Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

Data Element
Care Team Role
Claim Service Start Date
Claim Service End Date
Claim Paid Date
Modifier Code -4
Modifier Code -3
Modifier Code -2
Modifier Code -1
Procedure Type
Procedure Code Type
Procedure Code Type
Procedure Date
Procedure Code
Diagnosis Code Type
Diagnosis Type
Diagnosis Code Type
Present on Admission
Is E code
Diagnosis Code
Line Copay Amount
Line Member Liability
Line Allowed Amount
Line Submitted Amount
Line Coinsurance Amount
Line Other Payer Paid Amount
Line Patient Deductible
Line Amount Paid to Provider
Line Allowed Amount
Drug Cost
Line Amount Paid by Patient
Line Discount Amount
Line Payment Amount
Line Member Reimbursement
Claim Referring Physician Network Status
Line Noncovered Amount
Payment member explanation
Line Payment Denial Code
Benefit Payment Status
Quantity Qualifier Code
Quantity Dispensed
Compound Code
National Drug Code
Allowed Number of Units
Revenue Center Code
Place of Service Code
Type of Service
Service to Date
Line Number
Service (from) Date
Total Amount
Claim Discount Amount
Claim Other Payer Paid Amount
Member Liability
Copay Amount
Statement From Date
Co-insurance Liability Amount
Member Paid Deductible
Claim Non-covered Amount
Claim Payment Amount
Member Reimbursement
Claim Amount Paid to Provider
Amount Paid by Patient
Claim Total Allowed Amount
Claim Total Submitted Amount
Organization Identifier Type
Practitioner Identifier Type
Claim Operating NPI
Claim Operating Surgeon Name
Service Facility Address
Claim Supervising Physician Name
Claim Supervising Physician NPI
Claim Prescribing Physician Name
Claim Referring Physician Name
Service Facility Name
Claim PCP name
Claim Performing Provider Name
Claim Billing Provider Name
Claim Attending Physician Name
Service Facility NPI
Claim PCP NPI
Claim Prescriber Contracting Status
Claim Prescribing Provider NPI
Claim Performing Provider Network Status
Claim Performing Provider NPI
Claim Received Date
Claim Referring Physician NPI
Claim Site of Service Network Status
Claim Attending Physician NPI
Claim Billing Provider Contracting Status
Claim Billing Provider NPI
Claim Identifier Type
Plan Reported Brand-Generic Code
Prescription Origin Code
Refill Number
DAW Product Selection Code
RX Service Reference Number
Days Supply
Adjudication Amount Type
Procedure Code Type
Claim Identifier Type
Adjudication Date
Statement Thru Date
Claim Payer Identifier
Claim Payment Status Code
Claim Payee
Claim Payee Type
Claim Payer Name
Claim Other Payer Identifier(s)
Claim Payment Denial
Patient Discharge Status
Claim Sub Type
Claim Type
Claim Processing Status
Claim Frequency Code
Claim Service Classification Type Code
Claim Bill Facility Type Code
Claim Inpatient Admission Type Code
Claim Inpatient Source Admission Code
Claim Diagnosis Related Group Version
Claim Adjusted to Identifier
Claim Adjusted from Identifier
Payer Claim Unique Identifier
Member Discharge Date
Member Admission Date

Comment

Submitted by markaroberts85 on 2022-10-01

CARIN Alliance Submission to USCDI

The CARIN Alliance, a multi-sector group of stakeholders representing numerous hospitals, thousands of physicians, and millions of consumers, individuals, and caregivers would like to thank you and the ONC staff for reviewing the data classes and data elements submitted by the CARIN Alliance in September 2021 and April 2022. As part of this submission, we again want to make a recommendation to include the Explanation of Benefit (EOB) data classes and data elements associated with the CARIN IG for Blue Button as part of USCDI version 3.  

CARIN Alliance Comments on USCDI v4 093022.pdf

Submitted by markaroberts85 on 2022-10-04

Additional comment

Additionally, the names for US Core Data for Interoperability (USCDI) and the aligning HL7 US Core FHIR are misleading. The true scope of USCDI is focused largely on EHR interoperabilty and ONC certification of EHRs. However, “US Core” implies core data for the US in general, not the narrow focus on EHRs. For instance, public health and payer use cases are not well represented. Suggest renaming US Core to something more appropriate to it’s scope, such as US Core for EHR exchange, or expand the scope and make it truly encompassing of the chosen name. At a minimum clearly delineate the scope of USCDI, especially what is not in “US Core” that actually is a core need for the US (in a pandemic, how can public health not be considered core).

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