@prefix fhir: <http://hl7.org/fhir/> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .

# - resource -------------------------------------------------------------------

[] a fhir:CodeSystem;
  fhir:Resource.id [ fhir:value "v3-TribalEntityUS"];
  fhir:Resource.language [ fhir:value "en"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ]
  ];
  fhir:CodeSystem.url [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS"];
  fhir:CodeSystem.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.5.140" ]
  ];
  fhir:CodeSystem.version [ fhir:value "4.0.0"];
  fhir:CodeSystem.name [ fhir:value "TribalEntityUS"];
  fhir:CodeSystem.title [ fhir:value "TribalEntityUS"];
  fhir:CodeSystem.status [ fhir:value "active"];
  fhir:CodeSystem.experimental [ fhir:value "false"];
  fhir:CodeSystem.date [ fhir:value "2019-03-20"];
  fhir:CodeSystem.publisher [ fhir:value "Health Level Seven International"];
  fhir:CodeSystem.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://hl7.org" ]
     ], [
       fhir:index 1;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "hq@HL7.org" ]
     ]
  ];
  fhir:CodeSystem.description [ fhir:value "INDIAN ENTITIES RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS"];
  fhir:CodeSystem.copyright [ fhir:value "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"];
  fhir:CodeSystem.caseSensitive [ fhir:value "true"];
  fhir:CodeSystem.hierarchyMeaning [ fhir:value "is-a"];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.property [
     fhir:index 0;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-symmetry" ];
       fhir:Extension.value [ fhir:value "antisymmetric" ]
     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-transitivity" ];
       fhir:Extension.value [ fhir:value "transitive" ]
     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-reflexivity" ];
       fhir:Extension.value [ fhir:value "irreflexive" ]
     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-isNavigable" ];
       fhir:Extension.value [ fhir:value "true" ]
     ], [
       fhir:index 4;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-relationshipKind" ];
       fhir:Extension.value [ fhir:value "Specializes" ]
     ], [
       fhir:index 5;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-inverseName" ];
       fhir:Extension.value [ fhir:value "Generalizes" ]
     ];
     fhir:CodeSystem.code [ fhir:value "Specializes" ];
     fhir:CodeSystem.description [ fhir:value "The child code is a more narrow version of the concept represented by the parent code.  I.e. Every child concept is also a valid parent concept.  Used to allow determination of subsumption.  Must be transitive, irreflexive, antisymmetric." ];
     fhir:CodeSystem.type [ fhir:value "Coding" ]
  ], [
     fhir:index 1;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-symmetry" ];
       fhir:Extension.value [ fhir:value "antisymmetric" ]
     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-transitivity" ];
       fhir:Extension.value [ fhir:value "transitive" ]
     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-reflexivity" ];
       fhir:Extension.value [ fhir:value "irreflexive" ]
     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-isNavigable" ];
       fhir:Extension.value [ fhir:value "true" ]
     ], [
       fhir:index 4;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-relationshipKind" ];
       fhir:Extension.value [ fhir:value "Generalizes" ]
     ], [
       fhir:index 5;
       fhir:Extension.url [ fhir:value "http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-inverseName" ];
       fhir:Extension.value [ fhir:value "Specializes" ]
     ];
     fhir:CodeSystem.code [ fhir:value "Generalizes" ];
     fhir:CodeSystem.description [ fhir:value "Inverse of Specializes.  Only included as a derived relationship." ];
     fhir:CodeSystem.type [ fhir:value "Coding" ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.code [ fhir:value "internalId" ];
     fhir:CodeSystem.uri [ fhir:value "http://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-id" ];
     fhir:CodeSystem.description [ fhir:value "The internal identifier for the concept in the HL7 Access database repository." ];
     fhir:CodeSystem.type [ fhir:value "code" ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.code [ fhir:value "notSelectable" ];
     fhir:CodeSystem.uri [ fhir:value "http://hl7.org/fhir/concept-properties#notSelectable" ];
     fhir:CodeSystem.description [ fhir:value "Indicates that the code is abstract - only intended to be used as a selector for other concepts" ];
     fhir:CodeSystem.type [ fhir:value "boolean" ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.code [ fhir:value "status" ];
     fhir:CodeSystem.uri [ fhir:value "http://hl7.org/fhir/concept-properties#status" ];
     fhir:CodeSystem.description [ fhir:value "Designation of a concept's state. Normally is not populated unless the state is retired." ];
     fhir:CodeSystem.type [ fhir:value "code" ]
  ];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.code [ fhir:value "_NativeEntityAlaska" ];
     fhir:CodeSystem.display [ fhir:value "NativeEntityAlaska" ];
     fhir:CodeSystem.definition [ fhir:value "NATIVE ENTITIES WITHIN THE STATE OF ALASKA RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS" ];
     fhir:CodeSystem.designation [
       fhir:index 0;
       fhir:CodeSystem.language [ fhir:value "en" ];
       fhir:CodeSystem.use [
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
         fhir:Coding.code [ fhir:value "display" ]
       ];
       fhir:CodeSystem.value [ fhir:value "NativeEntityAlaska" ]
     ], [
       fhir:index 1;
       fhir:CodeSystem.language [ fhir:value "en" ];
       fhir:CodeSystem.use [
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
         fhir:Coding.code [ fhir:value "display" ]
       ];
       fhir:CodeSystem.value [ fhir:value "NativeEntityAlaska" ]
     ];
     fhir:CodeSystem.property [
       fhir:index 0;
       fhir:CodeSystem.code [ fhir:value "notSelectable" ];
       fhir:CodeSystem.value [ fhir:value "true" ]
     ], [
       fhir:index 1;
       fhir:CodeSystem.code [ fhir:value "status" ];
       fhir:CodeSystem.value [ fhir:value "active" ]
     ], [
       fhir:index 2;
       fhir:CodeSystem.code [ fhir:value "internalId" ];
       fhir:CodeSystem.value [ fhir:value "21286" ]
     ];
     fhir:CodeSystem.concept [
       fhir:index 0;
       fhir:CodeSystem.code [ fhir:value "338" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Afognak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Afognak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Afognak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11970" ]
       ]
     ], [
       fhir:index 1;
       fhir:CodeSystem.code [ fhir:value "339" ];
       fhir:CodeSystem.display [ fhir:value "Agdaagux Tribe of King Cove" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Agdaagux Tribe of King Cove" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Agdaagux Tribe of King Cove" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11971" ]
       ]
     ], [
       fhir:index 2;
       fhir:CodeSystem.code [ fhir:value "340" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Akhiok" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Akhiok" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Akhiok" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11972" ]
       ]
     ], [
       fhir:index 3;
       fhir:CodeSystem.code [ fhir:value "341" ];
       fhir:CodeSystem.display [ fhir:value "Akiachak Native Community" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Akiachak Native Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Akiachak Native Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11973" ]
       ]
     ], [
       fhir:index 4;
       fhir:CodeSystem.code [ fhir:value "342" ];
       fhir:CodeSystem.display [ fhir:value "Akiak Native Community" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Akiak Native Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Akiak Native Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11974" ]
       ]
     ], [
       fhir:index 5;
       fhir:CodeSystem.code [ fhir:value "343" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Akutan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Akutan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Akutan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11975" ]
       ]
     ], [
       fhir:index 6;
       fhir:CodeSystem.code [ fhir:value "344" ];
       fhir:CodeSystem.display [ fhir:value "Village of Alakanuk" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Alakanuk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Alakanuk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11976" ]
       ]
     ], [
       fhir:index 7;
       fhir:CodeSystem.code [ fhir:value "345" ];
       fhir:CodeSystem.display [ fhir:value "Alatna Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alatna Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alatna Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11977" ]
       ]
     ], [
       fhir:index 8;
       fhir:CodeSystem.code [ fhir:value "346" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Aleknagik" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Aleknagik" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Aleknagik" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11978" ]
       ]
     ], [
       fhir:index 9;
       fhir:CodeSystem.code [ fhir:value "347" ];
       fhir:CodeSystem.display [ fhir:value "Algaaciq Native Village (St. Mary's)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Algaaciq Native Village (St. Mary's)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Algaaciq Native Village (St. Mary's)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11979" ]
       ]
     ], [
       fhir:index 10;
       fhir:CodeSystem.code [ fhir:value "348" ];
       fhir:CodeSystem.display [ fhir:value "Allakaket Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Allakaket Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Allakaket Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11980" ]
       ]
     ], [
       fhir:index 11;
       fhir:CodeSystem.code [ fhir:value "349" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Ambler" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ambler" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ambler" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11981" ]
       ]
     ], [
       fhir:index 12;
       fhir:CodeSystem.code [ fhir:value "350" ];
       fhir:CodeSystem.display [ fhir:value "Village of Anaktuvuk Pass" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Anaktuvuk Pass" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Anaktuvuk Pass" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11982" ]
       ]
     ], [
       fhir:index 13;
       fhir:CodeSystem.code [ fhir:value "351" ];
       fhir:CodeSystem.display [ fhir:value "Yupiit of Andreafski" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yupiit of Andreafski" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yupiit of Andreafski" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11983" ]
       ]
     ], [
       fhir:index 14;
       fhir:CodeSystem.code [ fhir:value "352" ];
       fhir:CodeSystem.display [ fhir:value "Angoon Community Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Angoon Community Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Angoon Community Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11984" ]
       ]
     ], [
       fhir:index 15;
       fhir:CodeSystem.code [ fhir:value "353" ];
       fhir:CodeSystem.display [ fhir:value "Village of Aniak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Aniak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Aniak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11985" ]
       ]
     ], [
       fhir:index 16;
       fhir:CodeSystem.code [ fhir:value "354" ];
       fhir:CodeSystem.display [ fhir:value "Anvik Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Anvik Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Anvik Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11986" ]
       ]
     ], [
       fhir:index 17;
       fhir:CodeSystem.code [ fhir:value "355" ];
       fhir:CodeSystem.display [ fhir:value "Arctic Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Arctic Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Arctic Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11987" ]
       ]
     ], [
       fhir:index 18;
       fhir:CodeSystem.code [ fhir:value "356" ];
       fhir:CodeSystem.display [ fhir:value "Asa'carsarmiut Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Asa'carsarmiut Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Asa'carsarmiut Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11988" ]
       ]
     ], [
       fhir:index 19;
       fhir:CodeSystem.code [ fhir:value "357" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Atka" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Atka" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Atka" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11989" ]
       ]
     ], [
       fhir:index 20;
       fhir:CodeSystem.code [ fhir:value "358" ];
       fhir:CodeSystem.display [ fhir:value "Village of Atmautluak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Atmautluak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Atmautluak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11990" ]
       ]
     ], [
       fhir:index 21;
       fhir:CodeSystem.code [ fhir:value "359" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Atqasuk" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Atqasuk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Atqasuk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11991" ]
       ]
     ], [
       fhir:index 22;
       fhir:CodeSystem.code [ fhir:value "360" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Barrow Inupiat Traditional Government" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Barrow Inupiat Traditional Government" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Barrow Inupiat Traditional Government" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11992" ]
       ]
     ], [
       fhir:index 23;
       fhir:CodeSystem.code [ fhir:value "361" ];
       fhir:CodeSystem.display [ fhir:value "Beaver Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Beaver Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Beaver Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11993" ]
       ]
     ], [
       fhir:index 24;
       fhir:CodeSystem.code [ fhir:value "362" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Belkofski" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Belkofski" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Belkofski" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11994" ]
       ]
     ], [
       fhir:index 25;
       fhir:CodeSystem.code [ fhir:value "363" ];
       fhir:CodeSystem.display [ fhir:value "Village of Bill Moore's Slough" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Bill Moore's Slough" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Bill Moore's Slough" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11995" ]
       ]
     ], [
       fhir:index 26;
       fhir:CodeSystem.code [ fhir:value "364" ];
       fhir:CodeSystem.display [ fhir:value "Birch Creek Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Birch Creek Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Birch Creek Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11996" ]
       ]
     ], [
       fhir:index 27;
       fhir:CodeSystem.code [ fhir:value "365" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Brevig Mission" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Brevig Mission" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Brevig Mission" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11997" ]
       ]
     ], [
       fhir:index 28;
       fhir:CodeSystem.code [ fhir:value "366" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Buckland" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Buckland" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Buckland" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11998" ]
       ]
     ], [
       fhir:index 29;
       fhir:CodeSystem.code [ fhir:value "367" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Cantwell" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Cantwell" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Cantwell" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11999" ]
       ]
     ], [
       fhir:index 30;
       fhir:CodeSystem.code [ fhir:value "368" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Chenega (aka Chanega)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chenega (aka Chanega)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chenega (aka Chanega)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12000" ]
       ]
     ], [
       fhir:index 31;
       fhir:CodeSystem.code [ fhir:value "369" ];
       fhir:CodeSystem.display [ fhir:value "Chalkyitsik Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chalkyitsik Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chalkyitsik Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12001" ]
       ]
     ], [
       fhir:index 32;
       fhir:CodeSystem.code [ fhir:value "370" ];
       fhir:CodeSystem.display [ fhir:value "Village of Chefornak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Chefornak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Chefornak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12002" ]
       ]
     ], [
       fhir:index 33;
       fhir:CodeSystem.code [ fhir:value "371" ];
       fhir:CodeSystem.display [ fhir:value "Chevak Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chevak Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chevak Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12003" ]
       ]
     ], [
       fhir:index 34;
       fhir:CodeSystem.code [ fhir:value "372" ];
       fhir:CodeSystem.display [ fhir:value "Chickaloon Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickaloon Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickaloon Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12004" ]
       ]
     ], [
       fhir:index 35;
       fhir:CodeSystem.code [ fhir:value "373" ];
       fhir:CodeSystem.display [ fhir:value "Chignik Bay Tribal Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chignik Bay Tribal Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chignik Bay Tribal Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12005" ]
       ]
     ], [
       fhir:index 36;
       fhir:CodeSystem.code [ fhir:value "374" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Chignik Lagoon" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chignik Lagoon" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chignik Lagoon" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12006" ]
       ]
     ], [
       fhir:index 37;
       fhir:CodeSystem.code [ fhir:value "375" ];
       fhir:CodeSystem.display [ fhir:value "Chignik Lake Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chignik Lake Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chignik Lake Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12007" ]
       ]
     ], [
       fhir:index 38;
       fhir:CodeSystem.code [ fhir:value "376" ];
       fhir:CodeSystem.display [ fhir:value "Chilkat Indian Village (Klukwan)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chilkat Indian Village (Klukwan)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chilkat Indian Village (Klukwan)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12008" ]
       ]
     ], [
       fhir:index 39;
       fhir:CodeSystem.code [ fhir:value "377" ];
       fhir:CodeSystem.display [ fhir:value "Chilkoot Indian Association (Haines)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chilkoot Indian Association (Haines)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chilkoot Indian Association (Haines)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12009" ]
       ]
     ], [
       fhir:index 40;
       fhir:CodeSystem.code [ fhir:value "378" ];
       fhir:CodeSystem.display [ fhir:value "Chinik Eskimo Community (Golovin)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chinik Eskimo Community (Golovin)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chinik Eskimo Community (Golovin)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12010" ]
       ]
     ], [
       fhir:index 41;
       fhir:CodeSystem.code [ fhir:value "379" ];
       fhir:CodeSystem.display [ fhir:value "Cheesh-Na Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheesh-Na Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheesh-Na Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12011" ]
       ]
     ], [
       fhir:index 42;
       fhir:CodeSystem.code [ fhir:value "380" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Chitina" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chitina" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chitina" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12012" ]
       ]
     ], [
       fhir:index 43;
       fhir:CodeSystem.code [ fhir:value "381" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Chuathbaluk (Russian Mission, Kuskokwim)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chuathbaluk (Russian Mission, Kuskokwim)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Chuathbaluk (Russian Mission, Kuskokwim)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12013" ]
       ]
     ], [
       fhir:index 44;
       fhir:CodeSystem.code [ fhir:value "382" ];
       fhir:CodeSystem.display [ fhir:value "Chuloonawick Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chuloonawick Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chuloonawick Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12014" ]
       ]
     ], [
       fhir:index 45;
       fhir:CodeSystem.code [ fhir:value "383" ];
       fhir:CodeSystem.display [ fhir:value "Circle Native Community" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Circle Native Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Circle Native Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12015" ]
       ]
     ], [
       fhir:index 46;
       fhir:CodeSystem.code [ fhir:value "384" ];
       fhir:CodeSystem.display [ fhir:value "Village of Clarks Point" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Clarks Point" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Clarks Point" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12016" ]
       ]
     ], [
       fhir:index 47;
       fhir:CodeSystem.code [ fhir:value "385" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12017" ]
       ]
     ], [
       fhir:index 48;
       fhir:CodeSystem.code [ fhir:value "386" ];
       fhir:CodeSystem.display [ fhir:value "Craig Tribal Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Craig Tribal Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Craig Tribal Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12018" ]
       ]
     ], [
       fhir:index 49;
       fhir:CodeSystem.code [ fhir:value "387" ];
       fhir:CodeSystem.display [ fhir:value "Village of Crooked Creek" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Crooked Creek" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Crooked Creek" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12019" ]
       ]
     ], [
       fhir:index 50;
       fhir:CodeSystem.code [ fhir:value "388" ];
       fhir:CodeSystem.display [ fhir:value "Curyung Tribal Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Curyung Tribal Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Curyung Tribal Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12020" ]
       ]
     ], [
       fhir:index 51;
       fhir:CodeSystem.code [ fhir:value "389" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Deering" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Deering" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Deering" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12021" ]
       ]
     ], [
       fhir:index 52;
       fhir:CodeSystem.code [ fhir:value "390" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Diomede (aka Inalik)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Diomede (aka Inalik)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Diomede (aka Inalik)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12022" ]
       ]
     ], [
       fhir:index 53;
       fhir:CodeSystem.code [ fhir:value "391" ];
       fhir:CodeSystem.display [ fhir:value "Village of Dot Lake" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Dot Lake" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Dot Lake" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12023" ]
       ]
     ], [
       fhir:index 54;
       fhir:CodeSystem.code [ fhir:value "392" ];
       fhir:CodeSystem.display [ fhir:value "Douglas Indian Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Douglas Indian Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Douglas Indian Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12024" ]
       ]
     ], [
       fhir:index 55;
       fhir:CodeSystem.code [ fhir:value "393" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Eagle" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eagle" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eagle" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12025" ]
       ]
     ], [
       fhir:index 56;
