diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
index a1c23af68..cadbb5429 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
@@ -866,16 +866,15 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
     if (noTerminologyServer) {
       return new ValueSetExpansionOutcome(formatMessage(I18nConstants.ERROR_EXPANDING_VALUESET_RUNNING_WITHOUT_TERMINOLOGY_SERVICES), TerminologyServiceErrorClass.NOSERVICE, false);
     }
-    Map<String, String> params = new HashMap<String, String>();
-    params.put("_limit", Integer.toString(expandCodesLimit ));
-    params.put("_incomplete", "true");
+    p.addParameter("count", expandCodesLimit);
+    p.addParameter("offset", 0);
     txLog("$expand on "+txCache.summary(vs)+" on "+tc.getAddress());
     if (addDependentResources(tc, p, vs)) {
       p.addParameter().setName("cache-id").setValue(new IdType(terminologyClientManager.getCacheId()));
     }
 
     try {
-      ValueSet result = tc.getClient().expandValueset(vs, p, params);
+      ValueSet result = tc.getClient().expandValueset(vs, p, null);
       res = new ValueSetExpansionOutcome(result).setTxLink(txLog.getLastId());  
     } catch (Exception e) {
       res = new ValueSetExpansionOutcome(e.getMessage() == null ? e.getClass().getName() : e.getMessage(), TerminologyServiceErrorClass.UNKNOWN, true);
@@ -904,6 +903,10 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
   }
 
   public ValueSetExpansionOutcome expandVS(ValueSet vs, boolean cacheOk, boolean hierarchical, boolean incompleteOk, Parameters pIn)  {
+    return expandVS(vs, cacheOk, hierarchical, incompleteOk, pIn, false);
+  }
+  
+  public ValueSetExpansionOutcome expandVS(ValueSet vs, boolean cacheOk, boolean hierarchical, boolean incompleteOk, Parameters pIn, boolean noLimits)  {
     if (pIn == null) {
       throw new Error(formatMessage(I18nConstants.NO_PARAMETERS_PROVIDED_TO_EXPANDVS));
     }
@@ -934,7 +937,11 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
         return res;
       }
     }
-    
+
+    if (!noLimits) {
+      p.addParameter("count", expandCodesLimit);
+      p.addParameter("offset", 0);
+    }
     p.setParameter("excludeNested", !hierarchical);
     if (incompleteOk) {
       p.setParameter("incomplete-ok", true);      
@@ -973,15 +980,12 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
     Set<String> systems = findRelevantSystems(vs);
     TerminologyClientContext tc = terminologyClientManager.chooseServer(systems, true);
     addDependentResources(tc, p, vs);
-    
-    Map<String, String> params = new HashMap<String, String>();
-    params.put("_limit", Integer.toString(expandCodesLimit ));
-    params.put("_incomplete", "true");
+
     
     txLog("$expand on "+txCache.summary(vs)+" on "+tc.getAddress());
     
     try {
-      ValueSet result = tc.getClient().expandValueset(vs, p, params);
+      ValueSet result = tc.getClient().expandValueset(vs, p, null);
       if (result != null) {
         if (!result.hasUrl()) {
           result.setUrl(vs.getUrl());
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/Parameters.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/Parameters.java
index 145f39ad0..27e3b18b6 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/Parameters.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/Parameters.java
@@ -1729,6 +1729,11 @@ public String toString() {
     return this;
   }
 
+  public Parameters addParameter(String name, int i) {
+    addParameter().setName(name).setValue(new IntegerType(i));
+    return this;
+  }
+
   public Parameters addParameter(String name, String s) {
     if (s != null)
       addParameter().setName(name).setValue(new StringType(s));
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/ValueSetRenderer.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/ValueSetRenderer.java
index 888895d58..b9de46760 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/ValueSetRenderer.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/ValueSetRenderer.java
@@ -7,8 +7,10 @@ import java.util.ArrayList;
 import java.util.Collections;
 import java.util.Date;
 import java.util.HashMap;
+import java.util.HashSet;
 import java.util.List;
 import java.util.Map;
+import java.util.Set;
 
