2014

Medicare Plus BlueSM PPO Essential, Vitality, Signature, Assure Medicare Plus BlueSM Group PPO Prescription BlueSM PDP Prescription BlueSM Group PDP Pharmacy Directory For more information, please contact: Medicare Plus Blue PPO Essential, Vitality, Signature, Assure Phone: 1‑877‑241‑2583 Hours: 8 a.m. to 8 p.m. Monday through Friday. TTY: 711 Web: www.bcbsm.com/medicare Prescription Blue PDP Phone: 1‑800‑565‑1770 Hours: 8 a.m. to 8 p.m. Monday through Friday. TTY: 711 Web: www.bcbsm.com/medicare Medicare Plus Blue Group PPO Prescription Blue Group PDP Phone: 1‑866‑684‑8216 Hours: 8:30 a.m. to 5 p.m. Monday through Friday. TTY: 711 Web: www.bcbsm.com/medicare Beneficiaries must use network pharmacies to access their prescription drug benefit. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2015. This Pharmacy Directory was updated on August 1, 2014. Medicare Plus Blue and Medicare Plus Blue Group are PPO plans with a Medicare contract. Enrollment in Medicare Plus Blue and Medicare Plus Blue Group depends on contract renewal. Prescription Blue and Prescription Blue Group are PDP plans with Medicare contracts. Enrollment in Prescription Blue and Prescription Blue Group depends on contract renewal. This document is available in alternate formats. For more information, call the Member Services number above.

DB 13338 SEP 13 H9572 S5584_C_14PPOPDPPharmDirIG CMS Accepted 091413

Introduction

Medicare Plus Blue PPO Essential, Vitality, Signature and Assure Plan Members

This booklet provides a list of Medicare Plus Blue PPO’s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Medicare Plus Blue PPO’s formulary. If you have additional questions, please call our Member Services at 1‑877‑241‑2583, 8 a.m. to 8 p.m. Monday through Friday. TTY users should call 711. Or, visit www.bcbsm.com/medicare. We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Medicare Plus Blue PPO. In most cases, your prescriptions are covered under Medicare Plus Blue PPO only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any of our network pharmacies. We will fill prescriptions at non‑network pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network or there may be newer pharmacies in our network that are not listed. This list is current as of August 1, 2014. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all pharmacies on this list, but your costs may be less at certain pharmacies in this list, which we have marked with a “P”. We call these pharmacies preferred pharmacies and they may offer lower cost‑sharing than non‑preferred pharmacies. If you have any questions about any of the above, please see the front and back cover pages of this directory for information on how to contact us.

Medicare Plus Blue PPO’s Network Pharmacies To choose a pharmacy to meet your needs, first select the type of pharmacy, found at the top of each page, then look for the county, city and pharmacy name. You can also search the index at the back of this directory to locate a pharmacy by name. Prescription Blue PDP Members: Phone: 1‑800‑565‑1770 Hours: 8 a.m. to 8 p.m. Monday through Friday. TTY: 711 Web: www.bcbsm.com/medicare

i Medicare Plus Blue Group PPO

If your employer or union plan provides Part D prescription drug benefits through this Medicare Plus Blue Group PPO plan, the following provides a list of network pharmacies. You will find a complete description of your prescription coverage, including how to fill your prescriptions, in the Evidence of Coverage and Medicare Plus Blue Group PPO’s formulary. If you have additional questions, please call our Member Services at 1‑866‑684‑8216, Monday through Friday from 8:30 a.m. to 5 p.m. Eastern time. TTY users should call 711. Or, visit www.bcbsm.com/medicare. We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Medicare Plus Blue Group PPO. In most cases, your prescriptions are covered under Medicare Plus Blue Group PPO only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any of our network pharmacies. We will fill prescriptions at non‑network pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network or there may be newer pharmacies in our network that are not listed. This list is current as of August 1, 2014. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all pharmacies on this list, but your costs may be less at certain pharmacies in this list, which we have marked with a “P”. We call these pharmacies preferred pharmacies and they may offer lower cost‑sharing than non‑preferred pharmacies. If you have any questions about any of the above, please see the front and back cover pages of this directory for information on how to contact us.

Medicare Plus Blue Group PPO’s Network Pharmacies To choose a pharmacy to meet your needs, first select the type of pharmacy, found at the top of each page, then look for the county, city and pharmacy name. You can also search the index at the back of this directory to locate a pharmacy by name.

ii CHAIN PHARMACIES

Costco Pharmacies (P) Toll-free: (800) 774-2678 TTY: 771 www.costco.com CVS Pharmacies (NP Toll-free: (800) 746-7287 TTY: 771 www.cvs.com Kmart Pharmacies (P) Toll-free: (866) 562-7848 TTY: 771 www.kmart.com Kroger Co Of Michigan

Pharmacies (P) PHARMACIES CHAIN Toll-free: (800) 576-4377 TTY: 771 www.kroger.com/pharmacy Meijer Pharmacies (P) Toll-free: (616) 453-3499 TTY: 771 www.meijer.com/pharmacy Rite Aid Pharmacies (P) Toll-free: (800) 748-3243 TTY: 771 www.riteaid.com Sams Club Pharmacies (NP) Toll-free: (888) 746-7726 TTY: 771 www.samsclub.com Target Pharmacies (P) Toll-free: (800) 440-0680 TTY: (800) 755-5852 www.target.com/pharmacy Walgreens Pharmacies (P) Toll-free: (800) 925-4733 TTY: 711 www.walgreens.com/ pharmacy Wal-Mart Pharmacies (NP) Toll-free: (800) 925-6278 TTY: 771 www.walmart.com/pharmacy

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 1 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

ALCONA COUNTY ALLEGAN COUNTY HAMILTON

HARRISVILLE ALLEGAN Hamilton Family Pharmacy (P) 3416 M-40 Richard’s Pharmacy (NP) Allegan Community Hamilton, MI 49419 117 Main Street Pharmacy (NP) (269) 751-8482 Harrisville, MI 48740 115 Locust Street (989) 724-5178 Allegan, MI 49010 (269) 673-4188 HOLLAND

RETAIL PHARMACIES LINCOLN Allegan Medical Center Pharmacy (P) Family Fare Pharmacy #123 551 Linn St - Suite 120 (P) Alcona Health Center Allegan, MI 49010 1185 S Washington Avenue Pharmacy (P) (269) 673-4700 Holland, MI 49423 177 North Barlow Rd Rite Aid Pharmacy #1534 (616) 392-7504 Lincoln, MI 48742 (P) (989) 736-9888 Pauls Pharmacy (NP) 560 Jenner Drive 803 Lincoln Lincoln Pharmacy (NP) Allegan, MI 49010 Holland, MI 49423 301 Second Street (269) 673-2181 (616) 396-5233 Lincoln, MI 48742 Value Drugs Allegan (NP) (989) 736-8138 100 Monroe Allegan, MI 49010 MARTIN (269) 673-6749 ALGER COUNTY Carman Pharmacy DORR 1598 S Main Street MUNISING Martin, MI 49070 (269) 672-5543 Dorr Community Pharmacy Putvins Drug Store (NP) (NP) OTSEGO 119 Elm Avenue 1730 142nd Ave Munising, MI 49862 Dorr, MI 49323 (906) 387-2248 (616) 681-9947 Harding’s Pharmacy (P) Snyder Drug #207 (P) 114 South Farmer Street 415 East M-28 FENNVILLE Otsego, MI 49078 Munising, MI 49862 (269) 692-6011 (906) 387-4855 Alexander’s Drug Store PLAINWELL (NP) 211 East Main Fennville, MI 49408 Campbell Pharmacy (P) (269) 561-4411 102 South Main Street Plainwell, MI 49080 (269) 685-6808

