diff --git a/.github/workflows/ci.yaml b/.github/workflows/ci.yaml
index c786ea41..a07d9c8a 100644
--- a/.github/workflows/ci.yaml
+++ b/.github/workflows/ci.yaml
@@ -36,7 +36,7 @@ jobs:
             --runtime=linux-x64 \
             --configuration=Release \
             -p:PublishSingleFile=true \
-            --output=~/.local/bin \
+            --output=$HOME/.local/bin \
             mstool/FHIR/src/Microsoft.Health.Fhir.Anonymizer.R4.CommandLineTool
 
       - name: Test with pytest
diff --git a/cumulus/common.py b/cumulus/common.py
index 75e0024f..79556cf5 100644
--- a/cumulus/common.py
+++ b/cumulus/common.py
@@ -9,7 +9,6 @@
 from urllib.parse import urlparse
 
 import fsspec
-import pandas
 from fhirclient.models.resource import Resource
 from fhirclient.models.fhirabstractbase import FHIRAbstractBase
 
@@ -58,20 +57,6 @@ def find_by_name(folder, path_contains='filemask', progress_bar=1000) -> list:
     return found
 
 
-def extract_csv(path_csv: str, sample=1.0) -> pandas.DataFrame:
-    """
-    :param path_csv: /path/to/file.csv
-    :param sample: %percentage of file to read
-    :return: pandas Dataframe
-    """
-    logging.info('Reading csv %s ...', path_csv)
-    df = pandas.read_csv(path_csv, dtype=str, na_filter=False)
-    if sample != 1.0:
-        df = df.sample(frac=sample)
-    logging.info('Done reading %s .', path_csv)
-    return df
-
-
 def fake_id(category: str) -> str:
     """
     Randomly generate a linked Patient identifier
diff --git a/cumulus/config.py b/cumulus/config.py
index 48616399..d0946bd7 100644
--- a/cumulus/config.py
+++ b/cumulus/config.py
@@ -87,7 +87,7 @@ def success_rate(self, show_every=1000 * 10) -> float:
         prct = float(self.success) / float(self.attempt)
 
         if 0 == self.attempt % show_every:
-            print(f'success = {self.success} rate % {prct}')
+            print(f'success = {self.success:,} rate % {prct}')
 
         return prct
 
diff --git a/cumulus/ctakes.py b/cumulus/ctakes.py
index fa130a2f..c32eaaca 100644
--- a/cumulus/ctakes.py
+++ b/cumulus/ctakes.py
@@ -42,7 +42,11 @@ def symptoms(cache: store.Root, docref: DocumentReference) -> List[Observation]:
         logging.warning('No text/plain content for symptoms')  # ideally would print identifier, but it's PHI...
         return []
 
-    ctakes_json = extract(cache, physician_note)
+    try:
+        ctakes_json = extract(cache, physician_note)
+    except Exception as exc:  # pylint: disable=broad-except
+        logging.error('Could not extract symptoms: %s', exc)
+        return []
 
     observations = []
     for match in ctakes_json.list_sign_symptom(ctakesclient.typesystem.Polarity.pos):
diff --git a/cumulus/deid/mstool.py b/cumulus/deid/mstool.py
index a9d79230..187e7bb0 100644
--- a/cumulus/deid/mstool.py
+++ b/cumulus/deid/mstool.py
@@ -8,7 +8,7 @@
 import subprocess  # nosec: B404
 import sys
 
-from cumulus import errors
+from cumulus import common, errors
 
 MSTOOL_CMD = 'Microsoft.Health.Fhir.Anonymizer.R4.CommandLineTool'
 
@@ -23,6 +23,7 @@ def run_mstool(input_dir: str, output_dir: str) -> None:
 
     The input must be in ndjson format. And the output will be as well.
     """
+    common.print_header('De-identifying data...')
     try:
         # The following call only points at some temporary directory names (which we generate),
         # so it should be safe, and we thus disable the security linter warning about validating inputs.
diff --git a/cumulus/etl.py b/cumulus/etl.py
index 88a0a95c..853d566a 100644
--- a/cumulus/etl.py
+++ b/cumulus/etl.py
@@ -366,9 +366,9 @@ def main(args: List[str]):
                         help='input format (default is ndjson)')
     parser.add_argument('--output-format', default='parquet', choices=['json', 'ndjson', 'parquet'],
                         help='output format (default is parquet)')
-    parser.add_argument('--batch-size', type=int, metavar='SIZE', default=10000000,
+    parser.add_argument('--batch-size', type=int, metavar='SIZE', default=200000,
                         help='how many entries to process at once and thus '
-                             'how many to put in one output file (default is 10M)')
+                             'how many to put in one output file (default is 200k)')
     parser.add_argument('--comment', help='add the comment to the log file')
     parser.add_argument('--s3-region', help='if using S3 paths (s3://...), this is their region')
     parser.add_argument('--s3-kms-key', help='if using S3 paths (s3://...), this is the KMS key ID to use')
@@ -397,7 +397,7 @@ def main(args: List[str]):
     job_datetime = common.datetime_now()  # grab timestamp before we do anything
 
     if args.input_format == 'i2b2':
-        config_loader = loaders.I2b2Loader(root_input)
+        config_loader = loaders.I2b2Loader(root_input, args.batch_size)
     else:
         config_loader = loaders.FhirNdjsonLoader(root_input, client_id=args.smart_client_id, jwks=args.smart_jwks)
 
diff --git a/cumulus/loaders/fhir/fhir_ndjson.py b/cumulus/loaders/fhir/fhir_ndjson.py
index da109a28..8aacb0f2 100644
--- a/cumulus/loaders/fhir/fhir_ndjson.py
+++ b/cumulus/loaders/fhir/fhir_ndjson.py
@@ -35,16 +35,18 @@ def load_all(self, resources: List[str]) -> tempfile.TemporaryDirectory:
         if self.root.protocol in ['http', 'https']:
             return self._load_from_bulk_export(resources)
 
