The UB1 segment contains data specific to the United States. Only billing/claims fields that do not exist in other HL7 defined segments appear in this segment. The codes listed as examples are not an exhaustive or current list.
Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Seq# | DataElement | Description | Must Implement | Flags | Cardinality | Length | C.LEN | Vocabulary | DataType |
---|---|---|---|---|---|---|---|---|---|
UB1 | |||||||||
1 | 00530 | Set ID - UB1 | SHALL NOT | W | [0..0] | SI | |||
2 | 00531 | Blood Deductible | SHALL NOT | W | [0..0] | ||||
3 | 00532 | Blood Furnished-Pints | SHALL NOT | W | [0..0] | ||||
4 | 00533 | Blood Replaced-Pints | SHALL NOT | W | [0..0] | ||||
5 | 00534 | Blood Not Replaced-Pints | SHALL NOT | W | [0..0] | ||||
6 | 00535 | Co-Insurance Days | SHALL NOT | W | [0..0] | ||||
7 | 00536 | Condition Code | SHALL NOT | W | [0..0] | ||||
8 | 00537 | Covered Days | SHALL NOT | W | [0..0] | ||||
9 | 00538 | Non Covered Days | SHALL NOT | W | [0..0] | ||||
10 | 00539 | Value Amount & Code | SHALL NOT | W | [0..0] | ||||
11 | 00540 | Number Of Grace Days | SHALL NOT | W | [0..0] | ||||
12 | 00541 | Special Program Indicator | SHALL NOT | W | [0..0] | ||||
13 | 00542 | PSRO/UR Approval Indicator | SHALL NOT | W | [0..0] | ||||
14 | 00543 | PSRO/UR Approved Stay-Fm | SHALL NOT | W | [0..0] | ||||
15 | 00544 | PSRO/UR Approved Stay-To | SHALL NOT | W | [0..0] | ||||
16 | 00545 | Occurrence | SHALL NOT | W | [0..0] | ||||
17 | 00546 | Occurrence Span | SHALL NOT | W | [0..0] | ||||
18 | 00547 | Occur Span Start Date | SHALL NOT | W | [0..0] | ||||
19 | 00548 | Occur Span End Date | SHALL NOT | W | [0..0] | ||||
20 | 00549 | UB-82 Locator 2 | SHALL NOT | W | [0..0] | ||||
21 | 00550 | UB-82 Locator 9 | SHALL NOT | W | [0..0] | ||||
22 | 00551 | UB-82 Locator 27 | SHALL NOT | W | [0..0] | ||||
23 | 00552 | UB-82 Locator 45 | SHALL NOT | W | [0..0] |
Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-3 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-4 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-5 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-6 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-7 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-8 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-9 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-10 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-11 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-12 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-13 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-14 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-15 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-16 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-17 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-18 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-19 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-20 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-21 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-22 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.
Attention: UB1-23 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.