Item | DT | Card | Conf | Description | Label |
---|
hl7v2:UB1.1
| SI | 0 … 1 | | Set ID - UB1 | UB1_ment |
@Item
| | 0 … 1 | F | 530 |
@Type
| | 0 … 1 | F | SI |
@LongName
| | 0 … 1 | F | Set ID - UB1 |
hl7v2:UB1.2
| NM | 0 … 1 | | Blood Deductible (43) | UB1_ment |
@Item
| | 0 … 1 | F | 531 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Blood Deductible (43) |
hl7v2:UB1.3
| NM | 0 … 1 | | Blood Furnished-Pints Of (40) | UB1_ment |
@Item
| | 0 … 1 | F | 532 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Blood Furnished-Pints Of (40) |
hl7v2:UB1.4
| NM | 0 … 1 | | Blood Replaced-Pints (41) | UB1_ment |
@Item
| | 0 … 1 | F | 533 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Blood Replaced-Pints (41) |
hl7v2:UB1.5
| NM | 0 … 1 | | Blood Not Replaced-Pints(42) | UB1_ment |
@Item
| | 0 … 1 | F | 534 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Blood Not Replaced-Pints(42) |
hl7v2:UB1.6
| NM | 0 … 1 | | Co-Insurance Days (25) | UB1_ment |
@Item
| | 0 … 1 | F | 535 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Co-Insurance Days (25) |
hl7v2:UB1.7
| IS | 0 … * | | Condition Code (35-39) | UB1_ment |
@Item
| | 0 … 1 | F | 536 |
@Type
| | 0 … 1 | F | IS |
@Table
| | 0 … 1 | F | HL70043 |
@LongName
| | 0 … 1 | F | Condition Code (35-39) |
hl7v2:UB1.8
| NM | 0 … 1 | | Covered Days - (23) | UB1_ment |
@Item
| | 0 … 1 | F | 537 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Covered Days - (23) |
hl7v2:UB1.9
| NM | 0 … 1 | | Non Covered Days - (24) | UB1_ment |
@Item
| | 0 … 1 | F | 538 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Non Covered Days - (24) |
hl7v2:UB1.10
| UVC | 0 … * | | Value Amount & Code (46-49) Contains 2.16.840.1.113883.3.1937.99.60.4.15.66 (DYNAMIC) | UB1_ment |
@Item
| | 0 … 1 | F | 539 |
@Type
| | 0 … 1 | F | UVC |
@LongName
| | 0 … 1 | F | Value Amount & Code (46-49) |
hl7v2:UB1.11
| NM | 0 … 1 | | Number Of Grace Days (90) | UB1_ment |
@Item
| | 0 … 1 | F | 540 |
@Type
| | 0 … 1 | F | NM |
@LongName
| | 0 … 1 | F | Number Of Grace Days (90) |
hl7v2:UB1.12
| CE | 0 … 1 | | Special Program Indicator (44) Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | UB1_ment |
@Item
| | 0 … 1 | F | 541 |
@Type
| | 0 … 1 | F | CE |
@Table
| | 0 … 1 | F | HL70348 |
@LongName
| | 0 … 1 | F | Special Program Indicator (44) |
hl7v2:UB1.13
| CE | 0 … 1 | | PSRO/UR Approval Indicator (87) Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | UB1_ment |
@Item
| | 0 … 1 | F | 542 |
@Type
| | 0 … 1 | F | CE |
@Table
| | 0 … 1 | F | HL70349 |
@LongName
| | 0 … 1 | F | PSRO/UR Approval Indicator (87) |
hl7v2:UB1.14
| DT | 0 … 1 | | PSRO/UR Approved Stay-Fm (88) | UB1_ment |
@Item
| | 0 … 1 | F | 543 |
@Type
| | 0 … 1 | F | DT |
@LongName
| | 0 … 1 | F | PSRO/UR Approved Stay-Fm (88) |
hl7v2:UB1.15
| DT | 0 … 1 | | PSRO/UR Approved Stay-To (89) | UB1_ment |
@Item
| | 0 … 1 | F | 544 |
@Type
| | 0 … 1 | F | DT |
@LongName
| | 0 … 1 | F | PSRO/UR Approved Stay-To (89) |
hl7v2:UB1.16
| OCD | 0 … * | | Occurrence (28-32) Contains 2.16.840.1.113883.3.1937.99.60.4.15.40 (DYNAMIC) | UB1_ment |
@Item
| | 0 … 1 | F | 545 |
@Type
| | 0 … 1 | F | OCD |
@LongName
| | 0 … 1 | F | Occurrence (28-32) |
hl7v2:UB1.17
| CE | 0 … 1 | | Occurrence Span (33) Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | UB1_ment |
@Item
| | 0 … 1 | F | 546 |
@Type
| | 0 … 1 | F | CE |
@Table
| | 0 … 1 | F | HL70351 |
@LongName
| | 0 … 1 | F | Occurrence Span (33) |
hl7v2:UB1.18
| DT | 0 … 1 | | Occur Span Start Date(33) | UB1_ment |
@Item
| | 0 … 1 | F | 547 |
@Type
| | 0 … 1 | F | DT |
@LongName
| | 0 … 1 | F | Occur Span Start Date(33) |
hl7v2:UB1.19
| DT | 0 … 1 | | Occur Span End Date (33) | UB1_ment |
@Item
| | 0 … 1 | F | 548 |
@Type
| | 0 … 1 | F | DT |
@LongName
| | 0 … 1 | F | Occur Span End Date (33) |
hl7v2:UB1.20
| ST | 0 … 1 | | UB-82 Locator 2 | UB1_ment |
@Item
| | 0 … 1 | F | 549 |
@Type
| | 0 … 1 | F | ST |
@LongName
| | 0 … 1 | F | UB-82 Locator 2 |
hl7v2:UB1.21
| ST | 0 … 1 | | UB-82 Locator 9 | UB1_ment |
@Item
| | 0 … 1 | F | 550 |
@Type
| | 0 … 1 | F | ST |
@LongName
| | 0 … 1 | F | UB-82 Locator 9 |
hl7v2:UB1.22
| ST | 0 … 1 | | UB-82 Locator 27 | UB1_ment |
@Item
| | 0 … 1 | F | 551 |
@Type
| | 0 … 1 | F | ST |
@LongName
| | 0 … 1 | F | UB-82 Locator 27 |
hl7v2:UB1.23
| ST | 0 … 1 | | UB-82 Locator 45 | UB1_ment |
@Item
| | 0 … 1 | F | 552 |
@Type
| | 0 … 1 | F | ST |
@LongName
| | 0 … 1 | F | UB-82 Locator 45 |