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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
Level 0	Patient Summary and Plan	Information that guides treatment of the patient and recommendations for future treatment.	Clinical Decision Support Data	Data and reporting used for risk stratification, optimization of patient outcomes, detection of decompensation, clinical and patient education.	SNOMED CT	Grace Cordovano	Enlightening Results	08/14/2021 - 19:16
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Service Classification Type Code	UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The second digit classifies the type of care (service classification) being billed.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Bill Facility Type Code	UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of facility.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Inpatient Admission Type Code	Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Inpatient Source Admission Code	Identifies the place where the patient was identified as needing admission to a facility. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15).	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Diagnosis Related Group Version	Version of the DRG codes assigned for inpatient facility claims. Claim diagnosis related group (DRG) code value. Name of the DRG grouper assigned; i.e., MS-DRG, AP-DRG or APR-DRG	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Adjusted to Identifier	If the current claim has been adjusted; i.e., replaced by or merged to another claim number, this data element represents that new number.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Claim Adjusted from Identifier	If the current claim represents a claim that has been adjusted and was given a prior claim number, this field represents the prior claim number	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Payer Claim Unique Identifier	Identifier assigned by a payer for a claim received from a provider or subscriber. It is not the same identifier as that assigned by a provider.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Cancer Care		Provider Reported Toxicity Measure	For each Cancer Patient - Provider Reported Toxicity record the Toxicity Measure specifies what value is measured. For example if CTCAE v5.0 (https://ctep.cancer.gov/protocoldevelopment/electronic_applications/doc…) is used then the Toxicity Measure would correspond to CTCAE Term (e.g. Dry Mouth, or Dry Mouth) The AAPM Operational Ontology for Radiation Oncology ( https://aapmbdsc.azurewebsites.net) identified this as a high priority element supporting patient care, outcomes research and public policy	Common Terminology Criteria for Adverse Events https://ctep.cancer.gov/protocoldevelopment/electronic_applications/doc…	Charles Mayo	University of Michigan	09/28/2022 - 21:38
Level 0	Cancer Care		Provider Reported Toxicity Value	For each Cancer Patient - Provider Reported Toxicity record the Toxicity Value corresponding to the Toxicity Measure specified indicates the severity of the toxicity using the standardized table. specifies what value is measured. For example if CTCAE v5.0 (https://ctep.cancer.gov/protocoldevelopment/electronic_applications/doc…) the values in the standardized set are 0,1,2,3,4,5 The AAPM Operational Ontology for Radiation Oncology ( https://aapmbdsc.azurewebsites.net) identified this as a high priority element supporting patient care, outcomes research and public policy	Common Terminology Criteria for Adverse Events https://ctep.cancer.gov/protocoldevelopment/electronic_applications/doc…	Charles Mayo	University of Michigan	09/28/2022 - 21:38
Level 0	Cancer Care		Pathology Molecular Test Name	Name of the molecular pathology test used as part of diagnosis and staging. There are a wide range of tests. In the case of prostate cancer values include: DECIPHER Prolaris Oncotype DX Genomic Prostate Score ProMark	American Joint Committee on Cancer e.g. AJCC8	Charles Mayo, PhD	University of Michigan	09/11/2022 - 20:25
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Member Discharge Date	Date the beneficiary was discharged from the facility, or died. Matches the Statement Thru Date. When there is a discharge date, the Patient Discharge Status Code indicates the final disposition of the patient after discharge.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Explanation of Benefit	Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.	Member Admission Date	The date corresponding with admission of the beneficiary to a facility and the onset of services. May precede the Statement From Date if this claim is for a beneficiary who has been continuously under care.	NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes.	Mark Roberts	Leavitt Partners	09/30/2021 - 22:05
Level 0	Immunizations	Record of vaccine administration.	Patient Assertion of Vaccine Credentials	Whether or not the patient asserts they have verifiable vaccine credentials.	HL7 FHIR: Vaccine Credential Patient Assertion Observation profile HL7 CDA: Vaccine Credential Patient Assertion Observation LOINC: 11370-4 "Immunization status - Reported"	Nedra Garrett	CDC	09/30/2021 - 18:53
Level 0	Substance Use		Alcohol binge episodes per month	This data element comprises how many alcohol binge episodes an individual has per month	Most of the requested data elements are in LOINC, as per the codes below. We have requested the addition of the NIAAA Single-Item Screener and the diagnosis of Alcohol Use Disorder to LOINC. AUDIT-C : 72109-2 Ethanol in blood: 5640-8 Ever drink alcohol: 69721-9 Average daily alcohol intake: 74013-4 Alcohol binge episodes/month: 11286-2 Alcohol abuse or dependence: 74043-1 Alcohol help during pregnancy: 64718-0	Laura Kwako	National Institute on Alcohol Abuse and Alcoholism	10/22/2020 - 19:43