       fhir:CodeSystem.code [ fhir:value "394" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Eek" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eek" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eek" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12026" ]
       ]
     ], [
       fhir:index 57;
       fhir:CodeSystem.code [ fhir:value "395" ];
       fhir:CodeSystem.display [ fhir:value "Egegik Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Egegik Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Egegik Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12027" ]
       ]
     ], [
       fhir:index 58;
       fhir:CodeSystem.code [ fhir:value "396" ];
       fhir:CodeSystem.display [ fhir:value "Eklutna Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eklutna Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eklutna Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12028" ]
       ]
     ], [
       fhir:index 59;
       fhir:CodeSystem.code [ fhir:value "397" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Ekuk" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ekuk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ekuk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12029" ]
       ]
     ], [
       fhir:index 60;
       fhir:CodeSystem.code [ fhir:value "398" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Ekwok" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ekwok" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ekwok" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12030" ]
       ]
     ], [
       fhir:index 61;
       fhir:CodeSystem.code [ fhir:value "399" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Elim" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Elim" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Elim" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12031" ]
       ]
     ], [
       fhir:index 62;
       fhir:CodeSystem.code [ fhir:value "400" ];
       fhir:CodeSystem.display [ fhir:value "Emmonak Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Emmonak Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Emmonak Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12032" ]
       ]
     ], [
       fhir:index 63;
       fhir:CodeSystem.code [ fhir:value "401" ];
       fhir:CodeSystem.display [ fhir:value "Evansville Village (aka Bettles Field)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Evansville Village (aka Bettles Field)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Evansville Village (aka Bettles Field)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12033" ]
       ]
     ], [
       fhir:index 64;
       fhir:CodeSystem.code [ fhir:value "402" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Eyak (Cordova)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eyak (Cordova)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Eyak (Cordova)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12034" ]
       ]
     ], [
       fhir:index 65;
       fhir:CodeSystem.code [ fhir:value "403" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of False Pass" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of False Pass" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of False Pass" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12035" ]
       ]
     ], [
       fhir:index 66;
       fhir:CodeSystem.code [ fhir:value "404" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Fort Yukon" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Fort Yukon" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Fort Yukon" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12036" ]
       ]
     ], [
       fhir:index 67;
       fhir:CodeSystem.code [ fhir:value "405" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Gakona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Gakona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Gakona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12037" ]
       ]
     ], [
       fhir:index 68;
       fhir:CodeSystem.code [ fhir:value "406" ];
       fhir:CodeSystem.display [ fhir:value "Galena Village (aka Louden Village)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Galena Village (aka Louden Village)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Galena Village (aka Louden Village)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12038" ]
       ]
     ], [
       fhir:index 69;
       fhir:CodeSystem.code [ fhir:value "407" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Gambell" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Gambell" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Gambell" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12039" ]
       ]
     ], [
       fhir:index 70;
       fhir:CodeSystem.code [ fhir:value "408" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Georgetown" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Georgetown" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Georgetown" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12040" ]
       ]
     ], [
       fhir:index 71;
       fhir:CodeSystem.code [ fhir:value "409" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Goodnews Bay" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Goodnews Bay" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Goodnews Bay" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12041" ]
       ]
     ], [
       fhir:index 72;
       fhir:CodeSystem.code [ fhir:value "410" ];
       fhir:CodeSystem.display [ fhir:value "Organized Village of Grayling (aka Holikachuk)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Grayling (aka Holikachuk)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Grayling (aka Holikachuk)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12042" ]
       ]
     ], [
       fhir:index 73;
       fhir:CodeSystem.code [ fhir:value "411" ];
       fhir:CodeSystem.display [ fhir:value "Gulkana Village Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Gulkana Village Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Gulkana Village Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12043" ]
       ]
     ], [
       fhir:index 74;
       fhir:CodeSystem.code [ fhir:value "412" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Hamilton" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Hamilton" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Hamilton" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12044" ]
       ]
     ], [
       fhir:index 75;
       fhir:CodeSystem.code [ fhir:value "413" ];
       fhir:CodeSystem.display [ fhir:value "Healy Lake Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Healy Lake Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Healy Lake Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12045" ]
       ]
     ], [
       fhir:index 76;
       fhir:CodeSystem.code [ fhir:value "414" ];
       fhir:CodeSystem.display [ fhir:value "Holy Cross Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Holy Cross Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Holy Cross Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12046" ]
       ]
     ], [
       fhir:index 77;
       fhir:CodeSystem.code [ fhir:value "415" ];
       fhir:CodeSystem.display [ fhir:value "Hoonah Indian Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoonah Indian Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoonah Indian Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12047" ]
       ]
     ], [
       fhir:index 78;
       fhir:CodeSystem.code [ fhir:value "416" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Hooper Bay" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Hooper Bay" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Hooper Bay" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12048" ]
       ]
     ], [
       fhir:index 79;
       fhir:CodeSystem.code [ fhir:value "417" ];
       fhir:CodeSystem.display [ fhir:value "Hughes Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hughes Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hughes Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12049" ]
       ]
     ], [
       fhir:index 80;
       fhir:CodeSystem.code [ fhir:value "418" ];
       fhir:CodeSystem.display [ fhir:value "Huslia Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Huslia Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Huslia Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12050" ]
       ]
     ], [
       fhir:index 81;
       fhir:CodeSystem.code [ fhir:value "419" ];
       fhir:CodeSystem.display [ fhir:value "Hydaburg Cooperative Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hydaburg Cooperative Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hydaburg Cooperative Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12051" ]
       ]
     ], [
       fhir:index 82;
       fhir:CodeSystem.code [ fhir:value "420" ];
       fhir:CodeSystem.display [ fhir:value "Igiugig Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Igiugig Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Igiugig Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12052" ]
       ]
     ], [
       fhir:index 83;
       fhir:CodeSystem.code [ fhir:value "421" ];
       fhir:CodeSystem.display [ fhir:value "Village of Iliamna" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Iliamna" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Iliamna" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12053" ]
       ]
     ], [
       fhir:index 84;
       fhir:CodeSystem.code [ fhir:value "422" ];
       fhir:CodeSystem.display [ fhir:value "Inupiat Community of the Arctic Slope" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Inupiat Community of the Arctic Slope" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Inupiat Community of the Arctic Slope" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12054" ]
       ]
     ], [
       fhir:index 85;
       fhir:CodeSystem.code [ fhir:value "423" ];
       fhir:CodeSystem.display [ fhir:value "Iqugmiut Traditional Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iqugmiut Traditional Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iqugmiut Traditional Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12055" ]
       ]
     ], [
       fhir:index 86;
       fhir:CodeSystem.code [ fhir:value "424" ];
       fhir:CodeSystem.display [ fhir:value "Ivanof Bay Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ivanof Bay Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ivanof Bay Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12056" ]
       ]
     ], [
       fhir:index 87;
       fhir:CodeSystem.code [ fhir:value "425" ];
       fhir:CodeSystem.display [ fhir:value "Kaguyak Village" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaguyak Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12057" ]
       ]
     ], [
       fhir:index 88;
       fhir:CodeSystem.code [ fhir:value "426" ];
       fhir:CodeSystem.display [ fhir:value "Organized Village of Kake" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Kake" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Kake" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12058" ]
       ]
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       fhir:index 89;
       fhir:CodeSystem.code [ fhir:value "427" ];
       fhir:CodeSystem.display [ fhir:value "Kaktovik Village (aka Barter Island)" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaktovik Village (aka Barter Island)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12059" ]
       ]
     ], [
       fhir:index 90;
       fhir:CodeSystem.code [ fhir:value "428" ];
       fhir:CodeSystem.display [ fhir:value "Village of Kalskag" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Kalskag" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Kalskag" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12060" ]
       ]
     ], [
       fhir:index 91;
       fhir:CodeSystem.code [ fhir:value "429" ];
       fhir:CodeSystem.display [ fhir:value "Village of Kaltag" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Kaltag" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Kaltag" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12061" ]
       ]
     ], [
       fhir:index 92;
       fhir:CodeSystem.code [ fhir:value "430" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kanatak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kanatak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kanatak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12062" ]
       ]
     ], [
       fhir:index 93;
       fhir:CodeSystem.code [ fhir:value "431" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Karluk" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Karluk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Karluk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12063" ]
       ]
     ], [
       fhir:index 94;
       fhir:CodeSystem.code [ fhir:value "432" ];
       fhir:CodeSystem.display [ fhir:value "Organized Village of Kasaan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Kasaan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Organized Village of Kasaan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12064" ]
       ]
     ], [
       fhir:index 95;
       fhir:CodeSystem.code [ fhir:value "433" ];
       fhir:CodeSystem.display [ fhir:value "Kasigluk Traditional Elders Council" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kasigluk Traditional Elders Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kasigluk Traditional Elders Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12065" ]
       ]
     ], [
       fhir:index 96;
       fhir:CodeSystem.code [ fhir:value "434" ];
       fhir:CodeSystem.display [ fhir:value "Kenaitze Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kenaitze Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kenaitze Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12066" ]
       ]
     ], [
       fhir:index 97;
       fhir:CodeSystem.code [ fhir:value "435" ];
       fhir:CodeSystem.display [ fhir:value "Ketchikan Indian Community" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ketchikan Indian Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ketchikan Indian Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12067" ]
       ]
     ], [
       fhir:index 98;
       fhir:CodeSystem.code [ fhir:value "436" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kiana" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kiana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kiana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12068" ]
       ]
     ], [
       fhir:index 99;
       fhir:CodeSystem.code [ fhir:value "437" ];
       fhir:CodeSystem.display [ fhir:value "King Island Native Community" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "King Island Native Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "King Island Native Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12069" ]
       ]
     ], [
       fhir:index 100;
       fhir:CodeSystem.code [ fhir:value "438" ];
       fhir:CodeSystem.display [ fhir:value "King Salmon Tribe" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "King Salmon Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "King Salmon Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12070" ]
       ]
     ], [
       fhir:index 101;
       fhir:CodeSystem.code [ fhir:value "439" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kipnuk" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kipnuk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kipnuk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12071" ]
       ]
     ], [
       fhir:index 102;
       fhir:CodeSystem.code [ fhir:value "440" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kivalina" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kivalina" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kivalina" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12072" ]
       ]
     ], [
       fhir:index 103;
       fhir:CodeSystem.code [ fhir:value "441" ];
       fhir:CodeSystem.display [ fhir:value "Klawock Cooperative Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Klawock Cooperative Association" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Klawock Cooperative Association" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12073" ]
       ]
     ], [
       fhir:index 104;
       fhir:CodeSystem.code [ fhir:value "442" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kluti Kaah (aka Copper Center)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kluti Kaah (aka Copper Center)" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kluti Kaah (aka Copper Center)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12074" ]
       ]
     ], [
       fhir:index 105;
       fhir:CodeSystem.code [ fhir:value "443" ];
       fhir:CodeSystem.display [ fhir:value "Knik Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Knik Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Knik Tribe" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
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         fhir:CodeSystem.value [ fhir:value "12075" ]
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       fhir:index 106;
       fhir:CodeSystem.code [ fhir:value "444" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kobuk" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kobuk" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kobuk" ]
       ];
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         fhir:CodeSystem.value [ fhir:value "12076" ]
       ]
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       fhir:index 107;
       fhir:CodeSystem.code [ fhir:value "445" ];
       fhir:CodeSystem.display [ fhir:value "Kokhanok Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kokhanok Village" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
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         fhir:CodeSystem.value [ fhir:value "12077" ]
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       fhir:index 108;
       fhir:CodeSystem.code [ fhir:value "446" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kongiganak" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kongiganak" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "12078" ]
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       fhir:index 109;
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       fhir:CodeSystem.display [ fhir:value "Village of Kotlik" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Kotlik" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.value [ fhir:value "12079" ]
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       fhir:index 110;
       fhir:CodeSystem.code [ fhir:value "448" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kotzebue" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kotzebue" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kotzebue" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12080" ]
       ]
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       fhir:index 111;
       fhir:CodeSystem.code [ fhir:value "449" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Koyuk" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Koyuk" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Native Village of Koyuk" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12081" ]
       ]
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       fhir:index 112;
       fhir:CodeSystem.code [ fhir:value "450" ];
       fhir:CodeSystem.display [ fhir:value "Koyukuk Native Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Koyukuk Native Village" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12082" ]
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       fhir:index 113;
       fhir:CodeSystem.code [ fhir:value "451" ];
       fhir:CodeSystem.display [ fhir:value "Organized Village of Kwethluk" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "12083" ]
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       fhir:CodeSystem.code [ fhir:value "452" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kwigillingok" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "12084" ]
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       fhir:index 115;
       fhir:CodeSystem.code [ fhir:value "453" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Kwinhagak (aka Quinhagak)" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Kwinhagak (aka Quinhagak)" ]
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12085" ]
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       fhir:index 116;
       fhir:CodeSystem.code [ fhir:value "454" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Larsen Bay" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12086" ]
       ]
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       fhir:index 117;
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       fhir:CodeSystem.display [ fhir:value "Levelock Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Levelock Village" ]
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         ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12087" ]
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       fhir:index 118;
       fhir:CodeSystem.code [ fhir:value "456" ];
       fhir:CodeSystem.display [ fhir:value "Tangirnaq Native Village" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tangirnaq Native Village" ]
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         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12088" ]
       ]
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       fhir:index 119;
       fhir:CodeSystem.code [ fhir:value "457" ];
       fhir:CodeSystem.display [ fhir:value "Lime Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lime Village" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12089" ]
       ]
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       fhir:index 120;
       fhir:CodeSystem.code [ fhir:value "458" ];
       fhir:CodeSystem.display [ fhir:value "Village of Lower Kalskag" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Lower Kalskag" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Lower Kalskag" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12090" ]
       ]
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       fhir:index 121;
       fhir:CodeSystem.code [ fhir:value "459" ];
       fhir:CodeSystem.display [ fhir:value "Manley Hot Springs Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manley Hot Springs Village" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manley Hot Springs Village" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12091" ]
       ]
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       fhir:index 122;
       fhir:CodeSystem.code [ fhir:value "460" ];
       fhir:CodeSystem.display [ fhir:value "Manokotak Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manokotak Village" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manokotak Village" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12092" ]
       ]
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       fhir:index 123;
       fhir:CodeSystem.code [ fhir:value "461" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Marshall (aka Fortuna Ledge)" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Marshall (aka Fortuna Ledge)" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Marshall (aka Fortuna Ledge)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12093" ]
       ]
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       fhir:index 124;
       fhir:CodeSystem.code [ fhir:value "462" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Mary's Igloo" ];
       fhir:CodeSystem.designation [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Mary's Igloo" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Mary's Igloo" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12094" ]
       ]
     ], [
       fhir:index 125;
       fhir:CodeSystem.code [ fhir:value "463" ];
       fhir:CodeSystem.display [ fhir:value "McGrath Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "McGrath Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "McGrath Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12095" ]
       ]
     ], [
       fhir:index 126;
       fhir:CodeSystem.code [ fhir:value "464" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Mekoryuk" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Mekoryuk" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Mekoryuk" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12096" ]
       ]
     ], [
       fhir:index 127;
       fhir:CodeSystem.code [ fhir:value "465" ];
       fhir:CodeSystem.display [ fhir:value "Mentasta Traditional Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mentasta Traditional Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mentasta Traditional Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12097" ]
       ]
     ], [
       fhir:index 128;
       fhir:CodeSystem.code [ fhir:value "466" ];
       fhir:CodeSystem.display [ fhir:value "Metlakatla Indian Community, Annette Island Reserve" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Metlakatla Indian Community, Annette Island Reserve" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Metlakatla Indian Community, Annette Island Reserve" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12098" ]
       ]
     ], [
       fhir:index 129;
       fhir:CodeSystem.code [ fhir:value "467" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Minto" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Minto" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Minto" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12099" ]
