ERS Extended Day Supply (EDS) network list of participating pharmacies (List updated November 30, 2018)

Participating pharmacy retail chains ABS LLC SO CAL AND IMW (Safeway) City Market Inc (Kroger) Includes: , Osco, Safeway and 1-800-576-4377 Sav On pharmacies CVS Pharmacy in Target 1-800-723-3929 Includes: CVS Pharmacy and Longs Drugs Albertsons LLC 1-800-746-7287 Includes: Albertsons, Osco, Safeway, CVS Pharmacy Inc Sav On and Tom Thumb pharmacies Includes: Carecenter Pharmacy, Careplus CVS/ 1-800-723-3929 Pharmacy, CVS Pharmacy, Waterman Village Arete Pharmacy Network Pharmacy and Wellness Works Pharmacy 1-800-800-2988 1-800-746-7287 Arete Pharmacy Network (426) Dillon Stores (Kroger) 1-800-800-2988 Includes: Bakers, Dillon, Gerbes, and Arete Pharmacy Network (678) King Soopers pharmacies 1-800-800-2988 1-800-576-4377 Arete Pharmacy Network (783) E-MedRX Solutions 1-800-800-2988 1-217-697-5533 Brookshire Bros Inc Elevate Provider Network Includes: B and B Pharmacy and 1-888-880-1388 Brookshire Brothers Pharmacy EPIC Pharmacy Network Inc 1-888-937-3776 1-800-965-3742 Brookshire Grocery Company Fred Meyer Inc (Kroger) Includes: Brookshires Pharmacy and 1-800-576-4377 Super 1 Pharmacy Frys Food and Drug Stores (Kroger) 1-800-825-9166 1-800-576-4377 Carrs Quality Center (Safeway) Haggen Pharmacies (Safeway) Includes: Managed Care Pharmacy, 1-800-723-3929 Carrs Pharmacy and Safeway Pharmacy 1-800-723-3929 Harris Teeter Inc (Kroger) 1-800-576-4377

Pharmacies may have been added or removed from the list after this was printed. TTY users should call 711, unless a different phone number is listed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Participating pharmacy retail chains (continued)

Health Mart Atlas 605 Medcart Specialty Care LLC 1-800-824-1763 1-877-770-4633 Health Mart Atlas 630 Medicap Pharmacies Inc 1-800-824-1763 Stores individually owned; no main phone Health Mart Atlas 841 number available 1-800-824-1763 Medicine Shoppe HEB Grocery Company LP Stores individually owned; no main phone 1-800-432-3113 number available Hy-Vee Inc MHA Long Term Care Network Inc 1-800-289-8343 1-973-966-9200 Innovatix Specialty Network NAI Saturn Eastern LLC (Safeway) 1-888-258-3273 Includes: Safeway Pharmacy 1-800-723-3929 InstyMeds 1-866-306-3502 Navarro Discount Pharmacies LLC (CVS) 1-800-746-7287 Kmart Pharmacy 1-847-286-2500 New Albertsons LP Includes: Acme Pharmacy, Medcart Pharmacy, King Soopers Pharmacy Co (Kroger) Osco Drug and Sav On Pharmacy Includes: City Market Pharmacy and 1-800-723-3929 King Soopers Pharmacy 1-800-576-4377 Pharmacy First 1-913-661-0298 The Kroger Co Includes: Jay C Pharmacy, Kroger Pharmacy Pharmacy First PR and Scott’s Pharmacy 1-913-661-0298 1-800-576-4377 Planned Parenthood of the St Louis Region Leader Drug Stores Inc and Southwest Missouri 1-888-887-5323 1-314-921-4445 Leader Puerto Rico PPOk RxSelect Pharmacy Network 1-888-887-5323 1-877-557-5707, Option 1 Long’s Drug Stores LLC (CVS) Procare Pharmacy LLC (CVS) Includes: CVS Pharmacy, Long’s Drugs and Includes: Benevere Pharmacy, Careplus CVS Long’s Pharmacy Pharmacy and CVS Pharmacy 1-800-746-7287 1-800-746-7287 Mariano’s Pharmacies (Kroger) Quality Food Centers Inc (Kroger) 1-800-576-4377 Includes: QFC Pharmacy 1-800-576-4377

Pharmacies may have been added or removed from the list after this was printed. TTY users should call 711, unless a different phone number is listed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Participating pharmacy retail chains (continued)

