Sequential Number: 1
Description: Set ID - UB2
Data Type: SI
Item ID: 553
Sequential Number: 2
Description: Co-Insurance Days (9)
Data Type: ST
Item ID: 554
UB2.3_Condition_Code_24-30_Sequential Number: 3
Description: Condition Code (24-30)
Data Type: CWE
Item ID: 555
Table: 0043
Sequential Number: 4
Description: Covered Days (7)
Data Type: ST
Item ID: 556
Sequential Number: 5
Description: Non-Covered Days (8)
Data Type: ST
Item ID: 557
UB2.6_Value_Amount__Code_39-41_Sequential Number: 6
Description: Value Amount & Code (39-41)
Data Type: UVC
Item ID: 558
UB2.7_Occurrence_Code__Date_32-35_Sequential Number: 7
Description: Occurrence Code & Date (32-35)
Data Type: OCD
Item ID: 559
UB2.8_Occurrence_Span_Code_Dates_36_Sequential Number: 8
Description: Occurrence Span Code/Dates (36)
Data Type: OSP
Item ID: 560
UB2.9_Uniform_Billing_Locator_2_state_Sequential Number: 9
Description: Uniform Billing Locator 2 (state)
Data Type: ST
Item ID: 561
UB2.10_Uniform_Billing_Locator_11_state_Sequential Number: 10
Description: Uniform Billing Locator 11 (state)
Data Type: ST
Item ID: 562
Sequential Number: 11
Description: Uniform Billing Locator 31 (national)
Data Type: ST
Item ID: 563
UB2.12_Document_Control_NumberSequential Number: 12
Description: Document Control Number
Data Type: ST
Item ID: 564
UB2.13_Uniform_Billing_Locator_49_national_Sequential Number: 13
Description: Uniform Billing Locator 49 (national)
Data Type: ST
Item ID: 565
UB2.14_Uniform_Billing_Locator_56_state_Sequential Number: 14
Description: Uniform Billing Locator 56 (state)
Data Type: ST
Item ID: 566
Sequential Number: 15
Description: Uniform Billing Locator 57 (sational)
Data Type: ST
Item ID: 567
UB2.16_Uniform_Billing_Locator_78_state_Sequential Number: 16
Description: Uniform Billing Locator 78 (state)
Data Type: ST
Item ID: 568
Sequential Number: 17
Description: Special Visit Count
Data Type: NM
Item ID: 815
any