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18.8.180 UB1 - Uniform Billing 1 Segment (6.5.10)

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Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.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 ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
UB1
100530Set ID - UB1
W

withdrawn Element

SHOULD NOT  
SI

Sequence ID

200531Blood Deductible
W

withdrawn Element

SHOULD NOT   
300532Blood Furnished-Pints
W

withdrawn Element

SHOULD NOT   
400533Blood Replaced-Pints
W

withdrawn Element

SHOULD NOT   
500534Blood Not Replaced-Pints
W

withdrawn Element

SHOULD NOT   
600535Co-Insurance Days
W

withdrawn Element

SHOULD NOT   
700536Condition Code
W

withdrawn Element

SHOULD NOT   
800537Covered Days
W

withdrawn Element

SHOULD NOT   
900538Non Covered Days
W

withdrawn Element

SHOULD NOT   
1000539Value Amount & Code
W

withdrawn Element

SHOULD NOT   
1100540Number Of Grace Days
W

withdrawn Element

SHOULD NOT   
1200541Special Program Indicator
W

withdrawn Element

SHOULD NOT   
1300542PSRO/UR Approval Indicator
W

withdrawn Element

SHOULD NOT   
1400543PSRO/UR Approved Stay-Fm
W

withdrawn Element

SHOULD NOT   
1500544PSRO/UR Approved Stay-To
W

withdrawn Element

SHOULD NOT   
1600545Occurrence
W

withdrawn Element

SHOULD NOT   
1700546Occurrence Span
W

withdrawn Element

SHOULD NOT   
1800547Occur Span Start Date
W

withdrawn Element

SHOULD NOT   
1900548Occur Span End Date
W

withdrawn Element

SHOULD NOT   
2000549UB-82 Locator 2
W

withdrawn Element

SHOULD NOT   
2100550UB-82 Locator 9
W

withdrawn Element

SHOULD NOT   
2200551UB-82 Locator 27
W

withdrawn Element

SHOULD NOT   
2300552UB-82 Locator 45
W

withdrawn Element

SHOULD NOT   
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
UB1
100530Set ID - UB1
W

withdrawn Element

SHOULD NOT  
SI

Sequence ID

200531Blood Deductible
W

withdrawn Element

SHOULD NOT   
300532Blood Furnished-Pints
W

withdrawn Element

SHOULD NOT   
400533Blood Replaced-Pints
W

withdrawn Element

SHOULD NOT   
500534Blood Not Replaced-Pints
W

withdrawn Element

SHOULD NOT   
600535Co-Insurance Days
W

withdrawn Element

SHOULD NOT   
700536Condition Code
W

withdrawn Element

SHOULD NOT   
800537Covered Days
W

withdrawn Element

SHOULD NOT   
900538Non Covered Days
W

withdrawn Element

SHOULD NOT   
1000539Value Amount & Code
W

withdrawn Element

SHOULD NOT   
1100540Number Of Grace Days
W

withdrawn Element

SHOULD NOT   
1200541Special Program Indicator
W

withdrawn Element

SHOULD NOT   
1300542PSRO/UR Approval Indicator
W

withdrawn Element

SHOULD NOT   
1400543PSRO/UR Approved Stay-Fm
W

withdrawn Element

SHOULD NOT   
1500544PSRO/UR Approved Stay-To
W

withdrawn Element

SHOULD NOT   
1600545Occurrence
W

withdrawn Element

SHOULD NOT   
1700546Occurrence Span
W

withdrawn Element

SHOULD NOT   
1800547Occur Span Start Date
W

withdrawn Element

SHOULD NOT   
1900548Occur Span End Date
W

withdrawn Element

SHOULD NOT   
2000549UB-82 Locator 2
W

withdrawn Element

SHOULD NOT   
2100550UB-82 Locator 9
W

withdrawn Element

SHOULD NOT   
2200551UB-82 Locator 27
W

withdrawn Element

SHOULD NOT   
2300552UB-82 Locator 45
W

withdrawn Element

SHOULD NOT   
Base FrameworkBase Standard Profile
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData TypeImplementVocabulary
UB1 
100530Set ID - UB1
W