Level 0	Patient Demographics/Information	Data used to categorize individuals for identification, records matching, and other purposes.	Country of Nationality	The patient's country of nationality.	HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) based on FHIR R4 HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) HL7 FHIR: Country of Nationality profile HL7 CDA: Country of Nationality template SNOMED: 186034007 \|Ethnicity / related nationality data (observable entity)\| https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519 https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436	Sarah Gaunt		12/07/2021 - 21:20
Level 0	Social Determinants of Health		Congregate Living	Shared housing includes a broad range of settings, such as apartments, condominiums, student or faculty housing, national and state park staff housing, transitional housing, and domestic violence and abuse shelters	HL7 CDA: C-CDA Characteristics of Home Environment template HL7 FHIR: US Public Health Characteristics of Home Environment LOINC: 75274-1 "Characteristics of residence" Value set: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.49/expansion (Residence and Accommodation Type)	Nedra Garrett	CDC	09/30/2021 - 19:00
Level 0	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.	Antepartum Summary Note	The Antepartum Summary Note defines the aggregation of significant events, diagnoses, and plans of care derived from the visits over the course of an antepartum episode. It is a summary of the most critical information antepartum care providers capture and share regarding the status of a patient’s pregnancy. It is represented in part by Estimated Due Dates and summaries of the various antepartum visits. The information is aggregated data from which the patient’s interactions with care providers are captured. It includes data such as the patient’s allergies, advance directives, care planning, and selected histories. The antepartum summary note includes information such as structured evaluation of risk (e.g., PRAPARE, homelessness, AHC-HRSN screening tool, etc.) for any maternal health SDOH data related to conditions in which people live, learn, work, and play and their effects on health risks and outcomes; plan of care including social support interventions including but not limited to access to care; education; income; food stability; housing; neighborhood characteristics; safety; transportation security; violence/abuse preventions, ETOH, Smoking, Substance use disorder assessment and treatment drug abuse prevention and treatment; living arrangement; Social support involvement baby father involvement; etc.	SNOMED CT 276986009 Antepartum LOINC: 57061-4 Antepartum flowsheet panel Narrative https://loinc.org/57061-4/ 57055-6 Antepartum summary note https://loinc.org/57055-6/ ICD9 CM Complications of Pregnancy, Childbirth and the Puerperium http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.11.1021 ICD10CM, SNOMEDCT Complications of Pregnancy, Childbirth and the Puerperium http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1012 Pregnancy https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion	Andrea Fourquet	IHE USA	04/30/2022 - 01:26
Level 0	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.	Maternal Social Determinants of Health Note	The Maternal Social Determinants of Health Note supports the aggregation of significant events, social problems and related health concerns, and plans of care derived from the visits over the course of a maternal care episode. It is a summary of the most critical information maternal care providers capture and share regarding the status of a maternal patient's social issues. The information is aggregated data from which the patient’s interactions with healthcare and social services providers are captured. The Maternal Social Determinants of Health Note includes information such as structured evaluation of risk (e.g., PRAPARE, homelessness, AHC-HRSN screening tool, etc.) for any maternal health SDOH data related to conditions in which people live, learn, work, and play and their effects on health risks and outcomes; plan of care including social support interventions including but not limited to access to care; education; income; food stability; housing; neighborhood characteristics; safety; transportation security; violence/abuse preventions, ETOH, Smoking, Substance use disorder assessment and treatment drug abuse prevention and treatment; living arrangement; Social support involvement baby father involvement; etc.	SNOMED CT 183425000 Social care 61072005 Social factor 315042007 Social support 161152002 Social problem 310134006 Social services 406551008 Social assessment 405076007 Social support status 108329005 Social context finding LOINC 52234-2 Medical social services treatment plan, Assessment information Set 52218-5 Medical social services treatment plan, Referral information Set 29762-2 Social history Narrative 91642-9 Medical Outcomes Study Social Support Survey panel 91663-5 Social support index ICD10 Z60.9 Problem related to social environment, unspecified Z60.8 Other problems related to social environment ICD9 CM Complications of Pregnancy, Childbirth and the Puerperium ICD10CM, SNOMEDCT Complications of Pregnancy, Childbirth and the Puerperium Pregnancy SNOMED CT: https://www.snomed.org/ LOINC: https://loinc.org/ ICD10: https://www.icd10data.com/	Asha G Immanuelle	Center For Black Women's Wellness	04/29/2022 - 15:06