diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/DaoConfig.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/DaoConfig.java
index a3e93390c8e..a50c382d95a 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/DaoConfig.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/DaoConfig.java
@@ -149,7 +149,7 @@ public class DaoConfig {
 	/**
 	 * EXPERIMENTAL - Do not use in production! Do not change default of {@code false}!
 	 */
-	private boolean myPreExpandValueSetsExperimental = false;
+	private boolean myPreExpandValueSetsExperimental = true;
 	private boolean myFilterParameterEnabled = false;
 	private StoreMetaSourceInformationEnum myStoreMetaSourceInformation = StoreMetaSourceInformationEnum.SOURCE_URI_AND_REQUEST_ID;
 	/**
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDao.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDao.java
index 3f0f8a9e2a3..09a59729ff9 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDao.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDao.java
@@ -40,7 +40,7 @@ public interface ITermValueSetConceptDao extends JpaRepository<TermValueSetConce
 	@Modifying
 	void deleteByTermValueSetId(@Param("pid") Long theValueSetId);
 
-	@Query("SELECT vsc from TermValueSetConcept vsc LEFT OUTER JOIN FETCH vsc.myDesignations WHERE vsc.myValueSet.myId = :pid")
+	@Query("SELECT vsc from TermValueSetConcept vsc LEFT OUTER JOIN FETCH vsc.myDesignations WHERE vsc.myValueSet.myId = :pid ORDER BY vsc.myOrder ASC")
 	Slice<TermValueSetConcept> findByTermValueSetIdAndPreFetchDesignations(Pageable thePage, @Param("pid") Long theValueSetId);
 
 	@Query("SELECT vsc FROM TermValueSetConcept vsc WHERE vsc.myValueSet.myId = :pid AND vsc.mySystem = :system_url AND vsc.myCode = :codeval")
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConcept.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConcept.java
index 4827e756d89..85ebf24a0ef 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConcept.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConcept.java
@@ -40,7 +40,8 @@ import static org.apache.commons.lang3.StringUtils.length;
  * bork up migration tasks.
  */
 @Table(name = "TRM_VALUESET_CONCEPT", uniqueConstraints = {
-	@UniqueConstraint(name = "IDX_VS_CONCEPT_CS_CD", columnNames = {"VALUESET_PID", "SYSTEM_URL", "CODEVAL"})
+	@UniqueConstraint(name = "IDX_VS_CONCEPT_CS_CD", columnNames = {"VALUESET_PID", "SYSTEM_URL", "CODEVAL"}),
+	@UniqueConstraint(name = "IDX_VS_CONCEPT_ORDER", columnNames = {"VALUESET_PID", "VALUESET_ORDER"})
 })
 @Entity()
 public class TermValueSetConcept implements Serializable {
@@ -56,6 +57,12 @@ public class TermValueSetConcept implements Serializable {
 	@JoinColumn(name = "VALUESET_PID", referencedColumnName = "PID", nullable = false, foreignKey = @ForeignKey(name = "FK_TRM_VALUESET_PID"))
 	private TermValueSet myValueSet;
 
+	@Column(name = "VALUESET_PID", insertable = false, updatable = false, nullable = false)
+	private Long myValueSetPid;
+
+	@Column(name = "VALUESET_ORDER", nullable = false)
+	private int myOrder;
+
 	@Transient
 	private String myValueSetUrl;
 
@@ -87,6 +94,15 @@ public class TermValueSetConcept implements Serializable {
 		return this;
 	}
 