2 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Community Pharmacy Wal-Mart Pharmacy ALPENA COUNTY 533 Allegan Street #10-2358 (NP)

Plainwell, MI 49080 1180 M-32 West PHARMACIES RETAIL (269) 685-5847 ALPENA Alpena, MI 49707 Meijer Pharmacy #191 (P) (989) 354-0731 1195 M-89 Plainwell, MI 49080 Alcona Health Center OSSINEKE (269) 685-3810 Pharmacy Services (NP) Walgreens #07484 (P) 1185 Us 23 North 1277 M 89 Alpena, MI 49707 Ossineke Pharmacy (NP) Plainwell, MI 49080 (989) 358-3950 11745 South Us 23 (269) 685-5623 Alpena Regional Medical Ossineke, MI 49766 (989) 471-2339 Wal-Mart Pharmacy Center (P) #10-2061 (NP) 1501 West Chisholm Street Alpena, MI 49707 412 Cross Oaks Mall ANTRIM COUNTY Plainwell, MI 49080 (989) 356-7375 (269) 685-9820 Kmart Pharmacy #7733 (P) 2355 Us 23 South BELLAIRE Alpena, MI 49707 SAUGATUCK (989) 356-2263 Lefave Pharmacy & Home Bellaire Pharmacy (NP) Saugatuck Drug (NP) Medical Equipment, Inc. 115 N Bridge 201 Butler Street (P) Bellaire, MI 49615 Saugatuck, MI 49453 1202 W Chisholm Street (231) 533-8014 (269) 857-2300 Alpena, MI 49707 Glen’s Pharmacy #645 (P) (989) 354-3189 211 South Division Bellaire, MI 49615 SHELBYVILLE Neimans Family Pharmacy (P) (231) 533-5534 2205 Us 23 South Suite 144 Weick’s Pharmacy (P) Alpena, MI 49707 CENTRAL LAKE 71 124th Avenue (989) 356-2191 Shelbyville, MI 49344 Rite Aid Pharmacy #4532 (269) 672-7774 (P) Central Lake Pharmacy Inc 2140 State Street (NP) 2424 N Main Street WAYLAND Alpena, MI 49707 (989) 354-4630 Central Lake, MI 49622 (231) 544-2929 The Drug Store (P) Wayland Village Pharmacy 2236 Us 23 South (NP) Alpena, MI 49707 ELK RAPIDS 300 Reno Drive (989) 354-2171 Wayland, MI 49348 Walgreens #09148 (P) (269) 792-6223 Corner Druggist (NP) 1011 M 32 West 154 River Street Alpena, MI 49707 Elk Rapids, MI 49629 (989) 354-8784 (231) 264-8033

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 3 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

River Pharmacy Inc. (P) 124 Ames Street BARAGA COUNTY HASTINGS Elk Rapids, MI 49629 (231) 264-8165 BARAGA Bosley Pharmacy #2 Inc. (P) 118 S Jefferson Street MANCELONA Hastings, MI 49058 Keweenaw Bay Indian (269) 945-3429 Community (P) Glen’s Pharmacy #1507 102 Superior Ave 118 S Jefferson Street Hastings, MI 49058 (Brooks Pharmacy) (P) Baraga, MI 49908 (269) 945-3429 617 North Williams (906) 353-4555

RETAIL PHARMACIES Mancelona, MI 49659 Family Fare Pharmacy (231) 587-8491 #1990 (P) L’ANSE 902 W State St Hastings, MI 49058 ARENAC COUNTY L’Anse Pharmacy Inc. (269) 945-2466 18341 Us Highway 41 902 W State St AU GRES L’Anse, MI 49946 Hastings, MI 49058 (906) 524-6202 (269) 945-2466 Shopko Pharmacy #2624 (P) Kmart Pharmacy #3819 (P) Augres Pharmacy (P) 15900 Picture Bay Trl 802 West State Street 236 W Huron L’Anse, MI 49946 Hastings, MI 49058 Au Gres, MI 48703 (906) 524-7032 (269) 948-9411 (989) 876-8899 802 West State Street BARRY COUNTY Hastings, MI 49058 STANDISH (269) 948-9411 Pennock Pharmacy (P) DELTON 1005 W Green St Rite Aid Pharmacy #2549 Hastings, MI 49058 (P) (269) 948-3136 301 S Main Street Delton Family Pharmacy, Standish, MI 48658 Inc. (P) 1005 W Green St (989) 846-4508 338 N Grove St Hastings, MI 49058 Shopko Pharmacy #2646 (P) Delton, MI 49046 (269) 948-3136 3825 S Huron Dr (269) 623-5250 Wal-Mart Pharmacy Standish, MI 48658 338 N Grove St #10-2620 (NP) (989) 846-0749 Delton, MI 49046 1618 West M 43 Standish Pharmacy (P) (269) 623-5250 Hastings, MI 49058 533 S Main Street (269) 948-0481 Standish, MI 48658 1618 West M 43 (989) 846-0411 Hastings, MI 49058 (269) 948-0481

4 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Meijer Pharmacy #048 (P) MIDDLEVILLE BAY CITY 2980 East Wilder Road

Bay City, MI 48706 PHARMACIES RETAIL Pharmacy Care Inc. Anderson Pharmacy (NP) (989) 686-7717 4652 M-37 Highway 1108 Marquette Meijer Pharmacy #187 (P) Middleville, MI 49333 Bay City, MI 48706 595 North Pine Road (269) 795-7936 (989) 684-8905 Bay City, MI 48708 (989) 891-1510 4652 M-37 Highway Country Drugs (NP) Middleville, MI 49333 362 State Park Drive Monitor Pharmacy (NP) (269) 795-7936 Bay City, MI 48706 2981 E Midland Road (989) 684-8251 Bay City, MI 48706 (989) 684-2343 NASHVILLE Kmart Pharmacy #4091 (P) 4001 N Euclid Avenue Rite Aid Pharmacy #1576 Bay City, MI 48706 (P) Maple Valley Pharmacy (989) 686-6820 901 W Midland Street 219 North Main Kroger (P) Bay City, MI 48706 Nashville, MI 49073 945 N Euclid Road (989) 684-9370 (517) 852-0845 Bay City, MI 48706 Rite Aid Pharmacy #1740 219 North Main (989) 686-3592 (P) Nashville, MI 49073 Layerer’s Pharmacy (P) 500 Lafayette Avenue (517) 852-0845 1100 Columbus Bay City, MI 48708 Bay City, MI 48708 (989) 892-5300 (989) 893-7579 Rite Aid Pharmacy #4357 WAYLAND Maplewood Pharmacy (P) (P) 920 N Johnson Street 3880 Wilder Rd Pennock Pharmacy - Gun Bay City, MI 48708 Bay City, MI 48706 Lake (P) (989) 892-4531 (989) 686-5800 12851 West M-179 Hwy McLaren Drug Shop - Amb Southside Pharmacy (NP) Wayland, MI 49348 (P) 1002 Lafayette (269) 945-8050 200 S Wenona St Bay City, MI 48708 (989) 891-9999 12851 West M-179 Hwy Bay City, MI 48706 Wayland, MI 49348 (989) 892-2561 Target T-0631 (P) (269) 945-8050 McLaren Drug Shop - Brmc 4135 Wilder Road (P) Bay City, MI 48706 1900 Columbus Avenue (989) 686-1770 BAY COUNTY Bay City, MI 48708 Walgreens #05167 (P) (989) 894-3744 416 South Euclid Avenue Bay City, MI 48706 AUBURN McLaren Drug Shop - Wsmm (P) (989) 671-0468 4175 N Euclid Avenue Wal-Mart Pharmacy Wackerly Pharmacy (P) Bay City, MI 48706 #10-1752 (NP) 310 E Midland (989) 667-2940 3921 Wilder Road Auburn, MI 48611 McLaren Long Term Care Bay City, MI 48706 (989) 662-7773 Pharmacy (989) 684-1877 3140 W Campus Drive Bay City, MI 48706 (989) 316-4280

