diff --git a/RELEASE_NOTES.md b/RELEASE_NOTES.md
index a2a7149e8..e1f659890 100644
--- a/RELEASE_NOTES.md
+++ b/RELEASE_NOTES.md
@@ -3,3 +3,4 @@
 * add procedures conversion form dstu2 to r4
 * add medication conversion from dstu2 to r4
 * Adding Maven exec to test validation cli jar
+* Validation of cardinality on address-line elements containing pattern elements fixed
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/SIDUtilities.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/SIDUtilities.java
new file mode 100644
index 000000000..69664a879
--- /dev/null
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/SIDUtilities.java
@@ -0,0 +1,62 @@
+package org.hl7.fhir.utilities;
+
+import java.util.ArrayList;
+import java.util.Collection;
+import java.util.List;
+import java.util.Map;
+
+public class SIDUtilities {
+
+  public static List<String> codeSystemList() {
+    List<String> codeSystems = new ArrayList<>();
+    codeSystems.add("http://hl7.org/fhir/sid/ndc");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-10");
+    codeSystems.add("http://hl7.org/fhir/sid/icpc2");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-9");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-10");  
+    codeSystems.add("http://hl7.org/fhir/sid/icpc2"); 
+    codeSystems.add("http://hl7.org/fhir/sid/cvx");
+    codeSystems.add("http://hl7.org/fhir/sid/srt");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-10-vn");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-10-cm");
+    codeSystems.add("http://hl7.org/fhir/sid/icd-9-cm"); 
+    return codeSystems;
+  }
+
+  public static List<String> idSystemList() {
+    List<String> idSystems = new ArrayList<>();
+    idSystems.add("http://hl7.org/fhir/sid/us-ssn");
+    idSystems.add("http://hl7.org/fhir/sid/us-npi");
+    idSystems.add("http://hl7.org/fhir/sid/eui-48/bluetooth");
+    idSystems.add("http://hl7.org/fhir/sid/eui-48/ethernet");
+    return idSystems;
+  }
+
+  private static boolean isPassPortSID(String url) {
+    // TODO: verify ISO countrycode part vs country code list
+    return url.matches("^http:\\/\\/hl7.org\\/fhir\\/sid\\/passport-[a-zA-Z]{3}$");
+  }
+  
+  public static boolean isknownCodeSystem(String system) {
+    return codeSystemList().contains(system);
+  }
+
+  public static boolean isKnownSID(String url) {
+    return isknownCodeSystem(url) || isknownIDSystem(url);
+  }
+
+  private static boolean isknownIDSystem(String url) {
+    return idSystemList().contains(url) || isPassPortSID(url);
+  }
+
+  public static List<String> allSystemsList() {
+    List<String> allSystems = new ArrayList<>();
+    allSystems.addAll(codeSystemList());
+    allSystems.addAll(idSystemList());
+    return allSystems;
+  }
+  
+  
+
+  
+}
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 93e0220f2..2fdd04965 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
@@ -274,6 +274,7 @@ public class I18nConstants {
   public static final String OBJECT_MUST_HAVE_SOME_CONTENT = "Object_must_have_some_content";
   public static final String PACKAGE_VERSION_MISMATCH = "PACKAGE_VERSION_MISMATCH";
   public static final String PARSER_TYPE__NOT_SUPPORTED = "Parser_Type__not_supported";
+  public static final String PATTERN_CHECK_STRING = "PATTERN_CHECK_STRING";
   public static final String PROBLEM_EVALUATING_SLICING_EXPRESSION_FOR_ELEMENT_IN_PROFILE__PATH__FHIRPATH___ = "Problem_evaluating_slicing_expression_for_element_in_profile__path__fhirPath___";
   public static final String PROBLEM_PROCESSING_EXPRESSION__IN_PROFILE__PATH__ = "Problem_processing_expression__in_profile__path__";
   public static final String PROFILE_BASED_DISCRIMINATORS_MUST_HAVE_A_TYPE_WITH_A_PROFILE__IN_PROFILE_ = "Profile_based_discriminators_must_have_a_type_with_a_profile__in_profile_";
diff --git a/org.hl7.fhir.utilities/src/main/resources/Messages.properties b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
index adf551e39..50276b3da 100644
--- a/org.hl7.fhir.utilities/src/main/resources/Messages.properties
+++ b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
@@ -653,3 +653,4 @@ BUNDLE_SEARCH_ENTRY_WRONG_RESOURCE_TYPE_OUTCOME = This is not an OperationOutcom
 BUNDLE_SEARCH_ENTRY_WRONG_RESOURCE_TYPE_NO_MODE = This is not a matching resource type for the specified search (is a search mode needed?) ({0} expecting {1})
 BUNDLE_SEARCH_NO_MODE = SearchSet bundles should have search modes on the entries
 INV_FAILED = Rule {0} Failed
+PATTERN_CHECK_STRING = The pattern [{0}] defined in the profile {1} not found. Issues: {2}
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
index c0bec1f31..a56fb03bc 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
@@ -728,9 +728,8 @@ public class ValidationEngine implements IValidatorResourceFetcher, IPackageInst
     }
     if (context.fetchResource(Resource.class, url) != null)
       return true;
