;
+        // For now, return only a single value. See note above.
+        // return mode;
+        return mode[0];
       }
     }
   }
diff --git a/test/elm/aggregate/aggregate-test.ts b/test/elm/aggregate/aggregate-test.ts
index 0498812f9..11d5bf1dd 100644
--- a/test/elm/aggregate/aggregate-test.ts
+++ b/test/elm/aggregate/aggregate-test.ts
@@ -417,16 +417,22 @@ describe('Mode', () => {
     should(await this.empty.exec(this.ctx)).be.null();
   });
   it('should be able to find bimodal', async function () {
-    (await this.bi_modal.exec(this.ctx)).should.eql([2, 3]);
+    // TODO: until https://jira.hl7.org/browse/FHIR-58745 is resolved,
+    // only expect one value
+    // (await this.bi_modal.exec(this.ctx)).should.eql([2, 3]);
+    (await this.bi_modal.exec(this.ctx)).should.eql(2);
   });
 
   it('should preserve units for single and tied quantity modes', async function () {
     validateQuantity(await this.quantitySingleMode.exec(this.ctx), 1, 'g');
 
     const modes = await this.quantityBiModal.exec(this.ctx);
-    modes.should.have.length(2);
-    validateQuantity(modes[0], 1, 'g');
-    validateQuantity(modes[1], 2, 'g');
+    // TODO: until https://jira.hl7.org/browse/FHIR-58745 is resolved,
+    // only expect one value
+    // modes.should.have.length(2);
+    // validateQuantity(modes[0], 1, 'g');
+    // validateQuantity(modes[1], 2, 'g');
+    validateQuantity(modes, 1, 'g');
   });
 
   it('should be null if some are numbers and some are quantities', async function () {

From 04891c82f64db11cf46dd6317c9e8dace5a3c35c Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 10:40:11 -0400
Subject: [PATCH 56/62] update skip-list per feedback

---
 test/spec-tests/cql/CqlArithmeticFunctionsTest.cql  |  2 +-
 test/spec-tests/cql/CqlArithmeticFunctionsTest.json |  2 +-
 test/spec-tests/cql/CqlDateTimeOperatorsTest.cql    |  4 ++--
 test/spec-tests/cql/CqlDateTimeOperatorsTest.json   |  4 ++--
 test/spec-tests/cql/CqlIntervalOperatorsTest.cql    |  6 +++---
 test/spec-tests/cql/CqlIntervalOperatorsTest.json   |  6 +++---
 test/spec-tests/cql/CqlStringOperatorsTest.cql      |  2 +-
 test/spec-tests/cql/CqlStringOperatorsTest.json     |  2 +-
 test/spec-tests/skip-list.txt                       | 12 ++++++------
 9 files changed, 20 insertions(+), 20 deletions(-)

diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
index b57c1a44b..cc9a77001 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.cql
@@ -720,7 +720,7 @@ define "Predecessor": Tuple{
     output: 0.99999999'cm'
     */  },
   "PredecessorOf1QCMPrecision": Tuple{
-    skipped: 'Wrong answer: Translator loses Decimal in ELM representation of Quantity literal.'
+    skipped: 'Wrong answer: Translator loses Decimal precision (trailing zeros) in ELM representation of Quantity literal'
     /*
     expression: predecessor of 1.0 'cm',
     output: 0.9'cm'
diff --git a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
index 2bb93b119..a53711706 100644
--- a/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
+++ b/test/spec-tests/cql/CqlArithmeticFunctionsTest.json
@@ -19414,7 +19414,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer: Translator loses Decimal in ELM representation of Quantity literal.",
+                        "value": "Wrong answer: Translator loses Decimal precision (trailing zeros) in ELM representation of Quantity literal",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
index 42f483d6b..39bd60360 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.cql
@@ -718,7 +718,7 @@ define "Uncertainty tests": Tuple{
     invalid: true
     */  },
   "TimeDurationBetweenHourDiffPrecision2": Tuple{
-    skipped: 'Wrong answer: 1 vs uncertainty [0, 1]'
+    skipped: 'Wrong output: Comparing an imprecise time with a more precise time results in uncertainty'
     /*
     expression: hours between @T06 and @T07:00:00,
     output: 1
@@ -1235,7 +1235,7 @@ define "Subtract": Tuple{
     output: @2005-05-10T05:05:05
   },
   "DateTimeSubtract1YearInSeconds": Tuple{
-    skipped: 'Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05'
+    skipped: 'Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05, due to us using more-precise semantics for calendar-based units'
     /*
     expression: DateTime(2016,5) - 31535999 seconds = DateTime(2015, 5),
     output: true
diff --git a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
index 4b9b7ed6e..4f461739c 100644
--- a/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
+++ b/test/spec-tests/cql/CqlDateTimeOperatorsTest.json
@@ -30991,7 +30991,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer: 1 vs uncertainty [0, 1]",
+                        "value": "Wrong output: Comparing an imprecise time with a more precise time results in uncertainty",
                         "annotation": []
                       }
                     }
@@ -53863,7 +53863,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05",
+                        "value": "Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05, due to us using more-precise semantics for calendar-based units",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
index d8d7c9407..6d71ef9ad 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.cql
@@ -544,7 +544,7 @@ define "Except": Tuple{
     output: null
   },
   "DecimalIntervalExcept1to3": Tuple{
-    skipped: '# Wrong output: Interval Except should be precision-aware (based on interval Start/End).'
+    skipped: '# Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0, 4.0) . Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229'
     /*
     expression: Interval[1.0, 10.0] except Interval[4.0, 10.0],
     output: Interval [ 1.0, 3.99999999 ]
@@ -554,7 +554,7 @@ define "Except": Tuple{
     output: null
   },
   "QuantityIntervalExcept1to4": Tuple{
-    skipped: '# Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale'
+    skipped: '# Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0 \'g\', 5.0 \'g\'). Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229'
     /*
     expression: Interval[1.0 'g', 10.0 'g'] except Interval[5.0 'g', 10.0 'g'],
     output: Interval [ 1.0 'g', 4.99999999 'g' ]
@@ -760,7 +760,7 @@ define "Included In": Tuple{
 
