Thanks a lot @Peter Lifshits actually that's the approach ( using identifier ) I started to use , and I agree it's less problematic. However I'm not sure how to deal with pure Organization's elements that are not present in identifier , like address country, see MSH.17 in http://hl7.org/fhir/uv/v2mappings/2020Sep/ConceptMap-segment-msh-to-messageheader.html Would it be acceptable to add dedicated extension for address country ?

Hi , Actually it doesn't have to be negative , I can edit the resource and make it invalid when needed. But I do need some massive amount of patient resources , and by massive I mean hundreds of diverse patients and what I found so far it's only JSON bundles (no XML) from https://synthea.mitre.org/fhir-api . Do you know of any proper way : 1. how to extract the resources from bundle , i.e. creating separate resource files from a bundle? 2. translate JSON to XML ? There is pretty good converter https://fhir-formats.github.io/, however it's one by one