 import org.hl7.fhir.exceptions.DefinitionException;
 import org.hl7.fhir.exceptions.FHIRException;
@@ -191,22 +193,35 @@ public class ValueSetRenderer extends TerminologyRenderer {
     generateVersionNotice(x, vs.getExpansion(), vs);
     
     if (ToolingExtensions.hasExtension(vs.getExpansion(), ToolingExtensions.EXT_EXP_TOOCOSTLY)) {
-      List<Extension> exl = vs.getExpansion().getExtensionsByUrl(ToolingExtensions.EXT_EXP_TOOCOSTLY);
-      boolean other = false;
-      for (Extension ex : exl) {
-        if (ex.getValue() instanceof BooleanType) {
-          x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px").addText(vs.getExpansion().getContains().isEmpty() ? getContext().getTooCostlyNoteEmpty() : getContext().getTooCostlyNoteNotEmpty());
-        } else if (!other) {
-          x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px").addText(vs.getExpansion().getContains().isEmpty() ? getContext().getTooCostlyNoteEmptyDependent() : getContext().getTooCostlyNoteNotEmptyDependent());
-          other = true;
-        }
+//      List<Extension> exl = vs.getExpansion().getExtensionsByUrl(ToolingExtensions.EXT_EXP_TOOCOSTLY);
+//      boolean other = false;
+//      for (Extension ex : exl) {
+//        if (ex.getValue() instanceof BooleanType) {
+//          x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px").addText(vs.getExpansion().getContains().isEmpty() ? getContext().getTooCostlyNoteEmpty() : getContext().getTooCostlyNoteNotEmpty());
+//        } else if (!other) {
+//          x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px").addText(vs.getExpansion().getContains().isEmpty() ? getContext().getTooCostlyNoteEmptyDependent() : getContext().getTooCostlyNoteNotEmptyDependent());
+//          other = true;
+//        }
+//      }
+      String msg = null;
+      if (vs.getExpansion().getContains().isEmpty()) {
+        msg = "This value set cannot be expanded because of the way it is defined - it has an infinite number of members"; // not sure that's true?
+      } else {
+        msg = "This value set cannot be fully expanded, but a selection ("+countMembership(vs)+" codes) of the whole set of codes is shown here";
       }
+      x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px").addText(msg);
     } else {
-      Integer count = countMembership(vs);
-      if (count == null)
-        x.para().tx("This value set does not contain a fixed number of concepts");
-      else
-        x.para().tx("This value set contains "+(hasFragment ? "at least " : "")+count.toString()+" concepts");
+      int count = conceptCount(vs.getExpansion().getContains());
+      if (vs.getExpansion().hasTotal()) {
+        if (count != vs.getExpansion().getTotal()) {
+          x.para().style("border: maroon 1px solid; background-color: #FFCCCC; font-weight: bold; padding: 8px")
+            .addText("This value set has "+(hasFragment ? "at least " : "")+vs.getExpansion().getTotal()+" codes in it. In order to keep the publication size manageable, only a selection ("+count+" codes) of the whole set of codes is shown");
+        } else {
+          x.para().tx("This value set contains "+(hasFragment ? "at least " : "")+vs.getExpansion().getTotal()+" concepts");          
+        }
+      } else {
+        x.para().tx("This value set expansion contains "+count+" concepts");
+      }
     }
     
 
@@ -403,7 +418,6 @@ public class ValueSetRenderer extends TerminologyRenderer {
     return null;    
   }
 