 define "Intersect": Tuple{
   "TestIntersectNull": Tuple{
-    skipped: 'Wrong answer (Interval[5, 10] vs Interval[5, null))'
+    skipped: 'Wrong output: Expected is Interval[5, null) but this example is in the spec, where the result "ends at some value between 5 and 10" meaning an uncertainty.'
     /*
     expression: Interval[1, 10] intersect Interval[5, null),
     output: Interval[5, null)
diff --git a/test/spec-tests/cql/CqlIntervalOperatorsTest.json b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
index 350371239..4e9a8440d 100644
--- a/test/spec-tests/cql/CqlIntervalOperatorsTest.json
+++ b/test/spec-tests/cql/CqlIntervalOperatorsTest.json
@@ -30331,7 +30331,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "# Wrong output: Interval Except should be precision-aware (based on interval Start/End).",
+                        "value": "# Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0, 4.0) . Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229",
                         "annotation": []
                       }
                     }
@@ -30487,7 +30487,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "# Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale",
+                        "value": "# Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0 'g', 5.0 'g'). Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229",
                         "annotation": []
                       }
                     }
@@ -41377,7 +41377,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong answer (Interval[5, 10] vs Interval[5, null))",
+                        "value": "Wrong output: Expected is Interval[5, null) but this example is in the spec, where the result \"ends at some value between 5 and 10\" meaning an uncertainty.",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.cql b/test/spec-tests/cql/CqlStringOperatorsTest.cql
index 177e252f2..ff764d375 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.cql
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.cql
@@ -356,7 +356,7 @@ define "Upper": Tuple{
 
 define "toString tests": Tuple{
   "QuantityToString": Tuple{
-    skipped: 'Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side'
+    skipped: 'Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side. Note this requirement itself also causes issues by introducing precision in the string that may not exist in the original Decimal. Future spec changes may make this test\'s expected value correct.'
     /*
     expression: ToString(125 'cm'),
     output: '125 \'cm\''
diff --git a/test/spec-tests/cql/CqlStringOperatorsTest.json b/test/spec-tests/cql/CqlStringOperatorsTest.json
index 1f54242c4..a796173b2 100644
--- a/test/spec-tests/cql/CqlStringOperatorsTest.json
+++ b/test/spec-tests/cql/CqlStringOperatorsTest.json
@@ -10434,7 +10434,7 @@
                         "type": "Literal",
                         "resultTypeName": "{urn:hl7-org:elm-types:r1}String",
                         "valueType": "{urn:hl7-org:elm-types:r1}String",
-                        "value": "Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side",
+                        "value": "Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side. Note this requirement itself also causes issues by introducing precision in the string that may not exist in the original Decimal. Future spec changes may make this test's expected value correct.",
                         "annotation": []
                       }
                     }
diff --git a/test/spec-tests/skip-list.txt b/test/spec-tests/skip-list.txt
index db6ab0f55..3e77faa14 100644
--- a/test/spec-tests/skip-list.txt
+++ b/test/spec-tests/skip-list.txt
@@ -15,14 +15,15 @@ CqlIntervalOperatorsTest.ProperIn.TimeProperInPrecisionFalse    Wrong output: Ac
 CqlIntervalOperatorsTest.ProperIn.TimeProperInFalse             Wrong output: According to spec, a contained point is properly in as long as the interval is not a unit interval
 CqlIntervalOperatorsTest.Expand.ExpandPer0D1                    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
 CqlIntervalOperatorsTest.Expand.ExpandPer0D1IntervalOverload    Wrong output: Clarification still needed but provided answer is incorrect. See https://jira.hl7.org/browse/FHIR-58705
-CqlIntervalOperatorsTest.Except.DecimalIntervalExcept1to3       # Wrong output: Interval Except should be precision-aware (based on interval Start/End).
-CqlIntervalOperatorsTest.Except.QuantityIntervalExcept1to4      # Wrong output: Interval Except should be precision-aware (based on interval Start/End). Unrelated second issue: the ELM representation of Quantity is a plain number which does not preserve the value scale
+CqlIntervalOperatorsTest.Except.DecimalIntervalExcept1to3       # Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0, 4.0) . Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229
+CqlIntervalOperatorsTest.Except.QuantityIntervalExcept1to4      # Wrong output: The expected value is a closed form of the correct open-endpoint Interval[1.0 'g', 5.0 'g'). Converting to closed-form produces different results for CQL 2.0.0+ due to Decimal precision-awareness. See https://jira.hl7.org/browse/FHIR-59229
+CqlIntervalOperatorsTest.Intersect.TestIntersectNull            Wrong output: Expected is Interval[5, null) but this example is in the spec, where the result "ends at some value between 5 and 10" meaning an uncertainty.
 
