| Seq |
Description |
German Interpretation |
Length |
C.LEN |
Table |
r/o/c |
Rep# |
Item |
Data Structure |
Section |
| 1 |
Set ID - UB92 |
(Segment UB2 wird nicht verwendet) |
..4 |
|
|
|
|
00553 |
SI |
|
| 2 |
Co-insurance days (9) |
nicht verwendet |
..3 |
|
|
|
|
00554 |
ST |
|
| 3 |
Condition code (24-30) |
nicht verwendet |
..2 |
|
0043 |
|
Y/7 |
00555 |
ID |
|
| 4 |
Covered days (7) |
nicht verwendet |
..3 |
|
|
|
|
00556 |
ST |
|
| 5 |
Non-covered days (8) |
nicht verwendet |
..4 |
|
|
|
|
00557 |
ST |
|
| 6 |
Value amount and code (39-41) |
nicht verwendet |
..11 |
|
|
|
Y/12 |
00558 |
CM_UVC |
|
| 7 |
Occurrence code and date (32-35) |
nicht verwendet |
..11 |
|
|
|
Y/8 |
00559 |
CM_OCD |
|
| 8 |
Occurrence span code / dates (36) |
nicht verwendet |
..28 |
|
|
|
Y/2 |
00560 |
CM_OSP |
|
| 9 |
UB92 locator 2 (state) |
nicht verwendet |
..29 |
|
|
|
Y/2 |
00561 |
ST |
|
| 10 |
UB92 locator 11 (state) |
nicht verwendet |
..12 |
|
|
|
Y/2 |
00562 |
ST |
|
| 11 |
UB92 locator 31 (national) |
nicht verwendet |
..5 |
|
|
|
|
00563 |
ST |
|
| 12 |
Document control number (37) |
nicht verwendet |
..23 |
|
|
|
Y/3 |
00564 |
ST |
|
| 13 |
UB92 locator 49 (national) |
nicht verwendet |
..4 |
|
|
|
Y/23 |
00565 |
ST |
|
| 14 |
UB92 locator 56 (state) |
nicht verwendet |
..14 |
|
|
|
Y/5 |
00566 |
ST |
|
| 15 |
UB92 locator 57 (national) |
nicht verwendet |
..27 |
|
|
|
|
00567 |
ST |
|
| 16 |
UB92 Locator 78 (state) |
nicht verwendet |
..2 |
|
|
|
Y/2 |
00568 |
ST |
|