Ralphs Pharmacy (Kroger) Smiths Food and Drug Center Inc (Kroger) 1-800-576-4377 Includes: Fry’s Pharmacy and Randalls Food and Drug Inc (Safeway) Smiths Pharmacy Includes: Randalls Pharmacy and 1-800-576-4377 Tom Thumb Pharmacy Thrifty Drug Stores Inc 1-800-723-3929 1-800-642-3275 Corporation Tom Thumb Pharmacies (Safeway) 1-800-748-3243 1-800-723-3929 Roundy’s Pharmacies United Pharmacy TX Includes: Copps Food Center Pharmacy, Metro Includes: Albertsons Market Pharmacy, Amigos Market Pharmacy and Pick N Save Pharmacy Pharmacy, Market Street Pharmacy, United 1-414-231-5000 Coalition Pharmacy and United Pharmacy Safeway Inc 1-855-445-4401 Includes: Safeway Pharmacy and Sav On Vons Companies Inc (Albertsons / Safeway) Pharmacy Includes: Albertsonson-Safeway Pharmacy, 1-800-723-3929 Pavilions Pharmacy, Vons Pharmacy Sam’s Club East & West Inc 1-800-723-3929 Includes: Sam’s Pharmacy and Drug Store Sam’s Club Pharmacy 1-877-250-5823, TTY 1-877-924-7889 1-888-746-7726 WalMart Stores Inc Shaws Supermarket Inc (Safeway) Includes: Sam’s Pharmacy and Includes: Osco Pharmacy WalMart Pharmacy 1-800-723-3929 1-800-925-6278 Wegman Food Market Inc 1-877-934-2479

Independent Pharmacies Located in Texas (in alphabetical order by city)

Revco Healthcare Pharmacy Blue Ribbon Pharmacy 5504 Matlock Rd, Ste 130A 3517 N Main St, Ste 1 Arlington, TX 76018 Baytown, TX 77521 1-817-303-5100 1-281-838-8025 Naus Enfield Drug Kenjura Pharmacy, Inc 1115 W Lynn St 303 N Park St Austin, TX 78703 Brenham, TX 77833 1-512-476-1221 1-979-836-7922

Pharmacies may have been added or removed from the list after this was printed. TTY users should call 711, unless a different phone number is listed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Independent Pharmacies Located in Texas (continued)

Cook Childrens Home Health Bear Creek Pharmacy LLC 1101 W Vickery Blvd 101B Bear Creek Parkway Fort Worth, TX 76104 Keller, TX 76248 1-682-303-2230 1-817-562-4766 Pieratts Pharmacy Caprock Discount Drug 233 S Manse 2625 50th St Giddings, TX 78942 Lubbock, TX 79413 1-979-542-3164 1-806-792-6122 DNA Pharmacy Sanitarium Drug Store 9419 Mesa Dr 156 Coleman St Houston, TX 77028 Marlin, TX 76661 1-713-633-3362 1-254-883-3541 Express Specialty Pharmacy BlueBonnet Apothecary Services 837 Cypress Creek Pkwy, Ste 105A 11720 W Airport Blvd, Ste 800 Houston, TX 77090 Meadows Place, TX 77477 1-281-453-7205 1-713-691-6200 Sterling Pharmacy All Care Pharmacy 6609 W Sam Houston Pkwy S, Ste 98B 1441 S Midlothian Pkwy, Ste 140 Houston, TX 77072 Midlothian, TX 76065 1-713-955-8885 1-972-775-5222 Vac Pharmacy Inc RRX Pharmacy 9100 Southwest Fwy, Ste 225 4014 Woodlawn Ave, Ste B Houston, TX 77074 Pasadena, TX 77504 1-832-269-5944 1-281-991-3441 Wellness Plus Pharmacy Inc Pflugerville Pharmacy 13141 Fm 1960 West, Ste 200 15608 Spring Hill, Ste 114 Houston, TX 77065 Pflugerville, TX 78660 1-832-604-7418 1-512-990-5226 Doyfran Pharmacy Hometown Pharmacy 9701 N Sam Houston Pkwy E, Ste 110 132 W Main St Humble, TX 77396 Post, TX 79356 1-281-973-8042 1-806-495-2535 Sina Pharmacy Tomball Professional Atrium Phrm 3815 N Fry Rd, Ste 600 425 Holderrieth Blvd, Ste 111 Katy, TX 77449 Tomball, TX 77375 1-281-717-4521 1-281-351-8239

Pharmacies may have been added or removed from the list after this was printed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Independent Pharmacies Located in Texas (continued)

Wilcox Pharmacy 415 State Hwy 124 Winnie, TX 77665 1-409-296-2497

Independent Pharmacies, not located in Texas (in alphabetical order by state, then city)

CALIFORNIA Direct Pharmacy Source BriovaRx Infusion Services #402, LLC 4574 N Hiatus Rd 12604 Hiddencreek Way, Ste C Sunrise, FL 33351 Cerritos, CA 90703 1-954-233-0100 1-562-263-5600 King Pharmacy Drew Center Pharmacy 1405 Tampa Park Plaza St 2111 University Ave, Ste B Tampa, FL 33605 East Palo Alto , CA 94303 1-813-766-9763 1-650-321-1449 GEORGIA West Val Pharmacy Tracys Medicine Center 5353 Balboa Blvd 3650 Chamblee Tucker Rd Encino, CA 91316 Chamblee, GA 30341 1-818-788-2411 1-770-934-7703 South Coast Mission Pharmacy Pyramid Discount Pharmacy 31852 Pacific Coast Hwy, Ste 103 1185 Cleveland Ave Laguna Beach, CA 92651 East Point, GA 30344 1-949-499-0885 1-404-559-0715 Science Pharmaceutical Pharmacy Larrys Pharmacy 7225 Fulton Ave #H 1710 Alice St North Hollywood, CA 91605 Waycross, GA 31501 1-818-759-7223 1-912-283-1151 FLORIDA Olson Liggett Drug Good Health Pharmacy LLC 75 South Tuttle Ave 1120 Maunakea St, #173 Sarasota, FL 34237 , HI 96817 1-941-366-0090 1-808-523-9882

