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Classification Level Sort descending	Data Class	Data Class Description	Data Element	Data Element Description	Applicable Standards	Submitter Name	Submitter Organization	Submission Date
USCDI V2	Encounter Information	Information related to interactions between healthcare providers and a patient.	Encounter Disposition	Identifies the location or type of facility to where the patient left following a hospital or encounter episode.		Joel Andress	Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)	10/02/2020 - 08:35
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 Telecom	Electronic contact information of a provider or other care team member	ITU-T E.123, Series E: Overall Network Operation, Telephone Service, Service Operation and Human Factors, International operation - General provisions concerning users: Notation for national and international telephone numbers, email addresses and web addresses (incorporated by reference in § 170.299); and ITU-T E.164, Series E: Overall Network Operation, Telephone Service, Service Operation and Human Factors, International operation - Numbering plan of the international telephone service: The international public telecommunication numbering plan	Keith W. Boone	Audacious Inquiry	10/14/2020 - 17:12
USCDI V2	Vital Signs	Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.	Body Height		Logical Observation Identifiers Names and Codes (LOINC®) version 2.70 The Unified Code of Units for Measure (UCUM), Revision 2.1
Level 2	Allergies and Intolerances	Harmful or undesired physiological responses associated with exposure to a substance.	Criticality	Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.	HL7 FHIR R4 Allergy Intolerance Criticality, Rx Norm, SNOMED CT, National Drug Code (NDC)	Sandi Mitchell	J P Systems, Inc.	09/20/2023 - 17:27
Level 2	Biologically Derived Product	Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.	Source Identifier	Provides details on collections and pooled products such as donation identifier	ISBT-128 Donation Identification Number	Barbee Whitaker	Food and Drug Administration (FDA) Center for Biologics Evaluation and Research (CBER)	09/30/2021 - 15:19
Level 2	Organization		Healthcare Services	Describe a specific healthcare service or category of services (such as counseling, imaging, or laboratory) offered by an organization at a designated location, which can be either physical or virtual. The service provider may include hospitals, clinics, pharmacies, or other specialized healthcare providers.	In addition to LOINC and SNOMED CT, other relevant code systems for the Healthcare Service data element include: 1. NDC (National Drug Code): For identifying medications and drug services. 2. ICD (International Classification of Diseases): For coding diagnoses that may relate to specific healthcare services. 3. CPT (Current Procedural Terminology): For coding medical procedures and services provided by healthcare professionals. 4. HCPCS (Healthcare Common Procedure Coding System): For coding healthcare services, supplies, and equipment. These additional code systems further support the standardized representation of healthcare services.	Mike Hamidi	Vulcan	09/30/2024 - 14:42
Level 2	Healthcare Information Attributes	Contextual information that provides supporting details for healthcare data.	Report Date	The date on which the reporting party (e.g., physician, nurse practitioner, physician assistant, etc.), completes collection of data for the report.		Sarah Gaunt	The Association of Public Health Laboratories (APHL)	04/16/2024 - 02:53
Level 2	Immunizations	Record of vaccine administration.	Immunization Status	Indicates the current status (i.e., completed, entered in error, not done) of the immunization event.	Immunization Code: CVX: Vaccines Administered 2.16.840.1.113762.1.4.1010.6: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1010.6/expansion Immunization Code: National Drug Codes (NDC): http://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_tableaccess.asp Immunization Status: FHIR Immunization Status Codes: http://hl7.org/fhir/ValueSet/immunization-status Immunization Administered Date: FHIR datatypes: dateTime, String: https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-immunization-definitions.html#Immunization.occurrence[x] Reason Immunization Not Performed: FHIR Immunization Status Reason Codes: http://hl7.org/fhir/R4/valueset-immunization-status-reason.html	Maria Michaels	CDC	10/20/2020 - 17:59
Level 2	Adverse Events	Unintended effects associated with clinical interventions.	Adverse Event	An adverse event is any undesirable experience associated with the use of a medical product in a patient.	SNOMED CT (e.g., Life-threatening severity)	Mitra Rocca	Food and Drug Administration	09/30/2022 - 23:30
Level 2	Immunizations	Record of vaccine administration.	Vaccination Event Record Type	Indicates whether the vaccination event is based on a historical record (e.g., second hand knowledge of the vaccination event) or was administered at the facility submitting the data.	LOINC:30952-6- Date and time of vaccination: https://loinc.org/30952-6/ PHINVAD Immunization Information Source	Nedra Garrett	Centers for Disease Control and Prevention	10/22/2020 - 16:09
Level 2	Health Insurance Information	Data related to an individual’s insurance coverage for health care.	Group Name	Name of the Employer Account.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:24
