Premera Blue Cross Three Character Prefixes

Last updated: 08/01/2019

The purpose of this list is to assist WA and AK providers determine plan submission based on the prefix and location of
the services. Use CTRL + F to locate prefix and submit claim according to these guidelines:

• Prefix Highlighted in Blue (Premera Blue Cross members)

o Western/Eastern WA and AK providers submit to Premera.
• Prefix not listed (BlueCard Host prefix)
o Western/Eastern WA and AK providers submit to Premera. (Clark County providers submit to Regence)

Prefix BCBS Plan Prefix BCBS Plan Prefix BCBS Plan

A2T Premera Blue Cross CKZ Premera Blue Cross GQJ Premera Blue Cross
A9P Premera Blue Cross CLR Premera Blue Cross GQL Premera Blue Cross
ACF Premera Blue Cross CAN Premera Blue Cross GTN Premera Blue Cross
AGL Premera Blue Cross/Shared CRS Premera Blue Cross GUJ Premera Blue Cross
Admin CTT Premera Blue Cross GVQ Premera Blue Cross
AHC Premera Blue Cross CTW Premera Blue Cross GVY Premera Blue Cross
AIQ Premera Blue Cross CXF Premera Blue Cross GWJ Premera Blue Cross
AJJ Premera Blue Cross CZJ Premera Blue Cross H3G Premera Blue Cross
AJX Premera Blue Cross DBH Premera Blue Cross HLC Premera Blue Cross
ALD Premera Blue Cross DEN Premera Blue Cross HLD Premera Blue Cross
ALK Premera Blue Cross DXK Premera Blue Cross HLU Premera Blue Cross
ALV Premera Blue Cross E3N Premera Blue Cross HMS Premera Blue Cross
AMK Premera Blue Cross E5X Premera Blue Cross HOP Premera Blue Cross
AQJ Premera Blue Cross EDM Premera Blue Cross HRK Premera Blue Cross
AQT Premera Blue Cross EGN Premera Blue Cross/Shared HRN Premera Blue Cross
AVL Premera Blue Cross Admin HRS Premera Blue Cross
AVN Premera Blue Cross EGZ Premera Blue Cross HSP Premera Blue Cross
AVV Premera Blue Cross EIQ Premera Blue Cross HTS Premera Blue Cross
AWB Premera Blue Cross EKN Premera Blue Cross HUL Premera Blue Cross
AWJ Premera Blue Cross EMY Premera Blue Cross HWY Premera Blue Cross/Shared
AYS Premera Blue Cross EOX Premera Blue Cross Admin
B3J Premera Blue Cross ERE Premera Blue Cross HXR Premera Blue Cross
BBC Premera Blue Cross ETE Premera Blue Cross HYA Premera Blue Cross
BBJ Premera Blue Cross EXD Premera Blue Cross HZJ Premera Blue Cross
BCC Premera Blue Cross EXZ Premera Blue Cross HZR Premera Blue Cross
BGS Premera Blue Cross EZD Premera Blue Cross HZU Premera Blue Cross
BKD Premera Blue Cross F2K Premera Blue Cross IEH Premera Blue Cross/Shared
BKH Premera Blue Cross F3B Premera Blue Cross/Shared Admin
BOR Premera Blue Cross Admin ILS Premera Blue Cross
BSR Premera Blue Cross FHU Premera Blue Cross INB Premera Blue Cross/Shared
BTG Premera Blue Cross FIT Premera Blue Cross/Shared Admin
BE Premera Blue Cross Admin ISB Premera Blue Cross
BZB Premera Blue Cross FKK Premera Blue Cross IUG Premera Blue Cross
BZK Premera Blue Cross FMR Premera Blue Cross IYN Premera Blue Cross
C2E Premera Blue Cross FOA Premera Blue Cross JCN Premera Blue Cross
C3D Premera Blue Cross FRJ Premera Blue Cross JED Premera Blue Cross
C4A Premera Blue Cross FSH Premera Blue Cross JNB Premera Blue Cross
C4R Premera Blue Cross FSR Premera Blue Cross JNQ Premera Blue Cross
CAQ Premera Blue Cross FZW Premera Blue Cross JSQ Premera Blue Cross
CAV Premera Blue Cross GDF Premera Blue Cross JTN Premera Blue Cross
CFX Premera Blue Cross GFU Premera Blue Cross JYG Premera Blue Cross
CIR Premera Blue Cross GHD Premera Blue Cross JYS Premera Blue Cross
CJJ Premera Blue Cross GOU Premera Blue Cross K2S Premera Blue Cross