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 5 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

ESSEXVILLE PINCONNING BERRIEN COUNTY

Kroger Co Of Michigan Pinny Pharmacy Inc. (P) BENTON HARBOR #635 (P) 704 South Mable 2910 Center Avenue Pinconning, MI 48650 Essexville, MI 48732 (989) 879-7705 Genoa Healthcare (989) 892-0313 1485 S M-139 Benton Harbor, MI 49023 Labrenz Pharmacy (NP) BENZIE COUNTY (269) 934-0119 1606 Woodside Essexville, MI 48732 Lakeland Home Infusion RETAIL PHARMACIES (989) 892-5491 2550 Meadowbrook Ste 106 BENZONIA Benton Harbor, MI 49022 McLaren Drug Shop - Mm (269) 985-4422 (P) 1454 W Center Road Suite 1 Community Drug Of Meijer Pharmacy #041 Essexville, MI 48732 Benzonia (NP) 1920 Pipestone Road (989) 895-4570 1693 Benzie Highway Benton Harbor, MI 49022 Benzonia, MI 49616 (269) 926-8229 Rite Aid Pharmacy #1573 (231) 882-4311 (P) 1920 Pipestone Road 1490 West Center Road Shop-N-Save Pharmacy Benton Harbor, MI 49022 Essexville, MI 48732 1747 Benzie Hwy (269) 926-8229 (989) 892-1565 Benzonia, MI 49616 Rite Aid Pharmacy #1481 (231) 882-0254 Walgreens # 12042 (P) 1701 South M-139 2901 Center Ave Benton Harbor, MI 49022 Essexville, MI 48732 FRANKFORT (269) 927-3101 (989) 894-4832 1701 South M-139 Benton Harbor, MI 49022 Community Drugs Of (269) 927-3101 KAWKAWLIN Frankfort (NP) 401 Main Street Walgreens #10078 (P) Frankfort, MI 49635 875 E Napier Rd Sabourins Pharmacy (NP) (231) 352-4471 Benton Harbor, MI 49022 1461 S Huron Road (269) 983-3463 Kawkawlin, MI 48631 (989) 667-4877 HONOR 875 E Napier Rd Benton Harbor, MI 49022 (269) 983-3463 MIDLAND The Prescription Shop (NP) Wal-Mart Pharmacy 10587 Main Street #10-2062 Honor, MI 49640 Wal-Mart Pharmacy 1400 Mall Drive (231) 325-2735 #10-2619 (NP) Benton Harbor, MI 49022 910 Joe Mann Blvd (269) 927-6514 Midland, MI 48642 1400 Mall Drive (989) 835-6364 Benton Harbor, MI 49022 (269) 927-6514

6 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4236 BERRIEN CENTER COLOMA 11 South 11th Street

Niles, MI 49120 PHARMACIES RETAIL Lakeland Pharmacy Berrien Harding’s Pharmacy (269) 684-6556 6418 Deans Hill Road 6577 Paw Paw Ave 11 South 11th Street Berrien Center, MI 49102 Coloma, MI 49038 Niles, MI 49120 (269) 473-3082 (269) 468-6702 (269) 684-6556 6577 Paw Paw Ave Walgreens #03364 BERRIEN SPRINGS Coloma, MI 49038 907 South 11th Street (269) 468-6702 Niles, MI 49120 Rite Aid Pharmacy #4239 (269) 683-0234 Rite Aid Pharmacy #3368 6699 Paw Paw Ave 907 South 11th Street 612 North St Joseph Avenue Coloma, MI 49038 Niles, MI 49120 Berrien Springs, MI 49103 (269) 468-3858 (269) 683-0234 (269) 471-5020 6699 Paw Paw Ave Wal-Mart Pharmacy 612 North St Joseph Avenue Coloma, MI 49038 #10-2010 (NP) Berrien Springs, MI 49103 (269) 468-3858 2107 South 11th Street (269) 471-5020 Niles, MI 49120 (269) 683-5573 NEW BUFFALO BRIDGMAN 2107 South 11th Street Niles, MI 49120 New Buffalo Pharmacy (P) (269) 683-5573 Rite Aid Pharmacy #4238 1 North Whittaker Street (P) New Buffalo, MI 49117 3681 Shawnee Road (269) 469-3636 SAWYER Bridgman, MI 49106 (269) 465-6777 1 North Whittaker Street New Buffalo, MI 49117 Schlipps Pharmacy Inc. 3681 Shawnee Road (269) 469-3636 5857 Sawyer Road Bridgman, MI 49106 Sawyer, MI 49125 (269) 465-6777 (269) 426-3487 NILES 5857 Sawyer Road BUCHANAN Sawyer, MI 49125 Martins Pharmacy #19 (P) (269) 426-3487 720 South 11th Street Rite Aid Pharmacy #4237 Niles, MI 49120 715 E Front Street (269) 684-1418 ST. JOSEPH Buchanan, MI 49107 (269) 695-2000 720 South 11th Street Niles, MI 49120 Gillespie Pharmacy 715 E Front Street (269) 684-1418 2020 Washington Avenue Buchanan, MI 49107 St. Joseph, MI 49085 (269) 695-2000 Nile Family Pharmacy (P) 70 E Main St (269) 983-6881 Niles, MI 49120 2020 Washington Avenue (269) 683-1400 St. Joseph, MI 49085 70 E Main St (269) 983-6881 Niles, MI 49120 (269) 683-1400

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 7 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Lakeland Medical Center - St. Joseph STEVENSVILLE BRANCH COUNTY 1234 Napier Avenue St. Joseph, MI 49085 Martins Pharmacy #23 COLDWATER (269) 983-8557 5637 Cleveland Avenue Lakeland Pharmacy Shoppe Stevensville, MI 49127 3900 Hollywood Road (269) 429-8441 CVS Pharmacy #8126 (NP) St. Joseph, MI 49085 61 W Pearl Street (269) 556-2888 5637 Cleveland Avenue Coldwater, MI 49036 Stevensville, MI 49127 (517) 278-6186 3900 Hollywood Road (269) 429-8441 St. Joseph, MI 49085 Felpausch Coldwater