Level 2	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.	Referral note	Documentation sent to a consultant, for example, by a primary care provider, summarizing the patient’s clinical history and reason for consult.	LOINC. We recommend adding the new data elements with a LOINC term representing the most generic term for that particular data element, along with information about how to access the value set of more specific LOINC terms available for each note type. The Regenstrief LOINC team can provide FHIR ValueSets with associated OIDs and/or webpages with downloadable content for each note type. Both of these resources would include the same set of LOINC terms. These resources do not exist yet but can easily be created if approved as additions to the USCDI. The benefit of hosting these resources on the LOINC website or providing them via LOINC FHIR terminology services compared to VSAC or other value set repositories is that the resources will be updated automatically with every LOINC release and would not require a separate process.	Swapna Abhyankar	Regenstrief Institute, LOINC Document Ontology Subcommittee	10/23/2020 - 15:55
Level 2	Vital Signs	Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.	BMI		LOINC	Joel Andress	Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)	10/06/2020 - 11:14
Level 2	Diagnostic Imaging	Tests that result in visual images requiring interpretation by a credentialed professional.	Imaging Reference	The technical details of the retrieval access path to indicate network services that can be used to access DICOM studies, series, or instances content and metadata (e.g., a DICOMweb server endpoint providing QIDO-RS, WADO-RS, or WADO-URI).	LOINC/RSNA Radiology Playbook includes Diagnostic Imaging Procedure Codes and Descriptions. HL7 Standard for CDA® Release 2: Imaging Integration; Basic Imaging Reports in CDA and DICOM Release 1 references LOINC® Document Type Codes, SNOMED CT® Quantity Measurement Type Codes, as well as DICOM Code Systems. FHIR ImagingStudy references SNOMED CT Body Structures	Brian Bialecki	American College of Radiology	09/19/2022 - 16:02
Level 2	Health Insurance Information	Data related to an individual’s insurance coverage for health care.	Payer Name	The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.	Coverage type and self paid codes; Many of the defined elements in a resource are references to other resources. Using these references, the resources combine to build a web of information about healthcare; ID assigned to the subscriber	Shelly Spiro	Pharmacy HIT Collaborative	10/20/2020 - 20:46
Level 2	Biologically Derived Product	Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.	Division	Provides details on aliquots or when a donation event involves more than one collection	ISBT-128 Division Identifier	Barbee Whitaker	Food and Drug Administration (FDA) Center for Biologics Evaluation and Research (CBER)	09/30/2021 - 15:19
Level 2	Diagnostic Imaging	Tests that result in visual images requiring interpretation by a credentialed professional.	Accession Number	A unique identifier created by a departmental information system which identifies the Imaging Service Request. The Accession Number links the scheduled procedure, images, and their resulting diagnostic imaging report, created by the radiologist, back to the original order, supporting both clinical workflow and billing. The Accession Number may group one or more Requested Procedures.	LOINC/RSNA Radiology Playbook includes Diagnostic Imaging Procedure Codes and Descriptions. HL7 Standard for CDA® Release 2: Imaging Integration; Basic Imaging Reports in CDA and DICOM Release 1 references LOINC® Document Type Codes, SNOMED CT® Quantity Measurement Type Codes, as well as DICOM Code Systems. FHIR ImagingStudy references SNOMED CT Body Structures	Brian Bialecki	American College of Radiology	09/19/2022 - 16:02
Level 2	Health Insurance Information	Data related to an individual’s insurance coverage for health care.	Plan Name	Name of the health plan benefit offering assigned to the Plan Identifier.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:24
Level 2	Medical Devices	Instrument, machine, appliance, implant, software, or similar device intended to be used for a medical purpose.	Device used	Devices are an identifiable grouping of mobility devices (i.e., wheelchairs), implantable devices (i.e., pace makers), or other wearable devices (i.e. compression socks or venous foot pump) with significant impact on patient functionality and health. The QDM v5.5 notes that “Device represents an instrument, apparatus, implement, machine, contrivance, implant, in-vitro reagent, or other similar or related article, including a component part or accessory, intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and not dependent on being metabolized to achieve any of its primary intended purposes.”	SNOMED CT (Frailty Device, value set OID: 2.16.840.1.113883.3.464.1003.118.12.1300) SNOMED CT (Intermittent Pneumatic Compression Devices (IPC), value set OID: 2.16.840.1.113883.3.117.1.7.1.214) SNOMED CT (Graduated Compression Stockings (GSC), value set OID: 2.16.840.1.113883.3.117.1.7.1.256) SNOMED CT (Venous Foot Pumps (VFP), value set OID: 2.16.840.1.113883.3.117.1.7.1.230) SNOMED CT (Cardiac Pacer, value set OID: 2.16.840.1.113883.3.526.3.1193) ICD-10-CM, SNOMED CT (Cardiac Pacer in Situ, value set OID: 2.16.840.1.113883.3.526.3.368)	Joel Andress	Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)	10/06/2020 - 11:26
Level 2	Health Status Assessments	Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s authorized representative, or patient’s healthcare provider that could identify a need, problem, or condition.	Nutrition Assessment	A systematic nutrition assessment of an individual's nutrition intake, physical exam, anthropometric measurements, biochemical, and health condition data compared to accepted standards, recommendations, and/or goals to arrive at a determination of the client’s nutrition well-being or malnutrition.	LOINC 75304-6 Nutrition status observation panel	Michelle Ashafa	Academy of Nutrition and Dietetics	09/13/2023 - 15:42