-        # Are we reading from a local directory?
-        if self.root.protocol == 'file':
-            # We can actually just re-use the input dir without copying the files, since everything is local.
-            class Dir:
-                name: str = self.root.path
-            return Dir()  # once we drop python3.7, we can have load_all return a Protocol for proper typing
-
-        # Fall back to copying from a remote directory (like S3 buckets) to a local one
+        # Copy the resources we need from the remote directory (like S3 buckets) to a local one.
+        #
+        # We do this even if the files are local, because the next step in our pipeline is the MS deid tool,
+        # and it will just process *everything* in a directory. So if there are other *.ndjson sitting next to our
+        # target resources, they'll get processed by the MS tool and that slows down running a single task with
+        # "--task" a lot.
+        #
+        # This uses more disk space temporarily (copied files will get deleted once the MS tool is done and this
+        # TemporaryDirectory gets discarded), but that seems reasonable.
         tmpdir = tempfile.TemporaryDirectory()  # pylint: disable=consider-using-with
-        self.root.get(self.root.joinpath('*.ndjson'), f'{tmpdir.name}/')
+        for resource in resources:
+            self.root.get(self.root.joinpath(f'*{resource}*.ndjson'), f'{tmpdir.name}/')
         return tmpdir
 
     def _load_from_bulk_export(self, resources: List[str]) -> tempfile.TemporaryDirectory:
diff --git a/cumulus/loaders/i2b2/external_mappings.py b/cumulus/loaders/i2b2/external_mappings.py
new file mode 100644
index 00000000..899ac52d
--- /dev/null
+++ b/cumulus/loaders/i2b2/external_mappings.py
@@ -0,0 +1,74 @@
+"""Mappings of various external coding systems to the concepts they represent"""
+
+
+# PHIN VADS 1000-9, Race & Ethnicity - CDC
+# https://phinvads.cdc.gov/vads/ViewCodeSystemConcept.action?oid=2.16.840.1.113883.6.238&code=1000-9
+# https://hl7.org/fhir/us/core/StructureDefinition-us-core-race.html
+CDC_RACE = {
+    'White': ('urn:oid:2.16.840.1.113883.6.238', '2106-3'),
+    'Black or African American': ('urn:oid:2.16.840.1.113883.6.238', '2054-5'),
+    'American Indian or Alaska Native': ('urn:oid:2.16.840.1.113883.6.238', '1002-5'),
+    'Asian': ('urn:oid:2.16.840.1.113883.6.238', '2028-9'),
+    'Native Hawaiian or Other Pacific Islander': ('urn:oid:2.16.840.1.113883.6.238', '2076-8'),
+    'Other': ('urn:oid:2.16.840.1.113883.6.238', '2131-1'),
+    'Declined to Answer': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'ASKU'),
+    'Unable to Answer': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'ASKU'),
+    'Unknown': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'UNK'),
+}
+
+# https://hl7.org/fhir/us/core/StructureDefinition-us-core-ethnicity.html
+CDC_ETHNICITY = {
+    'Hispanic or Latino': ('urn:oid:2.16.840.1.113883.6.238', '2135-2'),
+    'Not Hispanic or Latino': ('urn:oid:2.16.840.1.113883.6.238', '2186-5'),
+    'Declined to Answer': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'ASKU'),
+    'Unable to Answer': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'ASKU'),
+    'Unknown': ('http://terminology.hl7.org/CodeSystem/v3-NullFlavor', 'UNK'),
+}
+
+# FHIR AdministrativeGender code (not a full gender spectrum, but quite limited)
+# https://www.hl7.org/fhir/valueset-administrative-gender.html
+# Anything not in this dictionary maps should map to 'other'
+FHIR_GENDER = {
+    'F': 'female',
+    'M': 'male',
+    'U': 'unknown',
+}
+
+
+# BCH internal lab codes mapping to international covid-19 codes
+# system: http://loinc.org
+LOINC_COVID_LAB_TESTS = {
+    'LAB:1043473617': '94500-6',
+    'LAB:1044804335': '94500-6',
+    'LAB:1044704735': '94500-6',
+    'LAB:1134792565': '95406-5',
+    'LAB:1148157467': '95406-5',
+    'LAB:467288722': '85477-8',
+    'LAB:152831642': '85476-0',
+    'LAB:467288694': '85478-6',
+    'LAB:467288700': '85479-4',
+    'LAB:13815125': '62462-7'
+}
+
+
+# PHIN VADS General adjectival modifier (qualifier value) {106234000 , SNOMED-CT }
+# Subset of codes related to evaluating lab results
+# system: http://snomed.info/sct
+SNOMED_LAB_RESULT = {
+    'Positive': '10828004',
+    'Negative': '260385009',
+    'Absent': '272519000'
+}
+
+
+# PHIN VADS Admission statuses {308277006, SNOMED-CT }
+# Subset of codes related to means of admission
+# system: http://snomed.info/sct
+# https://terminology.hl7.org/5.0.0/ValueSet-v3-ActEncounterCode.html
+SNOMED_ADMISSION = {
+    'Day Surgery': 'AMB',
+    'Emergency': 'EMER',
+    'Inpatient': 'IMP',
+    'Outpatient': 'AMB',
+    'Recurring Outpatient Series': 'AMB',
+}
diff --git a/cumulus/loaders/i2b2/extract.py b/cumulus/loaders/i2b2/extract.py
index 47bbf889..1f1feb79 100644
--- a/cumulus/loaders/i2b2/extract.py
+++ b/cumulus/loaders/i2b2/extract.py
@@ -1,68 +1,58 @@
 """Read files into data structures"""
 