-    if (Utilities.existsInList(url, "http://hl7.org/fhir/sid/us-ssn", "http://hl7.org/fhir/sid/cvx", "http://hl7.org/fhir/sid/ndc", "http://hl7.org/fhir/sid/us-npi", "http://hl7.org/fhir/sid/icd-10",
-      "http://hl7.org/fhir/sid/icd-10-vn", "http://hl7.org/fhir/sid/icd-10-cm", "http://hl7.org/fhir/sid/icd-9-cm", "http://hl7.org/fhir/w5", "http://hl7.org/fhir/fivews",
-      "http://hl7.org/fhir/workflow", "http://hl7.org/fhir/ConsentPolicy/opt-out", "http://hl7.org/fhir/ConsentPolicy/opt-in")) {
+    if (SIDUtilities.isKnownSID(url) || 
+        Utilities.existsInList(url, "http://hl7.org/fhir/w5", "http://hl7.org/fhir/fivews", "http://hl7.org/fhir/workflow", "http://hl7.org/fhir/ConsentPolicy/opt-out", "http://hl7.org/fhir/ConsentPolicy/opt-in")) {
       return true;
     }
     if (Utilities.existsInList(url, "http://loinc.org", "http://unitsofmeasure.org", "http://snomed.info/sct")) {
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
index b96fad244..119cd9afd 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
@@ -134,6 +134,7 @@ import org.hl7.fhir.r5.utils.IResourceValidator;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
 import org.hl7.fhir.r5.utils.XVerExtensionManager;
 import org.hl7.fhir.utilities.CommaSeparatedStringBuilder;
+import org.hl7.fhir.utilities.SIDUtilities;
 import org.hl7.fhir.utilities.Utilities;
 import org.hl7.fhir.utilities.Utilities.DecimalStatus;
 import org.hl7.fhir.utilities.VersionUtilities;
@@ -762,10 +763,40 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
 
     List<Element> lines = new ArrayList<Element>();
     focus.getNamedChildren("line", lines);
-    if (rule(errors, IssueType.VALUE, focus.line(), focus.col(), path, lines.size() == fixed.getLine().size(), I18nConstants.FIXED_TYPE_CHECKS_DT_ADDRESS_LINE, Integer.toString(fixed.getLine().size()), Integer.toString(lines.size()))) {
-      for (int i = 0; i < lines.size(); i++)
-        checkFixedValue(errors, path + ".coding", lines.get(i), fixed.getLine().get(i), fixedSource, "coding", focus, pattern);
-    }
+    boolean lineSizeCheck;
+    
+    if (pattern) {
+      lineSizeCheck = lines.size() >= fixed.getLine().size();
+      if (rule(errors, IssueType.VALUE, focus.line(), focus.col(), path, lineSizeCheck, I18nConstants.FIXED_TYPE_CHECKS_DT_ADDRESS_LINE, Integer.toString(fixed.getLine().size()),
+        Integer.toString(lines.size()))) {
+        for (int i = 0; i < fixed.getLine().size(); i++) {
+          StringType fixedLine = fixed.getLine().get(i);
+          boolean found = false;
+          List<ValidationMessage> allErrorsFixed = new ArrayList<>();
+          List<ValidationMessage> errorsFixed = null;
+          for (int j = 0; j < lines.size() && !found; ++j) {
+            errorsFixed = new ArrayList<>();
+            checkFixedValue(errorsFixed, path + ".line", lines.get(j), fixedLine, fixedSource, "line", focus, pattern);
+            if (!hasErrors(errorsFixed)) {
+              found = true;
+            } else {
+              errorsFixed.stream().filter(t -> t.getLevel().ordinal() >= IssueSeverity.ERROR.ordinal()).forEach(t -> allErrorsFixed.add(t));
+            }
+          }
+          if (!found) {
+            rule(errorsFixed, IssueType.VALUE, focus.line(), focus.col(), path, false, I18nConstants.PATTERN_CHECK_STRING, fixedLine.getValue(), fixedSource, allErrorsFixed);
+          }
+        }
+      }
+    } else if (!pattern) {
+      lineSizeCheck = lines.size() == fixed.getLine().size();
+      if (rule(errors, IssueType.VALUE, focus.line(), focus.col(), path, lineSizeCheck, I18nConstants.FIXED_TYPE_CHECKS_DT_ADDRESS_LINE,
+        Integer.toString(fixed.getLine().size()), Integer.toString(lines.size()))) {
+        for (int i = 0; i < lines.size(); i++) {
+          checkFixedValue(errors, path + ".line", lines.get(i), fixed.getLine().get(i), fixedSource, "line", focus, pattern);
+        }
+      }
+    }  
   }
 
   private void checkAttachment(List<ValidationMessage> errors, String path, Element focus, Attachment fixed, String fixedSource, boolean pattern) {
@@ -807,8 +838,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       rule(errors, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_SYSTEM_WRONG_BUILD, system, suggestSystemForBuild(system));        
       return false;
     } else if (system.startsWith("http://hl7.org/fhir") || system.startsWith("https://hl7.org/fhir") || system.startsWith("http://www.hl7.org/fhir") || system.startsWith("https://www.hl7.org/fhir")) {
-      if (Utilities.existsInList(system, "http://hl7.org/fhir/sid/icd-10", "http://hl7.org/fhir/sid/cvx", "http://hl7.org/fhir/sid/icd-10", "http://hl7.org/fhir/sid/icd-10-cm", 
-               "http://hl7.org/fhir/sid/icd-9-cm", "http://hl7.org/fhir/sid/icd-9", "http://hl7.org/fhir/sid/ndc", "http://hl7.org/fhir/sid/srt")) {
+      if (SIDUtilities.isknownCodeSystem(system)) {
         return true; // else don't check these (for now)
       } else if (system.startsWith("http://hl7.org/fhir/test")) {
         return true; // we don't validate these