Pharmacies may have been added or removed from the list after this was printed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Independent Pharmacies (continued)

HAWAII (continued) MINNESOTA Lihue Professional Pharmacy Siverson’s Pharmacy & Gifts LLC 3-3420B Kuhio Hwy, Ste 101 118 S Main St Lihue, HI 96766 Hendricks, MN 56136 1-808-245-3800 1-507-275-3323 ILLINOIS MISSOURI Peace Pharmacy Sherri’s Pharmacy Services 2320 S Wentworth Ave 108 S Main St Chicago, IL 60616 Grant City, MO 64456 1-312-842-2500 1-660-564-3784 Mason City Pharmacy Whaleys West Side Pharmacy 149 E Chestnut St 3526 Amazonas Mason City, IL 62664 Jefferson City, MO 65109 1-217-482-5985 1-573-659-0650 INDIANA Rogers Pharmacy H and R Pharmacy Inc 607 State St 27 Main St Mound City, MO 64470 Poseyville, IN 47633 1-660-442-3355 1-812-874-2815 Prater’s Pharmacy KENTUCKY 1711 Cherokee Ave Seneca, MO 64865 Medicine Market Pharmacy 1-417-776-8701 10870 Main St Martin, KY 41649 Rogers Pharmacy 1-606-285-3400 2524 Frederick Ave St Joseph, MO 64506 LOUISIANA 1-816-232-3348 Prescription Compounds Rogers Pharmacy 5302 O’Donovan Dr 411 Main St Baton Rouge, LA 70808 Tarkio, MO 64491 1-225-766-9577 1-660-736-5512 Lady Of The Sea Community Pharmacy MISSISSIPPI 13086 Highway 3235 Larose, LA 70373 Marty’s Pharmacy And Compounding Center 1-985-693-9260 1042 River Oaks Dr Flowood, MS 39232 Tompkins Pharmacy 1-601-932-2027 2064 W Main St Lutcher, LA 70071 1-225-869-3535

Pharmacies may have been added or removed from the list after this was printed. ERS Extended Day Supply (EDS) network list of participating pharmacies

Independent Pharmacies (continued)

MISSISSIPPI (continued) PUERTO RICO Corner Drug Store Farmacia Rey #8 101 W Railroad Ave N Ave Font Martelo 124-126 Magnolia, MS 39652 Humacao, PR 00791 1-601-783-2321 1-787-852-1818 Advanced Infusion Solutions Super Farmacia Caguana 623 Highland Colony Pkwy, Ste 1 Road 111 Km 52.7 Bo Caguana Ridgeland, MS 39157 Utuado, PR 00641 1-601-988-1700 1-787-894-8283 NORTH CAROLINA TENNESSEE Novant Health Pharmacy Alliance Healthcare System Whitney 200 Hawthorne Lane 2150 Whitney Ave Charlotte, NC 28204 Memphis, TN 38127 1-704-384-9065 1-901-354-7621

NEVADA TwelveStone Medical, Inc Unique Care Pharmacy 352 W Northfield Blvd, Ste 3A 4571 W Flamingo Rd Murfreesboro, TN 37129 Las Vegas, NV 89103 1-844-893-0012 1-702-522-9777 NEW YORK Lieb Pharmacy 5006 16th Ave Brooklyn, NY 11204 1-718-633-5770 PENNSYLVANIA Heritage Therapeutics, LLC 2173 MacDade Blvd, Unit C & D Holmes, PA 19043 1-855-343-2136

Pharmacies may have been added or removed from the list after this was printed. Questions? Give us a call.

Call UnitedHealthcare Customer Service toll-free at (866) 868-0609 (TTY: 711), 7 a.m. – 7 p.m. CT, Monday – Friday, 7 a.m. – 3 p.m., Saturday.

Or visit www.HSMedicareRx.com to learn more about your plan 24/7.

The pharmacy network may change at any time. You will receive notice when necessary. Retirees must use network pharmacies to access their prescription drug benefit. Formulary, pharmacy network, premium and/or copayments/coinsurance may change each year. HealthSelect Medicare Rx is an Employer Prescription Drug Plan provided by ERS and administered by UnitedHealthcare Insurance Company, a Medicare-approved Part D sponsor. Enrollment in UnitedHealthcare depends on UnitedHealthcare’s contract renewal with Medicare. Y0066_181210_111230_C SPRJ45834