RETAIL PHARMACIES Meijer Pharmacy #251 (P) (269) 556-2888 Pharmacy #1955 (P) 5019 Red Arrow Highway 410 N Marshall Martins Pharmacy #21 (P) Stevensville, MI 49127 Coldwater, MI 49036 2121 South Cleveland (269) 556-2410 (517) 279-1230 Avenue St. Joseph, MI 49085 5019 Red Arrow Highway Meijer Pharmacy #179 (P) (269) 983-5847 Stevensville, MI 49127 620 East Chicago Road (269) 556-2410 Coldwater, MI 49036 2121 South Cleveland Walgreens #06444 (P) (517) 279-3310 Avenue 2485 West Glenlord Road Rite Aid Pharmacy #2711 St. Joseph, MI 49085 Stevensville, MI 49127 (269) 983-5847 (P) (269) 429-7044 450 Chicago Street Roger’s Pharmacy (P) 2485 West Glenlord Road Coldwater, MI 49036 4039 Hollywood Rd (517) 278-7342 St. Joseph, MI 49085 Stevensville, MI 49127 (269) 429-9661 (269) 429-7044 Walgreens #06092 (P) Walgreens #11265 500 East Chicago Street 4039 Hollywood Rd 1710 W John Beers Rd Coldwater, MI 49036 St. Joseph, MI 49085 Stevensville, MI 49127 (517) 278-8272 (269) 429-9661 (269) 429-1153 Wal-Mart Pharmacy Vans Pharmacy (NP) 1710 W John Beers Rd #10-1593 (NP) 807 Napier Ave 800 E Chicago Road St. Joseph, MI 49085 Stevensville, MI 49127 (269) 429-1153 Coldwater, MI 49036 (269) 983-4802 (517) 278-5897 807 Napier Ave WATERVLIET St. Joseph, MI 49085 UNION CITY (269) 983-4802 Walgreens #04536 (P) Belfy Drug Store (NP) 1260 Hilltop Street 387 N Main Street Miller’s Pharmacy Inc. (P) St. Joseph, MI 49085 Watervliet, MI 49098 206 N Broadway (269) 983-0315 (269) 463-3164 Union City, MI 49094 (517) 741-3604 1260 Hilltop Street 387 N Main Street St. Joseph, MI 49085 Watervliet, MI 49098 (269) 983-0315 (269) 463-3164

8 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Genoa Pharmacy Michigan, Target T-0610 (P) CALHOUN COUNTY LLC 5700 Beckley Road

3630 Capital Avenue Sw Battle Creek, MI 49015 PHARMACIES RETAIL ALBION Battle Creek, MI 49015 (269) 979-0778 (269) 979-7822 Twin Valley Pharmacy (NP) Health System Pharmacy 1250 East Columbia Ave Family Fare Pharmacy 1992 (NP) Battle Creek, MI 49014 (P) 363 Fremont St Suite 201 (269) 964-9467 1406 N Eaton St Battle Creek, MI 49015 Walgreens #02856 (P) Albion, MI 49224 (269) 966-8646 800 Capital Avenue Ne (517) 629-2286 Kmart Pharmacy #4065 (P) Battle Creek, MI 49017 Parks Drug Store, Inc. (NP) 200 Capital Avenue Sw (269) 965-3313 318 South Superior Battle Creek, MI 49015 Walgreens #07158 (P) Albion, MI 49224 (269) 963-1569 50 Columbia Avenue West (517) 629-9481 Meijer Pharmacy #016 (P) Battle Creek, MI 49015 Youngs Pharmacy (P) 2177 W Columbia Avenue (269) 969-9500 120 S Clark Street Battle Creek, MI 49015 Walgreens #09130 (P) Albion, MI 49224 (269) 968-3359 5991 Beckley Road (517) 629-2900 Meijer Pharmacy #195 (P) Battle Creek, MI 49015 6405 B Drive North (269) 979-5438 ATHENS Battle Creek, MI 49014 Walgreens #10513 (P) (269) 979-6610 605 North Avenue Rite Aid Pharmacy #1474 Battle Creek, MI 49017 Larmours Village Drug (P) (P) (269) 660-1198 106 Capital Ave 1434 West Michigan Street Wal-Mart Pharmacy Athens, MI 49011 Battle Creek, MI 49017 (269) 729-5161 #10-2080 (NP) (269) 965-5178 6020 B Drive North Rite Aid Pharmacy #2425 Battle Creek, MI 49014 BATTLE CREEK (P) (269) 979-4727 600 North Avenue Battle Creek, MI 49017 HOMER Family Fare Pharmacy (269) 963-1524 #1904 (P) 45 Columbia Ave E Rite Aid Pharmacy #4369 - Battle Creek, MI 49015 Battle Creek Plaza (P) Hopps Pharmacy (NP) (269) 965-5631 30 E Columbia Ave Suite A 126 W Main Street Battle Creek, MI 49015 Homer, MI 49245 Family Fare Pharmacy (269) 965-3237 (517) 568-3400 #1972 (P) 1525 W Michigan Ave Rite Aid Pharmacy #4963 Battle Creek, MI 49037 (P) MARSHALL (269) 965-1258 890 East Michigan Avenue Battle Creek, MI 49014 Family Fare Pharmacy (269) 660-9509 Hemmingsen Drug Store #1979 (P) Inc. (P) 1603 Capital Ne Sam’s Pharmacy #10-6429 12737 Cotton Lake Road 132 West Michigan Battle Creek, MI 49017 Marshall, MI 49068 (269) 962-1456 Battle Creek, MI 49014 (269) 979-7671 (269) 781-3411

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 9 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #3841 (P) Rite Aid Pharmacy #4401 Walgreens #12508 (P) 15861 Michigan Avenue (P) 1500 Bridge St Marshall, MI 49068 102 N State Street Charlevoix, MI 49720 (269) 781-8484 Dowagiac, MI 49047 (231) 597-1356 Remedi Seniorcare (269) 782-2962 1600 S Kalamazoo Ave Ste 2 102 N State Street EAST JORDAN Marshall, MI 49068 Dowagiac, MI 49047 (937) 473-3333 (269) 782-2962 Rite Aid Pharmacy #4233 Shopko Pharmacy #2650 (P) East Jordan Family (P) 56419 Pokagon Street Pharmacy (P) 15893 W Michigan Avenue Dowagiac, MI 49047 100 Main Street RETAIL PHARMACIES Marshall, MI 49068 (269) 782-0280 East Jordan, MI 49727 (269) 781-1191 (231) 536-2207 56419 Pokagon Street Rite Aid Pharmacy #2504 Dowagiac, MI 49047 (P) (269) 782-0280 CASS COUNTY 240 S Lake Street Suite A East Jordan, MI 49727 (231) 536-0901 CASSOPOLIS CHARLEVOIX COUNTY

CHEBOYGAN COUNTY Rite Aid Pharmacy #3366 BOYNE CITY (P) 305 E State Street CHEBOYGAN Cassopolis, MI 49031 Glen’s Pharmacy #1517 (P) (269) 445-5369 430 N Lake St Suite B Boyne City, MI 49712 Glen’s Pharmacy #1504 (P) 305 E State Street (231) 582-2101 992 South Main Cassopolis, MI 49031 Huff Pharmacy (NP) (269) 445-5369 Cheboygan, MI 49721 121 East Water Street (231) 627-5371 Boyne City, MI 49712 Kmart Pharmacy #9245 (P) (231) 582-6514 DOWAGIAC 1131 E State Street Cheboygan, MI 49721 Family Fare Pharmacy 1975 CHARLEVOIX (231) 627-7139 56151 M-51 Modern Pharmacy (NP) 127 N Main Street Dowagiac, MI 49047 Central Drug Store (NP) (269) 782-4511 Cheboygan, MI 49721 301 Bridge Street (231) 627-9949 56151 M-51 Charlevoix, MI 49720 Dowagiac, MI 49047 (231) 547-2424 Walgreens #10514 (P) 991 S Main St (269) 782-4511 Kmart Pharmacy #3820 (P) Cheboygan, MI 49721 Pokagon Health Services 06600 M-66 North (231) 627-1080 Pharmacy Charlevoix, MI 49720 57392 M-51 South (231) 547-0915 Wal-Mart Pharmacy #10-2100 (NP) Dowagiac, MI 49047 Rite Aid Pharmacy #1801 1150 South Main (269) 782-4570 (P) Cheboygan, MI 49721 57392 M-51 South 195 M-66 Highway (231) 627-4337 Dowagiac, MI 49047 Charlevoix, MI 49720 (269) 782-4570 (231) 547-4001