       ]
     ], [
       fhir:index 130;
       fhir:CodeSystem.code [ fhir:value "468" ];
       fhir:CodeSystem.display [ fhir:value "Naknek Native Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Naknek Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Naknek Native Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12100" ]
       ]
     ], [
       fhir:index 131;
       fhir:CodeSystem.code [ fhir:value "469" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Nanwalek (aka English Bay)" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nanwalek (aka English Bay)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nanwalek (aka English Bay)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12101" ]
       ]
     ], [
       fhir:index 132;
       fhir:CodeSystem.code [ fhir:value "470" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Napaimute" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napaimute" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napaimute" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12102" ]
       ]
     ], [
       fhir:index 133;
       fhir:CodeSystem.code [ fhir:value "471" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Napakiak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napakiak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napakiak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12103" ]
       ]
     ], [
       fhir:index 134;
       fhir:CodeSystem.code [ fhir:value "472" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Napaskiak" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napaskiak" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Napaskiak" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12104" ]
       ]
     ], [
       fhir:index 135;
       fhir:CodeSystem.code [ fhir:value "473" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Nelson Lagoon" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nelson Lagoon" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nelson Lagoon" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12105" ]
       ]
     ], [
       fhir:index 136;
       fhir:CodeSystem.code [ fhir:value "474" ];
       fhir:CodeSystem.display [ fhir:value "Nenana Native Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nenana Native Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nenana Native Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12106" ]
       ]
     ], [
       fhir:index 137;
       fhir:CodeSystem.code [ fhir:value "475" ];
       fhir:CodeSystem.display [ fhir:value "New Koliganek Village Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "New Koliganek Village Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "New Koliganek Village Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12107" ]
       ]
     ], [
       fhir:index 138;
       fhir:CodeSystem.code [ fhir:value "476" ];
       fhir:CodeSystem.display [ fhir:value "New Stuyahok Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "New Stuyahok Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "New Stuyahok Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12108" ]
       ]
     ], [
       fhir:index 139;
       fhir:CodeSystem.code [ fhir:value "477" ];
       fhir:CodeSystem.display [ fhir:value "Newhalen Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Newhalen Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Newhalen Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12109" ]
       ]
     ], [
       fhir:index 140;
       fhir:CodeSystem.code [ fhir:value "478" ];
       fhir:CodeSystem.display [ fhir:value "Newtok Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Newtok Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Newtok Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12110" ]
       ]
     ], [
       fhir:index 141;
       fhir:CodeSystem.code [ fhir:value "479" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Nightmute" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nightmute" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Nightmute" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12111" ]
       ]
     ], [
       fhir:index 142;
       fhir:CodeSystem.code [ fhir:value "480" ];
       fhir:CodeSystem.display [ fhir:value "Nikolai Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nikolai Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nikolai Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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       fhir:index 158;
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       fhir:index 159;
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       fhir:index 160;
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       fhir:index 161;
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           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pedro Bay Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12131" ]
       ]
     ], [
       fhir:index 162;
       fhir:CodeSystem.code [ fhir:value "500" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Perryville" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Perryville" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Perryville" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12132" ]
       ]
     ], [
       fhir:index 163;
       fhir:CodeSystem.code [ fhir:value "501" ];
       fhir:CodeSystem.display [ fhir:value "Petersburg Indian Association" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Petersburg Indian Association" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Petersburg Indian Association" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12133" ]
       ]
     ], [
       fhir:index 164;
       fhir:CodeSystem.code [ fhir:value "502" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Pilot Point" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Pilot Point" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Pilot Point" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12134" ]
       ]
     ], [
       fhir:index 165;
       fhir:CodeSystem.code [ fhir:value "503" ];
       fhir:CodeSystem.display [ fhir:value "Pilot Station Traditional Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pilot Station Traditional Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pilot Station Traditional Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12135" ]
       ]
     ], [
       fhir:index 166;
       fhir:CodeSystem.code [ fhir:value "504" ];
       fhir:CodeSystem.display [ fhir:value "Pitka's Point Traditional Council" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pitka's Point Traditional Council" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pitka's Point Traditional Council" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12136" ]
       ]
     ], [
       fhir:index 167;
       fhir:CodeSystem.code [ fhir:value "505" ];
       fhir:CodeSystem.display [ fhir:value "Platinum Traditional Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Platinum Traditional Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Platinum Traditional Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12137" ]
       ]
     ], [
       fhir:index 168;
       fhir:CodeSystem.code [ fhir:value "506" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Point Hope" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Point Hope" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Point Hope" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12138" ]
       ]
     ], [
       fhir:index 169;
       fhir:CodeSystem.code [ fhir:value "507" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Point Lay" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Point Lay" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Point Lay" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12139" ]
       ]
     ], [
       fhir:index 170;
       fhir:CodeSystem.code [ fhir:value "508" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Port Graham" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Graham" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Graham" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12140" ]
       ]
     ], [
       fhir:index 171;
       fhir:CodeSystem.code [ fhir:value "509" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Port Heiden" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Heiden" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Heiden" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12141" ]
       ]
     ], [
       fhir:index 172;
       fhir:CodeSystem.code [ fhir:value "510" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Port Lions" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Lions" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Port Lions" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12142" ]
       ]
     ], [
       fhir:index 173;
       fhir:CodeSystem.code [ fhir:value "511" ];
       fhir:CodeSystem.display [ fhir:value "Portage Creek Village (aka Ohgsenakale)" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Portage Creek Village (aka Ohgsenakale)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Portage Creek Village (aka Ohgsenakale)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12143" ]
       ]
     ], [
       fhir:index 174;
       fhir:CodeSystem.code [ fhir:value "512" ];
       fhir:CodeSystem.display [ fhir:value "Pribilof Islands Aleut Communities of St. Paul & St. George Islands (Saint George Island and Saint Paul Island)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pribilof Islands Aleut Communities of St. Paul & St. George Islands (Saint George Island and Saint Paul Island)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pribilof Islands Aleut Communities of St. Paul & St. George Islands (Saint George Island and Saint Paul Island)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "retired" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12144" ]
       ]
     ], [
       fhir:index 175;
       fhir:CodeSystem.code [ fhir:value "513" ];
       fhir:CodeSystem.display [ fhir:value "Qagan Tayagungin Tribe of Sand Point" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Qagan Tayagungin Tribe of Sand Point" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Qagan Tayagungin Tribe of Sand Point" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12145" ]
       ]
     ], [
       fhir:index 176;
       fhir:CodeSystem.code [ fhir:value "514" ];
       fhir:CodeSystem.display [ fhir:value "Qawalangin Tribe of Unalaska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Qawalangin Tribe of Unalaska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Qawalangin Tribe of Unalaska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12146" ]
       ]
     ], [
       fhir:index 177;
       fhir:CodeSystem.code [ fhir:value "515" ];
       fhir:CodeSystem.display [ fhir:value "Rampart Village" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rampart Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rampart Village" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12147" ]
       ]
     ], [
       fhir:index 178;
       fhir:CodeSystem.code [ fhir:value "516" ];
       fhir:CodeSystem.display [ fhir:value "Village of Red Devil" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Red Devil" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Red Devil" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12148" ]
       ]
     ], [
       fhir:index 179;
       fhir:CodeSystem.code [ fhir:value "517" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Ruby" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ruby" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Ruby" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12149" ]
       ]
     ], [
       fhir:index 180;
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           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Tyonek" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12187" ]
       ]
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       fhir:index 218;
       fhir:CodeSystem.code [ fhir:value "556" ];
       fhir:CodeSystem.display [ fhir:value "Ugashik Village" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ugashik Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ugashik Village" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12188" ]
       ]
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       fhir:index 219;
       fhir:CodeSystem.code [ fhir:value "557" ];
       fhir:CodeSystem.display [ fhir:value "Umkumiut Native Village" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Umkumiut Native Village" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12189" ]
       ]
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       fhir:index 220;
       fhir:CodeSystem.code [ fhir:value "558" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Unalakleet" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Unalakleet" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12190" ]
       ]
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       fhir:index 221;
       fhir:CodeSystem.code [ fhir:value "559" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Unga" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Unga" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Unga" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12191" ]
       ]
     ], [
       fhir:index 222;
       fhir:CodeSystem.code [ fhir:value "560" ];
       fhir:CodeSystem.display [ fhir:value "Village of Venetie" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Venetie" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Venetie" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12192" ]
       ]
     ], [
       fhir:index 223;
       fhir:CodeSystem.code [ fhir:value "561" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Venetie Tribal Government (Arctic Village and Village of Venetie)" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Venetie Tribal Government (Arctic Village and Village of Venetie)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Venetie Tribal Government (Arctic Village and Village of Venetie)" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "retired" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12193" ]
       ]
     ], [
       fhir:index 224;
       fhir:CodeSystem.code [ fhir:value "562" ];
       fhir:CodeSystem.display [ fhir:value "Village of Wainwright" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Wainwright" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Village of Wainwright" ]
       ];
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         fhir:CodeSystem.value [ fhir:value "12194" ]
       ]
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       fhir:index 225;
       fhir:CodeSystem.code [ fhir:value "563" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of Wales" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Native Village of Wales" ]
       ];
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         fhir:CodeSystem.value [ fhir:value "12195" ]
       ]
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       fhir:index 226;
       fhir:CodeSystem.code [ fhir:value "564" ];
       fhir:CodeSystem.display [ fhir:value "Native Village of White Mountain" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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       ];
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         fhir:CodeSystem.value [ fhir:value "12196" ]
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       fhir:index 227;
       fhir:CodeSystem.code [ fhir:value "565" ];
       fhir:CodeSystem.display [ fhir:value "Wrangell Cooperative Association" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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         ];
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       ];
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         fhir:CodeSystem.value [ fhir:value "12197" ]
       ]
     ], [
       fhir:index 228;
       fhir:CodeSystem.code [ fhir:value "566" ];
       fhir:CodeSystem.display [ fhir:value "Yakutat Tlingit Tribe" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "12198" ]
       ]
     ]
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     fhir:index 1;
     fhir:CodeSystem.code [ fhir:value "_NativeEntityContiguous" ];
     fhir:CodeSystem.display [ fhir:value "NativeEntityContiguous" ];
     fhir:CodeSystem.definition [ fhir:value "NATIVE ENTITIES WITHIN THE CONTIGUOUS 48 STATES" ];
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       fhir:CodeSystem.language [ fhir:value "en" ];
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         fhir:Coding.code [ fhir:value "display" ]
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     ], [
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       fhir:CodeSystem.language [ fhir:value "en" ];
       fhir:CodeSystem.use [
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         fhir:Coding.code [ fhir:value "display" ]
       ];
       fhir:CodeSystem.value [ fhir:value "NativeEntityContiguous" ]
     ];
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       fhir:index 0;
       fhir:CodeSystem.code [ fhir:value "notSelectable" ];
       fhir:CodeSystem.value [ fhir:value "true" ]
     ], [
       fhir:index 1;
       fhir:CodeSystem.code [ fhir:value "status" ];
       fhir:CodeSystem.value [ fhir:value "active" ]
     ], [
       fhir:index 2;
       fhir:CodeSystem.code [ fhir:value "internalId" ];
       fhir:CodeSystem.value [ fhir:value "21287" ]
     ];
     fhir:CodeSystem.concept [
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       fhir:CodeSystem.code [ fhir:value "1" ];
       fhir:CodeSystem.display [ fhir:value "Absentee-Shawnee Tribe of Indians of Oklahoma" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Absentee-Shawnee Tribe of Indians of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Absentee-Shawnee Tribe of Indians of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11632" ]
       ]
     ], [
       fhir:index 1;
       fhir:CodeSystem.code [ fhir:value "2" ];
       fhir:CodeSystem.display [ fhir:value "Agua Caliente Band of Cahuilla Indians of the Agua Caliente Indian Reservation, California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Agua Caliente Band of Cahuilla Indians of the Agua Caliente Indian Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Agua Caliente Band of Cahuilla Indians of the Agua Caliente Indian Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11633" ]
       ]
     ], [
       fhir:index 2;
       fhir:CodeSystem.code [ fhir:value "3" ];
       fhir:CodeSystem.display [ fhir:value "Ak-Chin Indian Community" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ak-Chin Indian Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ak-Chin Indian Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11634" ]
       ]
     ], [
       fhir:index 3;
       fhir:CodeSystem.code [ fhir:value "4" ];
       fhir:CodeSystem.display [ fhir:value "Alabama-Coushatta Tribe of Texas" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alabama-Coushatta Tribe of Texas" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alabama-Coushatta Tribe of Texas" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11635" ]
       ]
     ], [
       fhir:index 4;
       fhir:CodeSystem.code [ fhir:value "5" ];
       fhir:CodeSystem.display [ fhir:value "Alabama-Quassarte Tribal Town" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alabama-Quassarte Tribal Town" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alabama-Quassarte Tribal Town" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11636" ]
       ]
     ], [
       fhir:index 5;
       fhir:CodeSystem.code [ fhir:value "6" ];
       fhir:CodeSystem.display [ fhir:value "Alturas Indian Rancheria, California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alturas Indian Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Alturas Indian Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11637" ]
       ]
     ], [
       fhir:index 6;
       fhir:CodeSystem.code [ fhir:value "7" ];
       fhir:CodeSystem.display [ fhir:value "Apache Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Apache Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Apache Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11638" ]
       ]
     ], [
       fhir:index 7;
       fhir:CodeSystem.code [ fhir:value "8" ];
       fhir:CodeSystem.display [ fhir:value "Northern Arapaho Tribe of the Wind River Reservation, Wyoming" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northern Arapaho Tribe of the Wind River Reservation, Wyoming" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northern Arapaho Tribe of the Wind River Reservation, Wyoming" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11639" ]
       ]
     ], [
       fhir:index 8;
       fhir:CodeSystem.code [ fhir:value "9" ];
       fhir:CodeSystem.display [ fhir:value "Mi'kmaq Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mi'kmaq Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mi'kmaq Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11640" ]
       ]
     ], [
       fhir:index 9;
       fhir:CodeSystem.code [ fhir:value "10" ];
       fhir:CodeSystem.display [ fhir:value "Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11641" ]
       ]
     ], [
       fhir:index 10;
       fhir:CodeSystem.code [ fhir:value "11" ];
       fhir:CodeSystem.display [ fhir:value "Augustine Band of Cahuilla Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Augustine Band of Cahuilla Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Augustine Band of Cahuilla Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11642" ]
       ]
     ], [
       fhir:index 11;
       fhir:CodeSystem.code [ fhir:value "12" ];
       fhir:CodeSystem.display [ fhir:value "Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11643" ]
       ]
     ], [
       fhir:index 12;
       fhir:CodeSystem.code [ fhir:value "33" ];
       fhir:CodeSystem.display [ fhir:value "Barona Group of Capitan Grande Band of Mission Ind" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Barona Group of Capitan Grande Band of Mission Ind" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Barona Group of Capitan Grande Band of Mission Ind" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "retired" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11664" ]
       ]
     ], [
       fhir:index 13;
       fhir:CodeSystem.code [ fhir:value "13" ];
       fhir:CodeSystem.display [ fhir:value "Bay Mills Indian Community, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bay Mills Indian Community, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bay Mills Indian Community, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11644" ]
       ]
     ], [
       fhir:index 14;
       fhir:CodeSystem.code [ fhir:value "14" ];
       fhir:CodeSystem.display [ fhir:value "Bear River Band of the Rohnerville Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bear River Band of the Rohnerville Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bear River Band of the Rohnerville Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11645" ]
       ]
     ], [
       fhir:index 15;
       fhir:CodeSystem.code [ fhir:value "15" ];
       fhir:CodeSystem.display [ fhir:value "Berry Creek Rancheria of Maidu Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Berry Creek Rancheria of Maidu Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Berry Creek Rancheria of Maidu Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11646" ]
       ]
     ], [
       fhir:index 16;
       fhir:CodeSystem.code [ fhir:value "16" ];
       fhir:CodeSystem.display [ fhir:value "Big Lagoon Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Lagoon Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Lagoon Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11647" ]
       ]
     ], [
       fhir:index 17;
       fhir:CodeSystem.code [ fhir:value "17" ];
       fhir:CodeSystem.display [ fhir:value "Big Pine Paiute Tribe of the Owens Valley" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Pine Paiute Tribe of the Owens Valley" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Pine Paiute Tribe of the Owens Valley" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11648" ]
       ]
     ], [
       fhir:index 18;
       fhir:CodeSystem.code [ fhir:value "18" ];
       fhir:CodeSystem.display [ fhir:value "Big Sandy Rancheria of Western Mono Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Sandy Rancheria of Western Mono Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Sandy Rancheria of Western Mono Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11649" ]
       ]
     ], [
       fhir:index 19;
       fhir:CodeSystem.code [ fhir:value "19" ];
       fhir:CodeSystem.display [ fhir:value "Big Valley Band of Pomo Indians of the Big Valley Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Valley Band of Pomo Indians of the Big Valley Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Big Valley Band of Pomo Indians of the Big Valley Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11650" ]
       ]
     ], [
       fhir:index 20;
       fhir:CodeSystem.code [ fhir:value "20" ];
       fhir:CodeSystem.display [ fhir:value "Blackfeet Tribe of the Blackfeet Indian Reservation of Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Blackfeet Tribe of the Blackfeet Indian Reservation of Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Blackfeet Tribe of the Blackfeet Indian Reservation of Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11651" ]
