Form Locator 4 corresponds to which required data element?

• A. Type of Bill
• B. Provider name and address
• C. Birth date
• D. Payer ID

Answer: (A)

Form Locator numbers on UB-04 map to specific data elements needed for a claim. Form Locator 4 is the Type of Bill, which indicates the billing category of the claim (such as inpatient vs outpatient) and drives how the claim is processed, priced, and routed. This makes FL 4 the key data element that tells the payer what kind of claim is being submitted.

Other data elements like the provider name and address are part of the provider information section, not the bill type. The birth date is a patient demographic used for identification, not the billing category. The payer ID identifies who is paying, used for routing and adjudication, not for indicating the claim type.