 CqlListOperatorsTest.Equal.EqualNullNull                        Wrong output: According to spec, if either list contains a null, the result is null
 CqlListOperatorsTest.Sort.simpleSortAsc                         Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlListOperatorsTest.Sort.simpleSortDesc                        Wrong output: Queries return distinct lists by default; need to use "all" to retain duplicates
 CqlIntervalOperatorsTest.PointFrom.TestPointFromNull            Wrong output: Interval[null, null] is not a unit interval, nor is it null
-"CqlStringOperatorsTest.toString tests.QuantityToString"        Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side
+"CqlStringOperatorsTest.toString tests.QuantityToString"        Wrong output: Spec says Quantity and Decimal ToString must always contain a decimal point and at least 1 digit on each side. Note this requirement itself also causes issues by introducing precision in the string that may not exist in the original Decimal. Future spec changes may make this test's expected value correct.
 CqlArithmeticFunctionsTest.Power.Power0To0                      Wrong output: As of CQL 2.0, Power always returns Decimal
 CqlArithmeticFunctionsTest.Power.Power2To2                      Wrong output: As of CQL 2.0, Power always returns Decimal
 CqlArithmeticFunctionsTest.Power.PowerNeg2To2                   Wrong output: As of CQL 2.0, Power always returns Decimal
@@ -39,6 +40,7 @@ ValueLiteralsAndSelectors.Integer.IntegerNeg2Pow31IntegerMinValue           Wron
 CqlComparisonOperatorsTest.Equal.TupleEqDifferentNamesWithOneNullId                 Wrong output: Tuple equality with a known-unequal element should return false
 "CqlComparisonOperatorsTest.Not Equal.TupleNotEqDifferingNamesWithOneNullId"        Wrong output: Tuple inequality with a known-unequal element should return true
 CqlStringOperatorsTest.Substring.SubstringEmptyAnd0                   Wrong output: Substring(x, x.length) should be null'. Note similar test SubstringAB2. See https://github.com/cqframework/cql-tests/issues/149
+"CqlDateTimeOperatorsTest.Uncertainty tests.TimeDurationBetweenHourDiffPrecision2"      Wrong output: Comparing an imprecise time with a more precise time results in uncertainty
 
 # Potentially Incorrect Expected Output
 "CqlStringOperatorsTest.toString tests.DateTimeToString2"         Answer does not include timezone offset, but default offset depends on test environment
@@ -62,7 +64,6 @@ CqlComparisonOperatorsTest.Equal.DateTimeEqNull                 Wrong answer (tr
 
 CqlIntervalOperatorsTest.Collapse.TestCollapseNull              Wrong answer (Interval(null, null) vs null)
 CqlIntervalOperatorsTest.Expand.ExpandListWithNull                        Wrong answer (should be empty list due to removing nulls)
-CqlIntervalOperatorsTest.Intersect.TestIntersectNull            Wrong answer (Interval[5, 10] vs Interval[5, null))
 CqlTypeOperatorsTest.Convert.StringToDateTime                   Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime1                     Wrong answer (different offsets)
 CqlTypeOperatorsTest.ToDateTime.ToDateTime2                     Wrong answer (different offsets)
@@ -71,8 +72,7 @@ ValueLiteralsAndSelectors.Decimal.Decimal10Pow28ToZeroOneStepDecimalMaxValue
 ValueLiteralsAndSelectors.Decimal.DecimalPos10Pow28ToZeroOneStepDecimalMaxValue Wrong answer (null vs big number); intermediate value exceeds max Decimal
 
