diff --git a/content/millennium/r4/financial/general/account.md b/content/millennium/r4/financial/general/account.md
index 1de90ed97..ff0b5bc2a 100644
--- a/content/millennium/r4/financial/general/account.md
+++ b/content/millennium/r4/financial/general/account.md
@@ -77,15 +77,15 @@ _Implementation Notes_
 
 ### Parameters
 
- Name         | Required? | Type          | Description
---------------|-----------|---------------|-----------------------------------------------------------------------------------------------------------------------------------------------
- `_id`        | See notes | [`token`]     | The logical resource id associated with the resource. Example: `F703726`
- `identifier` | See notes | [`token`]     | Aliases of the Account like Statement Number. Example: `https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/statement-number|500000078`
- `type`       | See notes | [`token`]     | The specific type of account. Example: `financial-account`
- `patient`    | See notes | [`reference`] | The entity that caused the expenses. Example: `Patient/12345`
- `-guarantor` | See notes | [`reference`] | The parties responsible for balancing the account. Example: `6330015-6330017`
- `-encounter`  | See notes | [`reference`] | The id to identify the encounter. Example: `98028029`
- `_count`     | no        | [`number`]    | The maximum number of results to return. Defaults to `10`.
+ Name         | Required? | Type            | Description
+--------------|-----------|-----------------|-----------------------------------------------------------------------------------------------------------------------------------------------
+ `_id`        | See notes | [`token`]       | The logical resource id associated with the resource. Example: `F703726`
+ `identifier` | See notes | [`token`]       | Aliases of the Account like Statement Number. Example: `https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/statement-number|500000078`
+ `type`       | See notes | [`token`]       | The specific type of account. Example: `financial-account`
+ `patient`    | See notes | [`reference`]   | The entity that caused the expenses. Example: `Patient/12345`
+ `-guarantor` | See notes | [`reference`]   | The parties responsible for balancing the account. Example: `6330015-6330017`
+ `-encounter` | See notes | [`reference`]   | The id to identify the encounter. Example: `98028029`
+ `_count`     | no        | [`number`]      | The maximum number of results to return. Defaults to `10`.
 
 Notes:
 
@@ -124,7 +124,7 @@ Notes:
 
 #### Request - `-encounter`
 
-    GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Account?encounter=98028029&type=guarantor-balance
+    GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Account?-encounter=98028029&type=guarantor-balance
 
 #### Response
 
diff --git a/lib/resources/example_json/r4_examples_account.rb b/lib/resources/example_json/r4_examples_account.rb
index 75b3550d3..2758978d6 100644
--- a/lib/resources/example_json/r4_examples_account.rb
+++ b/lib/resources/example_json/r4_examples_account.rb
@@ -192,13 +192,12 @@ module Resources
         {
           'relation': 'self',
           'url': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Account'\
-                 '?encounter=98028029&type=guarantor-balance'
+                 '?-encounter=98028029&type=guarantor-balance'
         }
       ],
       'entry': [
         {
-          'fullUrl': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Account'\
-                     '?encounter=98028029&type=guarantor-balance',
+          'fullUrl': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Account/G71248138',
           'resource': {
             'resourceType': 'Account',
             'id': 'G71248138',
diff --git a/lib/resources/example_json/r4_examples_appointment.rb b/lib/resources/example_json/r4_examples_appointment.rb
index 28ab36dd8..cb484d9ea 100644
--- a/lib/resources/example_json/r4_examples_appointment.rb
+++ b/lib/resources/example_json/r4_examples_appointment.rb
@@ -519,6 +519,18 @@ module Resources
         'op': 'replace',
         'path': '/status',
         'value': 'cancelled'
+      },
+      {
+        'op': 'add',
+        'path': '/cancelationReason',
+        'value': {
+          'coding': [
+            {
+              'system': 'http://terminology.hl7.org/CodeSystem/appointment-cancellation-reason',
+              'code': 'oth-err'
+            }
+          ]
+        }
       }
     ].freeze
 
diff --git a/lib/resources/r4/appointment_patch.yaml b/lib/resources/r4/appointment_patch.yaml
index a6c355159..63a330aea 100644
--- a/lib/resources/r4/appointment_patch.yaml
+++ b/lib/resources/r4/appointment_patch.yaml
@@ -290,7 +290,7 @@ operations:
         }
     note: >
       <ul>
-        <li>When present, this patch operation must be accompanied by the replace status patch operation when updating the status to `cancelled`</li>
+        <li>When present, this patch operation must be accompanied by add cancellation reason and replace status patch operation when updating the status to `cancelled`</li>
         <li>Only one value may be provided in the value array</li>
       </ul>
   - name: replace-comment