-
   private Integer countMembership(ValueSet vs) {
     int count = 0;
     if (vs.hasExpansion())
@@ -457,9 +471,11 @@ public class ValueSetRenderer extends TerminologyRenderer {
   @SuppressWarnings("rawtypes")
   private void generateVersionNotice(XhtmlNode x, ValueSetExpansionComponent expansion, Resource vs) {
     Multimap<String, String> versions = HashMultimap.create();
+    Set<String> vlist = new HashSet<>();
     for (ValueSetExpansionParameterComponent p : expansion.getParameter()) {
-      if (p.getName().startsWith("used-") || p.getName().equals("version")) {
+      if ((p.getName().startsWith("used-") || p.getName().equals("version")) && !vlist.contains(p.getValue().primitiveValue())) {
         String name = p.getName().equals("version") ? "system" : p.getName().substring(5);
+        vlist.add(p.getValue().primitiveValue());
         String[] parts = ((PrimitiveType) p.getValue()).asStringValue().split("\\|");
         if (parts.length == 2 && !Utilities.noString(parts[0]))
           versions.put(name+"|"+parts[0], parts[1]);
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/ValueSetUtilities.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/ValueSetUtilities.java
index 6f4886c7b..5442dc28d 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/ValueSetUtilities.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/ValueSetUtilities.java
@@ -60,6 +60,7 @@ import org.hl7.fhir.r5.model.DataType;
 import org.hl7.fhir.r5.model.ValueSet.ConceptReferenceComponent;
 import org.hl7.fhir.r5.model.ValueSet.ConceptSetComponent;
 import org.hl7.fhir.r5.model.ValueSet.ValueSetComposeComponent;
+import org.hl7.fhir.r5.model.ValueSet.ValueSetExpansionComponent;
 import org.hl7.fhir.r5.model.ValueSet.ValueSetExpansionContainsComponent;
 import org.hl7.fhir.r5.model.ValueSet.ValueSetExpansionPropertyComponent;
 import org.hl7.fhir.r5.terminologies.CodeSystemUtilities.ConceptDefinitionComponentSorter;
@@ -456,5 +457,29 @@ public class ValueSetUtilities extends TerminologyUtilities {
     }
     return systems;
   }
+  
+
+  private static int conceptCount(List<ValueSetExpansionContainsComponent> list) {
+    int count = 0;
+    for (ValueSetExpansionContainsComponent c : list) {
+      if (!c.getAbstract())
+        count++;
+      count = count + conceptCount(c.getContains());
+    }
+    return count;
+  }
+  
+
+  public static boolean isIncompleteExpansion(ValueSet valueSet) {
+    if (valueSet.hasExpansion()) {
+      ValueSetExpansionComponent exp = valueSet.getExpansion();
+      if (exp.hasTotal()) {
+        if (exp.getTotal() != conceptCount(exp.getContains())) {
+          return true;
+        }
+      }
+    }
+    return false;
+  }
 
 }
\ No newline at end of file
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/ValueSetExpander.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/ValueSetExpander.java
index 932594c25..01581ce8d 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/ValueSetExpander.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/ValueSetExpander.java
@@ -35,6 +35,7 @@ import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 import java.io.FileNotFoundException;
 import java.io.IOException;
+import java.text.MessageFormat;
 
 /*
  * Copyright (c) 2011+, HL7, Inc
@@ -186,7 +187,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
   
   private ValueSetExpansionContainsComponent addCode(WorkingContext wc, String system, String code, String display, String dispLang, ValueSetExpansionContainsComponent parent, List<ConceptDefinitionDesignationComponent> designations, Parameters expParams, 
       boolean isAbstract, boolean inactive, List<ValueSet> filters, boolean noInactive, boolean deprecated, List<ValueSetExpansionPropertyComponent> vsProp, 
-      List<ConceptPropertyComponent> csProps, CodeSystem cs, List<org.hl7.fhir.r5.model.ValueSet.ConceptPropertyComponent> expProps, List<Extension> csExtList, List<Extension> vsExtList, ValueSetExpansionComponent exp) throws ETooCostly {
+      List<ConceptPropertyComponent> csProps, CodeSystem cs, List<org.hl7.fhir.r5.model.ValueSet.ConceptPropertyComponent> expProps, List<Extension> csExtList, List<Extension> vsExtList, ValueSetExpansionComponent exp, boolean countToTotal) throws ETooCostly {
     opContext.deadCheck();
     