 "CqlDateTimeOperatorsTest.Uncertainty tests.DateTimeDurationBetweenUncertainInterval"   Wrong answer: [17, 44] vs [16, 44]
-"CqlDateTimeOperatorsTest.Uncertainty tests.TimeDurationBetweenHourDiffPrecision2"      Wrong answer: 1 vs uncertainty [0, 1]
-CqlDateTimeOperatorsTest.Subtract.DateTimeSubtract1YearInSeconds                        Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05
+CqlDateTimeOperatorsTest.Subtract.DateTimeSubtract1YearInSeconds                        Wrong answer: Date math evaluates to 2015-06 vs expected 2015-05, due to us using more-precise semantics for calendar-based units
 CqlTypesTest.DateTime.DateTimeNull                                                      Wrong answer: null vs DateTime with null components
 CqlTypesTest.Time.TimeMillisParsing                                                     Wrong answer: @T23:59:59.100 vs @T23:59:59.10000
 CqlArithmeticFunctionsTest.Predecessor.PredecessorOf1QCMPrecision          Wrong answer: Translator loses Decimal precision (trailing zeros) in ELM representation of Quantity literal

From fc2f1dd4eb23df8f3abc4592894f839a24b90c40 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 10:59:26 -0400
Subject: [PATCH 57/62] add more invalid-scale tests

---
 test/datatypes/decimal-test.ts | 25 +++++++++++++++++++++++++
 1 file changed, 25 insertions(+)

diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index 9fce2b2ee..bc935edd9 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -294,6 +294,20 @@ describe('Decimal', () => {
       Decimal.from('1.235').round(2).should.equalDecimal('1.24');
       Decimal.from('-1.235').round(2).should.equalDecimal('-1.24');
     });
+
+    it('should treat null and unspecified as scale 0', () => {
+      Decimal.from('1.235').round(0).should.equalDecimal('1');
+      Decimal.from('1.235').round(null).should.equalDecimal('1');
+      Decimal.from('1.235').round().should.equalDecimal('1');
+      Decimal.from('-1.235').round(0).should.equalDecimal('-1');
+      Decimal.from('-1.235').round(null).should.equalDecimal('-1');
+      Decimal.from('-1.235').round().should.equalDecimal('-1');
+    });
+
+    it('should reject invalid scales', () => {
+      (() => Decimal.from(1).round(-1)).should.throw(RangeError);
+      (() => Decimal.from(1).round(1.5)).should.throw(RangeError);
+    });
   });
 
   describe('withScale', () => {
@@ -329,6 +343,17 @@ describe('Decimal', () => {
       value.withMinimumScale(4).should.equalDecimal('1.2000');
       value.withMinimumScale(4).scale.should.equal(4);
     });
+
+    it('should reject invalid scales when impossible to satisfy', () => {
+      (() => Decimal.from(1).withMinimumScale(NaN)).should.throw(RangeError);
+      (() => Decimal.from(1).withMinimumScale(4.5)).should.throw(RangeError);
+
+      // fractional numbers don't need to throw if the minimum is satisfied
+      Decimal.from("1.0000").withMinimumScale(1.5).should.equalDecimal("1.0000");
+
+      // negative numbers don't need to throw because technically "scale > -x" is always satisfied
+      Decimal.from(1).withMinimumScale(-5).should.equalDecimal(1);
+    });
   });
 
   describe('withoutTrailingZeros', () => {

From 8abf173413f52bf341a0ca28c3080cd9066373a7 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 11:09:47 -0400
Subject: [PATCH 58/62] add tests for testing equals vs equivalence semantics
 in list operations

---
 test/elm/list/data.cql     |   5 +-
 test/elm/list/data.js      | 537 ++++++++++++++++++++++++++++++++++++-
 test/elm/list/list-test.ts |  21 ++
 3 files changed, 558 insertions(+), 5 deletions(-)

diff --git a/test/elm/list/data.cql b/test/elm/list/data.cql
index 4d31b3fe5..e4f471bb0 100644
--- a/test/elm/list/data.cql
+++ b/test/elm/list/data.cql
@@ -54,7 +54,7 @@ define NullUnion: null union {1, 2, 3}
 define UnionNull: {1, 2, 3} union null
 define nullUnionNull: (null as List<String>) union (null as List<String>)
 define UnionDecimalsAcrossScales: {1.0, 2.0} union {1.00, 3.0}
-
+define UnionDecimalsEquivalentNotEqual: {1.0, 2.0} union {1.04, 3.0}
 