-from typing import List
 import logging
+from typing import Iterator
+
 import pandas
-from cumulus import common
+
 from cumulus.loaders.i2b2.schema import ObservationFact, PatientDimension, VisitDimension
 
 
-def extract_csv(path_csv: str, sample=1.0) -> pandas.DataFrame:
+def extract_csv(path_csv: str, batch_size: int) -> Iterator[dict]:
     """
     :param path_csv: /path/to/i2b2_formatted_file.csv
-    :param sample: %percentage of file to read
-    :return: pandas Dataframe
+    :param batch_size: how many entries to load into memory at once
+    :return: an iterator over each row from the file
     """
-    return common.extract_csv(path_csv, sample)
+    print(f'Reading csv {path_csv}...')
+    count = 0
+    with pandas.read_csv(path_csv, dtype=str, na_filter=False, chunksize=batch_size) as reader:
+        for chunk in reader:
+            print(f'  Read {count:,} entries...')
+            for _, row in chunk.iterrows():
+                yield dict(row)
+            count += batch_size
+    print(f'Done reading {path_csv} .')
 
 
-def extract_csv_observation_facts(path_csv: str,
-                                  sample=1.0) -> List[ObservationFact]:
+def extract_csv_observation_facts(path_csv: str, batch_size: int) -> Iterator[ObservationFact]:
     """
     :param path_csv: /path/to/file.csv
-    :param sample: %percentage of file to read
+    :param batch_size: how many entries to load into memory at once
     :return: i2b2 ObservationFact table
     """
-    df = extract_csv(path_csv, sample)
-
     logging.info('Transforming text into List[ObservationFact]')
-    facts = []
-    for _, row in df.iterrows():
-        facts.append(ObservationFact(row))
-
-    logging.info('Ready List[ObservationFact]')
-    return facts
+    for row in extract_csv(path_csv, batch_size):
+        yield ObservationFact(row)
 
 
-def extract_csv_patients(path_csv: str, sample=1.0) -> List[PatientDimension]:
+def extract_csv_patients(path_csv: str, batch_size: int) -> Iterator[PatientDimension]:
     """
     :param path_csv: /path/to/file.csv
-    :param sample: %percentage of file to read
+    :param batch_size: how many entries to load into memory at once
     :return: List i2b2 patient dimension table
     """
-    df = extract_csv(path_csv, sample)
-
     logging.info('Transforming text into List[PatientDimension]')
-    patients = []
-    for _, row in df.iterrows():
-        patients.append(PatientDimension(row))
-
-    logging.info('Ready List[PatientDimension]')
-    return patients
+    for row in extract_csv(path_csv, batch_size):
+        yield PatientDimension(row)
 
 
-def extract_csv_visits(path_csv: str, sample=1.0) -> List[VisitDimension]:
+def extract_csv_visits(path_csv: str, batch_size: int) -> Iterator[VisitDimension]:
     """
     :param path_csv: /path/to/file.csv
-    :param sample: %percentage of file to read
+    :param batch_size: how many entries to load into memory at once
     :return: List i2b2 visit dimension table
     """
-    df = extract_csv(path_csv, sample)
-
     logging.info('Transforming text into List[VisitDimension]')
-    visits = []
-    for _, row in df.iterrows():
-        visits.append(VisitDimension(row))
-
-    logging.info('Ready List[VisitDimension]')
-    return visits
+    for row in extract_csv(path_csv, batch_size):
+        yield VisitDimension(row)
diff --git a/cumulus/loaders/i2b2/loader.py b/cumulus/loaders/i2b2/loader.py
index 31899084..43214fdd 100644
--- a/cumulus/loaders/i2b2/loader.py
+++ b/cumulus/loaders/i2b2/loader.py
@@ -8,6 +8,7 @@
 
 from fhirclient.models.resource import Resource
 
+from cumulus import store
 from cumulus.loaders.base import Loader
 from cumulus.loaders.i2b2 import extract, schema, transform
 from cumulus.loaders.i2b2.oracle import extract as oracle_extract
@@ -31,6 +32,15 @@ class I2b2Loader(Loader):
     - csv_visit
     """
 