+	public int getOrder() {
+		return myOrder;
+	}
+
+	public TermValueSetConcept setOrder(int theOrder) {
+		myOrder = theOrder;
+		return this;
+	}
+
 	public String getValueSetUrl() {
 		if (myValueSetUrl == null) {
 			myValueSetUrl = getValueSet().getUrl();
@@ -173,6 +189,8 @@ public class TermValueSetConcept implements Serializable {
 		return new ToStringBuilder(this, ToStringStyle.SHORT_PREFIX_STYLE)
 			.append("myId", myId)
 			.append(myValueSet != null ? ("myValueSet - id=" + myValueSet.getId()) : ("myValueSet=(null)"))
+			.append("myValueSetPid", myValueSetPid)
+			.append("myOrder", myOrder)
 			.append("myValueSetUrl", this.getValueSetUrl())
 			.append("myValueSetName", this.getValueSetName())
 			.append("mySystem", mySystem)
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConceptDesignation.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConceptDesignation.java
index e3aa0c5196a..87e5ef2e8ec 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConceptDesignation.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConceptDesignation.java
@@ -52,10 +52,16 @@ public class TermValueSetConceptDesignation implements Serializable {
 	@JoinColumn(name = "VALUESET_CONCEPT_PID", referencedColumnName = "PID", nullable = false, foreignKey = @ForeignKey(name = "FK_TRM_VALUESET_CONCEPT_PID"))
 	private TermValueSetConcept myConcept;
 
+	@Column(name = "VALUESET_CONCEPT_PID", insertable = false, updatable = false, nullable = false)
+	private Long myConceptPid;
+
 	@ManyToOne()
 	@JoinColumn(name = "VALUESET_PID", referencedColumnName = "PID", nullable = false, foreignKey = @ForeignKey(name = "FK_TRM_VSCD_VS_PID"))
 	private TermValueSet myValueSet;
 
+	@Column(name = "VALUESET_PID", insertable = false, updatable = false, nullable = false)
+	private Long myValueSetPid;
+
 	@Transient
 	private String myValueSetUrl;
 
@@ -202,7 +208,9 @@ public class TermValueSetConceptDesignation implements Serializable {
 		return new ToStringBuilder(this, ToStringStyle.SHORT_PREFIX_STYLE)
 			.append("myId", myId)
 			.append(myConcept != null ? ("myConcept - id=" + myConcept.getId()) : ("myConcept=(null)"))
+			.append("myConceptPid", myConceptPid)
 			.append(myValueSet != null ? ("myValueSet - id=" + myValueSet.getId()) : ("myValueSet=(null)"))
+			.append("myValueSetPid", myValueSetPid)
 			.append("myValueSetUrl", this.getValueSetUrl())
 			.append("myValueSetName", this.getValueSetName())
 			.append("myLanguage", myLanguage)
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/ValueSetConceptAccumulator.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/ValueSetConceptAccumulator.java
index 24f41232fbe..5c7fd8911f4 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/ValueSetConceptAccumulator.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/ValueSetConceptAccumulator.java
@@ -97,6 +97,7 @@ public class ValueSetConceptAccumulator implements IValueSetConceptAccumulator {
 
 		TermValueSetConcept concept = new TermValueSetConcept();
 		concept.setValueSet(myTermValueSet);
+		concept.setOrder(myConceptsSaved);
 		concept.setSystem(theSystem);
 		concept.setCode(theCode);
 		if (isNotBlank(theDisplay)) {
diff --git a/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplR4Test.java b/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplR4Test.java
index 599912cd965..de3e466a968 100644
--- a/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplR4Test.java
+++ b/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplR4Test.java
@@ -2097,11 +2097,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals(TermValueSetPreExpansionStatusEnum.EXPANDED, termValueSet.getExpansionStatus());
 
 			TermValueSetConcept concept = termValueSet.getConcepts().get(0);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8450-9", concept.getCode());
 			assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
 			assertEquals(2, concept.getDesignations().size());
+			assertEquals(0, concept.getOrder());
 
 			TermValueSetConceptDesignation designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2118,20 +2119,22 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systoliskt blodtryck - utgång", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(1);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("11378-7", concept.getCode());
 			assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(1, concept.getOrder());
 
 			// ...
 
 			concept = termValueSet.getConcepts().get(22);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8491-3", concept.getCode());
 			assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
 			assertEquals(1, concept.getDesignations().size());
+			assertEquals(22, concept.getOrder());
 
 			designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2141,11 +2144,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(23);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8492-1", concept.getCode());
 			assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(23, concept.getOrder());
 		});
 	}
 
@@ -2195,11 +2199,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals(TermValueSetPreExpansionStatusEnum.EXPANDED, termValueSet.getExpansionStatus());
 
 			TermValueSetConcept concept = termValueSet.getConcepts().get(0);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8450-9", concept.getCode());
 			assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
 			assertEquals(2, concept.getDesignations().size());
+			assertEquals(0, concept.getOrder());
 