 // @Test: Except
 define ExceptThreeFour: {1, 2, 3, 4, 5} except {3, 4}
@@ -71,6 +71,7 @@ define ExceptTuples: {Tuple{a: 1}, Tuple{a: 2}, Tuple{a: 3}} except {Tuple{a: 2}
 define ExceptNull: {1, 2, 3, 4, 5} except null
 define NullExcept: null except {1, 2, 3, 4, 5}
 define ExceptDecimalsAcrossScales: {1.0, 2.0} except {1.00, 3.0}
+define ExceptDecimalsEquivalentNotEqual: {1.0, 2.0} except {1.04, 3.0}
 
 // @Test: Intersect
 define NoIntersection: {1, 2, 2, 3} intersect {4, 5, 6}
@@ -85,6 +86,7 @@ define NullIntersect: null intersect {1, 2, 3}
 define IntersectNull: {1, 2, 3} intersect null
 define MultipleNullInListIntersect: {1, 2, 3, null} intersect {null, 3}
 define IntersectDecimalsAcrossScales: {1.0, 2.0} intersect {1.00, 3.0}
+define IntersectDecimalsEquivalentNotEqual: {1.0, 2.0} intersect {1.04, 3.0}
 
 // @Test: IndexOf
 define IndexOfSecond: IndexOf({'a', 'b', 'c', 'd'}, 'b')
@@ -233,6 +235,7 @@ define DupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland'
 define NoDupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' } }
 define DuplicateNulls: distinct {null, 1, 2, null, 3, 4, 5, null}
 define DistinctDecimalsAcrossScales: distinct {1.0, 1.00, 2.0}
+define DistinctDecimalsEquivalentNotEqual: distinct {1.0, 1.04, 2.0}
 
 // @Test: First
 define Numbers: First({1, 2, 3, 4})
diff --git a/test/elm/list/data.js b/test/elm/list/data.js
index c2cbdf3bb..aa75e7799 100644
--- a/test/elm/list/data.js
+++ b/test/elm/list/data.js
@@ -6293,6 +6293,7 @@ define NullUnion: null union {1, 2, 3}
 define UnionNull: {1, 2, 3} union null
 define nullUnionNull: (null as List<String>) union (null as List<String>)
 define UnionDecimalsAcrossScales: {1.0, 2.0} union {1.00, 3.0}
+define UnionDecimalsEquivalentNotEqual: {1.0, 2.0} union {1.04, 3.0}
 */
 
 module.exports['Union'] = {
@@ -6307,7 +6308,7 @@ module.exports['Union'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "487",
+        "r" : "509",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -8234,6 +8235,147 @@ module.exports['Union'] = {
             } ]
           } ]
         }
+      }, {
+        "localId" : "509",
+        "name" : "UnionDecimalsEquivalentNotEqual",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "509",
+            "s" : [ {
+              "value" : [ "", "define ", "UnionDecimalsEquivalentNotEqual", ": " ]
+            }, {
+              "r" : "520",
+              "s" : [ {
+                "r" : "510",
+                "s" : [ {
+                  "r" : "511",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " union " ]
+              }, {
+                "r" : "515",
+                "s" : [ {
+                  "r" : "516",
+                  "value" : [ "{", "1.04", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "527",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "528",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Union",
+          "localId" : "520",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "525",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "526",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "521",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "522",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "523",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "524",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "510",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "513",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "514",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "511",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "512",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "515",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "518",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "519",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "516",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.04",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "517",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -8257,6 +8399,7 @@ define ExceptTuples: {Tuple{a: 1}, Tuple{a: 2}, Tuple{a: 3}} except {Tuple{a: 2}
 define ExceptNull: {1, 2, 3, 4, 5} except null
 define NullExcept: null except {1, 2, 3, 4, 5}
 define ExceptDecimalsAcrossScales: {1.0, 2.0} except {1.00, 3.0}
+define ExceptDecimalsEquivalentNotEqual: {1.0, 2.0} except {1.04, 3.0}
 */
 
 module.exports['Except'] = {
@@ -8271,7 +8414,7 @@ module.exports['Except'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "549",
+        "r" : "571",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -10653,6 +10796,147 @@ module.exports['Except'] = {
             } ]
           } ]
         }
+      }, {
+        "localId" : "571",
+        "name" : "ExceptDecimalsEquivalentNotEqual",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "571",
+            "s" : [ {
+              "value" : [ "", "define ", "ExceptDecimalsEquivalentNotEqual", ": " ]
+            }, {
+              "r" : "582",
+              "s" : [ {
+                "r" : "572",
+                "s" : [ {
+                  "r" : "573",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " except " ]
+              }, {
+                "r" : "577",
+                "s" : [ {
+                  "r" : "578",
+                  "value" : [ "{", "1.04", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "589",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "590",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Except",
+          "localId" : "582",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "587",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "588",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "583",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "584",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "585",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "586",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "572",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "575",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "576",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "573",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "574",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "577",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "580",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "581",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "578",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.04",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "579",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -10674,6 +10958,7 @@ define NullIntersect: null intersect {1, 2, 3}
 define IntersectNull: {1, 2, 3} intersect null
 define MultipleNullInListIntersect: {1, 2, 3, null} intersect {null, 3}
 define IntersectDecimalsAcrossScales: {1.0, 2.0} intersect {1.00, 3.0}
+define IntersectDecimalsEquivalentNotEqual: {1.0, 2.0} intersect {1.04, 3.0}
 */
 
