UBD-F Sample of other form locator data elements TOB	
facility type	Bill Classification	Bill frequency 
110	Hospital Inpatient Nonpayment/Zero Claim 
111	Hospital Inpatient	Admit-Through-Discharge Claim 
112	Hospital Inpatient	Interim--First Claim 
113	Hospital Inpatient	Interim--Continuing Claim 
114	Hospital Inpatient	Interim--Last Claim 
116	Hospital Inpatient Adjustment Of Prior Claim 
117	Hospital Inpatient	Replacement Of Prior Claim 
118	Hospital Inpatient	Void/Cancel Of A Prior Claim 
120	Hospital Inpatient Medicare Part B Only	Nonpayment/Zero Claim 
121	Hospital Inpatient Medicare Part B Only	Admit-Through-Discharge Claim 
122	Hospital Inpatient Medicare Part B Only	Interim--First Claim 
123	Hospital Inpatient Medicare Part B Only	Interim--Continuing Claim 
124	Hospital Inpatient Medicare Part B Only	Interim--Last Claim 
126	Hospital Inpatient Medicare Part B Only	Adjustment Of Prior Claim 
127	Hospital Inpatient Medicare Part B Only	Replacement Of Prior Claim 
128	Hospital Inpatient Medicare Part B Only	Void/Cancel Of A Prior Claim