10 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #10405 (P) INDIAN RIVER 2101 Ashmun St HARRISON

Sault Ste. Marie, MI 49783 PHARMACIES RETAIL Indian River Village (906) 632-5135 Glen’s Pharmacy #1523 (P) Pharmacy (NP) Wal-Mart Pharmacy 1570 North Clare Avenue 9040 Old Trail Lane #10-1936 (NP) Harrison, MI 48625 Indian River, MI 49749 3763 I-75 Business Spur (989) 539-0584 (231) 238-8911 Sault Ste. Marie, MI 49783 Maclean Pharmacy (P) (906) 632-0582 155 N 2nd Street Harrison, MI 48625 CHIPPEWA COUNTY CLARE COUNTY (989) 539-7828 Rite Aid Pharmacy #3253 BRIMLEY (P) CLARE 161 Beech Street Harrison, MI 48625 Bay Mills Pharmacy (NP) (989) 539-4380 12124 West Lakeshore Drive Gateway Pharmacy Of Brimley, MI 49715 Clare, Inc. (NP) (906) 248-2031 1048 North Mcewan Street CLINTON COUNTY Clare, MI 48617 (989) 386-2900 SAULT STE. MARIE Shopko Pharmacy #2644 (P) DEWITT 11250 N Mission Road Arfstrom Pharmacy (NP) Clare, MI 48617 Hometown Pharmacy #34 415 Ashmun Street (989) 802-0354 113 S Bridge Street Sault Ste. Marie, MI 49783 Walgreens #11887 (P) Dewitt, MI 48820 (906) 632-9661 1141 N Mcewan St (517) 668-9299 Glen’s Pharmacy #1531 (P) Clare, MI 48617 (989) 386-6197 113 S Bridge Street 4284 I-75 Business Spur Dewitt, MI 48820 Sault Ste. Marie, MI 49783 (517) 668-9299 (906) 635-5267 FARWELL Meijer Pharmacy #209 (P) Rite Aid Pharmacy #4579 12821 Crossover Dr (P) Dewitt, MI 48820 Eagle Pharmacy Of Farwell 1025 Ashmun Street (517) 669-4733 Sault Ste. Marie, MI 49783 PC (NP) (906) 632-6874 109 W Main St 12821 Crossover Dr Dewitt, MI 48820 Sault Community Pharmacy Farwell, MI 48622 (517) 669-4733 (NP) (989) 588-2900 601 Osborn Blvd Rite Aid Pharmacy #3234 Rite Aid Pharmacy #1483 - Sault Ste. Marie, MI 49783 (P) Dewitt Shopping Center (906) 632-2122 146 N Corning Street 13157 1/2 Shavey Road Dewitt, MI 48820 Slt. Ste. Marie Tribal Health Farwell, MI 48622 (517) 669-2585 Center Pharmacy (P) (989) 588-2599 2864 Ashmun 13157 1/2 Shavey Road Sault Ste. Marie, MI 49783 Dewitt, MI 48820 (906) 632-5226 (517) 669-2585

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 11 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #10251 (P) DELTA COUNTY ELSIE 1410 S Us Highway 27 St. Johns, MI 48879 Harvest Pharmacy Inc. (NP) (989) 224-2052 ESCANABA 313 South Ovid Street 1410 S Us Highway 27 Elsie, MI 48831 St. Johns, MI 48879 (989) 862-4858 (989) 224-2052 Eldercare Pharmacy 1823 7th Ave N 313 South Ovid Street Wal-Mart Pharmacy Escanaba, MI 49829 Elsie, MI 48831 #10-1423 (906) 789-4451 (989) 862-4858 1939 S Scott Road St. Johns, MI 48879 Elmer’s Pharmacy (P) RETAIL PHARMACIES (989) 224-8299 412 N Lincoln Road ST. JOHNS Escanaba, MI 49829 1939 S Scott Road (906) 789-9200 St. Johns, MI 48879 Clinton Memorial Hospital (989) 224-8299 Kmart Pharmacy #9065 (P) Phfarmacy (NP) 801 N Lincoln Road 901 South Oakland Escanaba, MI 49829 St. Johns, MI 48879 CRAWFORD COUNTY (906) 786-1090 (989) 224-8155 Shopko Pharmacy #2016 (P) 2530 First Avenue North 901 South Oakland GRAYLING Escanaba, MI 49829 St. Johns, MI 48879 (906) 786-2011 (989) 224-8155 Glen’s Pharmacy #1511 (P) The People’s Drug Store Kmart Pharmacy #3804 (P) (NP) 2119 South Us 27 2470 South I-75 Business Loop 1208 Ludington Street St. Johns, MI 48879 Escanaba, MI 49829 (989) 224-8976 Grayling, MI 49738 (989) 348-5335 (906) 786-1731 2119 South Us 27 Mercy Hospital Grayling Walgreens #09364 (P) St. Johns, MI 48879 Pharmacy (NP) 2301 Ludington Street (989) 224-8976 1100 E Michigan Avenue Escanaba, MI 49829 Kroger Pharmacy #811 (P) Grayling, MI 49738 (906) 789-0382 900 South Us 27 (989) 348-0800 Wal-Mart Pharmacy St. Johns, MI 48879 Rite Aid Pharmacy #2753 #10-2522 (NP) (989) 224-7075 (P) 601 N Lincoln 900 South Us 27 312 S James Street Escanaba, MI 49829 St. Johns, MI 48879 Grayling, MI 49738 (906) 786-1232 (989) 224-7075 (989) 348-1350 Rite Aid Pharmacy #4577 The Medicine Shoppe DICKINSON COUNTY (P) #1675 (NP) 109 N Whittemore Street 500 North James Street St. Johns, MI 48879 Grayling, MI 49738 IRON MOUNTAIN (989) 224-2313 (989) 348-2000 109 N Whittemore Street Walgreens #11689 (P) St. Johns, MI 48879 2045 S I75 Business Loop Kmart Pharmacy #3833 (P) (989) 224-2313 Grayling, MI 49738 1810 S Stephenson Avenue (989) 344-0374 Iron Mountain, MI 49801 (906) 779-2163

