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UB1 - Uniform Billing 1 Segment

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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

HL7 Attribute Table - UB1 - Uniform Billing 1 Segment
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]

UB1-1: Set ID - UB1

Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-2: Blood Deductible

Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-3: Blood Furnished-Pints

Attention: UB1-3 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-4: Blood Replaced-Pints

Attention: UB1-4 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-5: Blood Not Replaced-Pints

Attention: UB1-5 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-6: Co-Insurance Days

Attention: UB1-6 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-7: Condition Code

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.

UB1-8: Covered Days

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.

UB1-9: Non Covered Days

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.

UB1-10: Value Amount & Code

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.

UB1-11: Number Of Grace Days

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.

UB1-12: Special Program Indicator

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.

UB1-13: PSRO/UR Approval Indicator

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.

UB1-14: PSRO/UR Approved Stay-Fm

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.

UB1-15: PSRO/UR Approved Stay-To

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.

UB1-16: Occurrence

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.

UB1-17: Occurrence Span

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.

UB1-18: Occur Span Start Date

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.

UB1-19: Occur Span End Date

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.

UB1-20: UB-82 Locator 2

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.

UB1-21: UB-82 Locator 9

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.

UB1-22: UB-82 Locator 27

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.

UB1-23: UB-82 Locator 45

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.