       ]
     ], [
       fhir:index 21;
       fhir:CodeSystem.code [ fhir:value "21" ];
       fhir:CodeSystem.display [ fhir:value "Blue Lake Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Blue Lake Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Blue Lake Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11652" ]
       ]
     ], [
       fhir:index 22;
       fhir:CodeSystem.code [ fhir:value "160" ];
       fhir:CodeSystem.display [ fhir:value "Bois Forte Band (Nett Lake); Fond du Lac Band; Gra" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bois Forte Band (Nett Lake); Fond du Lac Band; Gra" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bois Forte Band (Nett Lake); Fond du Lac Band; Gra" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "retired" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11791" ]
       ]
     ], [
       fhir:index 23;
       fhir:CodeSystem.code [ fhir:value "22" ];
       fhir:CodeSystem.display [ fhir:value "Bridgeport Indian Colony" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bridgeport Indian Colony" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bridgeport Indian Colony" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11653" ]
       ]
     ], [
       fhir:index 24;
       fhir:CodeSystem.code [ fhir:value "23" ];
       fhir:CodeSystem.display [ fhir:value "Buena Vista Rancheria of Me-Wuk Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Buena Vista Rancheria of Me-Wuk Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Buena Vista Rancheria of Me-Wuk Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11654" ]
       ]
     ], [
       fhir:index 25;
       fhir:CodeSystem.code [ fhir:value "24" ];
       fhir:CodeSystem.display [ fhir:value "Burns Paiute Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Burns Paiute Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Burns Paiute Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11655" ]
       ]
     ], [
       fhir:index 26;
       fhir:CodeSystem.code [ fhir:value "25" ];
       fhir:CodeSystem.display [ fhir:value "Cabazon Band of Cahuilla Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cabazon Band of Cahuilla Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cabazon Band of Cahuilla Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11656" ]
       ]
     ], [
       fhir:index 27;
       fhir:CodeSystem.code [ fhir:value "26" ];
       fhir:CodeSystem.display [ fhir:value "Cachil DeHe Band of Wintun Indians of the Colusa Indian Community of the Colusa Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cachil DeHe Band of Wintun Indians of the Colusa Indian Community of the Colusa Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cachil DeHe Band of Wintun Indians of the Colusa Indian Community of the Colusa Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11657" ]
       ]
     ], [
       fhir:index 28;
       fhir:CodeSystem.code [ fhir:value "27" ];
       fhir:CodeSystem.display [ fhir:value "Caddo Nation of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Caddo Nation of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Caddo Nation of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11658" ]
       ]
     ], [
       fhir:index 29;
       fhir:CodeSystem.code [ fhir:value "29" ];
       fhir:CodeSystem.display [ fhir:value "Cahto Tribe of the Laytonville Rancheria" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cahto Tribe of the Laytonville Rancheria" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cahto Tribe of the Laytonville Rancheria" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11660" ]
       ]
     ], [
       fhir:index 30;
       fhir:CodeSystem.code [ fhir:value "28" ];
       fhir:CodeSystem.display [ fhir:value "Cahuilla Band of Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cahuilla Band of Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cahuilla Band of Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11659" ]
       ]
     ], [
       fhir:index 31;
       fhir:CodeSystem.code [ fhir:value "30" ];
       fhir:CodeSystem.display [ fhir:value "California Valley Miwok Tribe, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "California Valley Miwok Tribe, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "California Valley Miwok Tribe, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11661" ]
       ]
     ], [
       fhir:index 32;
       fhir:CodeSystem.code [ fhir:value "31" ];
       fhir:CodeSystem.display [ fhir:value "Campo Band of Diegueno Mission Indians of the Campo Indian Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Campo Band of Diegueno Mission Indians of the Campo Indian Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Campo Band of Diegueno Mission Indians of the Campo Indian Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11662" ]
       ]
     ], [
       fhir:index 33;
       fhir:CodeSystem.code [ fhir:value "32" ];
       fhir:CodeSystem.display [ fhir:value "Capitan Grande Band of Diegueno Mission Indians of California" ];
       fhir:CodeSystem.definition [ fhir:value "Capitan Grande Band of Diegueno Mission Indians of California (Barona Group of Capitan Grande Band of Mission Indians of the Barona Reservation, California; Viejas (Baron Long) Group of Capitan Grande Band of Mission Indians of the Viejas Reservation, California)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Capitan Grande Band of Diegueno Mission Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Capitan Grande Band of Diegueno Mission Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11663" ]
       ]
     ], [
       fhir:index 34;
       fhir:CodeSystem.code [ fhir:value "35" ];
       fhir:CodeSystem.display [ fhir:value "Catawba Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Catawba Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Catawba Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11666" ]
       ]
     ], [
       fhir:index 35;
       fhir:CodeSystem.code [ fhir:value "36" ];
       fhir:CodeSystem.display [ fhir:value "Cayuga Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cayuga Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cayuga Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11667" ]
       ]
     ], [
       fhir:index 36;
       fhir:CodeSystem.code [ fhir:value "37" ];
       fhir:CodeSystem.display [ fhir:value "Cedarville Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cedarville Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cedarville Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11668" ]
       ]
     ], [
       fhir:index 37;
       fhir:CodeSystem.code [ fhir:value "38" ];
       fhir:CodeSystem.display [ fhir:value "Chemehuevi Indian Tribe of the Chemehuevi Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chemehuevi Indian Tribe of the Chemehuevi Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chemehuevi Indian Tribe of the Chemehuevi Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11669" ]
       ]
     ], [
       fhir:index 38;
       fhir:CodeSystem.code [ fhir:value "39" ];
       fhir:CodeSystem.display [ fhir:value "Cher-Ae Heights Indian Community of the Trinidad Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cher-Ae Heights Indian Community of the Trinidad Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cher-Ae Heights Indian Community of the Trinidad Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11670" ]
       ]
     ], [
       fhir:index 39;
       fhir:CodeSystem.code [ fhir:value "40" ];
       fhir:CodeSystem.display [ fhir:value "Cherokee Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cherokee Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cherokee Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11671" ]
       ]
     ], [
       fhir:index 40;
       fhir:CodeSystem.code [ fhir:value "42" ];
       fhir:CodeSystem.display [ fhir:value "Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11673" ]
       ]
     ], [
       fhir:index 41;
       fhir:CodeSystem.code [ fhir:value "41" ];
       fhir:CodeSystem.display [ fhir:value "Cheyenne and Arapaho Tribes, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheyenne and Arapaho Tribes, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cheyenne and Arapaho Tribes, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11672" ]
       ]
     ], [
       fhir:index 42;
       fhir:CodeSystem.code [ fhir:value "43" ];
       fhir:CodeSystem.display [ fhir:value "The Chickasaw Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Chickasaw Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Chickasaw Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11674" ]
       ]
     ], [
       fhir:index 43;
       fhir:CodeSystem.code [ fhir:value "44" ];
       fhir:CodeSystem.display [ fhir:value "Chicken Ranch Rancheria of Me-Wuk Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chicken Ranch Rancheria of Me-Wuk Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chicken Ranch Rancheria of Me-Wuk Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11675" ]
       ]
     ], [
       fhir:index 44;
       fhir:CodeSystem.code [ fhir:value "45" ];
       fhir:CodeSystem.display [ fhir:value "Chippewa Cree Indians of the Rocky Boy's Reservation, Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chippewa Cree Indians of the Rocky Boy's Reservation, Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chippewa Cree Indians of the Rocky Boy's Reservation, Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11676" ]
       ]
     ], [
       fhir:index 45;
       fhir:CodeSystem.code [ fhir:value "46" ];
       fhir:CodeSystem.display [ fhir:value "Chitimacha Tribe of Louisiana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chitimacha Tribe of Louisiana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chitimacha Tribe of Louisiana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11677" ]
       ]
     ], [
       fhir:index 46;
       fhir:CodeSystem.code [ fhir:value "47" ];
       fhir:CodeSystem.display [ fhir:value "The Choctaw Nation of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Choctaw Nation of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Choctaw Nation of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11678" ]
       ]
     ], [
       fhir:index 47;
       fhir:CodeSystem.code [ fhir:value "48" ];
       fhir:CodeSystem.display [ fhir:value "Citizen Potawatomi Nation, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Citizen Potawatomi Nation, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Citizen Potawatomi Nation, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11679" ]
       ]
     ], [
       fhir:index 48;
       fhir:CodeSystem.code [ fhir:value "49" ];
       fhir:CodeSystem.display [ fhir:value "Cloverdale Rancheria of Pomo Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cloverdale Rancheria of Pomo Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cloverdale Rancheria of Pomo Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11680" ]
       ]
     ], [
       fhir:index 49;
       fhir:CodeSystem.code [ fhir:value "50" ];
       fhir:CodeSystem.display [ fhir:value "Cocopah Tribe of Arizona" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cocopah Tribe of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cocopah Tribe of Arizona" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11681" ]
       ]
     ], [
       fhir:index 50;
       fhir:CodeSystem.code [ fhir:value "51" ];
       fhir:CodeSystem.display [ fhir:value "Coeur D'Alene Tribe" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Coeur D'Alene Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Coeur D'Alene Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11682" ]
       ]
     ], [
       fhir:index 51;
       fhir:CodeSystem.code [ fhir:value "52" ];
       fhir:CodeSystem.display [ fhir:value "Cold Springs Rancheria of Mono Indians of California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cold Springs Rancheria of Mono Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cold Springs Rancheria of Mono Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11683" ]
       ]
     ], [
       fhir:index 52;
       fhir:CodeSystem.code [ fhir:value "53" ];
       fhir:CodeSystem.display [ fhir:value "Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11684" ]
       ]
     ], [
       fhir:index 53;
       fhir:CodeSystem.code [ fhir:value "54" ];
       fhir:CodeSystem.display [ fhir:value "Comanche Nation, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Comanche Nation, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Comanche Nation, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11685" ]
       ]
     ], [
       fhir:index 54;
       fhir:CodeSystem.code [ fhir:value "55" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Salish and Kootenai Tribes of the Flathead Reservation" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Salish and Kootenai Tribes of the Flathead Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Salish and Kootenai Tribes of the Flathead Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11686" ]
       ]
     ], [
       fhir:index 55;
       fhir:CodeSystem.code [ fhir:value "64" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes and Bands of the Yakama Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes and Bands of the Yakama Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes and Bands of the Yakama Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11695" ]
       ]
     ], [
       fhir:index 56;
       fhir:CodeSystem.code [ fhir:value "56" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Chehalis Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Chehalis Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Chehalis Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11687" ]
       ]
     ], [
       fhir:index 57;
       fhir:CodeSystem.code [ fhir:value "57" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Colville Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Colville Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Colville Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11688" ]
       ]
     ], [
       fhir:index 58;
       fhir:CodeSystem.code [ fhir:value "58" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11689" ]
       ]
     ], [
       fhir:index 59;
       fhir:CodeSystem.code [ fhir:value "59" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Goshute Reservation, Nevada and Utah" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Goshute Reservation, Nevada and Utah" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Goshute Reservation, Nevada and Utah" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11690" ]
       ]
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       fhir:index 60;
       fhir:CodeSystem.code [ fhir:value "60" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Grand Ronde Community of Oregon" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Grand Ronde Community of Oregon" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Confederated Tribes of the Grand Ronde Community of Oregon" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11691" ]
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       fhir:index 61;
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       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of Siletz Indians of Oregon" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "11692" ]
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       fhir:index 62;
       fhir:CodeSystem.code [ fhir:value "62" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Umatilla Indian Reservation" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11693" ]
       ]
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       fhir:index 63;
       fhir:CodeSystem.code [ fhir:value "63" ];
       fhir:CodeSystem.display [ fhir:value "Confederated Tribes of the Warm Springs Reservation of Oregon" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11694" ]
       ]
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       fhir:index 64;
       fhir:CodeSystem.code [ fhir:value "65" ];
       fhir:CodeSystem.display [ fhir:value "Coquille Indian Tribe" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11696" ]
       ]
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       fhir:index 65;
       fhir:CodeSystem.code [ fhir:value "66" ];
       fhir:CodeSystem.display [ fhir:value "Kletsel Dehe Wintun Nation of the Cortina Rancheria" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kletsel Dehe Wintun Nation of the Cortina Rancheria" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.value [ fhir:value "11697" ]
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       fhir:index 66;
       fhir:CodeSystem.code [ fhir:value "67" ];
       fhir:CodeSystem.display [ fhir:value "Coushatta Tribe of Louisiana" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Coushatta Tribe of Louisiana" ]
       ], [
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11698" ]
       ]
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       fhir:index 67;
       fhir:CodeSystem.code [ fhir:value "68" ];
       fhir:CodeSystem.display [ fhir:value "Cow Creek Band of Umpqua Tribe of Indians" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Cow Creek Band of Umpqua Tribe of Indians" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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         fhir:CodeSystem.value [ fhir:value "11699" ]
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       fhir:CodeSystem.display [ fhir:value "Coyote Valley Band of Pomo Indians of California" ];
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         fhir:CodeSystem.value [ fhir:value "11700" ]
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       fhir:index 69;
       fhir:CodeSystem.code [ fhir:value "71" ];
       fhir:CodeSystem.display [ fhir:value "Crow Creek Sioux Tribe of the Crow Creek Reservation, South Dakota" ];
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           fhir:Coding.code [ fhir:value "display" ]
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       ], [
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       ];
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       ]
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       fhir:index 70;
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       fhir:CodeSystem.display [ fhir:value "Crow Tribe of Montana" ];
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       ], [
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       ];
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         fhir:CodeSystem.value [ fhir:value "11701" ]
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       fhir:index 71;
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       fhir:CodeSystem.display [ fhir:value "Ewiiaapaayp Band of Kumeyaay Indians, California" ];
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         ];
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         ];
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       ];
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         fhir:CodeSystem.value [ fhir:value "11703" ]
       ]
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       fhir:index 72;
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         ];
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         fhir:CodeSystem.value [ fhir:value "11704" ]
       ]
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       fhir:index 73;
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       fhir:CodeSystem.display [ fhir:value "Delaware Nation, Oklahoma" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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       ], [
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       ];
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         fhir:CodeSystem.value [ fhir:value "11705" ]
       ]
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       fhir:index 74;
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       fhir:CodeSystem.display [ fhir:value "Delaware Tribe of Indians" ];
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       ];
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         fhir:CodeSystem.value [ fhir:value "11706" ]
       ]
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       fhir:index 75;
       fhir:CodeSystem.code [ fhir:value "76" ];
       fhir:CodeSystem.display [ fhir:value "Dry Creek Rancheria Band of Pomo Indians, California" ];
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         fhir:CodeSystem.value [ fhir:value "11707" ]
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       fhir:index 76;
       fhir:CodeSystem.code [ fhir:value "77" ];
       fhir:CodeSystem.display [ fhir:value "Duckwater Shoshone Tribe of the Duckwater Reservation, Nevada" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Duckwater Shoshone Tribe of the Duckwater Reservation, Nevada" ]
       ], [
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           fhir:Coding.code [ fhir:value "display" ]
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       ];
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         fhir:CodeSystem.value [ fhir:value "11708" ]
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       fhir:index 77;
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       fhir:CodeSystem.display [ fhir:value "Eastern Band of Cherokee Indians" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.value [ fhir:value "Eastern Band of Cherokee Indians" ]
       ];
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         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11709" ]
       ]
     ], [
       fhir:index 78;
       fhir:CodeSystem.code [ fhir:value "79" ];
       fhir:CodeSystem.display [ fhir:value "Eastern Shawnee Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eastern Shawnee Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eastern Shawnee Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11710" ]
       ]
     ], [
       fhir:index 79;
       fhir:CodeSystem.code [ fhir:value "80" ];
       fhir:CodeSystem.display [ fhir:value "Elem Indian Colony of Pomo Indians of the Sulphur Bank Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Elem Indian Colony of Pomo Indians of the Sulphur Bank Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Elem Indian Colony of Pomo Indians of the Sulphur Bank Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11711" ]
       ]
     ], [
       fhir:index 80;
       fhir:CodeSystem.code [ fhir:value "81" ];
       fhir:CodeSystem.display [ fhir:value "Elk Valley Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Elk Valley Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Elk Valley Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11712" ]
       ]
     ], [
       fhir:index 81;
       fhir:CodeSystem.code [ fhir:value "82" ];
       fhir:CodeSystem.display [ fhir:value "Ely Shoshone Tribe of Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ely Shoshone Tribe of Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ely Shoshone Tribe of Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11713" ]
       ]
     ], [
       fhir:index 82;
       fhir:CodeSystem.code [ fhir:value "83" ];
       fhir:CodeSystem.display [ fhir:value "Enterprise Rancheria of Maidu Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Enterprise Rancheria of Maidu Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Enterprise Rancheria of Maidu Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11714" ]
       ]
     ], [
       fhir:index 83;
       fhir:CodeSystem.code [ fhir:value "84" ];
       fhir:CodeSystem.display [ fhir:value "Flandreau Santee Sioux Tribe of South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Flandreau Santee Sioux Tribe of South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Flandreau Santee Sioux Tribe of South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11715" ]
       ]
     ], [
       fhir:index 84;
       fhir:CodeSystem.code [ fhir:value "85" ];
       fhir:CodeSystem.display [ fhir:value "Forest County Potawatomi Community, Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Forest County Potawatomi Community, Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Forest County Potawatomi Community, Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11716" ]
       ]
     ], [
       fhir:index 85;
       fhir:CodeSystem.code [ fhir:value "86" ];
       fhir:CodeSystem.display [ fhir:value "Fort Belknap Indian Community of the Fort Belknap Reservation of Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Belknap Indian Community of the Fort Belknap Reservation of Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Belknap Indian Community of the Fort Belknap Reservation of Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11717" ]
       ]
     ], [
       fhir:index 86;
       fhir:CodeSystem.code [ fhir:value "87" ];
       fhir:CodeSystem.display [ fhir:value "Fort Bidwell Indian Community of the Fort Bidwell Reservation of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Bidwell Indian Community of the Fort Bidwell Reservation of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Bidwell Indian Community of the Fort Bidwell Reservation of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11718" ]