     if (filters != null && !filters.isEmpty() && !filterContainsCode(filters, system, code, exp))
@@ -323,14 +324,16 @@ public class ValueSetExpander extends ValueSetProcessBase {
     } else {
       wc.getCodes().add(n);
       wc.getMap().put(s, n);
-      wc.incTotal();
-      if (wc == dwc && wc.getTotal() > maxExpansionSize) {
-        if (wc.getOffset()+wc.getCount() > 0 && wc.getTotal() > wc.getOffset()+wc.getCount()) {
-          wc.setTotal(-1);
-          throw new EFinished();
-        }
-        throw failCostly(context.formatMessage(I18nConstants.VALUESET_TOO_COSTLY, focus.getUrl(), ">" + Integer.toString(maxExpansionSize)));
+      if (countToTotal) {
+        wc.incTotal();
       }
+//      if (wc == dwc && wc.getTotal() > maxExpansionSize) {
+//        if (wc.getOffset()+wc.getCount() > 0 && wc.getTotal() > wc.getOffset()+wc.getCount()) {
+//          wc.setTotal(-1);
+//          throw new EFinished();
+//        }
+//        throw failCostly(context.formatMessage(I18nConstants.VALUESET_TOO_COSTLY, focus.getUrl(), ">" + Integer.toString(maxExpansionSize)));
+//      }
     }
     if (wc.isCanBeHeirarchy() && parent != null) {
       parent.getContains().add(n);
@@ -443,19 +446,19 @@ public class ValueSetExpander extends ValueSetProcessBase {
     return null;
   }
 
-  private void addCodeAndDescendents(WorkingContext wc, ValueSetExpansionContainsComponent focus, ValueSetExpansionContainsComponent parent, Parameters expParams, List<ValueSet> filters, boolean noInactive, List<ValueSetExpansionPropertyComponent> vsProps, ValueSet vsSrc, ValueSetExpansionComponent exp)  throws FHIRException, ETooCostly {
+  private void addCodeAndDescendents(WorkingContext wc, ValueSetExpansionContainsComponent focus, ValueSetExpansionContainsComponent parent, Parameters expParams, List<ValueSet> filters, boolean noInactive, List<ValueSetExpansionPropertyComponent> vsProps, ValueSet vsSrc, ValueSetExpansionComponent exp, boolean countToTotal)  throws FHIRException, ETooCostly {
     opContext.deadCheck();
     focus.checkNoModifiers("Expansion.contains", "expanding");
     ValueSetExpansionContainsComponent np = null;
     for (String code : getCodesForConcept(focus, expParams)) {
       ValueSetExpansionContainsComponent t = addCode(wc, focus.getSystem(), code, focus.getDisplay(), vsSrc.getLanguage(), parent, 
-           convert(focus.getDesignation()), expParams, focus.getAbstract(), focus.getInactive(), filters, noInactive, false, vsProps, makeCSProps(focus.getExtensionString(ToolingExtensions.EXT_DEFINITION), null), null, focus.getProperty(), null, focus.getExtension(), exp);
+           convert(focus.getDesignation()), expParams, focus.getAbstract(), focus.getInactive(), filters, noInactive, false, vsProps, makeCSProps(focus.getExtensionString(ToolingExtensions.EXT_DEFINITION), null), null, focus.getProperty(), null, focus.getExtension(), exp, countToTotal);
       if (np == null) {
         np = t;
       }
     }
     for (ValueSetExpansionContainsComponent c : focus.getContains())
-      addCodeAndDescendents(wc, c, np, expParams, filters, noInactive, vsProps, vsSrc, exp);
+      addCodeAndDescendents(wc, c, np, expParams, filters, noInactive, vsProps, vsSrc, exp, countToTotal);
   }
   
