UB2

Uniform Billing Data

The UB2 segment contains data necessary to complete UB92 bills specific to the United States. Realms outside the US are referred to chapter 16. Only Uniform Billing fields that do not exist in other HL7 defined segments appear in this segment. For example, Patient Name and Date of Birth are required; they are included in the PID segment and therefore do not appear here. Uniform Billing field locators are provided in parentheses ( ). The UB codes listed as examples are not an exhaustive or current list; refer to a UB specification for additional information.
17
C.LenElementv2.7
11..4-SIO1-00553UB2-1Set ID - UB2
21..3-STO1-00554UB2-2Co-Insurance Days (9)
3--CWEO7004300555UB2-3Condition Code (24-30)
41..3-STO1-00556UB2-4Covered Days (7)
51..4-STO1-00557UB2-5Non-Covered Days (8)
6--UVCO12-00558UB2-6Value Amount & Code (39-41)Name
7--OCDO8-00559UB2-7Occurrence Code & Date (32-35)
8--OSPO2-00560UB2-8Occurrence Span Code/Dates (36)
91..29-STO2-00561UB2-9Uniform Billing Locator 2 (state)Name
101..12-STO2-00562UB2-10Uniform Billing Locator 11 (state)Name
111..5-STO1-00563UB2-11Uniform Billing Locator 31 (national)Name
121..23-STO3-00564UB2-12Document Control Number
131..4-STO23-00565UB2-13Uniform Billing Locator 49 (national)Name
141..14-STO5-00566UB2-14Uniform Billing Locator 56 (state)Name
151..27-STO1-00567UB2-15Uniform Billing Locator 57 (sational)Name
161..2-STO2-00568UB2-16Uniform Billing Locator 78 (state)Name
171..3-NMO1-00815UB2-17Special Visit Count
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