+    def __init__(self, root: store.Root, batch_size: int):
+        """
+        Initialize a new I2b2Loader class
+        :param root: the base location to read data from
+        :param batch_size: the most entries to keep in memory at once
+        """
+        super().__init__(root)
+        self.batch_size = batch_size
+
     def load_all(self, resources: List[str]) -> tempfile.TemporaryDirectory:
         if self.root.protocol in ['tcp']:
             return self._load_all_from_oracle(resources)
@@ -117,13 +127,14 @@ def _load_all_from_csv(self, resources: List[str]) -> tempfile.TemporaryDirector
         return self._load_all_with_extractors(
             resources,
             conditions=partial(extract.extract_csv_observation_facts,
-                               os.path.join(path, 'observation_fact_diagnosis.csv')),
+                               os.path.join(path, 'observation_fact_diagnosis.csv'), self.batch_size),
             observations=partial(extract.extract_csv_observation_facts,
-                                 os.path.join(path, 'observation_fact_lab_views.csv')),
+                                 os.path.join(path, 'observation_fact_lab_views.csv'), self.batch_size),
             documentreferences=partial(extract.extract_csv_observation_facts,
-                                       os.path.join(path, 'observation_fact_notes.csv')),
-            patients=partial(extract.extract_csv_patients, os.path.join(path, 'patient_dimension.csv')),
-            encounters=partial(extract.extract_csv_visits, os.path.join(path, 'visit_dimension.csv')),
+                                       os.path.join(path, 'observation_fact_notes.csv'), self.batch_size),
+            patients=partial(extract.extract_csv_patients, os.path.join(path, 'patient_dimension.csv'),
+                             self.batch_size),
+            encounters=partial(extract.extract_csv_visits, os.path.join(path, 'visit_dimension.csv'), self.batch_size),
         )
 
     ###################################################################################################################
diff --git a/cumulus/loaders/i2b2/oracle/query.py b/cumulus/loaders/i2b2/oracle/query.py
index 6a8e7710..a9db4728 100644
--- a/cumulus/loaders/i2b2/oracle/query.py
+++ b/cumulus/loaders/i2b2/oracle/query.py
@@ -37,7 +37,7 @@ def sql_visit() -> str:
     import_date = format_date('IMPORT_DATE')
 
     cols_dates = f'{start_date}, {end_date}, {import_date}, LENGTH_OF_STAY'
-    cols = 'ENCOUNTER_NUM, PATIENT_NUM, LOCATION_CD, INOUT_CD, LOCATION_CD, ' \
+    cols = 'ENCOUNTER_NUM, PATIENT_NUM, LOCATION_CD, INOUT_CD, ' \
            f'{cols_dates}'
     return f'select {cols} \n from {Table.visit.value}'
 
diff --git a/cumulus/loaders/i2b2/resources/external_mappings.py b/cumulus/loaders/i2b2/resources/external_mappings.py
deleted file mode 100644
index 5da353c8..00000000
--- a/cumulus/loaders/i2b2/resources/external_mappings.py
+++ /dev/null
@@ -1,59 +0,0 @@
-# This file contains a mapping of various external coding systems to the concepts they represent
-
-
-# PHIN VADS 1000-9, Race & Ethnicity - CDC
-# https://phinvads.cdc.gov/vads/ViewCodeSystemConcept.action?oid=2.16.840.1.113883.6.238&code=1000-9
-CDC_RACE = {
-    'White': '2106-3',
-    'Black or African American': '2054-5',
-    'American Indian or Alaska Native': '1002-5',
-    'Asian': '2028-9',
-    'Native Hawaiian or Other Pacific Islander': '2076-8',
-    'Hispanic or Latino': '2135-2',
-    'Not Hispanic or Latino': '2186-5'
-}
-
-
-# FHIR AdministrativeGender code (not a full gender spectrum, but quite limited)
-# https://www.hl7.org/fhir/valueset-administrative-gender.html
-# Anything not in this dictionary maps should map to 'other'
-FHIR_GENDER = {
-    'F': 'female',
-    'M': 'male',
-    'U': 'unknown',
-}
-
-
-# BCH internal lab codes mapping to international covid-19 codes
-# system: http://loinc.org
-LOINC_COVID_LAB_TESTS = {
-    'LAB:1043473617': '94500-6',
-    'LAB:1044804335': '94500-6',
-    'LAB:1044704735': '94500-6',
-    'LAB:1134792565': '95406-5',
-    'LAB:1148157467': '95406-5',
-    'LAB:467288722': '85477-8',
-    'LAB:152831642': '85476-0',
-    'LAB:467288694': '85478-6',
-    'LAB:467288700': '85479-4',
-    'LAB:13815125': '62462-7'
-}
-
-
-# PHIN VADS General adjectival modifier (qualifier value) {106234000 , SNOMED-CT }
-# Subset of codes related to evaluating lab results
-# system: http://snomed.info/sct
-SNOMED_LAB_RESULT = {
-    'Positive': '10828004',
-    'Negative': '260385009',
-    'Absent': '272519000'
-}
-
-
-# PHIN VADS Admission statuses {308277006, SNOMED-CT }
-# Subset of codes related to means of admition
-# system: http://snomed.info/sct
-SNOMED_ADMISSION = {
-    'Inpatient': 'IMP',
-    'Emergency': 'EMER'
-}
diff --git a/cumulus/loaders/i2b2/transform.py b/cumulus/loaders/i2b2/transform.py
index 3618c7c3..e20de606 100644
--- a/cumulus/loaders/i2b2/transform.py
+++ b/cumulus/loaders/i2b2/transform.py
@@ -20,7 +20,7 @@
 from fhirclient.models.period import Period
 
 from cumulus import fhir_common
-from cumulus.loaders.i2b2.resources import external_mappings
+from cumulus.loaders.i2b2 import external_mappings
 from cumulus.loaders.i2b2.schema import PatientDimension, VisitDimension, ObservationFact
 