 module.exports['Intersect'] = {
@@ -10688,7 +10973,7 @@ module.exports['Intersect'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "619",
+        "r" : "641",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -13560,6 +13845,147 @@ module.exports['Intersect'] = {
             } ]
           } ]
         }
+      }, {
+        "localId" : "641",
+        "name" : "IntersectDecimalsEquivalentNotEqual",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "641",
+            "s" : [ {
+              "value" : [ "", "define ", "IntersectDecimalsEquivalentNotEqual", ": " ]
+            }, {
+              "r" : "652",
+              "s" : [ {
+                "r" : "642",
+                "s" : [ {
+                  "r" : "643",
+                  "value" : [ "{", "1.0", ", ", "2.0", "}" ]
+                } ]
+              }, {
+                "value" : [ " intersect " ]
+              }, {
+                "r" : "647",
+                "s" : [ {
+                  "r" : "648",
+                  "value" : [ "{", "1.04", ", ", "3.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "659",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "660",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Intersect",
+          "localId" : "652",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "657",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "658",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "653",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "654",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          }, {
+            "type" : "ListTypeSpecifier",
+            "localId" : "655",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "656",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : [ {
+            "type" : "List",
+            "localId" : "642",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "645",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "646",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "643",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "644",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }, {
+            "type" : "List",
+            "localId" : "647",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "650",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "651",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "648",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.04",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "649",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "3.0",
+              "annotation" : [ ]
+            } ]
+          } ]
+        }
       } ]
     }
   }
@@ -37652,6 +38078,7 @@ define DupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland'
 define NoDupsTuples: distinct { Tuple{ hello: 'world' }, Tuple{ hello: 'cleveland' } }
 define DuplicateNulls: distinct {null, 1, 2, null, 3, 4, 5, null}
 define DistinctDecimalsAcrossScales: distinct {1.0, 1.00, 2.0}
+define DistinctDecimalsEquivalentNotEqual: distinct {1.0, 1.04, 2.0}
 */
 