   private List<ConceptPropertyComponent> makeCSProps(String definition, List<ConceptPropertyComponent> list) {
@@ -506,7 +509,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
     boolean dep = CodeSystemUtilities.isDeprecated(cs, def, false);
     if ((includeAbstract || !abs)  && filterFunc.includeConcept(cs, def) && passesOtherFilters(otherFilters, cs, def.getCode())) {
       for (String code : getCodesForConcept(def, expParams)) {
-        ValueSetExpansionContainsComponent t = addCode(wc, system, code, def.getDisplay(), cs.getLanguage(), parent, def.getDesignation(), expParams, abs, inc, filters, noInactive, dep, vsProps, makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), null, exp);
+        ValueSetExpansionContainsComponent t = addCode(wc, system, code, def.getDisplay(), cs.getLanguage(), parent, def.getDesignation(), expParams, abs, inc, filters, noInactive, dep, vsProps, makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), null, exp, true);
         if (np == null) {
           np = t;
         }
@@ -579,7 +582,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
         if (!existsInParams(params, p.getName(), p.getValue()))
           params.add(p);
       }
-
+      
       copyImportContains(expand.getContains(), null, expParams, filters, noInactive, vsProps, vsSrc, exp);
     }
   }
@@ -707,17 +710,17 @@ public class ValueSetExpander extends ValueSetProcessBase {
     if ("offset".equals(name) && value instanceof IntegerType) {
       focus.getExpansion().getParameter().removeIf(p -> p.getName().equals(name));
       focus.getExpansion().addParameter().setName(name).setValue(value);
-      dwc.setOffset(((IntegerType) value).getValue());
-      if (dwc.getOffset() < 0) {
-        dwc.setOffset(0);
+      dwc.setOffsetParam(((IntegerType) value).getValue());
+      if (dwc.getOffsetParam() < 0) {
+        dwc.setOffsetParam(0);
       }
     }
     if ("count".equals(name)) {
       focus.getExpansion().getParameter().removeIf(p -> p.getName().equals(name));
       focus.getExpansion().addParameter().setName(name).setValue(value);
-      dwc.setCount(((IntegerType) value).getValue());
-      if (dwc.getCount() < 0) {
-        dwc.setCount(0);
+      dwc.setCountParam(((IntegerType) value).getValue());
+      if (dwc.getCountParam() < 0) {
+        dwc.setCountParam(0);
       }
     }
   }
@@ -757,7 +760,13 @@ public class ValueSetExpander extends ValueSetProcessBase {
       // nothing - we intended to trap this here
     }
 
-    if (dwc.isCanBeHeirarchy()) {
+    if (dwc.getTotal() > maxExpansionSize && dwc.getOffsetParam() + dwc.getCountParam() == 0) {
+      if (dwc.isNoTotal()) {
+        throw failCostly(context.formatMessage(I18nConstants.VALUESET_TOO_COSTLY, focus.getVersionedUrl(), ">" + MessageFormat.format("{0,number,#}", maxExpansionSize)));        
+      } else {
+        throw failCostly(context.formatMessage(I18nConstants.VALUESET_TOO_COSTLY_COUNT, focus.getVersionedUrl(), ">" + MessageFormat.format("{0,number,#}", maxExpansionSize), MessageFormat.format("{0,number,#}", dwc.getTotal())));
+      }
+    } else if (dwc.isCanBeHeirarchy() && (dwc.getCountParam() == 0) || dwc.getCountParam() > dwc.getCodes().size()) {
       for (ValueSetExpansionContainsComponent c : dwc.getRoots()) {
         focus.getExpansion().getContains().add(c);
       }
@@ -766,11 +775,11 @@ public class ValueSetExpander extends ValueSetProcessBase {
       int cc = 0;
       for (ValueSetExpansionContainsComponent c : dwc.getCodes()) {
         if (dwc.getMap().containsKey(key(c)) && (includeAbstract || !c.getAbstract())) { // we may have added abstract codes earlier while we still thought it might be heirarchical, but later we gave up, so now ignore them
-          if (dwc.getOffset() == 0 || i >= dwc.getOffset()) {
+          if (dwc.getOffsetParam() == 0 || i >= dwc.getOffsetParam()) {
             focus.getExpansion().getContains().add(c);
             c.getContains().clear(); // make sure any heirarchy is wiped
             cc++;
-            if (cc == dwc.getCount()) {
+            if (cc == dwc.getCountParam()) {
               break;
             }
           }
@@ -779,10 +788,10 @@ public class ValueSetExpander extends ValueSetProcessBase {
       }
     }
 
