USCDI Export for the Public

Classification Level Sort descending Data Class Data Class Description Data Element Data Element Description Applicable Standards Submitter Name Submitter Organization Submission Date
USCDI V2 Care Team Members

Information about a person who participates or is expected to participate in the care of a patient.

Care Team Member Role

Function or functions that a person may perform while participating in the care for a patient

Al Taylor ONC
USCDI V2 Patient Demographics/Information

Data used to categorize individuals for identification, records matching, and other purposes.

Middle Name (Including middle initial)
USCDI V2 Allergies and Intolerances

Harmful or undesired physiological responses associated with exposure to a substance.

Reaction
  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
USCDI V2 Unique Device Identifier(s) for a Patient's Implantable Device(s)

Unique identifier(s) for a patient's implantable device(s).

Unique Device Identifier(s) for a patient's implantable device(s)
  • FDA Unique Device Identification System (UDI System)
Marti Velezis FDA/CDRH/Indira Konduri (FDA/CDRH/OPEQ/ORP/DRPIII)
USCDI V2 Clinical Notes

Narrative patient data relevant to the context identified by note types.

  •  
  • Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name. 
Consultation Note

Contains the response to request from a clinician for an opinion or advice from another clinician.

Logical Observation Identifiers Names and Codes (LOINC®) version 2.70

  • Consult Note (LOINC® code 11488-4)
USCDI V2 Care Team Members

Information about a person who participates or is expected to participate in the care of a patient.

Care Team Member Location

Physical location of provider or other care team member

Al Taylor ONC
USCDI V2 Patient Demographics/Information

Data used to categorize individuals for identification, records matching, and other purposes.

Suffix
USCDI V2 Clinical Tests

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions.

Clinical Test Result/Report

Interpreted results of clinical tests that may include study performed, reason performed, findings, and impressions. Includes both structured and unstructured (narrative) components.

Melissa Ayres SSA
USCDI V2 Care Team Members

Information about a person who participates or is expected to participate in the care of a patient.

Care Team Member Identifier Al Taylor ONC
USCDI V2 Clinical Notes

Narrative patient data relevant to the context identified by note types.

  •  
  • Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name. 
Progress Note

Represents a patient’s interval status during a hospitalization, outpatient visit, treatment with a post-acute care provider, or other healthcare encounter.

Logical Observation Identifiers Names and Codes (LOINC®) version 2.70

  • Progress Note (LOINC® code 11506-3)
USCDI V2 Patient Demographics/Information

Data used to categorize individuals for identification, records matching, and other purposes.

Sex (Assigned at Birth)

Birth sex must be coded in accordance with HL7 Version 3 (V3) Standard, Value Sets for AdministrativeGender and NullFlavor attributed as follows:

  • Female. F
  • Male. M
  • Unknown. nullFlavor UNK

Adopted at 45 CFR 170.207(n) 

USCDI V2 Allergies and Intolerances

Harmful or undesired physiological responses associated with exposure to a substance.

Substance (Drug Class)
  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
USCDI V2 Care Team Members

Information about a person who participates or is expected to participate in the care of a patient.

Care Team Member Name Al Taylor ONC
USCDI V2 Vital Signs

Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.

Body Temperature
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.70
  • The Unified Code of Units for Measure (UCUM), Revision 2.1
USCDI V2 Smoking Status

Representing a patient’s smoking behavior.

Smoking Status

Representing a patient’s smoking behaviors.

  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
USCDI V2 Patient Demographics/Information

Data used to categorize individuals for identification, records matching, and other purposes.

Date of Birth
USCDI V2 Allergies and Intolerances

Harmful or undesired physiological responses associated with exposure to a substance.

Substance (Medication)
  • RxNorm® Full Monthly Release, June 7, 2021
USCDI V2 Clinical Tests

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions.

Clinical Test

The name of the non-imaging or non-laboratory test performed on a patient.

  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.70
Joel Andress Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
USCDI V2 Problems

Condition, diagnosis, or reason for seeking medical attention.

SDOH Problems/Health Concerns

An identified Social Determinants of Health-related condition (e.g., Homelessness (finding), Lack of adequate food Z59.41, Transport too expensive (finding)). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes.

  • ​​​​SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
  • International Classification of Diseases ICD-10-CM 2021
Mark Savage for Gravity Project Gravity Project
USCDI V2 Vital Signs

Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.

BMI Percentile (2 - 20 years)
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.70
  • The Unified Code of Units for Measure (UCUM), Revision 2.1