 
@@ -58,7 +58,8 @@ def to_fhir_patient(patient: PatientDimension) -> Patient:
         })]
 
     if patient.race_cd:
-        race_code = parse_race(patient.race_cd)
+        # race_cd can be either a race or an ethnicity. In FHIR, those are two different extensions.
+        race_code = external_mappings.CDC_RACE.get(patient.race_cd)
         if race_code is not None:
             subject.extension = [Extension({
                 'url': 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race',
@@ -66,8 +67,24 @@ def to_fhir_patient(patient: PatientDimension) -> Patient:
                     {
                         'url': 'ombCategory',
                         'valueCoding': {
-                            'system': 'urn:oid:2.16.840.1.113883.6.238',
-                            'code': race_code,
+                            'system': race_code[0],
+                            'code': race_code[1],
+                            'display': patient.race_cd,
+                        },
+                    },
+                ],
+            })]
+
+        ethnicity_code = external_mappings.CDC_ETHNICITY.get(patient.race_cd)
+        if ethnicity_code is not None:
+            subject.extension = [Extension({
+                'url': 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity',
+                'extension': [
+                    {
+                        'url': 'ombCategory',
+                        'valueCoding': {
+                            'system': ethnicity_code[0],
+                            'code': ethnicity_code[1],
                             'display': patient.race_cd,
                         },
                     },
@@ -90,14 +107,10 @@ def to_fhir_encounter(visit: VisitDimension) -> Encounter:
     # TODO: status may be site specific, we may need to create mapping dict(s) at some point
     # we should also validate use of finished versus unknown
     encounter.status = 'finished'
-    # TODO: type may be site specific, we may need to create mapping dict(s) at some point
-
-    encounter.type = [CodeableConcept()]
-    encounter.type[0].coding = [Coding({
-        'system': 'http://snomed.info/sct',
-        'code': '308335008',
-        'display': 'Patient encounter procedure'}
-    )]
+
+    # Most generic encounter type possible, only included because the 'type' field is required in us-core
+    encounter.type = [make_concept('308335008', 'http://snomed.info/sct', 'Patient encounter procedure')]
+
     encounter.period = Period({
         'start': fhir_common.parse_fhir_date_isostring(visit.start_date),
         'end': fhir_common.parse_fhir_date_isostring(visit.end_date)
@@ -109,15 +122,14 @@ def to_fhir_encounter(visit: VisitDimension) -> Encounter:
             'value': parse_fhir_duration(visit.length_of_stay)
         })
 
-    if visit.inout_cd is not None:
+    if visit.inout_cd in external_mappings.SNOMED_ADMISSION:
         encounter.class_fhir = Coding({
             'system': 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
             'code': external_mappings.SNOMED_ADMISSION.get(visit.inout_cd)
         })
     else:
-        logging.warning(
-            'skipping encounter.class_fhir.code for i2b2 '
-            'INOUT_CD : %s', visit.inout_cd)
+        logging.warning('skipping encounter.class_fhir.code for i2b2 INOUT_CD : %s', visit.inout_cd)
+
     return encounter
 
 
@@ -152,6 +164,7 @@ def to_fhir_observation_lab(obsfact: ObservationFact) -> Observation:
         obs_system = None
 
     observation.code = make_concept(obs_code, obs_system)
+    observation.category = [make_concept('laboratory', 'http://terminology.hl7.org/CodeSystem/observation-category')]
 
     # lab result
     if obsfact.tval_char in external_mappings.SNOMED_LAB_RESULT:
@@ -202,7 +215,7 @@ def to_fhir_condition(obsfact: ObservationFact) -> Condition:
         i2b2_sys = 'http://snomed.info/sct'
     else:
         logging.warning('Unknown System')
-        i2b2_sys = '???'
+        i2b2_sys = None
 
     condition.code = make_concept(i2b2_code, i2b2_sys)
 
@@ -229,9 +242,10 @@ def to_fhir_documentreference(obsfact: ObservationFact) -> DocumentReference:
     docref.context = DocumentReferenceContext()
     docref.context.encounter = [fhir_common.ref_encounter(obsfact.encounter_num)]
 
-    docref.type = CodeableConcept({'text': str(obsfact.concept_cd)})  # i2b2 Note Type
+    # It would be nice to get a real mapping for the "NOTE:" concept CD types to a real system.
+    docref.type = make_concept(obsfact.concept_cd, None, obsfact.tval_char)
     docref.created = FHIRDate(fhir_common.parse_fhir_date_isostring(obsfact.start_date))
-    docref.status = 'superseded'
+    docref.status = 'current'
 
     blob = obsfact.observation_blob or ''
     content = DocumentReferenceContent()
@@ -268,16 +282,6 @@ def parse_gender(i2b2_sex_cd) -> Optional[str]:
         return external_mappings.FHIR_GENDER.get(i2b2_sex_cd, 'other')
 
