UB1

UB82

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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

23
C.LenElement
1--SIW1-00530UB1-1Set ID - UB1
2---W1-00531UB1-2Blood Deductible
3---W1-00532UB1-3Blood Furnished-Pints
4---W1-00533UB1-4Blood Replaced-Pints
5---W1-00534UB1-5Blood Not Replaced-Pints
6---W1-00535UB1-6Co-Insurance Days
7---W5-00536UB1-7Condition Code
8---W1-00537UB1-8Covered Days
9---W1-00538UB1-9Non Covered Days
10---W8-00539UB1-10Value Amount & Code
11---W1-00540UB1-11Number Of Grace Days
12---W1-00541UB1-12Special Program Indicator
13---W1-00542UB1-13PSRO/UR Approval Indicator
14---W1-00543UB1-14PSRO/UR Approved Stay-Fm
15---W1-00544UB1-15PSRO/UR Approved Stay-To
16---W5-00545UB1-16Occurrence
17---W1-00546UB1-17Occurrence Span
18---W1-00547UB1-18Occur Span Start Date
19---W1-00548UB1-19Occur Span End Date
20---W1-00549UB1-20UB-82 Locator 2
21---W1-00550UB1-21UB-82 Locator 9
22---W1-00551UB1-22UB-82 Locator 27
23---W1-00552UB1-23UB-82 Locator 45
5