 			TermValueSetConceptDesignation designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2216,20 +2221,22 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systoliskt blodtryck - utgång", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(1);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("11378-7", concept.getCode());
 			assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(1, concept.getOrder());
 
 			// ...
 
 			concept = termValueSet.getConcepts().get(22);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8491-3", concept.getCode());
 			assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
 			assertEquals(1, concept.getDesignations().size());
+			assertEquals(22, concept.getOrder());
 
 			designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2239,11 +2246,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(23);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8492-1", concept.getCode());
 			assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(23, concept.getOrder());
 		});
 	}
 
@@ -2293,11 +2301,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals(TermValueSetPreExpansionStatusEnum.EXPANDED, termValueSet.getExpansionStatus());
 
 			TermValueSetConcept concept = termValueSet.getConcepts().get(0);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8450-9", concept.getCode());
 			assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
 			assertEquals(2, concept.getDesignations().size());
+			assertEquals(0, concept.getOrder());
 
 			TermValueSetConceptDesignation designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2314,20 +2323,22 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systoliskt blodtryck - utgång", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(1);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("11378-7", concept.getCode());
 			assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(1, concept.getOrder());
 
 			// ...
 
 			concept = termValueSet.getConcepts().get(22 - 2);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8491-3", concept.getCode());
 			assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
 			assertEquals(1, concept.getDesignations().size());
+			assertEquals(22, concept.getOrder());
 
 			designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2337,11 +2348,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(23 - 2);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8492-1", concept.getCode());
 			assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(23, concept.getOrder());
 		});
 	}
 
@@ -2391,11 +2403,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals(TermValueSetPreExpansionStatusEnum.EXPANDED, termValueSet.getExpansionStatus());
 
 			TermValueSetConcept concept = termValueSet.getConcepts().get(0);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8450-9", concept.getCode());
 			assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
 			assertEquals(2, concept.getDesignations().size());
+			assertEquals(0, concept.getOrder());
 
 			TermValueSetConceptDesignation designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2412,20 +2425,22 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systoliskt blodtryck - utgång", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(1);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("11378-7", concept.getCode());
 			assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(1, concept.getOrder());
 
 			// ...
 
 			concept = termValueSet.getConcepts().get(22 - 2);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8491-3", concept.getCode());
 			assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
 			assertEquals(1, concept.getDesignations().size());
+			assertEquals(22, concept.getOrder());
 
 			designation = concept.getDesignations().get(0);
 			assertEquals("nl", designation.getLanguage());
@@ -2435,11 +2450,12 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 			assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
 
 			concept = termValueSet.getConcepts().get(23 - 2);
-			ourLog.info("Code:\n" + concept.toString());
+			ourLog.info("Concept:\n" + concept.toString());
 			assertEquals("http://acme.org", concept.getSystem());
 			assertEquals("8492-1", concept.getCode());
 			assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
 			assertEquals(0, concept.getDesignations().size());
+			assertEquals(23, concept.getOrder());
 		});
 	}
 
diff --git a/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java b/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java
index 5574be04e90..b21e03dcba3 100644
--- a/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java
+++ b/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java
@@ -93,6 +93,15 @@ public class HapiFhirJpaMigrationTasks extends BaseMigrationTasks<VersionEnum> {
 		Builder.BuilderWithTableName termValueSetTable = version.onTable("TRM_VALUESET");
 		termValueSetTable.addColumn("TOTAL_CONCEPTS").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
 		termValueSetTable.addColumn("TOTAL_CONCEPT_DESIGNATIONS").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
+
+		// TermValueSetConcept
+		version.startSectionWithMessage("Processing table: TRM_VALUESET_CONCEPT");
+		Builder.BuilderWithTableName termValueSetConceptTable = version.onTable("TRM_VALUESET_CONCEPT");
+		termValueSetConceptTable.addColumn("VALUESET_ORDER").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.INT);
+		termValueSetConceptTable
+			.addIndex("IDX_VS_CONCEPT_ORDER")
+			.unique(true)
+			.withColumns("VALUESET_PID", "VALUESET_ORDER");
 	}
 
 	protected void init400() {