 
-def parse_race(i2b2_race_cd) -> Optional[str]:
-    """
-    :param i2b2_race_cd:
-    :return: CDC R5 Race codes or None
-    """
-    if i2b2_race_cd and isinstance(i2b2_race_cd, str):
-        if i2b2_race_cd in external_mappings.CDC_RACE:
-            return external_mappings.CDC_RACE[i2b2_race_cd]
-
-
 def parse_fhir_duration(i2b2_length_of_stay) -> float:
     """
     :param i2b2_length_of_stay: usually an integer like "days"
@@ -292,6 +296,6 @@ def parse_fhir_duration(i2b2_length_of_stay) -> float:
             return i2b2_length_of_stay
 
 
-def make_concept(code: str, system: str, display: str = None) -> CodeableConcept:
+def make_concept(code: str, system: Optional[str], display: str = None) -> CodeableConcept:
     """Syntactic sugar to make a codeable concept"""
     return CodeableConcept({'coding': [{'code': code, 'system': system, 'display': display}]})
diff --git a/docs/howtos/run-cumulus-etl.md b/docs/howtos/run-cumulus-etl.md
index 3c5baccb..ec4ec44d 100644
--- a/docs/howtos/run-cumulus-etl.md
+++ b/docs/howtos/run-cumulus-etl.md
@@ -179,7 +179,7 @@ docker compose -f $CUMULUS_REPO_PATH/compose.yaml run --rm\
   --comment="Any interesting logging data you like, like which user launched this" \
   --input-format=ndjson \
   --output-format=parquet \
-  --batch-size=10000000 \
+  --batch-size=200000 \
   --s3-region=us-east-2 \
   s3://my-us-east-2-input-bucket/ \
   s3://my-cumulus-prefix-99999999999-us-east-2/subdir1/ \
diff --git a/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.000.ndjson b/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.000.ndjson
index 74faaf0e..a467e6bc 100644
--- a/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.000.ndjson
+++ b/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.000.ndjson
@@ -1 +1 @@
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"superseded","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"current","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
diff --git a/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.001.ndjson b/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.001.ndjson
index a6a0f898..d24be049 100644
--- a/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.001.ndjson
+++ b/tests/data/simple/batched-ndjson-output/documentreference/fhir_documentreferences.001.ndjson
@@ -1 +1 @@
-{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"superseded","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
+{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"current","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
diff --git a/tests/data/simple/batched-ndjson-output/observation/fhir_observations.000.ndjson b/tests/data/simple/batched-ndjson-output/observation/fhir_observations.000.ndjson
index bd3f0321..3402cf2a 100644
--- a/tests/data/simple/batched-ndjson-output/observation/fhir_observations.000.ndjson
+++ b/tests/data/simple/batched-ndjson-output/observation/fhir_observations.000.ndjson
@@ -1 +1 @@
-{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
diff --git a/tests/data/simple/batched-ndjson-output/observation/fhir_observations.001.ndjson b/tests/data/simple/batched-ndjson-output/observation/fhir_observations.001.ndjson
index 2a9311b1..87300b9a 100644
--- a/tests/data/simple/batched-ndjson-output/observation/fhir_observations.001.ndjson
+++ b/tests/data/simple/batched-ndjson-output/observation/fhir_observations.001.ndjson
@@ -1 +1 @@
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
diff --git a/tests/data/simple/json-output/118d/118dc10e-7745-20d7-e98d-7c358a84c15c/d30aad4b-4503-8e22-0bc4-621b94398520/fhir_docref_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json b/tests/data/simple/json-output/118d/118dc10e-7745-20d7-e98d-7c358a84c15c/d30aad4b-4503-8e22-0bc4-621b94398520/fhir_docref_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
index ea677683..d1cb8158 100644
--- a/tests/data/simple/json-output/118d/118dc10e-7745-20d7-e98d-7c358a84c15c/d30aad4b-4503-8e22-0bc4-621b94398520/fhir_docref_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
+++ b/tests/data/simple/json-output/118d/118dc10e-7745-20d7-e98d-7c358a84c15c/d30aad4b-4503-8e22-0bc4-621b94398520/fhir_docref_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
@@ -1 +1 @@
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"superseded","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
\ No newline at end of file
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"current","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
\ No newline at end of file
diff --git a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/175e9941-2607-ad5f-76ab-14759da618fd/fhir_lab_76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940.json b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/175e9941-2607-ad5f-76ab-14759da618fd/fhir_lab_76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940.json
index 0ea45422..5b742b49 100644
--- a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/175e9941-2607-ad5f-76ab-14759da618fd/fhir_lab_76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940.json
+++ b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/175e9941-2607-ad5f-76ab-14759da618fd/fhir_lab_76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940.json
@@ -1 +1 @@
-{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
\ No newline at end of file
+{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
\ No newline at end of file
diff --git a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_docref_c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971.json b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_docref_c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971.json
index 8bd3dbe5..d77333cc 100644
--- a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_docref_c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971.json
+++ b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_docref_c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971.json
@@ -1 +1 @@
-{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"superseded","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
\ No newline at end of file
+{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"current","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