 module.exports['Distinct'] = {
@@ -37666,7 +38093,7 @@ module.exports['Distinct'] = {
       "type" : "Annotation",
       "t" : [ ],
       "s" : {
-        "r" : "398",
+        "r" : "414",
         "s" : [ {
           "value" : [ "", "library TestSnippet version '1'" ]
         } ]
@@ -39070,6 +39497,108 @@ module.exports['Distinct'] = {
             } ]
           }
         }
+      }, {
+        "localId" : "414",
+        "name" : "DistinctDecimalsEquivalentNotEqual",
+        "context" : "Patient",
+        "accessLevel" : "Public",
+        "annotation" : [ {
+          "type" : "Annotation",
+          "t" : [ ],
+          "s" : {
+            "r" : "414",
+            "s" : [ {
+              "value" : [ "", "define ", "DistinctDecimalsEquivalentNotEqual", ": " ]
+            }, {
+              "r" : "415",
+              "s" : [ {
+                "value" : [ "distinct " ]
+              }, {
+                "r" : "416",
+                "s" : [ {
+                  "r" : "417",
+                  "value" : [ "{", "1.0", ", ", "1.04", ", ", "2.0", "}" ]
+                } ]
+              } ]
+            } ]
+          }
+        } ],
+        "resultTypeSpecifier" : {
+          "type" : "ListTypeSpecifier",
+          "localId" : "426",
+          "annotation" : [ ],
+          "elementType" : {
+            "type" : "NamedTypeSpecifier",
+            "localId" : "427",
+            "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+            "annotation" : [ ]
+          }
+        },
+        "expression" : {
+          "type" : "Distinct",
+          "localId" : "415",
+          "annotation" : [ ],
+          "resultTypeSpecifier" : {
+            "type" : "ListTypeSpecifier",
+            "localId" : "424",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "425",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          },
+          "signature" : [ {
+            "type" : "ListTypeSpecifier",
+            "localId" : "422",
+            "annotation" : [ ],
+            "elementType" : {
+              "type" : "NamedTypeSpecifier",
+              "localId" : "423",
+              "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "annotation" : [ ]
+            }
+          } ],
+          "operand" : {
+            "type" : "List",
+            "localId" : "416",
+            "annotation" : [ ],
+            "resultTypeSpecifier" : {
+              "type" : "ListTypeSpecifier",
+              "localId" : "420",
+              "annotation" : [ ],
+              "elementType" : {
+                "type" : "NamedTypeSpecifier",
+                "localId" : "421",
+                "name" : "{urn:hl7-org:elm-types:r1}Decimal",
+                "annotation" : [ ]
+              }
+            },
+            "element" : [ {
+              "type" : "Literal",
+              "localId" : "417",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.0",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "418",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "1.04",
+              "annotation" : [ ]
+            }, {
+              "type" : "Literal",
+              "localId" : "419",
+              "resultTypeName" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "valueType" : "{urn:hl7-org:elm-types:r1}Decimal",
+              "value" : "2.0",
+              "annotation" : [ ]
+            } ]
+          }
+        }
       } ]
     }
   }
diff --git a/test/elm/list/list-test.ts b/test/elm/list/list-test.ts
index eb9b7a36b..8f78f2c3b 100644
--- a/test/elm/list/list-test.ts
+++ b/test/elm/list/list-test.ts
@@ -209,6 +209,12 @@ describe('Union', () => {
     const expected = ['1.0', '2.0', '3.0'].map(Decimal.from);
     should(await this.unionDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
   });
+
+  it('should use equality semantics for Decimal (not equivalence)', async function () {
+    // {1.0, 2.0} union {1.04, 3.0}
+    const expected = ['1.0', '2.0', '1.04', '3.0'].map(Decimal.from);
+    should(await this.unionDecimalsEquivalentNotEqual.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('Except', () => {
@@ -268,6 +274,11 @@ describe('Except', () => {
     const expected = [Decimal.from('2.0')];
     should(await this.exceptDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
   });
+
+  it('should use equality semantics for Decimal (not equivalence)', async function () {
+    const expected = [Decimal.from('1.0'), Decimal.from('2.0')];
+    should(await this.exceptDecimalsEquivalentNotEqual.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('Intersect', () => {
@@ -323,6 +334,11 @@ describe('Intersect', () => {
     const expected = [Decimal.from('1.0')];
     should(await this.intersectDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
   });
+
+  it('should use equality semantics for Decimal (not equivalence)', async function () {
+    const expected: Array<Decimal> = [];
+    should(await this.intersectDecimalsEquivalentNotEqual.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('IndexOf', () => {
@@ -868,6 +884,11 @@ describe('Distinct', () => {
     const expected = [Decimal.from('1.0'), Decimal.from('2.0')];
     should(await this.distinctDecimalsAcrossScales.exec(this.ctx)).be.eql(expected);
   });
+
+  it('should use equality semantics for Decimal (not equivalence)', async function () {
+    const expected = [Decimal.from('1.0'), Decimal.from('1.04'), Decimal.from('2.0')];
+    should(await this.distinctDecimalsEquivalentNotEqual.exec(this.ctx)).be.eql(expected);
+  });
 });
 
 describe('First', () => {

From 5d325a86aa81a69ef795153743a6505631f0b9b0 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 11:10:00 -0400
Subject: [PATCH 59/62] prettier

---
 test/datatypes/decimal-test.ts | 2 +-
 1 file changed, 1 insertion(+), 1 deletion(-)

diff --git a/test/datatypes/decimal-test.ts b/test/datatypes/decimal-test.ts
index bc935edd9..79b758859 100644
--- a/test/datatypes/decimal-test.ts
+++ b/test/datatypes/decimal-test.ts
@@ -349,7 +349,7 @@ describe('Decimal', () => {
       (() => Decimal.from(1).withMinimumScale(4.5)).should.throw(RangeError);
 
       // fractional numbers don't need to throw if the minimum is satisfied
-      Decimal.from("1.0000").withMinimumScale(1.5).should.equalDecimal("1.0000");
+      Decimal.from('1.0000').withMinimumScale(1.5).should.equalDecimal('1.0000');
 
       // negative numbers don't need to throw because technically "scale > -x" is always satisfied
       Decimal.from(1).withMinimumScale(-5).should.equalDecimal(1);

From 3dbc096e8eed9481a45379dc099571d9df099474 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 11:14:40 -0400
Subject: [PATCH 60/62] add note explaining decimal scale logic is based on
 testing, rather than defined in spec

---
 src/datatypes/decimal.ts | 7 ++++++-
 1 file changed, 6 insertions(+), 1 deletion(-)

diff --git a/src/datatypes/decimal.ts b/src/datatypes/decimal.ts
index ca927e657..7be0cd4b3 100644
--- a/src/datatypes/decimal.ts
+++ b/src/datatypes/decimal.ts
@@ -68,6 +68,9 @@ export class Decimal {
 
     const unscaledResult = new Decimal(operation.call(this.value, decimalOther.value));
 
