Alabama California (continued) HPC Specialty Pharmacy Acaria Health Pharmacy

3100 Cottage Hill Road 4225 Northgate Boulevard Suite 200 Suite 2 Mobile, AL 36606 Sacramento, CA 95834 (800) 813-0583 (916) 927-0336

Diplomat Specialty Infusion Group

Arizona 1819 Aston Street Diplomat Specialty Infusion Group Suite 104

Carlsbad, CA 92008 9045 E Pima Center Parkway (760) 707-1486 Scottsdale, AZ 85258

(480) 745-3200

CVS Specialty Connecticut Diplomat Specialty Infusion Group 2700 W Frye Road Suite 200 100 Corporate Drive Chandler, AZ 85224 Windsor, CT 60592 (800) 755-1744 (860) 763-7020

California Accredo Health Group Accredo Health Group

2410 Wardlow Road 2 Boulden Circle Corona, CA 92880 New Castle, DE 19720 (951) 737-2355 (302) 395-8943

CVS Specialty

1127 Byrn Mawr Avenue Florida Redlands, CA 92374 CVS Specialty

(909) 796-7171 7930 Woodland Center Boulevard

Tampa, FL 33614 Acaria Health Pharmacy (813) 881-0949 3302 Garfield Avenue Commerce, CA 90040 Accredo Health Group

(323) 262-9403 6272 Lee Vista Boulevard

Orlando, FL 32822 (407) 852-4903

This document outlines Ambetter’s in-network hemophilia pharmacies. Each pharmacy is contracted to mail medications if necessary. Ambetter members may utilize any pharmacy listed regardless of member location or pharmacy location. Florida (continued) Iowa Matrix Health Diplomat Specialty Infusion Group

3300 Corporate Avenue 10607 & 10611 Aurora Avenue Weston, FL 33331 Urbandale, IA 50322 (954) 385-7322 (515) 727-7937

Diplomat Specialty Pharmacy

15471 SW 12th Street Illinois Suite 207 CVS Specialty Sunrise, FL 33326 800 Biermann Court (954) 527-0440 Mt. Prospect, IL 60056

(847) 634-7400 Acaria Health Pharmacy

6923 Lee Vista Boulevard Diplomat Specialty Pharmacy

Suite 200 1370 Busch Parkway Orlando, FL 32822 Buffalo Grove, IL 60089 (407) 903-1308 (847) 229-4141

Soleo Health Georgia Hemophilia of Georgia 10210 Werch Drive Suite 202 8607 Roberts Drive Woodridge, IL 60517 Suite 150A (630) 478-8240 Sandy Springs, GA 30350 (770) 518-8272 Indiana InTouch Pharmacy Indiana Hemophilia & Thrombosis Center

75 Elliott Road 8326 Naab Road Suite 200 Indianapolis, IN 46260 Dawsonville, GA 30534 (317) 871-0011 (706) 400-6180

Accredo Health Group Acaria Health Pharmacy 2825 W Perimeter Road 3021 Sandy Parkway Indianapolis, IN 46241 Building 2, Suite A (800) 870-6419 Columbus, GA 31909

(706) 780-4700

This document outlines Ambetter’s in-network hemophilia pharmacies. Each pharmacy is contracted to mail medications if necessary. Ambetter members may utilize any pharmacy listed regardless of member location or pharmacy location. Kansas Michigan CVS Specialty CVS Specialty

11162 Renner Boulevard 1307 Allen Drive Lenexa, KS 66219 Troy, MI 48083 (913) 748-3200 (248) 968-6000

Acaria Health Pharmacy Diplomat Specialty Pharmacy

10409 W. 84th Terrace 4100 S Saginaw Street Lenexa, KS 66214 Flint, MI 48507 (800) 511-5144 (810) 768-9000

Midwest Biologics

16124 Foster Street Overland Park, KS 66085 Foundation Care

(844) 237-3561 4010 Wedgeway Court

Earth City, MO 63045

(877) 291-1122 Louisiana Acaria Health Pharmacy Diplomat Specialty Infusion Group