-    if (dwc.hasOffset()) {
-      focus.getExpansion().setOffset(dwc.getOffset());
+    if (dwc.hasOffsetParam()) {
+      focus.getExpansion().setOffset(dwc.getOffsetParam());
     }
-    if (dwc.getTotal() >= 0) {
+    if (!dwc.isNoTotal()) {
       focus.getExpansion().setTotal(dwc.getTotal());
     }
     if (!requiredSupplements.isEmpty()) {      
@@ -826,7 +835,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
     // Exclude comes first because we build up a map of things to exclude
     for (ConceptSetComponent inc : compose.getExclude())
       excludeCodes(dwc, inc, expParams, exp, valueSet);
-    dwc.setCanBeHeirarchy(!expParams.getParameterBool("excludeNested") && dwc.getExcludeKeys().isEmpty() && dwc.getExcludeSystems().isEmpty() && dwc.getOffset()+dwc.getCount() == 0);
+    dwc.setCanBeHeirarchy(!expParams.getParameterBool("excludeNested") && dwc.getExcludeKeys().isEmpty() && dwc.getExcludeSystems().isEmpty() && dwc.getOffsetParam() == 0);
     includeAbstract = !expParams.getParameterBool("excludeNotForUI");
     boolean first = true;
     for (ConceptSetComponent inc : compose.getInclude()) {
@@ -878,7 +887,8 @@ public class ValueSetExpander extends ValueSetProcessBase {
       if (!existsInParams(exp.getParameter(), "used-valueset", u))
         exp.getParameter().add(new ValueSetExpansionParameterComponent().setName("used-valueset").setValue(u));
     }
-    for (Extension ex : vso.getValueset().getExpansion().getExtension()) {
+    ValueSetExpansionComponent evs = vso.getValueset().getExpansion();
+    for (Extension ex : evs.getExtension()) {
       if (ex.getUrl().equals(ToolingExtensions.EXT_EXP_TOOCOSTLY)) {
         if (ex.getValue() instanceof BooleanType) {
           exp.getExtension().add(new Extension(ToolingExtensions.EXT_EXP_TOOCOSTLY).setValue(new CanonicalType(value)));
@@ -887,12 +897,17 @@ public class ValueSetExpander extends ValueSetProcessBase {
         }
       } 
     }
-    for (ValueSetExpansionParameterComponent p : vso.getValueset().getExpansion().getParameter()) {
+    if (evs.hasTotal()) {
+      dwc.incTotal(evs.getTotal());
+    } else {
+      dwc.setNoTotal(true);
+    }
+    for (ValueSetExpansionParameterComponent p : evs.getParameter()) {
       if (!existsInParams(exp.getParameter(), p.getName(), p.getValue()))
         exp.getParameter().add(p);
     }
     if (isValueSetUnionImports(valueSet)) {
-      copyExpansion(wc, vso.getValueset().getExpansion().getContains());
+      copyExpansion(wc, evs.getContains());
     }
     wc.setCanBeHeirarchy(false); // if we're importing a value set, we have to be combining, so we won't try for a heirarchy
     return vso.getValueset();
@@ -976,7 +991,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
     for (ValueSetExpansionContainsComponent c : list) {
       c.checkNoModifiers("Imported Expansion in Code System", "expanding");
       ValueSetExpansionContainsComponent np = addCode(dwc, c.getSystem(), c.getCode(), c.getDisplay(), vsSrc.getLanguage(), parent, null, expParams, c.getAbstract(), c.getInactive(), 
-          filter, noInactive, false, vsProps, makeCSProps(c.getExtensionString(ToolingExtensions.EXT_DEFINITION), null), null, c.getProperty(), null, c.getExtension(), exp);
+          filter, noInactive, false, vsProps, makeCSProps(c.getExtensionString(ToolingExtensions.EXT_DEFINITION), null), null, c.getProperty(), null, c.getExtension(), exp, false);
       copyImportContains(c.getContains(), np, expParams, filter, noInactive, vsProps, vsSrc, exp);
     }
   }
@@ -1031,6 +1046,11 @@ public class ValueSetExpander extends ValueSetProcessBase {
         exp.getParameter().add(new ValueSetExpansionParameterComponent().setName("used-valueset").setValue(u));
       }
     }
+    if (vs.getExpansion().hasTotal()) {
+      dwc.incTotal(vs.getExpansion().getTotal());
+    } else {
+      dwc.setNoTotal(true);
+    }
     for (ValueSetExpansionParameterComponent p : vso.getValueset().getExpansion().getParameter()) {
       if (!existsInParams(exp.getParameter(), p.getName(), p.getValue())) {
         exp.getParameter().add(p);
@@ -1044,7 +1064,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
       }
     }
     for (ValueSetExpansionContainsComponent cc : vs.getExpansion().getContains()) {
-      addCodeAndDescendents(dwc, cc, null, expParams, imports, noInactive, vsProps, vs, exp);
+      addCodeAndDescendents(dwc, cc, null, expParams, imports, noInactive, vsProps, vs, exp, !vs.getExpansion().hasTotal());
     }
   }
 
