http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0

Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.
element_idtypes
Extension
Extension.extension
Extension.url
Extension.value[x]
Extension
Extension.id
Extension.extension
Extension.url
Extension.value[x]