12 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

The Drug Store (NP) 1112 S Stephenson Ave CHARLOTTE EATON RAPIDS

Iron Mountain, MI 49801 PHARMACIES RETAIL (906) 774-3654 CVS Pharmacy #8087 Felpausch Eaton Rapids Walgreens #11953 (P) 301 S Cochran Avenue Pharmacy #1994 (P) 300 East F Street Charlotte, MI 48813 1411 S Main St Iron Mountain, MI 49801 (517) 543-4905 Eaton Rapids, MI 48827 (906) 774-0563 301 S Cochran Avenue (517) 663-8331 Wal-Mart Pharmacy Charlotte, MI 48813 1411 S Main St #10-2434 (NP) (517) 543-4905 Eaton Rapids, MI 48827 1920 S Stephenson Ave (517) 663-8331 Iron Mountain, MI 49801 Meijer Pharmacy #194 (906) 779-7185 1167 East Clinton Trail Rite Aid Pharmacy #4600 Charlotte, MI 48813 (P) (517) 541-9233 715 South Main St KINGSFORD 1167 East Clinton Trail Eaton Rapids, MI 48827 Charlotte, MI 48813 (517) 663-8430 Shopko Pharmacy #2011 (P) (517) 541-9233 715 South Main St 500 S Carpenter Ave Wal-Mart Pharmacy Eaton Rapids, MI 48827 Kingsford, MI 49801 #10-1642 (517) 663-8430 (906) 774-7907 1680 Packard Highway Rottenbucher Pharmacy Charlotte, MI 48813 122-124 S Main Street (517) 543-0700 Eaton Rapids, MI 48827 NORWAY 1680 Packard Highway (517) 663-6811 Charlotte, MI 48813 122-124 S Main Street Norway Pharmacy (P) (517) 543-0700 Eaton Rapids, MI 48827 514 Main Street (517) 663-6811 Norway, MI 49870 (906) 563-5151 DIMONDALE GRAND LEDGE

EATON COUNTY Wilcox Pharmacy Inc. (P) 140 East Road Apothecary Shop At Grand Dimondale, MI 48821 Ledge BELLEVUE (517) 646-9274 820 Charlevoix Drive Unit 1h 140 East Road Grand Ledge, MI 48837 Dimondale, MI 48821 (517) 622-4000 Fruin Pharmacy (517) 646-9274 820 Charlevoix Drive Unit 1h 117 North Main Grand Ledge, MI 48837 Bellevue, MI 49021 (517) 622-4000 (269) 763-9407 Meijer Pharmacy #210 117 North Main 730 East Saginaw Highway Bellevue, MI 49021 Grand Ledge, MI 48837 (269) 763-9407 (517) 622-6833 730 East Saginaw Highway Grand Ledge, MI 48837 (517) 622-6833

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 13 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #1530 Walgreens #07770 EMMETT COUNTY 715 South Clinton Street 6421 W Saginaw Hwy Grand Ledge, MI 48837 Lansing, MI 48917 (517) 627-2800 (517) 703-0537 HARBOR SPRINGS 715 South Clinton Street 6421 W Saginaw Hwy Grand Ledge, MI 48837 Lansing, MI 48917 (517) 627-2800 (517) 703-0537 Kelbel Pharmacy (NP) 205 East Main Sparrow Pharmacy Plus #4 Wal-Mart Pharmacy Harbor Springs, MI 49740 508 S Clinton Street #10-2869 (NP) (231) 526-5971 Grand Ledge, MI 48837 409 N Marketplace Blvd (517) 627-1670 Lansing, MI 48917 RETAIL PHARMACIES 508 S Clinton Street (517) 622-1454 PETOSKEY Grand Ledge, MI 48837 409 N Marketplace Blvd (517) 627-1670 Lansing, MI 48917 Kmart Pharmacy #3821 (P) Walgreens #13150 (P) (517) 622-1454 1401 Spring Street 812 E Saginaw Hwy Petoskey, MI 49770 Grand Ledge, MI 48837 OLIVET (231) 347-7281 (517) 627-1240 Meijer Pharmacy #257 (P) 812 E Saginaw Hwy 1201 Lears Road Grand Ledge, MI 48837 Olivet Pharmacy (P) Petoskey, MI 49770 (517) 627-1240 102 Washington St (231) 348-4310 Olivet, MI 49076 (269) 749-2301 Northern Michigan Hospital LANSING Pharmacy 102 Washington St 416 Connable Ave Olivet, MI 49076 Petoskey, MI 49770 Sav On Westside Drugs (269) 749-2301 (231) 487-4770 632 N Dibble St R&RPrescription Services Lansing, MI 48917 POTTERVILLE 560 West Mitchell Street (517) 323-2382 Suite 200 632 N Dibble St Petoskey, MI 49770 Lansing, MI 48917 Potterville Pharmacy Inc. (P) (231) 487-2147 (517) 323-2382 127 W Pearl Street Rite Aid Pharmacy #1691 Potterville, MI 48876 (P) Target Pharmacy T-0616 (517) 645-9800 5609 West Saginaw Highway 1133 North Us 31 Lansing, MI 48917 127 W Pearl Street Petoskey, MI 49770 (517) 327-0620 Potterville, MI 48876 (231) 348-2767 (517) 645-9800 5609 West Saginaw Highway Rite Aid Pharmacy #4410 Lansing, MI 48917 (P) (517) 327-0620 630 W Mitchell Street Petoskey, MI 49770 Walgreens #05223 (231) 347-8282 3915 West Saginaw Hwy Lansing, MI 48917 Walgreens #05481 (P) (517) 703-0593 710 Spring Street Petoskey, MI 49770 3915 West Saginaw Hwy (231) 348-5556 Lansing, MI 48917 (517) 703-0593

14 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #12534 (P) Rite Aid Pharmacy #4340 Rite Aid Pharmacy #4333 1301 N Us Hwy 31 (P) (P)

Petoskey, MI 49770 G-4033 Fenton Road 100 East Vienna Street PHARMACIES RETAIL (231) 348-7510 Burton, MI 48529 Clio, MI 48420 Wal-Mart Pharmacy (810) 239-4614 (810) 687-0800 #10-2417 (NP) Rite Aid Pharmacy #4343 VG’s Pharmacy #1925 (P) 1600 Anderson Rd (P) 710 S Mill St Petoskey, MI 49770 G-3009 South Dort Hwy Clio, MI 48420 (231) 439-0071 Burton, MI 48529 (810) 686-0004 (810) 742-8401 Wal-Mart Pharmacy GENESEE COUNTY Rite Aid Pharmacy #4806 - #10-4243 (NP) Bentley Plaza (P) 11493 North Linden Rd 6026 Lapeer Road Clio, MI 48420 BURTON Burton, MI 48509 (810) 564-4278 (810) 742-3010 Rite Aid Pharmacy #4948 DAVISON ABC Discount Pharmacy (P) (P) 6009 E. Lapeer Rd. G-4007 S Saginaw St Burton, MI 48509 Burton, MI 48529 Kroger Pharmacy #714 (P) (810) 309-0886 (810) 742-7002 700 N State Street Belsay Medical Pharmacy Thrifty Drugs (NP) Davison, MI 48423 (NP) 5240 Lapeer Road (810) 658-8051 1096 S Belsay Rd Suite I Burton, MI 48509 Medicap (NP) Burton, MI 48509 (810) 743-6915 9070 Davison Road (810) 715-1415 VG’s Pharmacy #1933 (P) Davison, MI 48423 Hamilton Burton Pharmacy 4165 E Court (810) 658-2646 G-3375 S Saginaw St Burton, MI 48509 Meijer Pharmacy #244 (P) Burton, MI 48529 (810) 742-8326 8089 Lapeer Rd (810) 406-4001 Wal-Mart Pharmacy Davison, MI 48423 Kmart Pharmacy #3279 (P) #10-2273 (NP) (810) 658-5410 G-1145 N Belsay Road 5323 E Court Street North Rite Aid Pharmacy #4439 Burton, MI 48509 Burton, MI 48509 (P) (810) 744-3820 (810) 744-2984 841 S State Road Kroger Co Of Michigan Davison, MI 48423 #406 (P) (810) 653-7485 CLIO 1200 E Bristol Road Rite Aid Pharmacy #7738 Burton, MI 48529 (P) (810) 239-9941 Borden’s Pharmacy (NP) 521 North State Road Meijer Pharmacy #029 (P) 415 West Vienna Davison, MI 48423 G-2333 S Center Road Clio, MI 48420 (810) 658-2746 Burton, MI 48519 (810) 686-4550 VG’s Pharmacy #1930 (P) (810) 744-9733 Kmart Pharmacy #9385 (P) 8503 Davison Rd Rite Aid Pharmacy #3667 4290 West Vienna Road Davison, MI 48423 (P) Clio, MI 48420 (810) 658-9710 4001 Davison Road Ste A (810) 564-9351 Burton, MI 48509 (810) 742-0217