\ No newline at end of file
diff --git a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_lab_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_lab_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
index 158f771d..9382bb0c 100644
--- a/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_lab_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
+++ b/tests/data/simple/json-output/1de9/1de9ea66-70d3-da1f-c735-df5ef7697fb9/af1e6186-3f9a-1fa9-3c73-cfa56c84a056/fhir_lab_f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd.json
@@ -1 +1 @@
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
\ No newline at end of file
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
\ No newline at end of file
diff --git a/tests/data/simple/ndjson-input/DocumentReference.ndjson b/tests/data/simple/ndjson-input/DocumentReference.ndjson
index 384313a3..0701144f 100644
--- a/tests/data/simple/ndjson-input/DocumentReference.ndjson
+++ b/tests/data/simple/ndjson-input/DocumentReference.ndjson
@@ -1,2 +1,2 @@
-{"id":"43","content":[{"attachment":{"contentType":"text\/plain","data":"Tm90ZXMgZm9yIGZldmVy"}}],"context":{"encounter":[{"reference":"Encounter\/23"}]},"status":"superseded","subject":{"reference":"Patient\/334567"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
-{"id":"44","content":[{"attachment":{"contentType":"text\/plain","data":"Tm90ZXMyIGZvciBmZXZlcg=="}}],"context":{"encounter":[{"reference":"Encounter\/25"}]},"status":"superseded","subject":{"reference":"Patient\/323456"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
+{"id":"43","content":[{"attachment":{"contentType":"text\/plain","data":"Tm90ZXMgZm9yIGZldmVy"}}],"context":{"encounter":[{"reference":"Encounter\/23"}]},"status":"current","subject":{"reference":"Patient\/334567"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
+{"id":"44","content":[{"attachment":{"contentType":"text\/plain","data":"Tm90ZXMyIGZvciBmZXZlcg=="}}],"context":{"encounter":[{"reference":"Encounter\/25"}]},"status":"current","subject":{"reference":"Patient\/323456"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
diff --git a/tests/data/simple/ndjson-input/Observation.ndjson b/tests/data/simple/ndjson-input/Observation.ndjson
index 1e9e1252..dc53fb6d 100644
--- a/tests/data/simple/ndjson-input/Observation.ndjson
+++ b/tests/data/simple/ndjson-input/Observation.ndjson
@@ -1,2 +1,2 @@
-{"id":"42","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/22"},"status":"final","subject":{"reference":"Patient\/323456"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
-{"id":"43","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/25"},"status":"final","subject":{"reference":"Patient\/323456"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"42","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/22"},"status":"final","subject":{"reference":"Patient\/323456"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"43","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/25"},"status":"final","subject":{"reference":"Patient\/323456"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
diff --git a/tests/data/simple/ndjson-output/documentreference/fhir_documentreferences.000.ndjson b/tests/data/simple/ndjson-output/documentreference/fhir_documentreferences.000.ndjson
index f611a666..1e4d6c1c 100644
--- a/tests/data/simple/ndjson-output/documentreference/fhir_documentreferences.000.ndjson
+++ b/tests/data/simple/ndjson-output/documentreference/fhir_documentreferences.000.ndjson
@@ -1,2 +1,2 @@
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"superseded","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
-{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"superseded","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"text":"NOTE:103933779"},"resourceType":"DocumentReference"}
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/d30aad4b-4503-8e22-0bc4-621b94398520"}]},"status":"current","subject":{"reference":"Patient\/118dc10e-7745-20d7-e98d-7c358a84c15c"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
+{"id":"c601849ceffe49dba22ee952533ac87928cd7a472dee6d0390d53c9130519971","content":[{"attachment":{"contentType":"text\/plain"}}],"context":{"encounter":[{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"}]},"status":"current","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"type":{"coding":[{"code":"NOTE:103933779","display":"ICP Admission MD"}]},"resourceType":"DocumentReference"}
diff --git a/tests/data/simple/ndjson-output/observation/fhir_observations.000.ndjson b/tests/data/simple/ndjson-output/observation/fhir_observations.000.ndjson
index 1a323b9d..5ddf0406 100644
--- a/tests/data/simple/ndjson-output/observation/fhir_observations.000.ndjson
+++ b/tests/data/simple/ndjson-output/observation/fhir_observations.000.ndjson
@@ -1,2 +1,2 @@
-{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
-{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"76da69dede003b4ceff5dc4921f838f3f8e583ef1e999cedc4bbe30c4d6d0940","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-19","encounter":{"reference":"Encounter\/175e9941-2607-ad5f-76ab-14759da618fd"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
+{"id":"f29736c29af5b962b3947fd40bed6b8c3e97c642b72aaa08e082fec05148e7dd","category":[{"coding":[{"code":"laboratory","system":"http://terminology.hl7.org/CodeSystem/observation-category"}]}],"code":{"coding":[{"code":"94500-6","system":"http:\/\/loinc.org"}]},"effectiveDateTime":"2020-03-20","encounter":{"reference":"Encounter\/af1e6186-3f9a-1fa9-3c73-cfa56c84a056"},"status":"final","subject":{"reference":"Patient\/1de9ea66-70d3-da1f-c735-df5ef7697fb9"},"valueCodeableConcept":{"coding":[{"code":"272519000","display":"Absent","system":"http:\/\/snomed.info\/sct"}]},"resourceType":"Observation"}
diff --git a/tests/i2b2_mock_data.py b/tests/i2b2_mock_data.py
index e5398f34..78d45b96 100644
--- a/tests/i2b2_mock_data.py
+++ b/tests/i2b2_mock_data.py
@@ -39,7 +39,7 @@ def condition_dim() -> transform.ObservationFact:
         'PATIENT_NUM': str(12345),
         'ENCOUNTER_NUM': 67890,
         'CONCEPT_CD': 'ICD10:U07.1',  # COVID19 Diagnosis
-        'START_DATE': '2016-01-01'
+        'START_DATE': '2016-01-01',
     })
 