@@ -1109,7 +1129,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
           inactive = CodeSystemUtilities.isInactive(cs, def);
           isAbstract = CodeSystemUtilities.isNotSelectable(cs, def);
           addCode(dwc, inc.getSystem(), c.getCode(), !Utilities.noString(c.getDisplay()) ? c.getDisplay() : def.getDisplay(), c.hasDisplay() ? vsSrc.getLanguage() : cs.getLanguage(), null, mergeDesignations(def, convertDesignations(c.getDesignation())), 
-              expParams, isAbstract, inactive, imports, noInactive, false, exp.getProperty(), makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), c.getExtension(), exp);
+              expParams, isAbstract, inactive, imports, noInactive, false, exp.getProperty(), makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), c.getExtension(), exp, true);
         }
       }
     }
@@ -1193,7 +1213,7 @@ public class ValueSetExpander extends ValueSetProcessBase {
                 excludeCode(wc, inc.getSystem(), code);
               } else {
                 addCode(wc, inc.getSystem(), code, def.getDisplay(), cs.getLanguage(), null, def.getDesignation(), expParams, CodeSystemUtilities.isNotSelectable(cs, def), CodeSystemUtilities.isInactive(cs, def),
-                  imports, noInactive, false, exp.getProperty(), makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), null, exp);
+                  imports, noInactive, false, exp.getProperty(), makeCSProps(def.getDefinition(), def.getProperty()), cs, null, def.getExtension(), null, exp, true);
               }
             }
           }
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/WorkingContext.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/WorkingContext.java
index 344fd16e8..f0a9e2e1a 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/WorkingContext.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/expansion/WorkingContext.java
@@ -18,10 +18,10 @@ class WorkingContext {
   private Set<String> excludeSystems = new HashSet<String>();
   
   private boolean canBeHeirarchy = true;
-  private int offset;
-  private boolean offs;
-  private int count;
-  private int total;
+  private Integer offsetParam;
+  private Integer countParam; // allowed count. Because of internal processing, we allow more 
+  private int total; // running count. This might be more than actually seen if we call out to an external server and only get the first 1000 codes
+  private boolean noTotal; // we lost count of the correct total
   
   public List<ValueSetExpansionContainsComponent> getCodes() {
     return codes;
@@ -51,37 +51,48 @@ class WorkingContext {
     this.canBeHeirarchy = canBeHeirarchy;
   }
   
-  public int getOffset() {
-    return offset;
+  public boolean hasOffsetParam() {
+    return offsetParam != null;
   }
   
-  public void setOffset(int offset) {
-    this.offs = true;
-    this.offset = offset;
+  public int getOffsetParam() {
+    return offsetParam == null ? 0 : offsetParam;
   }
   
-  public boolean hasOffset() {
-    return offs;
+  public void setOffsetParam(int offsetParam) {
+    this.offsetParam = offsetParam;
   }
   
-  public int getCount() {
-    return count;
+  public boolean hasCountParam() {
+    return countParam != null;
   }
   
-  public void setCount(int count) {
-    this.count = count;
+  public int getCountParam() {
+    return countParam == null ? 0 : countParam;
+  }
+  
+  public void setCountParam(int countParam) {
+    this.countParam = countParam;
   }
   
   public int getTotal() {
     return total;
   }
-  
-  public void setTotal(int total) {
-    this.total = total;
-  }
 
   public void incTotal() {
     total++;
   }
+
+  public void incTotal(int amount) {
+    total += amount;
+  }
+
+  public boolean isNoTotal() {
+    return noTotal;
+  }
+
+  public void setNoTotal(boolean noTotal) {
+    this.noTotal = noTotal;
+  }
   