       ]
     ], [
       fhir:index 87;
       fhir:CodeSystem.code [ fhir:value "88" ];
       fhir:CodeSystem.display [ fhir:value "Fort Independence Indian Community of Paiute Indians of the Fort Independence Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Independence Indian Community of Paiute Indians of the Fort Independence Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Independence Indian Community of Paiute Indians of the Fort Independence Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11719" ]
       ]
     ], [
       fhir:index 88;
       fhir:CodeSystem.code [ fhir:value "89" ];
       fhir:CodeSystem.display [ fhir:value "Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11720" ]
       ]
     ], [
       fhir:index 89;
       fhir:CodeSystem.code [ fhir:value "90" ];
       fhir:CodeSystem.display [ fhir:value "Fort McDowell Yavapai Nation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort McDowell Yavapai Nation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort McDowell Yavapai Nation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11721" ]
       ]
     ], [
       fhir:index 90;
       fhir:CodeSystem.code [ fhir:value "91" ];
       fhir:CodeSystem.display [ fhir:value "Fort Mojave Indian Tribe of Arizona, California & Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Mojave Indian Tribe of Arizona, California & Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Mojave Indian Tribe of Arizona, California & Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11722" ]
       ]
     ], [
       fhir:index 91;
       fhir:CodeSystem.code [ fhir:value "92" ];
       fhir:CodeSystem.display [ fhir:value "Fort Sill Apache Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Sill Apache Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Fort Sill Apache Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11723" ]
       ]
     ], [
       fhir:index 92;
       fhir:CodeSystem.code [ fhir:value "93" ];
       fhir:CodeSystem.display [ fhir:value "Gila River Indian Community of the Gila River Indian Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Gila River Indian Community of the Gila River Indian Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Gila River Indian Community of the Gila River Indian Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11724" ]
       ]
     ], [
       fhir:index 93;
       fhir:CodeSystem.code [ fhir:value "94" ];
       fhir:CodeSystem.display [ fhir:value "Grand Traverse Band of Ottawa and Chippewa Indians, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Grand Traverse Band of Ottawa and Chippewa Indians, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Grand Traverse Band of Ottawa and Chippewa Indians, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11725" ]
       ]
     ], [
       fhir:index 94;
       fhir:CodeSystem.code [ fhir:value "95" ];
       fhir:CodeSystem.display [ fhir:value "Federated Indians of Graton Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Federated Indians of Graton Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Federated Indians of Graton Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11726" ]
       ]
     ], [
       fhir:index 95;
       fhir:CodeSystem.code [ fhir:value "96" ];
       fhir:CodeSystem.display [ fhir:value "Greenville Rancheria" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Greenville Rancheria" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Greenville Rancheria" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11727" ]
       ]
     ], [
       fhir:index 96;
       fhir:CodeSystem.code [ fhir:value "97" ];
       fhir:CodeSystem.display [ fhir:value "Grindstone Indian Rancheria of Wintun-Wailaki Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Grindstone Indian Rancheria of Wintun-Wailaki Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Grindstone Indian Rancheria of Wintun-Wailaki Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11728" ]
       ]
     ], [
       fhir:index 97;
       fhir:CodeSystem.code [ fhir:value "98" ];
       fhir:CodeSystem.display [ fhir:value "Guidiville Rancheria of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Guidiville Rancheria of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Guidiville Rancheria of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11729" ]
       ]
     ], [
       fhir:index 98;
       fhir:CodeSystem.code [ fhir:value "99" ];
       fhir:CodeSystem.display [ fhir:value "Hannahville Indian Community, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hannahville Indian Community, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hannahville Indian Community, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11730" ]
       ]
     ], [
       fhir:index 99;
       fhir:CodeSystem.code [ fhir:value "100" ];
       fhir:CodeSystem.display [ fhir:value "Havasupai Tribe of the Havasupai Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Havasupai Tribe of the Havasupai Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Havasupai Tribe of the Havasupai Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11731" ]
       ]
     ], [
       fhir:index 100;
       fhir:CodeSystem.code [ fhir:value "101" ];
       fhir:CodeSystem.display [ fhir:value "Ho-Chunk Nation of Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ho-Chunk Nation of Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ho-Chunk Nation of Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11732" ]
       ]
     ], [
       fhir:index 101;
       fhir:CodeSystem.code [ fhir:value "102" ];
       fhir:CodeSystem.display [ fhir:value "Hoh Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoh Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoh Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11733" ]
       ]
     ], [
       fhir:index 102;
       fhir:CodeSystem.code [ fhir:value "103" ];
       fhir:CodeSystem.display [ fhir:value "Hoopa Valley Tribe, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoopa Valley Tribe, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hoopa Valley Tribe, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11734" ]
       ]
     ], [
       fhir:index 103;
       fhir:CodeSystem.code [ fhir:value "104" ];
       fhir:CodeSystem.display [ fhir:value "Hopi Tribe of Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hopi Tribe of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hopi Tribe of Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11735" ]
       ]
     ], [
       fhir:index 104;
       fhir:CodeSystem.code [ fhir:value "105" ];
       fhir:CodeSystem.display [ fhir:value "Hopland Band of Pomo Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hopland Band of Pomo Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hopland Band of Pomo Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11736" ]
       ]
     ], [
       fhir:index 105;
       fhir:CodeSystem.code [ fhir:value "106" ];
       fhir:CodeSystem.display [ fhir:value "Houlton Band of Maliseet Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Houlton Band of Maliseet Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Houlton Band of Maliseet Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11737" ]
       ]
     ], [
       fhir:index 106;
       fhir:CodeSystem.code [ fhir:value "107" ];
       fhir:CodeSystem.display [ fhir:value "Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11738" ]
       ]
     ], [
       fhir:index 107;
       fhir:CodeSystem.code [ fhir:value "108" ];
       fhir:CodeSystem.display [ fhir:value "Nottawaseppi Huron Band of the Potawatomi, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nottawaseppi Huron Band of the Potawatomi, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nottawaseppi Huron Band of the Potawatomi, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11739" ]
       ]
     ], [
       fhir:index 108;
       fhir:CodeSystem.code [ fhir:value "109" ];
       fhir:CodeSystem.display [ fhir:value "Inaja Band of Diegueno Mission Indians of the Inaja and Cosmit Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Inaja Band of Diegueno Mission Indians of the Inaja and Cosmit Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Inaja Band of Diegueno Mission Indians of the Inaja and Cosmit Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11740" ]
       ]
     ], [
       fhir:index 109;
       fhir:CodeSystem.code [ fhir:value "110" ];
       fhir:CodeSystem.display [ fhir:value "Ione Band of Miwok Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ione Band of Miwok Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ione Band of Miwok Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11741" ]
       ]
     ], [
       fhir:index 110;
       fhir:CodeSystem.code [ fhir:value "111" ];
       fhir:CodeSystem.display [ fhir:value "Iowa Tribe of Kansas and Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iowa Tribe of Kansas and Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iowa Tribe of Kansas and Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11742" ]
       ]
     ], [
       fhir:index 111;
       fhir:CodeSystem.code [ fhir:value "112" ];
       fhir:CodeSystem.display [ fhir:value "Iowa Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iowa Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iowa Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11743" ]
       ]
     ], [
       fhir:index 112;
       fhir:CodeSystem.code [ fhir:value "113" ];
       fhir:CodeSystem.display [ fhir:value "Jackson Band of Miwuk Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jackson Band of Miwuk Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jackson Band of Miwuk Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11744" ]
       ]
     ], [
       fhir:index 113;
       fhir:CodeSystem.code [ fhir:value "114" ];
       fhir:CodeSystem.display [ fhir:value "Jamestown S'Klallam Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jamestown S'Klallam Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jamestown S'Klallam Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11745" ]
       ]
     ], [
       fhir:index 114;
       fhir:CodeSystem.code [ fhir:value "115" ];
       fhir:CodeSystem.display [ fhir:value "Jamul Indian Village of California" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jamul Indian Village of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11746" ]
       ]
     ], [
       fhir:index 115;
       fhir:CodeSystem.code [ fhir:value "116" ];
       fhir:CodeSystem.display [ fhir:value "Jena Band of Choctaw Indians" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jena Band of Choctaw Indians" ]
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         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jena Band of Choctaw Indians" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11747" ]
       ]
     ], [
       fhir:index 116;
       fhir:CodeSystem.code [ fhir:value "117" ];
       fhir:CodeSystem.display [ fhir:value "Jicarilla Apache Nation, New Mexico" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jicarilla Apache Nation, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Jicarilla Apache Nation, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11748" ]
       ]
     ], [
       fhir:index 117;
       fhir:CodeSystem.code [ fhir:value "118" ];
       fhir:CodeSystem.display [ fhir:value "Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11749" ]
       ]
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       fhir:index 118;
       fhir:CodeSystem.code [ fhir:value "119" ];
       fhir:CodeSystem.display [ fhir:value "Kalispel Indian Community of the Kalispel Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kalispel Indian Community of the Kalispel Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kalispel Indian Community of the Kalispel Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11750" ]
       ]
     ], [
       fhir:index 119;
       fhir:CodeSystem.code [ fhir:value "120" ];
       fhir:CodeSystem.display [ fhir:value "Karuk Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Karuk Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Karuk Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11751" ]
       ]
     ], [
       fhir:index 120;
       fhir:CodeSystem.code [ fhir:value "121" ];
       fhir:CodeSystem.display [ fhir:value "Kashia Band of Pomo Indians of the Stewarts Point Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kashia Band of Pomo Indians of the Stewarts Point Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kashia Band of Pomo Indians of the Stewarts Point Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11752" ]
       ]
     ], [
       fhir:index 121;
       fhir:CodeSystem.code [ fhir:value "122" ];
       fhir:CodeSystem.display [ fhir:value "Kaw Nation, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaw Nation, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kaw Nation, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11753" ]
       ]
     ], [
       fhir:index 122;
       fhir:CodeSystem.code [ fhir:value "123" ];
       fhir:CodeSystem.display [ fhir:value "Keweenaw Bay Indian Community, Michigan" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Keweenaw Bay Indian Community, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Keweenaw Bay Indian Community, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11754" ]
       ]
     ], [
       fhir:index 123;
       fhir:CodeSystem.code [ fhir:value "124" ];
       fhir:CodeSystem.display [ fhir:value "Kialegee Tribal Town" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kialegee Tribal Town" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kialegee Tribal Town" ]
       ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11755" ]
       ]
     ], [
       fhir:index 124;
       fhir:CodeSystem.code [ fhir:value "127" ];
       fhir:CodeSystem.display [ fhir:value "Kickapoo Traditional Tribe of Texas" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Traditional Tribe of Texas" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Traditional Tribe of Texas" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11758" ]
       ]
     ], [
       fhir:index 125;
       fhir:CodeSystem.code [ fhir:value "125" ];
       fhir:CodeSystem.display [ fhir:value "Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11756" ]
       ]
     ], [
       fhir:index 126;
       fhir:CodeSystem.code [ fhir:value "126" ];
       fhir:CodeSystem.display [ fhir:value "Kickapoo Tribe of Oklahoma" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kickapoo Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11757" ]
       ]
     ], [
       fhir:index 127;
       fhir:CodeSystem.code [ fhir:value "128" ];
       fhir:CodeSystem.display [ fhir:value "Kiowa Indian Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kiowa Indian Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kiowa Indian Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11759" ]
       ]
     ], [
       fhir:index 128;
       fhir:CodeSystem.code [ fhir:value "129" ];
       fhir:CodeSystem.display [ fhir:value "Klamath Tribes" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Klamath Tribes" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Klamath Tribes" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11760" ]
       ]
     ], [
       fhir:index 129;
       fhir:CodeSystem.code [ fhir:value "130" ];
       fhir:CodeSystem.display [ fhir:value "Kootenai Tribe of Idaho" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kootenai Tribe of Idaho" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Kootenai Tribe of Idaho" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11761" ]
       ]
     ], [
       fhir:index 130;
       fhir:CodeSystem.code [ fhir:value "131" ];
       fhir:CodeSystem.display [ fhir:value "La Jolla Band of Luiseno Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "La Jolla Band of Luiseno Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "La Jolla Band of Luiseno Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11762" ]
       ]
     ], [
       fhir:index 131;
       fhir:CodeSystem.code [ fhir:value "132" ];
       fhir:CodeSystem.display [ fhir:value "La Posta Band of Diegueno Mission Indians of the La Posta Indian Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "La Posta Band of Diegueno Mission Indians of the La Posta Indian Reservation, California" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "La Posta Band of Diegueno Mission Indians of the La Posta Indian Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11763" ]
       ]
     ], [
       fhir:index 132;
       fhir:CodeSystem.code [ fhir:value "133" ];
       fhir:CodeSystem.display [ fhir:value "Lac Courte Oreilles Band of Lake Superior Chippewa Indians of Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lac Courte Oreilles Band of Lake Superior Chippewa Indians of Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lac Courte Oreilles Band of Lake Superior Chippewa Indians of Wisconsin" ]
       ];
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         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11764" ]
       ]
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       fhir:index 133;
       fhir:CodeSystem.code [ fhir:value "134" ];
       fhir:CodeSystem.display [ fhir:value "Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11765" ]
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       fhir:index 134;
       fhir:CodeSystem.code [ fhir:value "135" ];
       fhir:CodeSystem.display [ fhir:value "Lac Vieux Desert Band of Lake Superior Chippewa Indians of Michigan" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
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         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
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         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11766" ]
       ]
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       fhir:index 135;
       fhir:CodeSystem.code [ fhir:value "136" ];
       fhir:CodeSystem.display [ fhir:value "Las Vegas Tribe of Paiute Indians of the Las Vegas Indian Colony, Nevada" ];
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Las Vegas Tribe of Paiute Indians of the Las Vegas Indian Colony, Nevada" ]
       ], [
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         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Las Vegas Tribe of Paiute Indians of the Las Vegas Indian Colony, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11767" ]
       ]
     ], [
       fhir:index 136;
       fhir:CodeSystem.code [ fhir:value "137" ];
       fhir:CodeSystem.display [ fhir:value "Little River Band of Ottawa Indians, Michigan" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Little River Band of Ottawa Indians, Michigan" ]
       ];
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11768" ]
       ]
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       fhir:index 137;
       fhir:CodeSystem.code [ fhir:value "138" ];
       fhir:CodeSystem.display [ fhir:value "Little Traverse Bay Bands of Odawa Indians, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Little Traverse Bay Bands of Odawa Indians, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Little Traverse Bay Bands of Odawa Indians, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11769" ]
       ]
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       fhir:index 138;
       fhir:CodeSystem.code [ fhir:value "140" ];
       fhir:CodeSystem.display [ fhir:value "Los Coyotes Band of Cahuilla and Cupeno Indians, California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Los Coyotes Band of Cahuilla and Cupeno Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Los Coyotes Band of Cahuilla and Cupeno Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11771" ]
       ]
     ], [
       fhir:index 139;
       fhir:CodeSystem.code [ fhir:value "141" ];
       fhir:CodeSystem.display [ fhir:value "Lovelock Paiute Tribe of the Lovelock Indian Colony, Nevada" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lovelock Paiute Tribe of the Lovelock Indian Colony, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lovelock Paiute Tribe of the Lovelock Indian Colony, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11772" ]
       ]
     ], [
       fhir:index 140;
       fhir:CodeSystem.code [ fhir:value "142" ];
       fhir:CodeSystem.display [ fhir:value "Lower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11773" ]
       ]
     ], [
       fhir:index 141;
       fhir:CodeSystem.code [ fhir:value "143" ];
       fhir:CodeSystem.display [ fhir:value "Lower Elwha Tribal Community" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Elwha Tribal Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Elwha Tribal Community" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11774" ]
       ]
     ], [
       fhir:index 142;
       fhir:CodeSystem.code [ fhir:value "139" ];
       fhir:CodeSystem.display [ fhir:value "Koi Nation of Northern California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Koi Nation of Northern California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
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       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
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       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11770" ]
       ]
     ], [
       fhir:index 143;
       fhir:CodeSystem.code [ fhir:value "144" ];
       fhir:CodeSystem.display [ fhir:value "Lower Sioux Indian Community in the State of Minnesota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Sioux Indian Community in the State of Minnesota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lower Sioux Indian Community in the State of Minnesota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11775" ]
       ]
     ], [
       fhir:index 144;
       fhir:CodeSystem.code [ fhir:value "145" ];
       fhir:CodeSystem.display [ fhir:value "Lummi Tribe of the Lummi Reservation" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lummi Tribe of the Lummi Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lummi Tribe of the Lummi Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11776" ]
       ]
     ], [
       fhir:index 145;
       fhir:CodeSystem.code [ fhir:value "146" ];
       fhir:CodeSystem.display [ fhir:value "Lytton Rancheria of California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lytton Rancheria of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lytton Rancheria of California" ]
       ];
       fhir:CodeSystem.property [
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         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11777" ]
       ]
     ], [
       fhir:index 146;
       fhir:CodeSystem.code [ fhir:value "147" ];
       fhir:CodeSystem.display [ fhir:value "Makah Indian Tribe of the Makah Indian Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Makah Indian Tribe of the Makah Indian Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Makah Indian Tribe of the Makah Indian Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11778" ]
       ]
     ], [
       fhir:index 147;
       fhir:CodeSystem.code [ fhir:value "148" ];
       fhir:CodeSystem.display [ fhir:value "Manchester Band of Pomo Indians of the Manchester Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manchester Band of Pomo Indians of the Manchester Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
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           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manchester Band of Pomo Indians of the Manchester Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11779" ]
       ]
     ], [
       fhir:index 148;
       fhir:CodeSystem.code [ fhir:value "149" ];
       fhir:CodeSystem.display [ fhir:value "Manzanita Band of Diegueno Mission Indians of the Manzanita Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manzanita Band of Diegueno Mission Indians of the Manzanita Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Manzanita Band of Diegueno Mission Indians of the Manzanita Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11780" ]
       ]
     ], [
       fhir:index 149;
       fhir:CodeSystem.code [ fhir:value "150" ];
       fhir:CodeSystem.display [ fhir:value "Mashantucket Pequot Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mashantucket Pequot Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mashantucket Pequot Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11781" ]
       ]
     ], [
       fhir:index 150;
       fhir:CodeSystem.code [ fhir:value "151" ];
       fhir:CodeSystem.display [ fhir:value "Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11782" ]
       ]
     ], [
       fhir:index 151;
       fhir:CodeSystem.code [ fhir:value "152" ];
       fhir:CodeSystem.display [ fhir:value "Mechoopda Indian Tribe of Chico Rancheria, California" ];
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         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mechoopda Indian Tribe of Chico Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mechoopda Indian Tribe of Chico Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11783" ]
       ]
     ], [
       fhir:index 152;
       fhir:CodeSystem.code [ fhir:value "153" ];
       fhir:CodeSystem.display [ fhir:value "Menominee Indian Tribe of Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Menominee Indian Tribe of Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Menominee Indian Tribe of Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11784" ]
