Which Form Locator is used for provider name and address?

• A. Form Locator 1
• B. Form Locator 2
• C. Form Locator 3a
• D. Form Locator 4

Answer: (A)

Form Locators organize what data goes into each specific area of the UB-04 claim. The provider’s name and address are part of the header information that identifies who is submitting the claim, so it’s placed in the first locator. This location serves as the primary identifier for the Billing/Submitting provider, helping the payer quickly verify the submitter and route the claim appropriately. The other locators are assigned to different data elements (dates, patient details, service lines, payer information, etc.), so they aren’t used for recording the provider’s name and address.