Qualifier List
0B – State License Number
1A – Blue Cross Provider Number
1B – Blue Shield Provider Number
1C – Medicare Provider Number
1D – Medicaid Provider Number
1G – Provider UPIN Number
1H – Campus Identification Number
1J – Facility ID Number
B3 – Preferred Provider Organization Number BQ – Health Maintenance Organization Code Number EI – Employer’s Identification Number FH – Clinic Number
G2 – Provider Commercial Number
G5 – Provider Site Number
LU – Location Number
SY – Social Security Number
U3 – Unique Supplier Identification Number
X5 – State Industrial Accident Provider Number
This information is typed into the PINS field (under Insurance).