 }
\ No newline at end of file
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
index 08a496853..661b7fb71 100644
--- a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
@@ -878,6 +878,7 @@ public class I18nConstants {
   public static final String UNKNOWN_CODESYSTEM = "UNKNOWN_CODESYSTEM";
   public static final String UNKNOWN_CODESYSTEM_VERSION = "UNKNOWN_CODESYSTEM_VERSION";
   public static final String VALUESET_TOO_COSTLY = "VALUESET_TOO_COSTLY";
+  public static final String VALUESET_TOO_COSTLY_COUNT = "VALUESET_TOO_COSTLY_COUNT";
   public static final String VALUESET_TOO_COSTLY_TIME = "VALUESET_TOO_COSTLY_TIME";
   public static final String NO_VALID_DISPLAY_FOUND = "NO_VALID_DISPLAY_FOUND";
   public static final String SD_NO_CONTEXT_WHEN_NOT_EXTENSION = "SD_NO_CONTEXT_WHEN_NOT_EXTENSION";
diff --git a/org.hl7.fhir.utilities/src/main/resources/Messages.properties b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
index eaaa56314..ae97c7812 100644
--- a/org.hl7.fhir.utilities/src/main/resources/Messages.properties
+++ b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
@@ -933,8 +933,9 @@ SD_NO_TYPE_CODE_ON_CODE = Snapshot for {1} element {0} has type.code without a v
 UNKNOWN_CODESYSTEM = A definition for CodeSystem ''{0}'' could not be found, so the code cannot be validated
 UNKNOWN_CODESYSTEM_VERSION = A definition for CodeSystem ''{0}'' version ''{1}'' could not be found, so the code cannot be validated. Valid versions: {2}          
 UNABLE_TO_INFER_CODESYSTEM = The System URI could not be determined for the code {0} in the ValueSet {1}
-VALUESET_TOO_COSTLY = The value set {0} has too many codes to display ({1})
-VALUESET_TOO_COSTLY_TIME = The value set {0} took too long to process (>{1}sec)
+VALUESET_TOO_COSTLY = The value set ''{0}'' expansion has too many codes to display ({1})
+VALUESET_TOO_COSTLY_COUNT = The value set ''{0}'' expansion has {2} codes, which is too many to display ({1})
+VALUESET_TOO_COSTLY_TIME = The value set ''{0}'' expansion took too long to process (>{1}sec)
 NO_VALID_DISPLAY_FOUND_one = No valid Display Names found for {1}#{2} in the language {4}
 NO_VALID_DISPLAY_FOUND_other = No valid Display Names found for {1}#{2} in the languages {4}
 SD_NO_CONTEXT_WHEN_NOT_EXTENSION = The type is {0} so an extension context should not be specified
diff --git a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
index 2891f4ecf..957dab3a2 100644
--- a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
+++ b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
@@ -164,7 +164,7 @@ public class TerminologyServiceTests {
     if (lang != null && !p.hasParameter("displayLanguage")) {
       p.addParameter("displayLanguage", new CodeType(lang));
     }
-    ValueSetExpansionOutcome vse = engine.getContext().expandVS(vs, false, hierarchical, false, p);
+    ValueSetExpansionOutcome vse = engine.getContext().expandVS(vs, false, hierarchical, false, p, true);
     if (resp.contains("\"ValueSet\"")) {
       if (vse.getValueset() == null) {
         Assertions.fail(vse.getError());
diff --git a/pom.xml b/pom.xml
index 5c2ca3214..9abd25099 100644
--- a/pom.xml
+++ b/pom.xml
@@ -20,7 +20,7 @@
     <properties>
         <guava_version>32.0.1-jre</guava_version>
         <hapi_fhir_version>6.4.1</hapi_fhir_version>
-        <validator_test_case_version>1.4.25</validator_test_case_version>
+        <validator_test_case_version>1.4.26-SNAPSHOT</validator_test_case_version>
         <jackson_version>2.16.0</jackson_version>
         <junit_jupiter_version>5.9.2</junit_jupiter_version>
         <junit_platform_launcher_version>1.8.2</junit_platform_launcher_version>