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 15 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #10953 (P) Dort Longway Pharmacy (P) 901 S State Rd FLINT 2700 Robert T Longway Ste Davison, MI 48423 B (810) 653-4020 Advanced Care Pharmacy Flint, MI 48503 Services - Genesee LLC (810) 235-2800 FENTON (NP) Genesys Health Enterprises 420 West Fifth Avenue Inc. Flint, MI 48503 3909 Beecher Road Kmart Pharmacy #4700 (P) (810) 496-4876 Flint, MI 48532 18055 Silver Parkway Advanced Specialty Rx (810) 762-4420 Fenton, MI 48430 1260 S Linden Rd Ste 2 Hamilton Main Pharmacy RETAIL PHARMACIES (810) 629-2561 Flint, MI 48532 2900 N Saginaw St Rite Aid Pharmacy #4408 (888) 444-5309 Flint, MI 48505 (P) All American Pharmacy (P) (810) 406-4246 1001 North Leroy 3104-06 Flushing Rd H-Care Pharmacy (P) Fenton, MI 48430 Flint, MI 48504 G-4433 Miller Road Ste 102 (810) 750-1923 (810) 234-0480 Flint, MI 48507 Rite Aid Pharmacy #4594 Ballenger Health - Mart (810) 733-6653 (P) Pharmacy (NP) Kirk’s Family Pharmacy (P) 2420 Owen Road G1073 N Ballenger Hwy G-4444 Fenton Road Fenton, MI 48430 Flint, MI 48504 Flint, MI 48507 (810) 750-1497 (810) 766-9313 (810) 235-7995 Target T-2105 (P) Bristol Pharmacy (NP) Kmart Pharmacy #4083 (P) 3255 Owen Road 5154 Miller Road Suite G G-3083 Miller Road Fenton, MI 48430 Flint, MI 48507 Flint, MI 48507 (810) 714-2406 (810) 407-6101 (810) 238-0489 The Medicine Shoppe (NP) Brothers Pharmacy Inc (NP) Kroger (P) 223 Silver Lake Road 118 W Pierson Road G-5249 Corunna Rd Fenton, MI 48430 Flint, MI 48505 Flint, MI 48504 (810) 629-4002 (810) 785-7770 (810) 732-2005 VG’s Pharmacy #1921 (P) Clio Road Pharmacy (P) 2629 W Pierson Road 18005 Silver Parkway 4902 Clio Road Flint, MI 48504 Fenton, MI 48430 Flint, MI 48504 (810) 785-3406 (810) 750-1572 (810) 789-7084 Kroger Co Of Michigan VG’s Pharmacy #1927 (P) Diplomat Specialty #115 (P) 1390 N Leroy St Pharmacy (NP) 3838 Richfeld Road Fenton, MI 48430 G-3320 Beecher Road Flint, MI 48506 (810) 629-6074 Flint, MI 48532 (810) 736-9913 Walgreens #07065 (P) (810) 732-8720 Linden Pharmacy (NP) 3270 W Silver Lake Road 4100 S Saginaw Ste D 1260 S Linden Rd Fenton, MI 48430 Flint, MI 48532 (810) 629-3134 Flint, MI 48507 (810) 230-5045 (810) 230-8300 Wal-Mart Pharmacy McLaren Drug Shop - Mrmc #10-2693 (NP) Discount Rx (NP) 4400 S Saginaw St Ste 1335 (P) 3700 Owen Road 401 S Ballenger Hwy Fenton, MI 48430 Flint, MI 48507 (810) 239-2667 Flint, MI 48532 (810) 750-3735 (810) 342-3400

16 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

McLaren Home Medical Rite Aid Pharmacy #4588 Walgreens #06830 (P) 2284-1 S Ballenger Hwy (P) 502 South Ballenger Highway

Flint, MI 48503 3521 Corunna Road Flint, MI 48532 PHARMACIES RETAIL (800) 774-6999 Flint, MI 48503 (810) 424-9270 Meijer Pharmacy #028 (P) (810) 235-6363 Walgreens #07500 (P) G-4333 W Pierson Road Rite Aid Pharmacy #4761 5020 Corunna Road Flint, MI 48504 (P) Flint, MI 48532 (810) 230-6033 1124 N Ballenger Highway (810) 720-5872 Meijer Pharmacy #044 (P) Flint, MI 48504 Walgreens #07501 (P) 2474 Hill Road (810) 233-6765 G-4110 Fenton Road Flint, MI 48507 Sam’s Pharmacy #10-8291 Flint, MI 48507 (810) 235-2711 (NP) (810) 424-0224 North Saginaw Pharmacy 4373 Corunna Road Wal-Mart Pharmacy (P) Flint, MI 48532 #10-1928 (NP) 2918 N Saginaw St (810) 733-0741 4313 Corunna Road Flint, MI 48505 Target T-0629 (P) Flint, MI 48532 (810) 234-5500 3701 Lapeer Road (810) 733-3355 Rite Aid Pharmacy #1587 Flint, MI 48503 (810) 715-3501 (P) FLUSHING 4519 Richfield Road Town Center Pharmacy (P) Flint, MI 48506 1201 Flushing Rd Ste 2 (810) 743-2300 Flint, MI 48504 Kroger (P) Rite Aid Pharmacy #3780 (810) 232-9100 1542 E Pierson Rd (P) Valley Medical Pharmacy Flushing, MI 48433 1810 Maplewood Avenue (NP) (810) 659-8057 Flint, MI 48506 G-5142 Miller Road Rite Aid Pharmacy #1729 (810) 232-6423 Flint, MI 48507 (P) Rite Aid Pharmacy #4310 (810) 230-8252 218 W Main Street (P) VG’s Pharmacy #1926 (P) Flushing, MI 48433 5018 Clio Road 5080 Corunna Rd (810) 659-6402 Flint, MI 48504 Flint, MI 48532 Rite Aid Pharmacy #4443 - (810) 787-2232 (810) 230-8226 Hamady Bros Plaza (P) Rite Aid Pharmacy #4438 Walgreens #04676 (P) 1561 East Pierson (P) 5703 South Saginaw Flushing, MI 48433 3717 Fenton Road Flint, MI 48507 (810) 659-2940 Flint, MI 48507 (810) 695-4623 Walgreens #06054 (P) (810) 232-5118 Walgreens #05917 (P) 1570 East Pierson Road Rite Aid Pharmacy #4442 2815 Davison Road Flushing, MI 48433 (P) Flint, MI 48506 (810) 659-1062 G-4515 Corunna Road (810) 234-0317 Flint, MI 48532 Walgreens #05918 (P) GENESEE (810) 732-7011 3753 South Dort Hwy Rite Aid Pharmacy #4504 Flint, MI 48507 (P) (810) 715-3092 VG’s Pharmacy #1929 (P) 2838 East Court Street 7461 N Genesee Flint, MI 48506 Genesee, MI 48437 (810) 767-3059 (810) 640-1424