withdrawn Element

SHOULD NOT  
SI

Sequence ID

SHOULD NOT
200531Blood Deductible
W

withdrawn Element

SHOULD NOT   SHOULD NOT
300532Blood Furnished-Pints
W

withdrawn Element

SHOULD NOT   SHOULD NOT
400533Blood Replaced-Pints
W

withdrawn Element

SHOULD NOT   SHOULD NOT
500534Blood Not Replaced-Pints
W

withdrawn Element

SHOULD NOT   SHOULD NOT
600535Co-Insurance Days
W

withdrawn Element

SHOULD NOT   SHOULD NOT
700536Condition Code
W

withdrawn Element

SHOULD NOT   SHOULD NOT
800537Covered Days
W

withdrawn Element

SHOULD NOT   SHOULD NOT
900538Non Covered Days
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1000539Value Amount & Code
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1100540Number Of Grace Days
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1200541Special Program Indicator
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1300542PSRO/UR Approval Indicator
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1400543PSRO/UR Approved Stay-Fm
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1500544PSRO/UR Approved Stay-To
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1600545Occurrence
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1700546Occurrence Span
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1800547Occur Span Start Date
W

withdrawn Element

SHOULD NOT   SHOULD NOT
1900548Occur Span End Date
W

withdrawn Element

SHOULD NOT   SHOULD NOT
2000549UB-82 Locator 2
W

withdrawn Element

SHOULD NOT   SHOULD NOT
2100550UB-82 Locator 9
W

withdrawn Element

SHOULD NOT   SHOULD NOT
2200551UB-82 Locator 27
W

withdrawn Element

SHOULD NOT   SHOULD NOT
2300552UB-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        

18.8.180.1 UB1 Field Definitions (6.5.10.0)

18.8.180.2 UB1-1 Set ID - UB1 00530 (6.5.10.1)

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.

18.8.180.3 UB1-2 Blood Deductible 00531 (6.5.10.2)

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.

18.8.180.4 UB1-3 Blood Furnished-Pints 00532 (6.5.10.3)

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.

18.8.180.5 UB1-4 Blood Replaced-Pints 00533 (6.5.10.4)

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.

18.8.180.6 UB1-5 Blood Not Replaced-Pints 00534 (6.5.10.5)

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.

18.8.180.7 UB1-6 Co-insurance Days 00535 (6.5.10.6)

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.

18.8.180.8 UB1-7 Condition Code 00536 (6.5.10.7)

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.

18.8.180.9 UB1-8 Covered Days 00537 (6.5.10.8)

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.

18.8.180.10 UB1-9 Non-Covered Days 00538 (6.5.10.9)

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.

18.8.180.11 UB1-10 Value Amount & Code 00539 (6.5.10.10)

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.

18.8.180.12 UB1-11 Number of Grace Days 00540 (6.5.10.11)

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.

18.8.180.13 UB1-12 Special Program Indicator 00541 (6.5.10.12)

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.

18.8.180.14 UB1-13 PSRO/UR Approval Indicator 00542 (6.5.10.13)

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.

18.8.180.15 UB1-14 PSRO/UR Approved Stay-Fm 00543 (6.5.10.14)

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.

18.8.180.16 UB1-15 PSRO/UR Approved Stay-To 00544 (6.5.10.15)

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.

18.8.180.17 UB1-16 Occurrence 00545 (6.5.10.16)

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.

18.8.180.18 UB1-17 Occurrence Span 00546 (6.5.10.17)

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.

18.8.180.19 UB1-18 Occur Span Start Date 00547 (6.5.10.18)

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.

18.8.180.20 UB1-19 Occur Span End Date 00548 (6.5.10.19)

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.

18.8.180.21 UB1-20 UB-82 Locator 2 00549 (6.5.10.20)

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.

18.8.180.22 UB1-21 UB-82 Locator 9 00550 (6.5.10.21)

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.

18.8.180.23 UB1-22 UB-82 Locator 27 00551 (6.5.10.22)

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.

18.8.180.24 UB1-23 UB-82 Locator 45 00552 (6.5.10.23)

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.