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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.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 Data 1
Base Framework | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Seq# | Data Element | Description | Flags | Implement | Cardinality | Length | C.LEN | Vocabulary | Data Type | |
UB1 | ||||||||||
1 | 00530 | Set ID - UB1 | W withdrawn Element | SHOULD NOT | SI Sequence ID | |||||
2 | 00531 | Blood Deductible | W withdrawn Element | SHOULD NOT | ||||||
3 | 00532 | Blood Furnished-Pints | W withdrawn Element | SHOULD NOT | ||||||
4 | 00533 | Blood Replaced-Pints | W withdrawn Element | SHOULD NOT | ||||||
5 | 00534 | Blood Not Replaced-Pints | W withdrawn Element | SHOULD NOT | ||||||
6 | 00535 | Co-Insurance Days | W withdrawn Element | SHOULD NOT | ||||||
7 | 00536 | Condition Code | W withdrawn Element | SHOULD NOT | ||||||
8 | 00537 | Covered Days | W withdrawn Element | SHOULD NOT | ||||||
9 | 00538 | Non Covered Days | W withdrawn Element | SHOULD NOT | ||||||
10 | 00539 | Value Amount & Code | W withdrawn Element | SHOULD NOT | ||||||
11 | 00540 | Number Of Grace Days | W withdrawn Element | SHOULD NOT | ||||||
12 | 00541 | Special Program Indicator | W withdrawn Element | SHOULD NOT | ||||||
13 | 00542 | PSRO/UR Approval Indicator | W withdrawn Element | SHOULD NOT | ||||||
14 | 00543 | PSRO/UR Approved Stay-Fm | W withdrawn Element | SHOULD NOT | ||||||
15 | 00544 | PSRO/UR Approved Stay-To | W withdrawn Element | SHOULD NOT | ||||||
16 | 00545 | Occurrence | W withdrawn Element | SHOULD NOT | ||||||
17 | 00546 | Occurrence Span | W withdrawn Element | SHOULD NOT | ||||||
18 | 00547 | Occur Span Start Date | W withdrawn Element | SHOULD NOT | ||||||
19 | 00548 | Occur Span End Date | W withdrawn Element | SHOULD NOT | ||||||
20 | 00549 | UB-82 Locator 2 | W withdrawn Element | SHOULD NOT | ||||||
21 | 00550 | UB-82 Locator 9 | W withdrawn Element | SHOULD NOT | ||||||
22 | 00551 | UB-82 Locator 27 | W withdrawn Element | SHOULD NOT | ||||||
23 | 00552 | UB-82 Locator 45 | W withdrawn Element | SHOULD NOT |
Seq# | Data Element | Description | Flags | Implement | Cardinality | Length | C.LEN | Vocabulary | Data Type | |
---|---|---|---|---|---|---|---|---|---|---|
UB1 | ||||||||||
1 | 00530 | Set ID - UB1 | W withdrawn Element | SHOULD NOT | SI Sequence ID | |||||
2 | 00531 | Blood Deductible | W withdrawn Element | SHOULD NOT | ||||||
3 | 00532 | Blood Furnished-Pints | W withdrawn Element | SHOULD NOT | ||||||
4 | 00533 | Blood Replaced-Pints | W withdrawn Element | SHOULD NOT | ||||||
5 | 00534 | Blood Not Replaced-Pints | W withdrawn Element | SHOULD NOT | ||||||
6 | 00535 | Co-Insurance Days | W withdrawn Element | SHOULD NOT | ||||||
7 | 00536 | Condition Code | W withdrawn Element | SHOULD NOT | ||||||
8 | 00537 | Covered Days | W withdrawn Element | SHOULD NOT | ||||||
9 | 00538 | Non Covered Days | W withdrawn Element | SHOULD NOT | ||||||
10 | 00539 | Value Amount & Code | W withdrawn Element | SHOULD NOT | ||||||
11 | 00540 | Number Of Grace Days | W withdrawn Element | SHOULD NOT | ||||||
12 | 00541 | Special Program Indicator | W withdrawn Element | SHOULD NOT | ||||||
13 | 00542 | PSRO/UR Approval Indicator | W withdrawn Element | SHOULD NOT | ||||||
14 | 00543 | PSRO/UR Approved Stay-Fm | W withdrawn Element | SHOULD NOT | ||||||
15 | 00544 | PSRO/UR Approved Stay-To | W withdrawn Element | SHOULD NOT | ||||||
16 | 00545 | Occurrence | W withdrawn Element | SHOULD NOT | ||||||
17 | 00546 | Occurrence Span | W withdrawn Element | SHOULD NOT | ||||||
18 | 00547 | Occur Span Start Date | W withdrawn Element | SHOULD NOT | ||||||
19 | 00548 | Occur Span End Date | W withdrawn Element | SHOULD NOT | ||||||
20 | 00549 | UB-82 Locator 2 | W withdrawn Element | SHOULD NOT | ||||||
21 | 00550 | UB-82 Locator 9 | W withdrawn Element | SHOULD NOT | ||||||
22 | 00551 | UB-82 Locator 27 | W withdrawn Element | SHOULD NOT | ||||||
23 | 00552 | UB-82 Locator 45 | W withdrawn Element | SHOULD NOT |
Base Framework | Base Standard Profile | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Seq# | Data Element | Description | Flags | Implement | Cardinality | Length | C.LEN | Vocabulary | Data Type | Implement | Vocabulary | |
UB1 | ||||||||||||
1 | 00530 | Set ID - UB1 | W withdrawn Element | SHOULD NOT | SI Sequence ID | SHOULD NOT | ||||||
2 | 00531 | Blood Deductible | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