       ]
     ], [
       fhir:index 153;
       fhir:CodeSystem.code [ fhir:value "154" ];
       fhir:CodeSystem.display [ fhir:value "Mesa Grande Band of Diegueno Mission Indians of the Mesa Grande Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mesa Grande Band of Diegueno Mission Indians of the Mesa Grande Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mesa Grande Band of Diegueno Mission Indians of the Mesa Grande Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11785" ]
       ]
     ], [
       fhir:index 154;
       fhir:CodeSystem.code [ fhir:value "155" ];
       fhir:CodeSystem.display [ fhir:value "Mescalero Apache Tribe of the Mescalero Reservation, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mescalero Apache Tribe of the Mescalero Reservation, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mescalero Apache Tribe of the Mescalero Reservation, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11786" ]
       ]
     ], [
       fhir:index 155;
       fhir:CodeSystem.code [ fhir:value "156" ];
       fhir:CodeSystem.display [ fhir:value "Miami Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Miami Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Miami Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11787" ]
       ]
     ], [
       fhir:index 156;
       fhir:CodeSystem.code [ fhir:value "157" ];
       fhir:CodeSystem.display [ fhir:value "Miccosukee Tribe of Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Miccosukee Tribe of Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Miccosukee Tribe of Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11788" ]
       ]
     ], [
       fhir:index 157;
       fhir:CodeSystem.code [ fhir:value "158" ];
       fhir:CodeSystem.display [ fhir:value "Middletown Rancheria of Pomo Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Middletown Rancheria of Pomo Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Middletown Rancheria of Pomo Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11789" ]
       ]
     ], [
       fhir:index 158;
       fhir:CodeSystem.code [ fhir:value "159" ];
       fhir:CodeSystem.display [ fhir:value "Minnesota Chippewa Tribe, Minnesota (Six component reservations: Bois Forte Band (Nett Lake); Fond du Lac Band; Grand Portage Band; Leech Lake Band; Mille Lacs Band; White Earth Band)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Minnesota Chippewa Tribe, Minnesota (Six component reservations: Bois Forte Band (Nett Lake); Fond du Lac Band; Grand Portage Band; Leech Lake Band; Mille Lacs Band; White Earth Band)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Minnesota Chippewa Tribe, Minnesota (Six component reservations: Bois Forte Band (Nett Lake); Fond du Lac Band; Grand Portage Band; Leech Lake Band; Mille Lacs Band; White Earth Band)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11790" ]
       ]
     ], [
       fhir:index 159;
       fhir:CodeSystem.code [ fhir:value "161" ];
       fhir:CodeSystem.display [ fhir:value "Mississippi Band of Choctaw Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mississippi Band of Choctaw Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mississippi Band of Choctaw Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11792" ]
       ]
     ], [
       fhir:index 160;
       fhir:CodeSystem.code [ fhir:value "162" ];
       fhir:CodeSystem.display [ fhir:value "Moapa Band of Paiute Indians of the Moapa River Indian Reservation, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Moapa Band of Paiute Indians of the Moapa River Indian Reservation, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Moapa Band of Paiute Indians of the Moapa River Indian Reservation, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11793" ]
       ]
     ], [
       fhir:index 161;
       fhir:CodeSystem.code [ fhir:value "163" ];
       fhir:CodeSystem.display [ fhir:value "Modoc Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Modoc Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Modoc Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11794" ]
       ]
     ], [
       fhir:index 162;
       fhir:CodeSystem.code [ fhir:value "164" ];
       fhir:CodeSystem.display [ fhir:value "Mohegan Tribe of Indians of Connecticut" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mohegan Tribe of Indians of Connecticut" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mohegan Tribe of Indians of Connecticut" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11795" ]
       ]
     ], [
       fhir:index 163;
       fhir:CodeSystem.code [ fhir:value "165" ];
       fhir:CodeSystem.display [ fhir:value "Mooretown Rancheria of Maidu Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mooretown Rancheria of Maidu Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mooretown Rancheria of Maidu Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11796" ]
       ]
     ], [
       fhir:index 164;
       fhir:CodeSystem.code [ fhir:value "166" ];
       fhir:CodeSystem.display [ fhir:value "Morongo Band of Mission Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Morongo Band of Mission Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Morongo Band of Mission Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11797" ]
       ]
     ], [
       fhir:index 165;
       fhir:CodeSystem.code [ fhir:value "167" ];
       fhir:CodeSystem.display [ fhir:value "Muckleshoot Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Muckleshoot Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Muckleshoot Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11798" ]
       ]
     ], [
       fhir:index 166;
       fhir:CodeSystem.code [ fhir:value "168" ];
       fhir:CodeSystem.display [ fhir:value "The Muscogee (Creek) Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Muscogee (Creek) Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Muscogee (Creek) Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11799" ]
       ]
     ], [
       fhir:index 167;
       fhir:CodeSystem.code [ fhir:value "169" ];
       fhir:CodeSystem.display [ fhir:value "Narragansett Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Narragansett Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Narragansett Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11800" ]
       ]
     ], [
       fhir:index 168;
       fhir:CodeSystem.code [ fhir:value "170" ];
       fhir:CodeSystem.display [ fhir:value "Navajo Nation, Arizona, New Mexico, & Utah" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Navajo Nation, Arizona, New Mexico, & Utah" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Navajo Nation, Arizona, New Mexico, & Utah" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11801" ]
       ]
     ], [
       fhir:index 169;
       fhir:CodeSystem.code [ fhir:value "171" ];
       fhir:CodeSystem.display [ fhir:value "Nez Perce Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nez Perce Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nez Perce Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11802" ]
       ]
     ], [
       fhir:index 170;
       fhir:CodeSystem.code [ fhir:value "172" ];
       fhir:CodeSystem.display [ fhir:value "Nisqually Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nisqually Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nisqually Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11803" ]
       ]
     ], [
       fhir:index 171;
       fhir:CodeSystem.code [ fhir:value "173" ];
       fhir:CodeSystem.display [ fhir:value "Nooksack Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nooksack Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nooksack Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11804" ]
       ]
     ], [
       fhir:index 172;
       fhir:CodeSystem.code [ fhir:value "174" ];
       fhir:CodeSystem.display [ fhir:value "Northern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11805" ]
       ]
     ], [
       fhir:index 173;
       fhir:CodeSystem.code [ fhir:value "175" ];
       fhir:CodeSystem.display [ fhir:value "Northfork Rancheria of Mono Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northfork Rancheria of Mono Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northfork Rancheria of Mono Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11806" ]
       ]
     ], [
       fhir:index 174;
       fhir:CodeSystem.code [ fhir:value "176" ];
       fhir:CodeSystem.display [ fhir:value "Northwestern Band of the Shoshone Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northwestern Band of the Shoshone Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Northwestern Band of the Shoshone Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11807" ]
       ]
     ], [
       fhir:index 175;
       fhir:CodeSystem.code [ fhir:value "177" ];
       fhir:CodeSystem.display [ fhir:value "Oglala Sioux Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oglala Sioux Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oglala Sioux Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11808" ]
       ]
     ], [
       fhir:index 176;
       fhir:CodeSystem.code [ fhir:value "178" ];
       fhir:CodeSystem.display [ fhir:value "Omaha Tribe of Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Omaha Tribe of Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Omaha Tribe of Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11809" ]
       ]
     ], [
       fhir:index 177;
       fhir:CodeSystem.code [ fhir:value "179" ];
       fhir:CodeSystem.display [ fhir:value "Oneida Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oneida Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oneida Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11810" ]
       ]
     ], [
       fhir:index 178;
       fhir:CodeSystem.code [ fhir:value "180" ];
       fhir:CodeSystem.display [ fhir:value "Oneida Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oneida Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Oneida Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11811" ]
       ]
     ], [
       fhir:index 179;
       fhir:CodeSystem.code [ fhir:value "181" ];
       fhir:CodeSystem.display [ fhir:value "Onondaga Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Onondaga Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Onondaga Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11812" ]
       ]
     ], [
       fhir:index 180;
       fhir:CodeSystem.code [ fhir:value "182" ];
       fhir:CodeSystem.display [ fhir:value "The Osage Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Osage Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Osage Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11813" ]
       ]
     ], [
       fhir:index 181;
       fhir:CodeSystem.code [ fhir:value "184" ];
       fhir:CodeSystem.display [ fhir:value "Otoe-Missouria Tribe of Indians, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Otoe-Missouria Tribe of Indians, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Otoe-Missouria Tribe of Indians, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11815" ]
       ]
     ], [
       fhir:index 182;
       fhir:CodeSystem.code [ fhir:value "183" ];
       fhir:CodeSystem.display [ fhir:value "Ottawa Tribe of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ottawa Tribe of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ottawa Tribe of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11814" ]
       ]
     ], [
       fhir:index 183;
       fhir:CodeSystem.code [ fhir:value "185" ];
       fhir:CodeSystem.display [ fhir:value "Paiute Indian Tribe of Utah (Cedar Band of Paiutes, Kanosh Band of Paiutes, Koosharem Band of Paiutes, Indian Peaks Band of Paiutes, and Shivwits Band of Paiutes)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paiute Indian Tribe of Utah (Cedar Band of Paiutes, Kanosh Band of Paiutes, Koosharem Band of Paiutes, Indian Peaks Band of Paiutes, and Shivwits Band of Paiutes)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paiute Indian Tribe of Utah (Cedar Band of Paiutes, Kanosh Band of Paiutes, Koosharem Band of Paiutes, Indian Peaks Band of Paiutes, and Shivwits Band of Paiutes)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11816" ]
       ]
     ], [
       fhir:index 184;
       fhir:CodeSystem.code [ fhir:value "186" ];
       fhir:CodeSystem.display [ fhir:value "Bishop Paiute Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bishop Paiute Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Bishop Paiute Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11817" ]
       ]
     ], [
       fhir:index 185;
       fhir:CodeSystem.code [ fhir:value "188" ];
       fhir:CodeSystem.display [ fhir:value "Lone Pine Paiute-Shoshone Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lone Pine Paiute-Shoshone Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Lone Pine Paiute-Shoshone Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11819" ]
       ]
     ], [
       fhir:index 186;
       fhir:CodeSystem.code [ fhir:value "187" ];
       fhir:CodeSystem.display [ fhir:value "Paiute-Shoshone Tribe of the Fallon Reservation and Colony, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paiute-Shoshone Tribe of the Fallon Reservation and Colony, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paiute-Shoshone Tribe of the Fallon Reservation and Colony, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11818" ]
       ]
     ], [
       fhir:index 187;
       fhir:CodeSystem.code [ fhir:value "189" ];
       fhir:CodeSystem.display [ fhir:value "Pala Band of Mission Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pala Band of Mission Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pala Band of Mission Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11820" ]
       ]
     ], [
       fhir:index 188;
       fhir:CodeSystem.code [ fhir:value "190" ];
       fhir:CodeSystem.display [ fhir:value "Pascua Yaqui Tribe of Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pascua Yaqui Tribe of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pascua Yaqui Tribe of Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11821" ]
       ]
     ], [
       fhir:index 189;
       fhir:CodeSystem.code [ fhir:value "191" ];
       fhir:CodeSystem.display [ fhir:value "Paskenta Band of Nomlaki Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paskenta Band of Nomlaki Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Paskenta Band of Nomlaki Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11822" ]
       ]
     ], [
       fhir:index 190;
       fhir:CodeSystem.code [ fhir:value "192" ];
       fhir:CodeSystem.display [ fhir:value "Passamaquoddy Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Passamaquoddy Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Passamaquoddy Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11823" ]
       ]
     ], [
       fhir:index 191;
       fhir:CodeSystem.code [ fhir:value "193" ];
       fhir:CodeSystem.display [ fhir:value "Pauma Band of Luiseno Mission Indians of the Pauma & Yuima Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pauma Band of Luiseno Mission Indians of the Pauma & Yuima Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pauma Band of Luiseno Mission Indians of the Pauma & Yuima Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11824" ]
       ]
     ], [
       fhir:index 192;
       fhir:CodeSystem.code [ fhir:value "194" ];
       fhir:CodeSystem.display [ fhir:value "Pawnee Nation of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pawnee Nation of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pawnee Nation of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11825" ]
       ]
     ], [
       fhir:index 193;
       fhir:CodeSystem.code [ fhir:value "195" ];
       fhir:CodeSystem.display [ fhir:value "Pechanga Band of Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pechanga Band of Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pechanga Band of Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11826" ]
       ]
     ], [
       fhir:index 194;
       fhir:CodeSystem.code [ fhir:value "196" ];
       fhir:CodeSystem.display [ fhir:value "Penobscot Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Penobscot Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Penobscot Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11827" ]
       ]
     ], [
       fhir:index 195;
       fhir:CodeSystem.code [ fhir:value "197" ];
       fhir:CodeSystem.display [ fhir:value "Peoria Tribe of Indians of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Peoria Tribe of Indians of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Peoria Tribe of Indians of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11828" ]
       ]
     ], [
       fhir:index 196;
       fhir:CodeSystem.code [ fhir:value "198" ];
       fhir:CodeSystem.display [ fhir:value "Picayune Rancheria of Chukchansi Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Picayune Rancheria of Chukchansi Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Picayune Rancheria of Chukchansi Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11829" ]
       ]
     ], [
       fhir:index 197;
       fhir:CodeSystem.code [ fhir:value "199" ];
       fhir:CodeSystem.display [ fhir:value "Pinoleville Pomo Nation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pinoleville Pomo Nation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pinoleville Pomo Nation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11830" ]
       ]
     ], [
       fhir:index 198;
       fhir:CodeSystem.code [ fhir:value "200" ];
       fhir:CodeSystem.display [ fhir:value "Pit River Tribe, California (includes XL Ranch, Big Bend, Likely, Lookout, Montgomery Creek, and Roaring Creek Rancherias)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pit River Tribe, California (includes XL Ranch, Big Bend, Likely, Lookout, Montgomery Creek, and Roaring Creek Rancherias)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pit River Tribe, California (includes XL Ranch, Big Bend, Likely, Lookout, Montgomery Creek, and Roaring Creek Rancherias)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11831" ]
       ]
     ], [
       fhir:index 199;
       fhir:CodeSystem.code [ fhir:value "201" ];
       fhir:CodeSystem.display [ fhir:value "Poarch Band of Creek Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Poarch Band of Creek Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Poarch Band of Creek Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11832" ]
       ]
     ], [
       fhir:index 200;
       fhir:CodeSystem.code [ fhir:value "202" ];
       fhir:CodeSystem.display [ fhir:value "Pokagon Band of Potawatomi Indians, Michigan and Indiana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pokagon Band of Potawatomi Indians, Michigan and Indiana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pokagon Band of Potawatomi Indians, Michigan and Indiana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11833" ]
       ]
     ], [
       fhir:index 201;
       fhir:CodeSystem.code [ fhir:value "203" ];
       fhir:CodeSystem.display [ fhir:value "Ponca Tribe of Indians of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ponca Tribe of Indians of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ponca Tribe of Indians of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11834" ]
       ]
     ], [
       fhir:index 202;
       fhir:CodeSystem.code [ fhir:value "204" ];
       fhir:CodeSystem.display [ fhir:value "Ponca Tribe of Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ponca Tribe of Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ponca Tribe of Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11835" ]
       ]
     ], [
       fhir:index 203;
       fhir:CodeSystem.code [ fhir:value "205" ];
       fhir:CodeSystem.display [ fhir:value "Port Gamble S'Klallam Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Port Gamble S'Klallam Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Port Gamble S'Klallam Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11836" ]
       ]
     ], [
       fhir:index 204;
       fhir:CodeSystem.code [ fhir:value "206" ];
       fhir:CodeSystem.display [ fhir:value "Potter Valley Tribe, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Potter Valley Tribe, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Potter Valley Tribe, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11837" ]
       ]
     ], [
       fhir:index 205;
       fhir:CodeSystem.code [ fhir:value "207" ];
       fhir:CodeSystem.display [ fhir:value "Prairie Band Potawatomi Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Prairie Band Potawatomi Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Prairie Band Potawatomi Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11838" ]
       ]
     ], [
       fhir:index 206;
       fhir:CodeSystem.code [ fhir:value "208" ];
       fhir:CodeSystem.display [ fhir:value "Prairie Island Indian Community in the State of Minnesota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Prairie Island Indian Community in the State of Minnesota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Prairie Island Indian Community in the State of Minnesota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11839" ]
       ]
     ], [
       fhir:index 207;
       fhir:CodeSystem.code [ fhir:value "209" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Acoma, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Acoma, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Acoma, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11840" ]
       ]
     ], [
       fhir:index 208;
       fhir:CodeSystem.code [ fhir:value "210" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Cochiti, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Cochiti, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Cochiti, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11841" ]
       ]
     ], [
       fhir:index 209;
       fhir:CodeSystem.code [ fhir:value "212" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Isleta, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Isleta, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Isleta, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11843" ]
       ]
     ], [
       fhir:index 210;
       fhir:CodeSystem.code [ fhir:value "211" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Jemez, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Jemez, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Jemez, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11842" ]
       ]
     ], [
       fhir:index 211;
       fhir:CodeSystem.code [ fhir:value "213" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Laguna, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Laguna, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Laguna, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11844" ]
       ]
     ], [
       fhir:index 212;
       fhir:CodeSystem.code [ fhir:value "214" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Nambe, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Nambe, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Nambe, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11845" ]
       ]
     ], [
       fhir:index 213;
       fhir:CodeSystem.code [ fhir:value "215" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Picuris, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Picuris, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Picuris, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11846" ]
       ]
     ], [
       fhir:index 214;
       fhir:CodeSystem.code [ fhir:value "216" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Pojoaque, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Pojoaque, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Pojoaque, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11847" ]
       ]
     ], [
       fhir:index 215;
       fhir:CodeSystem.code [ fhir:value "217" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of San Felipe, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of San Felipe, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of San Felipe, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11848" ]
       ]
     ], [
       fhir:index 216;
       fhir:CodeSystem.code [ fhir:value "219" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of San Ildefonso, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of San Ildefonso, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of San Ildefonso, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11850" ]
       ]
     ], [
       fhir:index 217;
       fhir:CodeSystem.code [ fhir:value "218" ];
       fhir:CodeSystem.display [ fhir:value "Ohkay Owingeh, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ohkay Owingeh, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ohkay Owingeh, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11849" ]
       ]
     ], [
       fhir:index 218;
       fhir:CodeSystem.code [ fhir:value "220" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Sandia, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Sandia, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Sandia, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11851" ]
       ]
     ], [
       fhir:index 219;
       fhir:CodeSystem.code [ fhir:value "221" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Santa Ana, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Santa Ana, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Santa Ana, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11852" ]
