UB04 Field 1: Rendering Provider Name and Address

Introduction

UB-04 Field 1 (also known as Box 1) is used to identify the Rendering Provider Name and Address. This field is a critical component of the institutional claim form, ensuring that the payer can identify the physical location and contact information of the facility or provider providing the services.

Requirements

Requirement Type	Status
Inpatient Requirement	Required
Outpatient Requirement	Required
Data Elements	Provider Name, Street Address, City, State, Zip Code, and Telephone Number

Billing Tips

When completing Box 1, ensure the provider name and address match the information on file with the payer and the National Plan and Provider Enumeration System (NPPES). Enter the provider name, address, zip code, and telephone number clearly to avoid claim rejections related to provider identification.