A silver color metal and enamel device 1 1/8 inches (2.86 cm) in height consisting of six blue bars radiating from center, interlaced at top by an arced maroon scroll inscribed "FIRST IN" at left and "THE FIELD" on the right in silver letters and enclosed at bottom by a wreath of laurel in gold tones, overall a vertical silver kris with a red hilt surmounted by a silver chess knight charged with a red cross on its base.

Maroon and white/silver are colors associated with the Medical branch.  The kris, a weapon of Philippine-Pacific theatre, alludes to the location of the unit's World War II campaign participation credits.  The red sword hilt expresses action and combat readiness.  The gold laurel wreath represents high achievement and honor and also commemorates the award of the Philippine Presidential Unit Citation award.  The red cross highlights the medical mission of the hospital.  The chess knight embodies swift movement and multi-directional capabilities on the battlefield.  The six radiating bars (forming a stylized star) emphasize the far reaching effects and responsibilities of a field hospital.  Blue and white/silver have been adapted from the 99th Army Reserve Command shoulder sleeve insignia and allude to the unit's association with that organization.

The distinctive unit insignia was approved on 3 March 1989.