       ]
     ], [
       fhir:index 220;
       fhir:CodeSystem.code [ fhir:value "222" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Santa Clara, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Santa Clara, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Santa Clara, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11853" ]
       ]
     ], [
       fhir:index 221;
       fhir:CodeSystem.code [ fhir:value "223" ];
       fhir:CodeSystem.display [ fhir:value "Santo Domingo Pueblo" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santo Domingo Pueblo" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santo Domingo Pueblo" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11854" ]
       ]
     ], [
       fhir:index 222;
       fhir:CodeSystem.code [ fhir:value "224" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Taos, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Taos, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Taos, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11855" ]
       ]
     ], [
       fhir:index 223;
       fhir:CodeSystem.code [ fhir:value "225" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Tesuque, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Tesuque, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Tesuque, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11856" ]
       ]
     ], [
       fhir:index 224;
       fhir:CodeSystem.code [ fhir:value "226" ];
       fhir:CodeSystem.display [ fhir:value "Pueblo of Zia, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Zia, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pueblo of Zia, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11857" ]
       ]
     ], [
       fhir:index 225;
       fhir:CodeSystem.code [ fhir:value "227" ];
       fhir:CodeSystem.display [ fhir:value "Puyallup Tribe of the Puyallup Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Puyallup Tribe of the Puyallup Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Puyallup Tribe of the Puyallup Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11858" ]
       ]
     ], [
       fhir:index 226;
       fhir:CodeSystem.code [ fhir:value "228" ];
       fhir:CodeSystem.display [ fhir:value "Pyramid Lake Paiute Tribe of the Pyramid Lake Reservation, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pyramid Lake Paiute Tribe of the Pyramid Lake Reservation, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pyramid Lake Paiute Tribe of the Pyramid Lake Reservation, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11859" ]
       ]
     ], [
       fhir:index 227;
       fhir:CodeSystem.code [ fhir:value "229" ];
       fhir:CodeSystem.display [ fhir:value "Quapaw Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quapaw Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quapaw Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11860" ]
       ]
     ], [
       fhir:index 228;
       fhir:CodeSystem.code [ fhir:value "230" ];
       fhir:CodeSystem.display [ fhir:value "Quartz Valley Indian Community of the Quartz Valley Reservation of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quartz Valley Indian Community of the Quartz Valley Reservation of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quartz Valley Indian Community of the Quartz Valley Reservation of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11861" ]
       ]
     ], [
       fhir:index 229;
       fhir:CodeSystem.code [ fhir:value "231" ];
       fhir:CodeSystem.display [ fhir:value "Quechan Tribe of the Fort Yuma Indian Reservation, California & Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quechan Tribe of the Fort Yuma Indian Reservation, California & Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quechan Tribe of the Fort Yuma Indian Reservation, California & Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11862" ]
       ]
     ], [
       fhir:index 230;
       fhir:CodeSystem.code [ fhir:value "232" ];
       fhir:CodeSystem.display [ fhir:value "Quileute Tribe of the Quileute Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quileute Tribe of the Quileute Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quileute Tribe of the Quileute Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11863" ]
       ]
     ], [
       fhir:index 231;
       fhir:CodeSystem.code [ fhir:value "233" ];
       fhir:CodeSystem.display [ fhir:value "Quinault Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quinault Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Quinault Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11864" ]
       ]
     ], [
       fhir:index 232;
       fhir:CodeSystem.code [ fhir:value "234" ];
       fhir:CodeSystem.display [ fhir:value "Ramona Band of Cahuilla, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ramona Band of Cahuilla, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ramona Band of Cahuilla, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11865" ]
       ]
     ], [
       fhir:index 233;
       fhir:CodeSystem.code [ fhir:value "235" ];
       fhir:CodeSystem.display [ fhir:value "Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11866" ]
       ]
     ], [
       fhir:index 234;
       fhir:CodeSystem.code [ fhir:value "236" ];
       fhir:CodeSystem.display [ fhir:value "Red Lake Band of Chippewa Indians, Minnesota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Red Lake Band of Chippewa Indians, Minnesota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Red Lake Band of Chippewa Indians, Minnesota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11867" ]
       ]
     ], [
       fhir:index 235;
       fhir:CodeSystem.code [ fhir:value "237" ];
       fhir:CodeSystem.display [ fhir:value "Redding Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Redding Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Redding Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11868" ]
       ]
     ], [
       fhir:index 236;
       fhir:CodeSystem.code [ fhir:value "238" ];
       fhir:CodeSystem.display [ fhir:value "Redwood Valley or Little River Band of Pomo Indians of the Redwood Valley Rancheria California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Redwood Valley or Little River Band of Pomo Indians of the Redwood Valley Rancheria California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Redwood Valley or Little River Band of Pomo Indians of the Redwood Valley Rancheria California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11869" ]
       ]
     ], [
       fhir:index 237;
       fhir:CodeSystem.code [ fhir:value "239" ];
       fhir:CodeSystem.display [ fhir:value "Reno-Sparks Indian Colony, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Reno-Sparks Indian Colony, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Reno-Sparks Indian Colony, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11870" ]
       ]
     ], [
       fhir:index 238;
       fhir:CodeSystem.code [ fhir:value "240" ];
       fhir:CodeSystem.display [ fhir:value "Resighini Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Resighini Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Resighini Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11871" ]
       ]
     ], [
       fhir:index 239;
       fhir:CodeSystem.code [ fhir:value "241" ];
       fhir:CodeSystem.display [ fhir:value "Rincon Band of Luiseno Mission Indians of Rincon Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rincon Band of Luiseno Mission Indians of Rincon Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rincon Band of Luiseno Mission Indians of Rincon Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11872" ]
       ]
     ], [
       fhir:index 240;
       fhir:CodeSystem.code [ fhir:value "242" ];
       fhir:CodeSystem.display [ fhir:value "Robinson Rancheria" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Robinson Rancheria" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Robinson Rancheria" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11873" ]
       ]
     ], [
       fhir:index 241;
       fhir:CodeSystem.code [ fhir:value "243" ];
       fhir:CodeSystem.display [ fhir:value "Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11874" ]
       ]
     ], [
       fhir:index 242;
       fhir:CodeSystem.code [ fhir:value "244" ];
       fhir:CodeSystem.display [ fhir:value "Round Valley Indian Tribes, Round Valley Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Round Valley Indian Tribes, Round Valley Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Round Valley Indian Tribes, Round Valley Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11875" ]
       ]
     ], [
       fhir:index 243;
       fhir:CodeSystem.code [ fhir:value "245" ];
       fhir:CodeSystem.display [ fhir:value "Yocha Dehe Wintun Nation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yocha Dehe Wintun Nation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yocha Dehe Wintun Nation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11876" ]
       ]
     ], [
       fhir:index 244;
       fhir:CodeSystem.code [ fhir:value "247" ];
       fhir:CodeSystem.display [ fhir:value "Sac & Fox Nation of Missouri in Kansas and Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Nation of Missouri in Kansas and Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Nation of Missouri in Kansas and Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11878" ]
       ]
     ], [
       fhir:index 245;
       fhir:CodeSystem.code [ fhir:value "248" ];
       fhir:CodeSystem.display [ fhir:value "Sac & Fox Nation, Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Nation, Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Nation, Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11879" ]
       ]
     ], [
       fhir:index 246;
       fhir:CodeSystem.code [ fhir:value "246" ];
       fhir:CodeSystem.display [ fhir:value "Sac & Fox Tribe of the Mississippi in Iowa" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Tribe of the Mississippi in Iowa" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sac & Fox Tribe of the Mississippi in Iowa" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11877" ]
       ]
     ], [
       fhir:index 247;
       fhir:CodeSystem.code [ fhir:value "249" ];
       fhir:CodeSystem.display [ fhir:value "Saginaw Chippewa Indian Tribe of Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Saginaw Chippewa Indian Tribe of Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Saginaw Chippewa Indian Tribe of Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11880" ]
       ]
     ], [
       fhir:index 248;
       fhir:CodeSystem.code [ fhir:value "250" ];
       fhir:CodeSystem.display [ fhir:value "Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11881" ]
       ]
     ], [
       fhir:index 249;
       fhir:CodeSystem.code [ fhir:value "251" ];
       fhir:CodeSystem.display [ fhir:value "Samish Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Samish Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Samish Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11882" ]
       ]
     ], [
       fhir:index 250;
       fhir:CodeSystem.code [ fhir:value "252" ];
       fhir:CodeSystem.display [ fhir:value "San Carlos Apache Tribe of the San Carlos Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Carlos Apache Tribe of the San Carlos Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Carlos Apache Tribe of the San Carlos Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11883" ]
       ]
     ], [
       fhir:index 251;
       fhir:CodeSystem.code [ fhir:value "253" ];
       fhir:CodeSystem.display [ fhir:value "San Juan Southern Paiute Tribe of Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Juan Southern Paiute Tribe of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Juan Southern Paiute Tribe of Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11884" ]
       ]
     ], [
       fhir:index 252;
       fhir:CodeSystem.code [ fhir:value "254" ];
       fhir:CodeSystem.display [ fhir:value "Yuhaaviatam of San Manuel Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yuhaaviatam of San Manuel Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yuhaaviatam of San Manuel Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11885" ]
       ]
     ], [
       fhir:index 253;
       fhir:CodeSystem.code [ fhir:value "255" ];
       fhir:CodeSystem.display [ fhir:value "San Pasqual Band of Diegueno Mission Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Pasqual Band of Diegueno Mission Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "San Pasqual Band of Diegueno Mission Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11886" ]
       ]
     ], [
       fhir:index 254;
       fhir:CodeSystem.code [ fhir:value "257" ];
       fhir:CodeSystem.display [ fhir:value "Santa Rosa Band of Cahuilla Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Rosa Band of Cahuilla Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Rosa Band of Cahuilla Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11888" ]
       ]
     ], [
       fhir:index 255;
       fhir:CodeSystem.code [ fhir:value "256" ];
       fhir:CodeSystem.display [ fhir:value "Santa Rosa Indian Community of the Santa Rosa Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Rosa Indian Community of the Santa Rosa Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Rosa Indian Community of the Santa Rosa Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11887" ]
       ]
     ], [
       fhir:index 256;
       fhir:CodeSystem.code [ fhir:value "258" ];
       fhir:CodeSystem.display [ fhir:value "Santa Ynez Band of Chumash Mission Indians of the Santa Ynez Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Ynez Band of Chumash Mission Indians of the Santa Ynez Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santa Ynez Band of Chumash Mission Indians of the Santa Ynez Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11889" ]
       ]
     ], [
       fhir:index 257;
       fhir:CodeSystem.code [ fhir:value "259" ];
       fhir:CodeSystem.display [ fhir:value "Iipay Nation of Santa Ysabel, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iipay Nation of Santa Ysabel, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Iipay Nation of Santa Ysabel, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11890" ]
       ]
     ], [
       fhir:index 258;
       fhir:CodeSystem.code [ fhir:value "260" ];
       fhir:CodeSystem.display [ fhir:value "Santee Sioux Nation, Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santee Sioux Nation, Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Santee Sioux Nation, Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11891" ]
       ]
     ], [
       fhir:index 259;
       fhir:CodeSystem.code [ fhir:value "261" ];
       fhir:CodeSystem.display [ fhir:value "Sauk-Suiattle Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sauk-Suiattle Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sauk-Suiattle Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11892" ]
       ]
     ], [
       fhir:index 260;
       fhir:CodeSystem.code [ fhir:value "262" ];
       fhir:CodeSystem.display [ fhir:value "Sault Ste. Marie Tribe of Chippewa Indians, Michigan" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sault Ste. Marie Tribe of Chippewa Indians, Michigan" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sault Ste. Marie Tribe of Chippewa Indians, Michigan" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11893" ]
       ]
     ], [
       fhir:index 261;
       fhir:CodeSystem.code [ fhir:value "263" ];
       fhir:CodeSystem.display [ fhir:value "Scotts Valley Band of Pomo Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Scotts Valley Band of Pomo Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Scotts Valley Band of Pomo Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11894" ]
       ]
     ], [
       fhir:index 262;
       fhir:CodeSystem.code [ fhir:value "264" ];
       fhir:CodeSystem.display [ fhir:value "The Seminole Nation of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Seminole Nation of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "The Seminole Nation of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11895" ]
       ]
     ], [
       fhir:index 263;
       fhir:CodeSystem.code [ fhir:value "265" ];
       fhir:CodeSystem.display [ fhir:value "Seminole Tribe of Florida" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seminole Tribe of Florida" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seminole Tribe of Florida" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11896" ]
       ]
     ], [
       fhir:index 264;
       fhir:CodeSystem.code [ fhir:value "266" ];
       fhir:CodeSystem.display [ fhir:value "Seneca Nation of Indians" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seneca Nation of Indians" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seneca Nation of Indians" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11897" ]
       ]
     ], [
       fhir:index 265;
       fhir:CodeSystem.code [ fhir:value "267" ];
       fhir:CodeSystem.display [ fhir:value "Seneca-Cayuga Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seneca-Cayuga Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Seneca-Cayuga Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11898" ]
       ]
     ], [
       fhir:index 266;
       fhir:CodeSystem.code [ fhir:value "268" ];
       fhir:CodeSystem.display [ fhir:value "Shakopee Mdewakanton Sioux Community of Minnesota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shakopee Mdewakanton Sioux Community of Minnesota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shakopee Mdewakanton Sioux Community of Minnesota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11899" ]
       ]
     ], [
       fhir:index 267;
       fhir:CodeSystem.code [ fhir:value "269" ];
       fhir:CodeSystem.display [ fhir:value "Shawnee Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shawnee Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shawnee Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11900" ]
       ]
     ], [
       fhir:index 268;
       fhir:CodeSystem.code [ fhir:value "270" ];
       fhir:CodeSystem.display [ fhir:value "Sherwood Valley Rancheria of Pomo Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sherwood Valley Rancheria of Pomo Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sherwood Valley Rancheria of Pomo Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11901" ]
       ]
     ], [
       fhir:index 269;
       fhir:CodeSystem.code [ fhir:value "271" ];
       fhir:CodeSystem.display [ fhir:value "Shingle Springs Band of Miwok Indians, Shingle Springs Rancheria (Verona Tract), California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shingle Springs Band of Miwok Indians, Shingle Springs Rancheria (Verona Tract), California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shingle Springs Band of Miwok Indians, Shingle Springs Rancheria (Verona Tract), California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11902" ]
       ]
     ], [
       fhir:index 270;
       fhir:CodeSystem.code [ fhir:value "272" ];
       fhir:CodeSystem.display [ fhir:value "Shoalwater Bay Indian Tribe of the Shoalwater Bay Indian Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoalwater Bay Indian Tribe of the Shoalwater Bay Indian Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoalwater Bay Indian Tribe of the Shoalwater Bay Indian Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11903" ]
       ]
     ], [
       fhir:index 271;
       fhir:CodeSystem.code [ fhir:value "273" ];
       fhir:CodeSystem.display [ fhir:value "Eastern Shoshone Tribe of the Wind River Reservation, Wyoming" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eastern Shoshone Tribe of the Wind River Reservation, Wyoming" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Eastern Shoshone Tribe of the Wind River Reservation, Wyoming" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11904" ]
       ]
     ], [
       fhir:index 272;
       fhir:CodeSystem.code [ fhir:value "274" ];
       fhir:CodeSystem.display [ fhir:value "Shoshone-Bannock Tribes of the Fort Hall Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoshone-Bannock Tribes of the Fort Hall Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoshone-Bannock Tribes of the Fort Hall Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11905" ]
       ]
     ], [
       fhir:index 273;
       fhir:CodeSystem.code [ fhir:value "275" ];
       fhir:CodeSystem.display [ fhir:value "Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11906" ]
       ]
     ], [
       fhir:index 274;
       fhir:CodeSystem.code [ fhir:value "276" ];
       fhir:CodeSystem.display [ fhir:value "Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11907" ]
       ]
     ], [
       fhir:index 275;
       fhir:CodeSystem.code [ fhir:value "277" ];
       fhir:CodeSystem.display [ fhir:value "Skokomish Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Skokomish Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Skokomish Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11908" ]
       ]
     ], [
       fhir:index 276;
       fhir:CodeSystem.code [ fhir:value "278" ];
       fhir:CodeSystem.display [ fhir:value "Skull Valley Band of Goshute Indians of Utah" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Skull Valley Band of Goshute Indians of Utah" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Skull Valley Band of Goshute Indians of Utah" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11909" ]
       ]
     ], [
       fhir:index 277;
       fhir:CodeSystem.code [ fhir:value "279" ];
       fhir:CodeSystem.display [ fhir:value "Tolowa Dee-ni' Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tolowa Dee-ni' Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tolowa Dee-ni' Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11910" ]
       ]
     ], [
       fhir:index 278;
       fhir:CodeSystem.code [ fhir:value "280" ];
       fhir:CodeSystem.display [ fhir:value "Snoqualmie Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Snoqualmie Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Snoqualmie Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11911" ]
       ]
     ], [
       fhir:index 279;
       fhir:CodeSystem.code [ fhir:value "281" ];
       fhir:CodeSystem.display [ fhir:value "Soboba Band of Luiseno Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Soboba Band of Luiseno Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Soboba Band of Luiseno Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11912" ]
       ]
     ], [
       fhir:index 280;
       fhir:CodeSystem.code [ fhir:value "282" ];
       fhir:CodeSystem.display [ fhir:value "Sokaogon Chippewa Community, Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sokaogon Chippewa Community, Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sokaogon Chippewa Community, Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11913" ]
       ]
     ], [
       fhir:index 281;
       fhir:CodeSystem.code [ fhir:value "283" ];
       fhir:CodeSystem.display [ fhir:value "Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11914" ]
       ]
     ], [
       fhir:index 282;
       fhir:CodeSystem.code [ fhir:value "284" ];
       fhir:CodeSystem.display [ fhir:value "Spirit Lake Tribe, North Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Spirit Lake Tribe, North Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Spirit Lake Tribe, North Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11915" ]
       ]
     ], [
       fhir:index 283;
       fhir:CodeSystem.code [ fhir:value "285" ];
       fhir:CodeSystem.display [ fhir:value "Spokane Tribe of the Spokane Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Spokane Tribe of the Spokane Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Spokane Tribe of the Spokane Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11916" ]
       ]
     ], [
       fhir:index 284;
       fhir:CodeSystem.code [ fhir:value "286" ];
       fhir:CodeSystem.display [ fhir:value "Squaxin Island Tribe of the Squaxin Island Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Squaxin Island Tribe of the Squaxin Island Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Squaxin Island Tribe of the Squaxin Island Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11917" ]
       ]
     ], [
       fhir:index 285;
       fhir:CodeSystem.code [ fhir:value "287" ];
       fhir:CodeSystem.display [ fhir:value "St. Croix Chippewa Indians of Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "St. Croix Chippewa Indians of Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "St. Croix Chippewa Indians of Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11918" ]
       ]
     ], [
       fhir:index 286;
       fhir:CodeSystem.code [ fhir:value "288" ];
       fhir:CodeSystem.display [ fhir:value "Saint Regis Mohawk Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Saint Regis Mohawk Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Saint Regis Mohawk Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11919" ]
       ]
     ], [
       fhir:index 287;
       fhir:CodeSystem.code [ fhir:value "289" ];
       fhir:CodeSystem.display [ fhir:value "Standing Rock Sioux Tribe of North & South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Standing Rock Sioux Tribe of North & South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Standing Rock Sioux Tribe of North & South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11920" ]
       ]
     ], [
