UB1 - Uniform Billing 1 Segment

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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.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 1 Segment

Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
UB1
1	Set ID - UB1	SI	W		[0..1]	00530
2	Blood Deductible		W		[0..1]	00531
3	Blood Furnished-Pints		W		[0..1]	00532
4	Blood Replaced-Pints		W		[0..1]	00533
5	Blood Not Replaced-Pints		W		[0..1]	00534
6	Co-Insurance Days		W		[0..1]	00535
7	Condition Code		W		[0..5]	00536
8	Covered Days		W		[0..1]	00537
9	Non Covered Days		W		[0..1]	00538
10	Value Amount & Code		W		[0..8]	00539
11	Number Of Grace Days		W		[0..1]	00540
12	Special Program Indicator		W		[0..1]	00541
13	PSRO/UR Approval Indicator		W		[0..1]	00542
14	PSRO/UR Approved Stay-Fm		W		[0..1]	00543
15	PSRO/UR Approved Stay-To		W		[0..1]	00544
16	Occurrence		W		[0..5]	00545
17	Occurrence Span		W		[0..1]	00546
18	Occur Span Start Date		W		[0..1]	00547
19	Occur Span End Date		W		[0..1]	00548
20	UB-82 Locator 2		W		[0..1]	00549
21	UB-82 Locator 9		W		[0..1]	00550
22	UB-82 Locator 27		W		[0..1]	00551
23	UB-82 Locator 45		W		[0..1]	00552

UB1-1: Set ID - UB1 (SI) 00530

Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-2: Blood Deductible () 00531

Attention: UB1-2 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-3: Blood Furnished-Pints () 00532

Attention: UB1-3 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-4: Blood Replaced-Pints () 00533

Attention: UB1-4 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-5: Blood Not Replaced-Pints () 00534

Attention: UB1-5 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-6: Co-Insurance Days () 00535

Attention: UB1-6 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-7: Condition Code () 00536

Attention: UB1-7 was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

UB1-8: Covered Days () 00537

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.

UB1-9: Non Covered Days () 00538

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.

UB1-10: Value Amount & Code () 00539

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.

UB1-11: Number Of Grace Days () 00540

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.

UB1-12: Special Program Indicator () 00541

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.

UB1-13: PSRO/UR Approval Indicator () 00542

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.

UB1-14: PSRO/UR Approved Stay-Fm () 00543

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.

UB1-15: PSRO/UR Approved Stay-To () 00544

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.

UB1-16: Occurrence () 00545

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.

UB1-17: Occurrence Span () 00546

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.

UB1-18: Occur Span Start Date () 00547

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.

UB1-19: Occur Span End Date () 00548

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.

UB1-20: UB-82 Locator 2 () 00549

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.

UB1-21: UB-82 Locator 9 () 00550

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.

UB1-22: UB-82 Locator 27 () 00551

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.

UB1-23: UB-82 Locator 45 () 00552

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.