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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.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 | |
![]() | ||||||||||
![]() ![]() | 1 | 00530 | Set ID - UB1 | W withdrawn Element | SHOULD NOT | SI Sequence ID | ||||
![]() ![]() | 2 | 00531 | Blood Deductible | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 3 | 00532 | Blood Furnished-Pints | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 4 | 00533 | Blood Replaced-Pints | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 5 | 00534 | Blood Not Replaced-Pints | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 6 | 00535 | Co-Insurance Days | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 7 | 00536 | Condition Code | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 8 | 00537 | Covered Days | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 9 | 00538 | Non Covered Days | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 10 | 00539 | Value Amount & Code | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 11 | 00540 | Number Of Grace Days | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 12 | 00541 | Special Program Indicator | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 13 | 00542 | PSRO/UR Approval Indicator | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 14 | 00543 | PSRO/UR Approved Stay-Fm | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 15 | 00544 | PSRO/UR Approved Stay-To | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 16 | 00545 | Occurrence | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 17 | 00546 | Occurrence Span | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 18 | 00547 | Occur Span Start Date | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 19 | 00548 | Occur Span End Date | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 20 | 00549 | UB-82 Locator 2 | W withdrawn Element | SHOULD NOT | |||||
![]() ![]() | 21 | 00550 | UB-82 Locator 9 | W withdrawn Element | SHOULD NOT | |||||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 | |
---|---|---|---|---|---|---|---|---|---|---|
![]() | ||||||||||
![]() ![]() | 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 | |
![]() | ||||||||||||
![]() ![]() | 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 | |
![]() |
||||||||||||
![]() ![]() |
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 | |
---|---|---|---|---|---|---|---|---|---|
![]() |
|||||||||
![]() ![]() |
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.