3 | 00532 | Blood Furnished-Pints | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
4 | 00533 | Blood Replaced-Pints | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
5 | 00534 | Blood Not Replaced-Pints | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
6 | 00535 | Co-Insurance Days | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
7 | 00536 | Condition Code | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
8 | 00537 | Covered Days | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
9 | 00538 | Non Covered Days | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
10 | 00539 | Value Amount & Code | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
11 | 00540 | Number Of Grace Days | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
12 | 00541 | Special Program Indicator | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
13 | 00542 | PSRO/UR Approval Indicator | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
14 | 00543 | PSRO/UR Approved Stay-Fm | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
15 | 00544 | PSRO/UR Approved Stay-To | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
16 | 00545 | Occurrence | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
17 | 00546 | Occurrence Span | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
18 | 00547 | Occur Span Start Date | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
19 | 00548 | Occur Span End Date | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
20 | 00549 | UB-82 Locator 2 | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
21 | 00550 | UB-82 Locator 9 | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
22 | 00551 | UB-82 Locator 27 | W withdrawn Element | SHOULD NOT | SHOULD NOT | |||||||
23 | 00552 | UB-82 Locator 45 | W withdrawn Element | SHOULD NOT | SHOULD NOT |
Base Framework | Base Standard Profile | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Seq# | Data Element | Description | Flags | Optionality | Repetition | Length | C.LEN | Table | Data Type | Optionality | Table | |
UB1 | ||||||||||||
1 | 00530 | Set ID - UB1 | W | SI Sequence ID |
||||||||
2 | 00531 | Blood Deductible | W | |||||||||
3 | 00532 | Blood Furnished-Pints | W | |||||||||
4 | 00533 | Blood Replaced-Pints | W | |||||||||
5 | 00534 | Blood Not Replaced-Pints | W | |||||||||
6 | 00535 | Co-Insurance Days | W | |||||||||
7 | 00536 | Condition Code | W | Y/5 | ||||||||
8 | 00537 | Covered Days | W | |||||||||
9 | 00538 | Non Covered Days | W | |||||||||
10 | 00539 | Value Amount & Code | W | Y/8 | ||||||||
11 | 00540 | Number Of Grace Days | W | |||||||||
12 | 00541 | Special Program Indicator | W | |||||||||
13 | 00542 | PSRO/UR Approval Indicator | W | |||||||||
14 | 00543 | PSRO/UR Approved Stay-Fm | W | |||||||||
15 | 00544 | PSRO/UR Approved Stay-To | W | |||||||||
16 | 00545 | Occurrence | W | Y/5 | ||||||||
17 | 00546 | Occurrence Span | W | |||||||||
18 | 00547 | Occur Span Start Date | W | |||||||||
19 | 00548 | Occur Span End Date | W | |||||||||
20 | 00549 | UB-82 Locator 2 | W | |||||||||
21 | 00550 | UB-82 Locator 9 | W | |||||||||
22 | 00551 | UB-82 Locator 27 | W | |||||||||
23 | 00552 | UB-82 Locator 45 | W |
Seq# | Data Element | Description | Optionality | Repetition | Length | C.LEN | Table | Data Type | |
---|---|---|---|---|---|---|---|---|---|
UB1 | |||||||||
1 | 00530 | Set ID - UB1 | W | SI Sequence ID |
|||||
2 | 00531 | Blood Deductible | W | ||||||
3 | 00532 | Blood Furnished-Pints | W | ||||||
4 | 00533 | Blood Replaced-Pints | W | ||||||
5 | 00534 | Blood Not Replaced-Pints | W | ||||||
6 | 00535 | Co-Insurance Days | W | ||||||
7 | 00536 | Condition Code | W | Y/5 | |||||
8 | 00537 | Covered Days | W | ||||||
9 | 00538 | Non Covered Days | W | ||||||
10 | 00539 | Value Amount & Code | W | Y/8 | |||||
11 | 00540 | Number Of Grace Days | W | ||||||
12 | 00541 | Special Program Indicator | W | ||||||
13 | 00542 | PSRO/UR Approval Indicator | W | ||||||
14 | 00543 | PSRO/UR Approved Stay-Fm | W | ||||||
15 | 00544 | PSRO/UR Approved Stay-To | W | ||||||
16 | 00545 | Occurrence | W | Y/5 | |||||
17 | 00546 | Occurrence Span | W | ||||||
18 | 00547 | Occur Span Start Date | W | ||||||
19 | 00548 | Occur Span End Date | W | ||||||
20 | 00549 | UB-82 Locator 2 | W | ||||||
21 | 00550 | UB-82 Locator 9 | W | ||||||
22 | 00551 | UB-82 Locator 27 | W | ||||||
23 | 00552 | UB-82 Locator 45 | W |
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.