 
@@ -58,8 +58,8 @@ def documentreference_dim() -> transform.ObservationFact:
             'NOTE:103933779',  # Admission Note Type
         'START_DATE':
             '2016-01-01',
-        'OBSERVATION_BLOB':
-            'Chief complaint: fever and chills. Denies cough.'
+        'OBSERVATION_BLOB': 'Chief complaint: fever and chills. Denies cough.',
+        'TVAL_CHAR': 'Admission note',
     })
 
 
diff --git a/tests/test_etl.py b/tests/test_etl.py
index 79ec4937..739aa1c4 100644
--- a/tests/test_etl.py
+++ b/tests/test_etl.py
@@ -204,7 +204,7 @@ def test_unknown_task(self):
 
     def test_single_task(self):
         # Grab all observations before we mock anything
-        observations = loaders.I2b2Loader(store.Root(self.input_path)).load_all(['Observation'])
+        observations = loaders.I2b2Loader(store.Root(self.input_path), 5).load_all(['Observation'])
 
         def fake_load_all(internal_self, resources):
             del internal_self
@@ -221,7 +221,7 @@ def fake_load_all(internal_self, resources):
 
     def test_multiple_tasks(self):
         # Grab all observations before we mock anything
-        loaded = loaders.I2b2Loader(store.Root(self.input_path)).load_all(['Observation', 'Patient'])
+        loaded = loaders.I2b2Loader(store.Root(self.input_path), 5).load_all(['Observation', 'Patient'])
 
         def fake_load_all(internal_self, resources):
             del internal_self
@@ -439,7 +439,7 @@ def test_stores_cached_json(self):
         self.run_etl(output_format='parquet')
 
         notes_csv_path = os.path.join(self.input_path, 'observation_fact_notes.csv')
-        facts = extract.extract_csv_observation_facts(notes_csv_path)
+        facts = list(extract.extract_csv_observation_facts(notes_csv_path, 5))
 
         for index, checksum in enumerate(self.expected_checksums):
             self.assertEqual(
diff --git a/tests/test_i2b2_oracle_extract.py b/tests/test_i2b2_oracle_extract.py
index cfd03d15..eb67a271 100644
--- a/tests/test_i2b2_oracle_extract.py
+++ b/tests/test_i2b2_oracle_extract.py
@@ -79,7 +79,7 @@ def test_loader(self, mock_extract):
         mock_extract.list_visit.return_value = [i2b2_mock_data.encounter_dim()]
 
         root = store.Root('tcp://localhost/foo')
-        oracle_loader = loader.I2b2Loader(root)
+        oracle_loader = loader.I2b2Loader(root, 5)
         tmpdir = oracle_loader.load_all(['Condition', 'Encounter', 'Patient'])
 
         # Check results
diff --git a/tests/test_i2b2_oracle_query.py b/tests/test_i2b2_oracle_query.py
index 31d67e2f..a507c22a 100644
--- a/tests/test_i2b2_oracle_query.py
+++ b/tests/test_i2b2_oracle_query.py
@@ -57,7 +57,7 @@ def test_sql_visit(self):
         pretty(query.sql_visit() + query.limit(20))
         pretty(query.count_by_date_group(schema.Table.visit))
         self.assertEqual(
-            'select ENCOUNTER_NUM, PATIENT_NUM, LOCATION_CD, INOUT_CD, LOCATION_CD, '
+            'select ENCOUNTER_NUM, PATIENT_NUM, LOCATION_CD, INOUT_CD, '
             "to_char(cast(START_DATE as date), 'YYYY-MM-DD') as START_DATE, "
             "to_char(cast(END_DATE as date), 'YYYY-MM-DD') as END_DATE, "
             "to_char(cast(IMPORT_DATE as date), 'YYYY-MM-DD') as IMPORT_DATE, "
diff --git a/tests/test_i2b2_transform.py b/tests/test_i2b2_transform.py
index ab145d6b..52a2c9f3 100644
--- a/tests/test_i2b2_transform.py
+++ b/tests/test_i2b2_transform.py
@@ -53,7 +53,8 @@ def test_to_fhir_documentreference(self):
         self.assertEqual('Patient/12345', docref.subject.reference)
         self.assertEqual(1, len(docref.context.encounter))
         self.assertEqual('Encounter/67890', docref.context.encounter[0].reference)
-        self.assertEqual(str('NOTE:103933779'), docref.type.text)
+        self.assertEqual('NOTE:103933779', docref.type.coding[0].code)
+        self.assertEqual('Admission note', docref.type.coding[0].display)
 
     def test_to_fhir_observation_lab(self):
         lab_fhir = i2b2_mock_data.observation()