An Independent Licensee of the Blue Cross Blue Shield Association

020469 (08-01-2019)
 Premera Blue Cross Three Character Prefixes
Last updated: 08/01/2019
The purpose of this list is to assist WA and AK providers determine plan submission based on the prefix and location of the
services. Use CTRL + F to locate prefix and submit claim according to these guidelines:

• Prefix Highlighted in Blue (Premera Blue Cross members)

o Western/Eastern WA and AK providers submit to Premera.
• Prefix not listed (BlueCard Host prefix)
o Western/Eastern WA and AK providers submit to Premera. (Clark County providers submit to Regence)

K3S Premera Blue Cross MSJ Premera Blue Cross OBJ Premera Blue Cross
KBR Premera Blue Cross MSP Premera Blue Cross OGM Premera Blue Cross
KCQ Premera Blue Cross MSQ Premera Blue Cross OLG Premera Blue Cross
KFY Premera Blue Cross MST Premera Blue Cross OVH Premera Blue Cross
KHS Premera Blue Cross MTD Premera Blue Cross/Shared OXM Premera Blue Cross
KLZ Premera Blue Cross Admin P3M Premera Blue Cross
KQK Premera Blue Cross MTU Premera Blue Cross/Shared P3T Premera Blue Cross
KQU Premera Blue Cross Admin P4T Premera Blue Cross
KTN Premera Blue Cross MUQ Premera Blue Cross PAZ Premera Blue Cross
KTQ Premera Blue Cross MVD Premera Blue Cross PBF Premera Blue Cross
KVS Premera Blue Cross MXZ Premera Blue Cross PBQ Premera Blue Cross/Shared
KXM Premera Blue Cross N2D Premera Blue Cross Admin
KXR Premera Blue Cross N3T Premera Blue Cross PBV Premera Blue Cross
L2S Premera Blue Cross N4S Premera Blue Cross PCM Premera Blue Cross
L3M Premera Blue Cross N8P Premera Blue Cross PEY Premera Blue Cross
L4D Premera Blue Cross NAY Premera Blue Cross PFP Premera Blue Cross
L4N Premera Blue Cross NCT Premera Blue Cross/Shared PKO Premera Blue Cross
L5N Premera Blue Cross Admin PMT Premera Blue Cross
L5T Premera Blue Cross NCW Premera Blue Cross PNC Premera Blue Cross
LBO Premera Blue Cross NCZ Premera Blue Cross PNQ Premera Blue Cross
LBR Premera Blue Cross NFK Premera Blue Cross PNT Premera Blue Cross
LEE Premera Blue Cross NFX Premera Blue Cross PON Premera Blue Cross
LIT Premera Blue Cross/Shared NLQ Premera Blue Cross PPB Premera Blue Cross
Admin NLX Premera Blue Cross PPS Premera Blue Cross/Shared
LIY Premera Blue Cross NLZ Premera Blue Cross Admin
LKG Premera Blue Cross NNQ Premera Blue Cross PQA Premera Blue Cross
LPS Premera Blue Cross NNT Premera Blue Cross PQH Premera Blue Cross
LQL Premera Blue Cross NNY Premera Blue Cross PQP Premera Blue Cross
LRR Premera Blue Cross NPW Premera Blue Cross PSU Premera Blue Cross
LUR Premera Blue Cross NQF Premera Blue Cross/Shared PUL Premera Blue Cross
LVN Premera Blue Cross Admin PUX Premera Blue Cross
LXZ Premera Blue Cross NQN Premera Blue Cross PXE Premera Blue Cross
LZY Premera Blue Cross NRB Premera Blue Cross PYF Premera Blue Cross
MAD Premera Blue Cross NRH Premera Blue Cross QAH Premera Blue Cross
MCE Premera Blue Cross NRL Premera Blue Cross QBV Premera Blue Cross
MGD Premera Blue Cross NRS Premera Blue Cross QEN Premera Blue Cross
MIN Premera Blue Cross NTF Premera Blue Cross QFP Premera Blue Cross
MJG Premera Blue Cross NUJ Premera Blue Cross QHR Premera Blue Cross
MKU Premera Blue Cross NVH Premera Blue Cross QHU Premera Blue Cross
MLY Premera Blue Cross NVU Premera Blue Cross QML Premera Blue Cross
MMD Premera Blue Cross NWB Premera Blue Cross QNT Premera Blue Cross
MNW Premera Blue Cross/Shared NWV Premera Blue Cross QSX Premera Blue Cross
Admin NXL Premera Blue Cross QSY Premera Blue Cross
MNY Premera Blue Cross NXW Premera Blue Cross/Shared QTH Premera Blue Cross
MOR Premera Blue Cross Admin QTV Premera Blue Cross
An Independent Licensee of the Blue Cross Blue Shield Association
020469 (08-01-2019)
 Premera Blue Cross Three Character Prefixes
Last updated: 08/01/2019
The purpose of this list is to assist WA and AK providers determine plan submission based on the prefix and location of the
services. Use CTRL + F to locate prefix and submit claim according to these guidelines:

• Prefix Highlighted in Blue (Premera Blue Cross members)

o Western/Eastern WA and AK providers submit to Premera.
• Prefix not listed (BlueCard Host prefix)
o Western/Eastern WA and AK providers submit to Premera. (Clark County providers submit to Regence)

R2C Premera Blue Cross TRG Premera Blue Cross WAF Premera Blue Cross
R2X Premera Blue Cross WAH Premera Blue Cross
R3D Premera Blue Cross TST Premera Blue Cross/Shared WAX Premera Blue Cross
R3W Premera Blue Cross/Shared Admin WAZ Premera Blue Cross
Admin TSU Premera Blue Cross WBJ Premera Blue Cross
R4D Premera Blue Cross TXP Premera Blue Cross WCL Premera Blue Cross
RGJ Premera Blue Cross TYA Premera Blue Cross WFT Premera Blue Cross
RHL Premera Blue Cross TZS Premera Blue Cross WFX Premera Blue Cross
RMQ Premera Blue Cross UCB Premera Blue Cross WGA Premera Blue Cross
RMS Premera Blue Cross UDA Premera Blue Cross WIH Premera Blue Cross/Shared
RPM Premera Blue Cross UDV Premera Blue Cross Admin
RQZ Premera Blue Cross UIM Premera Blue Cross WJA Premera Blue Cross
RUJ Premera Blue Cross UIV Premera Blue Cross WKL Premera Blue Cross
RVR Premera Blue Cross UJD Premera Blue Cross WLJ Premera Blue Cross
RZG Premera Blue Cross UKQ Premera Blue Cross WNE Premera Blue Cross
S3G Premera Blue Cross ULD Premera Blue Cross WOB Premera Blue Cross
S4A Premera Blue Cross UMR Premera Blue Cross WOW Premera Blue Cross
S4C Premera Blue Cross UMX Premera Blue Cross/Shared WTC Premera Blue Cross
S4E Premera Blue Cross Admin WTT Premera Blue Cross
S4V Premera Blue Cross/Shared UMZ Premera Blue Cross WTU Premera Blue Cross
Admin UNN Premera Blue Cross WTV Premera Blue Cross
SBU Premera Blue Cross UOH Premera Blue Cross WWI Premera Blue Cross
SCL Premera Blue Cross UPJ Premera Blue Cross WYP Premera Blue Cross
SEA Premera Blue Cross UXS Premera Blue Cross WZH Premera Blue Cross
SKO Premera Blue Cross V6Y Premera Blue Cross XHT Premera Blue Cross
SLH Premera Blue Cross VCN Premera Blue Cross XKH Premera Blue Cross
SQN Premera Blue Cross VDG Premera Blue Cross XWT Premera Blue Cross
SRU Premera Blue Cross VEN Premera Blue Cross XVD Premera Blue Cross
SSZ Premera Blue Cross VFK Premera Blue Cross YDW Premera Blue Cross
STJ Premera Blue Cross/Shared VFN Premera Blue Cross YMJ Premera Blue Cross
Admin VKD Premera Blue Cross YMK Premera Blue Cross
SVC Premera Blue Cross VKH Premera Blue Cross YML Premera Blue Cross
SYZ Premera Blue Cross VLG Premera Blue Cross YMX Premera Blue Cross
SZR Premera Blue Cross VMT Premera Blue Cross YNT Premera Blue Cross
SZX Premera Blue Cross VMU Premera Blue Cross YOR Premera Blue Cross
T8R Premera Blue Cross VQI Premera Blue Cross YSJ Premera Blue Cross/Shared
TAH Premera Blue Cross VRO Premera Blue Cross Admin
TAP Premera Blue Cross/Shared VSY Premera Blue Cross YSL Premera Blue Cross
Admin VUK Premera Blue Cross ZFF Premera Blue Cross/Shared
TDT Premera Blue Cross W3H Premera Blue Cross/Shared Admin
TKD Premera Blue Cross Admin ZKA Premera Blue Cross
TMP Premera Blue Cross/Shared W3K Premera Blue Cross ZKB Premera Blue Cross
Admin W4T Premera Blue Cross ZKC Premera Blue Cross
TQA Premera Blue Cross/Shared W5H Premera Blue Cross ZKD Premera Blue Cross
Admin W5T Premera Blue Cross ZKE Premera Blue Cross
An Independent Licensee of the Blue Cross Blue Shield Association
020469 (08-01-2019)
 Premera Blue Cross Three Character Prefixes
Last updated: 08/01/2019
The purpose of this list is to assist WA and AK providers determine plan submission based on the prefix and location of the
services. Use CTRL + F to locate prefix and submit claim according to these guidelines:

• Prefix Highlighted in Blue (Premera Blue Cross members)

o Western/Eastern WA and AK providers submit to Premera.
• Prefix not listed (BlueCard Host prefix)
o Western/Eastern WA and AK providers submit to Premera. (Clark County providers submit to Regence)

ZKF Premera Blue Cross ZKV Premera Blue Cross ZRK Premera Blue Cross
ZKG Premera Blue Cross ZKX Premera Blue Cross ZRL Premera Blue Cross
ZKH Premera Blue Cross ZKY Premera Blue Cross ZXJ Premera Blue Cross
ZKI Premera Blue Cross ZKZ Premera Blue Cross ZXL Premera Blue Cross
ZKJ Premera Blue Cross ZNA Premera Blue Cross ZXN Premera Blue Cross
ZKK Premera Blue Cross ZNB Premera Blue Cross ZXU Premera Blue Cross
ZKL Premera Blue Cross ZNC Premera Blue Cross ZXZ Premera Blue Cross
ZKM Premera Blue Cross ZNJ Premera Blue Cross ZZM Premera Blue Cross
ZKN Premera Blue Cross ZNK Premera Blue Cross ZZN Premera Blue Cross
ZKP Premera Blue Cross ZNN Premera Blue Cross ZZP Premera Blue Cross
ZKQ Premera Blue Cross ZNP Premera Blue Cross ZZQ Premera Blue Cross
ZKR Premera Blue Cross ZNQ Premera Blue Cross ZZR Premera Blue Cross
ZKS Premera Blue Cross ZNW Premera Blue Cross ZZV Premera Blue Cross
ZKT Premera Blue Cross ZNY Premera Blue Cross ZZW Premera Blue Cross
ZKU Premera Blue Cross ZNZ Premera Blue Cross ZZY Premera Blue Cross

An Independent Licensee of the Blue Cross Blue Shield Association

020469 (08-01-2019)