       fhir:index 288;
       fhir:CodeSystem.code [ fhir:value "291" ];
       fhir:CodeSystem.display [ fhir:value "Stillaguamish Tribe of Indians of Washington" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Stillaguamish Tribe of Indians of Washington" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Stillaguamish Tribe of Indians of Washington" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11922" ]
       ]
     ], [
       fhir:index 289;
       fhir:CodeSystem.code [ fhir:value "290" ];
       fhir:CodeSystem.display [ fhir:value "Stockbridge Munsee Community, Wisconsin" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Stockbridge Munsee Community, Wisconsin" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Stockbridge Munsee Community, Wisconsin" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11921" ]
       ]
     ], [
       fhir:index 290;
       fhir:CodeSystem.code [ fhir:value "292" ];
       fhir:CodeSystem.display [ fhir:value "Summit Lake Paiute Tribe of Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Summit Lake Paiute Tribe of Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Summit Lake Paiute Tribe of Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11923" ]
       ]
     ], [
       fhir:index 291;
       fhir:CodeSystem.code [ fhir:value "293" ];
       fhir:CodeSystem.display [ fhir:value "Suquamish Indian Tribe of the Port Madison Reservation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Suquamish Indian Tribe of the Port Madison Reservation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Suquamish Indian Tribe of the Port Madison Reservation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11924" ]
       ]
     ], [
       fhir:index 292;
       fhir:CodeSystem.code [ fhir:value "294" ];
       fhir:CodeSystem.display [ fhir:value "Susanville Indian Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Susanville Indian Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Susanville Indian Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11925" ]
       ]
     ], [
       fhir:index 293;
       fhir:CodeSystem.code [ fhir:value "295" ];
       fhir:CodeSystem.display [ fhir:value "Swinomish Indian Tribal Community" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Swinomish Indian Tribal Community" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Swinomish Indian Tribal Community" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11926" ]
       ]
     ], [
       fhir:index 294;
       fhir:CodeSystem.code [ fhir:value "296" ];
       fhir:CodeSystem.display [ fhir:value "Sycuan Band of the Kumeyaay Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sycuan Band of the Kumeyaay Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Sycuan Band of the Kumeyaay Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11927" ]
       ]
     ], [
       fhir:index 295;
       fhir:CodeSystem.code [ fhir:value "297" ];
       fhir:CodeSystem.display [ fhir:value "Wiyot Tribe, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wiyot Tribe, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wiyot Tribe, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11928" ]
       ]
     ], [
       fhir:index 296;
       fhir:CodeSystem.code [ fhir:value "298" ];
       fhir:CodeSystem.display [ fhir:value "Table Mountain Rancheria" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Table Mountain Rancheria" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Table Mountain Rancheria" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11929" ]
       ]
     ], [
       fhir:index 297;
       fhir:CodeSystem.code [ fhir:value "299" ];
       fhir:CodeSystem.display [ fhir:value "Te-Moak Tribe of Western Shoshone Indians of Nevada (Four constituent bands: Battle Mountain Band; Elko Band; South Fork Band; and Wells Band)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Te-Moak Tribe of Western Shoshone Indians of Nevada (Four constituent bands: Battle Mountain Band; Elko Band; South Fork Band; and Wells Band)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Te-Moak Tribe of Western Shoshone Indians of Nevada (Four constituent bands: Battle Mountain Band; Elko Band; South Fork Band; and Wells Band)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11930" ]
       ]
     ], [
       fhir:index 298;
       fhir:CodeSystem.code [ fhir:value "300" ];
       fhir:CodeSystem.display [ fhir:value "Thlopthlocco Tribal Town" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Thlopthlocco Tribal Town" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Thlopthlocco Tribal Town" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11931" ]
       ]
     ], [
       fhir:index 299;
       fhir:CodeSystem.code [ fhir:value "301" ];
       fhir:CodeSystem.display [ fhir:value "Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11932" ]
       ]
     ], [
       fhir:index 300;
       fhir:CodeSystem.code [ fhir:value "302" ];
       fhir:CodeSystem.display [ fhir:value "Tohono O'odham Nation of Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tohono O'odham Nation of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tohono O'odham Nation of Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11933" ]
       ]
     ], [
       fhir:index 301;
       fhir:CodeSystem.code [ fhir:value "303" ];
       fhir:CodeSystem.display [ fhir:value "Tonawanda Band of Seneca" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonawanda Band of Seneca" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonawanda Band of Seneca" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11934" ]
       ]
     ], [
       fhir:index 302;
       fhir:CodeSystem.code [ fhir:value "304" ];
       fhir:CodeSystem.display [ fhir:value "Tonkawa Tribe of Indians of Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonkawa Tribe of Indians of Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonkawa Tribe of Indians of Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11935" ]
       ]
     ], [
       fhir:index 303;
       fhir:CodeSystem.code [ fhir:value "305" ];
       fhir:CodeSystem.display [ fhir:value "Tonto Apache Tribe of Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonto Apache Tribe of Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tonto Apache Tribe of Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11936" ]
       ]
     ], [
       fhir:index 304;
       fhir:CodeSystem.code [ fhir:value "306" ];
       fhir:CodeSystem.display [ fhir:value "Torres Martinez Desert Cahuilla Indians, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Torres Martinez Desert Cahuilla Indians, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Torres Martinez Desert Cahuilla Indians, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11937" ]
       ]
     ], [
       fhir:index 305;
       fhir:CodeSystem.code [ fhir:value "308" ];
       fhir:CodeSystem.display [ fhir:value "Tulalip Tribes of Washington" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tulalip Tribes of Washington" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tulalip Tribes of Washington" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11939" ]
       ]
     ], [
       fhir:index 306;
       fhir:CodeSystem.code [ fhir:value "307" ];
       fhir:CodeSystem.display [ fhir:value "Tule River Indian Tribe of the Tule River Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tule River Indian Tribe of the Tule River Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tule River Indian Tribe of the Tule River Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11938" ]
       ]
     ], [
       fhir:index 307;
       fhir:CodeSystem.code [ fhir:value "309" ];
       fhir:CodeSystem.display [ fhir:value "Tunica-Biloxi Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tunica-Biloxi Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tunica-Biloxi Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11940" ]
       ]
     ], [
       fhir:index 308;
       fhir:CodeSystem.code [ fhir:value "310" ];
       fhir:CodeSystem.display [ fhir:value "Tuolumne Band of Me-Wuk Indians of the Tuolumne Rancheria of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tuolumne Band of Me-Wuk Indians of the Tuolumne Rancheria of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tuolumne Band of Me-Wuk Indians of the Tuolumne Rancheria of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11941" ]
       ]
     ], [
       fhir:index 309;
       fhir:CodeSystem.code [ fhir:value "311" ];
       fhir:CodeSystem.display [ fhir:value "Turtle Mountain Band of Chippewa Indians of North Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Turtle Mountain Band of Chippewa Indians of North Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Turtle Mountain Band of Chippewa Indians of North Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11942" ]
       ]
     ], [
       fhir:index 310;
       fhir:CodeSystem.code [ fhir:value "312" ];
       fhir:CodeSystem.display [ fhir:value "Tuscarora Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tuscarora Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tuscarora Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11943" ]
       ]
     ], [
       fhir:index 311;
       fhir:CodeSystem.code [ fhir:value "313" ];
       fhir:CodeSystem.display [ fhir:value "Twenty-Nine Palms Band of Mission Indians of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Twenty-Nine Palms Band of Mission Indians of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Twenty-Nine Palms Band of Mission Indians of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11944" ]
       ]
     ], [
       fhir:index 312;
       fhir:CodeSystem.code [ fhir:value "314" ];
       fhir:CodeSystem.display [ fhir:value "United Auburn Indian Community of the Auburn Rancheria of California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "United Auburn Indian Community of the Auburn Rancheria of California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "United Auburn Indian Community of the Auburn Rancheria of California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11945" ]
       ]
     ], [
       fhir:index 313;
       fhir:CodeSystem.code [ fhir:value "315" ];
       fhir:CodeSystem.display [ fhir:value "United Keetoowah Band of Cherokee Indians in Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "United Keetoowah Band of Cherokee Indians in Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "United Keetoowah Band of Cherokee Indians in Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11946" ]
       ]
     ], [
       fhir:index 314;
       fhir:CodeSystem.code [ fhir:value "316" ];
       fhir:CodeSystem.display [ fhir:value "Habematolel Pomo of Upper Lake, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Habematolel Pomo of Upper Lake, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Habematolel Pomo of Upper Lake, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11947" ]
       ]
     ], [
       fhir:index 315;
       fhir:CodeSystem.code [ fhir:value "317" ];
       fhir:CodeSystem.display [ fhir:value "Upper Sioux Community, Minnesota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Sioux Community, Minnesota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Sioux Community, Minnesota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11948" ]
       ]
     ], [
       fhir:index 316;
       fhir:CodeSystem.code [ fhir:value "318" ];
       fhir:CodeSystem.display [ fhir:value "Upper Skagit Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Skagit Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Skagit Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11949" ]
       ]
     ], [
       fhir:index 317;
       fhir:CodeSystem.code [ fhir:value "319" ];
       fhir:CodeSystem.display [ fhir:value "Ute Indian Tribe of the Uintah & Ouray Reservation, Utah" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ute Indian Tribe of the Uintah & Ouray Reservation, Utah" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ute Indian Tribe of the Uintah & Ouray Reservation, Utah" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11950" ]
       ]
     ], [
       fhir:index 318;
       fhir:CodeSystem.code [ fhir:value "320" ];
       fhir:CodeSystem.display [ fhir:value "Ute Mountain Ute Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ute Mountain Ute Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ute Mountain Ute Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11951" ]
       ]
     ], [
       fhir:index 319;
       fhir:CodeSystem.code [ fhir:value "321" ];
       fhir:CodeSystem.display [ fhir:value "Utu Utu Gwaitu Paiute Tribe of the Benton Paiute Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Utu Utu Gwaitu Paiute Tribe of the Benton Paiute Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Utu Utu Gwaitu Paiute Tribe of the Benton Paiute Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11952" ]
       ]
     ], [
       fhir:index 320;
       fhir:CodeSystem.code [ fhir:value "34" ];
       fhir:CodeSystem.display [ fhir:value "Viejas (Baron Long) Group of Capitan Grande Band o" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Viejas (Baron Long) Group of Capitan Grande Band o" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Viejas (Baron Long) Group of Capitan Grande Band o" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "retired" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11665" ]
       ]
     ], [
       fhir:index 321;
       fhir:CodeSystem.code [ fhir:value "322" ];
       fhir:CodeSystem.display [ fhir:value "Walker River Paiute Tribe of the Walker River Reservation, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Walker River Paiute Tribe of the Walker River Reservation, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Walker River Paiute Tribe of the Walker River Reservation, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11953" ]
       ]
     ], [
       fhir:index 322;
       fhir:CodeSystem.code [ fhir:value "323" ];
       fhir:CodeSystem.display [ fhir:value "Wampanoag Tribe of Gay Head (Aquinnah)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wampanoag Tribe of Gay Head (Aquinnah)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wampanoag Tribe of Gay Head (Aquinnah)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11954" ]
       ]
     ], [
       fhir:index 323;
       fhir:CodeSystem.code [ fhir:value "324" ];
       fhir:CodeSystem.display [ fhir:value "Washoe Tribe of Nevada & California (Carson Colony, Dresslerville Colony, Woodfords Community, Stewart Community, & Washoe Ranches)" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Washoe Tribe of Nevada & California (Carson Colony, Dresslerville Colony, Woodfords Community, Stewart Community, & Washoe Ranches)" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Washoe Tribe of Nevada & California (Carson Colony, Dresslerville Colony, Woodfords Community, Stewart Community, & Washoe Ranches)" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11955" ]
       ]
     ], [
       fhir:index 324;
       fhir:CodeSystem.code [ fhir:value "325" ];
       fhir:CodeSystem.display [ fhir:value "White Mountain Apache Tribe of the Fort Apache Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "White Mountain Apache Tribe of the Fort Apache Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "White Mountain Apache Tribe of the Fort Apache Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11956" ]
       ]
     ], [
       fhir:index 325;
       fhir:CodeSystem.code [ fhir:value "326" ];
       fhir:CodeSystem.display [ fhir:value "Wichita and Affiliated Tribes (Wichita, Keechi, Waco, & Tawakonie), Oklahoma" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wichita and Affiliated Tribes (Wichita, Keechi, Waco, & Tawakonie), Oklahoma" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wichita and Affiliated Tribes (Wichita, Keechi, Waco, & Tawakonie), Oklahoma" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11957" ]
       ]
     ], [
       fhir:index 326;
       fhir:CodeSystem.code [ fhir:value "327" ];
       fhir:CodeSystem.display [ fhir:value "Winnebago Tribe of Nebraska" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Winnebago Tribe of Nebraska" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Winnebago Tribe of Nebraska" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11958" ]
       ]
     ], [
       fhir:index 327;
       fhir:CodeSystem.code [ fhir:value "328" ];
       fhir:CodeSystem.display [ fhir:value "Winnemucca Indian Colony of Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Winnemucca Indian Colony of Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Winnemucca Indian Colony of Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11959" ]
       ]
     ], [
       fhir:index 328;
       fhir:CodeSystem.code [ fhir:value "329" ];
       fhir:CodeSystem.display [ fhir:value "Wyandotte Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wyandotte Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wyandotte Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11960" ]
       ]
     ], [
       fhir:index 329;
       fhir:CodeSystem.code [ fhir:value "330" ];
       fhir:CodeSystem.display [ fhir:value "Yankton Sioux Tribe of South Dakota" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yankton Sioux Tribe of South Dakota" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yankton Sioux Tribe of South Dakota" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11961" ]
       ]
     ], [
       fhir:index 330;
       fhir:CodeSystem.code [ fhir:value "331" ];
       fhir:CodeSystem.display [ fhir:value "Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11962" ]
       ]
     ], [
       fhir:index 331;
       fhir:CodeSystem.code [ fhir:value "332" ];
       fhir:CodeSystem.display [ fhir:value "Yavapai-Prescott Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yavapai-Prescott Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yavapai-Prescott Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11963" ]
       ]
     ], [
       fhir:index 332;
       fhir:CodeSystem.code [ fhir:value "333" ];
       fhir:CodeSystem.display [ fhir:value "Yerington Paiute Tribe of the Yerington Colony & Campbell Ranch, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yerington Paiute Tribe of the Yerington Colony & Campbell Ranch, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yerington Paiute Tribe of the Yerington Colony & Campbell Ranch, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11964" ]
       ]
     ], [
       fhir:index 333;
       fhir:CodeSystem.code [ fhir:value "334" ];
       fhir:CodeSystem.display [ fhir:value "Yomba Shoshone Tribe of the Yomba Reservation, Nevada" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yomba Shoshone Tribe of the Yomba Reservation, Nevada" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yomba Shoshone Tribe of the Yomba Reservation, Nevada" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11965" ]
       ]
     ], [
       fhir:index 334;
       fhir:CodeSystem.code [ fhir:value "335" ];
       fhir:CodeSystem.display [ fhir:value "Ysleta del Sur Pueblo" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ysleta del Sur Pueblo" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Ysleta del Sur Pueblo" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11966" ]
       ]
     ], [
       fhir:index 335;
       fhir:CodeSystem.code [ fhir:value "336" ];
       fhir:CodeSystem.display [ fhir:value "Yurok Tribe of the Yurok Reservation, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yurok Tribe of the Yurok Reservation, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Yurok Tribe of the Yurok Reservation, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11967" ]
       ]
     ], [
       fhir:index 336;
       fhir:CodeSystem.code [ fhir:value "337" ];
       fhir:CodeSystem.display [ fhir:value "Zuni Tribe of the Zuni Reservation, New Mexico" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Zuni Tribe of the Zuni Reservation, New Mexico" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Zuni Tribe of the Zuni Reservation, New Mexico" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "11968" ]
       ]
     ], [
       fhir:index 337;
       fhir:CodeSystem.code [ fhir:value "567" ];
       fhir:CodeSystem.display [ fhir:value "Chickahominy Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickahominy Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickahominy Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30003" ]
       ]
     ], [
       fhir:index 338;
       fhir:CodeSystem.code [ fhir:value "568" ];
       fhir:CodeSystem.display [ fhir:value "Chickahominy Indian Tribe—Eastern Division" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickahominy Indian Tribe—Eastern Division" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Chickahominy Indian Tribe—Eastern Division" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30004" ]
       ]
     ], [
       fhir:index 339;
       fhir:CodeSystem.code [ fhir:value "569" ];
       fhir:CodeSystem.display [ fhir:value "Monacan Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Monacan Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Monacan Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30005" ]
       ]
     ], [
       fhir:index 340;
       fhir:CodeSystem.code [ fhir:value "570" ];
       fhir:CodeSystem.display [ fhir:value "Nansemond Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nansemond Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Nansemond Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30006" ]
       ]
     ], [
       fhir:index 341;
       fhir:CodeSystem.code [ fhir:value "571" ];
       fhir:CodeSystem.display [ fhir:value "Rappahannock Tribe, Inc." ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rappahannock Tribe, Inc." ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Rappahannock Tribe, Inc." ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30008" ]
       ]
     ], [
       fhir:index 342;
       fhir:CodeSystem.code [ fhir:value "572" ];
       fhir:CodeSystem.display [ fhir:value "Upper Mattaponi Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Mattaponi Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Upper Mattaponi Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30009" ]
       ]
     ], [
       fhir:index 343;
       fhir:CodeSystem.code [ fhir:value "573" ];
       fhir:CodeSystem.display [ fhir:value "Cowlitz Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cowlitz Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Cowlitz Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30010" ]
       ]
     ], [
       fhir:index 344;
       fhir:CodeSystem.code [ fhir:value "574" ];
       fhir:CodeSystem.display [ fhir:value "Little Shell Tribe of Chippewa Indians of Montana" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Little Shell Tribe of Chippewa Indians of Montana" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Little Shell Tribe of Chippewa Indians of Montana" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30011" ]
       ]
     ], [
       fhir:index 345;
       fhir:CodeSystem.code [ fhir:value "575" ];
       fhir:CodeSystem.display [ fhir:value "Mashpee Wampanoag Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mashpee Wampanoag Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Mashpee Wampanoag Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30012" ]
       ]
     ], [
       fhir:index 346;
       fhir:CodeSystem.code [ fhir:value "576" ];
       fhir:CodeSystem.display [ fhir:value "Pamunkey Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pamunkey Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Pamunkey Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30013" ]
       ]
     ], [
       fhir:index 347;
       fhir:CodeSystem.code [ fhir:value "577" ];
       fhir:CodeSystem.display [ fhir:value "Shinnecock Indian Nation" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shinnecock Indian Nation" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Shinnecock Indian Nation" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30014" ]
       ]
     ], [
       fhir:index 348;
       fhir:CodeSystem.code [ fhir:value "578" ];
       fhir:CodeSystem.display [ fhir:value "Wilton Rancheria, California" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wilton Rancheria, California" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Wilton Rancheria, California" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30015" ]
       ]
     ], [
       fhir:index 349;
       fhir:CodeSystem.code [ fhir:value "579" ];
       fhir:CodeSystem.display [ fhir:value "Tejon Indian Tribe" ];
       fhir:CodeSystem.designation [
         fhir:index 0;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tejon Indian Tribe" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.language [ fhir:value "en" ];
         fhir:CodeSystem.use [
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/designation-usage" ];
           fhir:Coding.code [ fhir:value "display" ]
         ];
         fhir:CodeSystem.value [ fhir:value "Tejon Indian Tribe" ]
       ];
       fhir:CodeSystem.property [
         fhir:index 0;
         fhir:CodeSystem.code [ fhir:value "status" ];
         fhir:CodeSystem.value [ fhir:value "active" ]
       ], [
         fhir:index 1;
         fhir:CodeSystem.code [ fhir:value "internalId" ];
         fhir:CodeSystem.value [ fhir:value "30016" ]
       ]
     ]
  ] .

# -------------------------------------------------------------------------------------