1736 Gause Boulevard 103 Corporate Lake Drive Suite 24 Suite B Slidell, LA 70461 Columbia, MO 65203 (985) 685-3303 (573) 256-4279

Apex Specialty Pharmacy

Massachusetts 616 NW Platte Valley Drive CVS Specialty Riverside, MO 64150

(816) 741-8844 25 Birch Street

Milford, MA 01757 Heritage Biologics (800) 950-2688 25 NW Victoria Drive Diplomat Specialty Infusion Group Lee’s Summit, MO 64086

(816) 875-5101 20 Commerce Way

Suite 2

Woburn, MA 01801 (781) 287-1500

Acaria Health Pharmacy

260 E Fordham Road Wilmington, MA 01887 (800) 511-5144 This document outlines Ambetter’s in-network hemophilia pharmacies. Each pharmacy is contracted to mail medications if necessary. Ambetter members may utilize any pharmacy listed regardless of member location or pharmacy location. North Carolina Accredo Health Group Diplomat Specialty Infusion Group

422 Gallimore Dairy Road 7167 E Kemper Road Greensboro, NC 27409 , OH 45249 (336) 393-0555 (513) 792-7080

CVS Specialty Soleo Health

10700 World Trade Boulevard 6190 Shamrock Court Suite 110 Suite 100 Raleigh, NC 27617 Dublin, OH 43016 (919) 474-6421 (614) 467-8200

Diplomat Specialty Infusion Group 140 Northway Court Procare Pharmacy Raleigh, NC 27615 (888) 571-3100 105 Mall Boulevard Monroeville, PA 15146 Diplomat Specialty Infusion Group (310) 544-6658

311 Pomona Drive Accredo Health Group Greensboro, NC 27407 (336) 218-5086 3000 Ericsson Drive Warrendale, PA 15086 (724) 772-6000 Elwyn Specialty Care CVS Specialty

3070 McCann Farm Drive 180 Passaic Avenue Suite 101 Fairfield, NJ 07004 Garnet Valley, PA 19060 (973) 461-1550 (610) 545-6040

New York Puerto Rico Acaria Health Pharmacy CVS Specialty 5 Skyline Drive Jesus T Pinero Ave #278-280 Suite 240 Rio Piedras, PR 927 Hawthorne, NY 10532 (787) 758-2700 (800) 511-5144

Diplomat Specialty Infusion Group

2805 Veterans Memorial Hwy # 19-22 Ronkonkoma, NY 11779 (631) 319-1920 This document outlines Ambetter’s in-network hemophilia pharmacies. Each pharmacy is contracted to mail medications if necessary. Ambetter members may utilize any pharmacy listed regardless of member location or pharmacy location. Tennessee Texas CVS Specialty Diplomat Specialty Infusion Group

8370 Wolf Lake Drive 1761 International Parkway Bartlett, TN 38133 Richardson, TX 75081 (901) 385-4100 (214) 503-1250

Accredo Health Group Specialty Therapeutic Care

1620 Century Center Parkway 1311 W Sam Houston Parkway N Memphis, TN 38134 Suite 150 (901) 385-3600 Houston, TX 77043 (866) 506-2626 Hemophilia Preferred Care of Memphis Paragon Healthcare Specialty 6243 Shelby View Drive Suite 104 17111 Preston Road Memphis, TN 38134 Dallas, TX 75248 (800) 757-9192 (833) 862-4559

Medex Biocare Acaria Health Pharmacy 8024 Stage Hills Boulevard Bartlett, TN 38133 1311 W Sam Houston Parkway N (800) 962-6339 Suite 130 Houston, TX 77043 (800) 511-5144

SandsRx

4 Regency Drive Wylie, TX 75098 (972) 535-2020

This document outlines Ambetter’s in-network hemophilia pharmacies. Each pharmacy is contracted to mail medications if necessary. Ambetter members may utilize any pharmacy listed regardless of member location or pharmacy location.