+    // NOTE: As of 2.0.0, the CQL spec says that scale of a Decimal should be preserved,
+    // but does not describe how to propagate scale through arithmetic operations.
+    // Unless otherwise stated, all the scale logic in this class is a best-guess based on testing.
     if (scaleLogic) {
       const targetScale = scaleLogic.call(null, this.scale, decimalOther.scale);
       return unscaledResult.withScale(targetScale);
@@ -96,6 +99,8 @@ export class Decimal {
       throw new RangeError('Cannot divide a decimal by zero');
     }
     // division scaling is more complex, depends on whether the actual result can be represented exactly
+    // IMPORTANT: The details of how to propagate Decimal scale through math are not defined in the CQL spec.
+    // The notes below are a best-guess on how to get desirable results based on some examples.
     const unscaledResult = this.applyWrapper(this.value.dividedBy, decimalOther);
     const unscaledDecimalPlaces = unscaledResult.value.decimalPlaces();
     if (unscaledDecimalPlaces > CQL_IMPLICIT_SCALE) {
@@ -111,7 +116,7 @@ export class Decimal {
     const preferredScale = Math.max(this.scale - decimalOther.scale, 0);
 
     // examples:
-    // |               | Preferred |  Expected  |
+    // |               | Preferred |  Desired   |
     // | Expression    |  scale    |   result   |
     // | ------------- | --------: | ---------: |
     // | 4.0 / 2       |         1 |        2.0 |

From a061f94827a45ac858e2656d4315467a436f9759 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 15:37:26 -0400
Subject: [PATCH 61/62] update package-lock for example projects

---
 examples/browser/package-lock.json    | 2 +-
 examples/node/package-lock.json       | 2 +-
 examples/typescript/package-lock.json | 2 +-
 3 files changed, 3 insertions(+), 3 deletions(-)

diff --git a/examples/browser/package-lock.json b/examples/browser/package-lock.json
index 3dd72b36c..847e9e409 100644
--- a/examples/browser/package-lock.json
+++ b/examples/browser/package-lock.json
@@ -18,11 +18,11 @@
       }
     },
     "../..": {
-      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {
         "@lhncbc/ucum-lhc": "^7.1.9",
+        "decimal.js": "^10.6.0",
         "immutable": "^5.1.6",
         "luxon": "^3.7.2"
       },
diff --git a/examples/node/package-lock.json b/examples/node/package-lock.json
index eed2c2712..e8185623d 100644
--- a/examples/node/package-lock.json
+++ b/examples/node/package-lock.json
@@ -15,11 +15,11 @@
       }
     },
     "../..": {
-      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {
         "@lhncbc/ucum-lhc": "^7.1.9",
+        "decimal.js": "^10.6.0",
         "immutable": "^5.1.6",
         "luxon": "^3.7.2"
       },
diff --git a/examples/typescript/package-lock.json b/examples/typescript/package-lock.json
index 49f0b1e52..3e7b291d7 100644
--- a/examples/typescript/package-lock.json
+++ b/examples/typescript/package-lock.json
@@ -20,11 +20,11 @@
       }
     },
     "../..": {
-      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {
         "@lhncbc/ucum-lhc": "^7.1.9",
+        "decimal.js": "^10.6.0",
         "immutable": "^5.1.6",
         "luxon": "^3.7.2"
       },

From 02952aeaf44357d00ec1e4fc0d48705ed61ac4c1 Mon Sep 17 00:00:00 2001
From: Dylan Hall <dehall@mitre.org>
Date: Tue, 15 Sep 2026 16:14:04 -0400
Subject: [PATCH 62/62] Regenerate lockfiles one more time

---
 examples/browser/package-lock.json    | 1 +
 examples/node/package-lock.json       | 1 +
 examples/typescript/package-lock.json | 1 +
 3 files changed, 3 insertions(+)

diff --git a/examples/browser/package-lock.json b/examples/browser/package-lock.json
index 847e9e409..b9882e1da 100644
--- a/examples/browser/package-lock.json
+++ b/examples/browser/package-lock.json
@@ -18,6 +18,7 @@
       }
     },
     "../..": {
+      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {
diff --git a/examples/node/package-lock.json b/examples/node/package-lock.json
index e8185623d..f64959168 100644
--- a/examples/node/package-lock.json
+++ b/examples/node/package-lock.json
@@ -15,6 +15,7 @@
       }
     },
     "../..": {
+      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {
diff --git a/examples/typescript/package-lock.json b/examples/typescript/package-lock.json
index 3e7b291d7..4ef57f7b1 100644
--- a/examples/typescript/package-lock.json
+++ b/examples/typescript/package-lock.json
@@ -20,6 +20,7 @@
       }
     },
     "../..": {
+      "name": "cql-execution",
       "version": "3.3.2",
       "license": "Apache-2.0",
       "dependencies": {