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 17 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #7733 Rite Aid Pharmacy #7736 GOODRICH (P) (P) 2506 East Hill Road 11801 North Saginaw Street Pharmd Co Pharmacy (NP) Grand Blanc, MI 48439 Mt. Morris, MI 48458 8191 S State Road (810) 606-1101 (810) 686-7104 Goodrich, MI 48438 Sam’s Pharmacy #10-4944 Union Prescription Center (810) 636-2979 (NP) (P) 6160 S Saginaw Road 11830 N Saginaw St Grand Blanc, MI 48439 Mt. Morris, MI 48458 GRAND BLANC (810) 603-9702 (810) 686-2900 Wal-Mart Pharmacy RETAIL PHARMACIES Genesys Regional Medical #10-3726 (NP) OTISVILLE Center 6170 South Saginaw Road 1 Genesys Parkway Grand Blanc, MI 48439 Grand Blanc, MI 48439 (810) 603-9765 Rite Aid Pharmacy #3510 (810) 606-6366 (P) 337 North State Street Knight Drugs - Grand Blanc LINDEN #1701 (P) Otisville, MI 48463 8483 Holly Road (810) 631-4551 Grand Blanc, MI 48439 Rite Aid Pharmacy #3452 (810) 603-0918 (P) SWARTZ CREEK Kroger (P) 602 Broad Street 12731 S Saginaw Hwy Linden, MI 48451 Grand Blanc, MI 48439 (810) 735-1341 Kroger Company Of (810) 953-9156 Michigan #711 (P) 7084 Miller Road MONTROSE Rite Aid Pharmacy #4319 Swartz Creek, MI 48473 (P) (810) 630-0585 8360 S Saginaw St Grand Blanc, MI 48439 Sav On Montrose Pharmacy Luea Pharmacy (NP) (810) 694-2500 (P) 8021 Miller Road 225 E State Street Swartz Creek, MI 48473 Rite Aid Pharmacy #4441 Montrose, MI 48457 (810) 635-3355 (P) (810) 639-2071 11609 S Saginaw Street Meijer Pharmacy #259 (P) Grand Blanc, MI 48439 4141 Morrish Road (810) 694-4983 MT. MORRIS Swartz Creek, MI 48473 (810) 635-1410 Rite Aid Pharmacy #4471 Rite Aid Pharmacy #4440 - (P) Kroger (P) 1020 East Hill Road Swartz Creek Plaza (P) 7188 N Saginaw Road 9090 Miller Road Grand Blanc, MI 48439 Mt. Morris, MI 48458 (810) 232-4111 Swartz Creek, MI 48473 (810) 687-6263 (810) 635-4481 Rite Aid Pharmacy #4956 Rite Aid Pharmacy #4447 (P) VPH Pharmacy (P) 5376 Miller Road 5370 E Hill Road 4515 Mt Morris Rd Grand Blanc, MI 48439 Swartz Creek, MI 48473 Mt. Morris, MI 48458 (810) 877-7170 (810) 694-4775 (810) 640-2110

18 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

GLADWIN COUNTY GOGEBIC COUNTY KINGSLEY EALPHARMACIES RETAIL BEAVERTON IRONWOOD Kingsley Pharmacy (NP) 114 S Brownson Kingsley, MI 49649 Rite Aid Pharmacy #2760 Kmart Pharmacy #3832 (P) (231) 263-7701 (P) 1400 E Cloverland Drive Northland Food Center, Inc. 352 North Ross Street Ironwood, MI 49938 Beaverton, MI 48612 (906) 932-1208 (P) (989) 435-7727 2377 E M-113 Walgreens #11954 (P) Kingsley, MI 49649 The Beaverton Pharmacy 802 E Cloverland Dr (231) 263-5671 (NP) Ironwood, MI 49938 127 West Brown St (906) 932-4267 Beaverton, MI 48612 Wal-Mart Pharmacy TRAVERSE CITY (989) 435-7778 #10-5444 (NP) 10305 Country Club Road CVS Pharmacy #06843 (NP) GLADWIN Ironwood, MI 49938 626 West Front St (906) 932-4191 Traverse City, MI 49684 (231) 935-0185 Glens Pharmacy #1524 (P) WAKEFIELD Glen’s Pharmacy #641 (P) 1204 N State Street 4122 Us 31 South Gladwin, MI 48624 Traverse City, MI 49684 (231) 398-3202 Wakefield Pharmacy (P) (231) 943-4017 Rite Aid Pharmacy #4488 - 408 Sunday Lake Street Kmart Pharmacy #3009 (P) Ashcrofts Shopping Ctr. (P) Wakefield, MI 49968 1712 S Garfield Avenue 120 E Cedar Ave (906) 229-5966 Traverse City, MI 49686 Gladwin, MI 48624 (231) 941-8432 (989) 426-1170 WATERSMEET Meijer Pharmacy #033 (P) Shopko Pharmacy #2653 (P) 3955 Us 31 Highway South 174 James Robertson Dr Traverse City, MI 49684 Gladwin, MI 48624 Lac Vieux Desert Health (231) 941-1793 (989) 426-7020 Center Pharmacy (P) Munson Community Health The Medicine Shoppe 23560 E Choate Rd Ctr Pharmacy (NP) #1174 (NP) Watersmeet, MI 49969 550 Munson Avenue 663 E Cedar Street (906) 358-4588 Suite G-100 Gladwin, MI 48624 Traverse City, MI 49686 (989) 426-4595 GRAND TRAVERSE (231) 935-8730 COUNTY Munson Hospital Pharmacy (NP) 1105 W Sixth Street FIFE LAKE Traverse City, MI 49684 (231) 935-5678 Fife Lake Pharmacy (NP) Petertyl Drug (NP) 108 W State Street 111 E Front Street Fife Lake, MI 49633 Traverse City, MI 49684 (231) 879-4243 (231) 946-4830

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 19 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #1010 Thompson Pharmacy West GRATIOT COUNTY (P) (NP) 13916 Sw Bay Shore Drive 3850 N Long Lake Rd Ste Traverse City, MI 49684 101 ALMA (231) 946-7400 Traverse City, MI 49684 Rite Aid Pharmacy #4276 (231) 947-2880 (P) Thompson Glen’s Pharmacy #1512 (P) 939 Us 31 South Pharmacy-Olesons East 1700 Wright Avenue Traverse City, MI 49684 (NP) Alma, MI 48801 (231) 993-9288 1100 Hammond Road E (989) 463-0411 Rite Aid Pharmacy #4495 Traverse City, MI 49686 Kmart Pharmacy #9640 (P) RETAIL PHARMACIES (P) (231) 947-2203 1755 Wright Avenue 1201-A South Division Walgreens # 12894 (P) Alma, MI 48801 Traverse City, MI 49684 975 W South Airport Rd (989) 463-4969 (231) 929-0526 Traverse City, MI 49686 Rite Aid Pharmacy #4378 Rite Aid Pharmacy #4586 (231) 946-5840 (P) (P) Walgreens #07369 (P) 1341 Wright Avenue 511 S Garfield 2350 Us 31 North Alma, MI 48801 Traverse City, MI 49684 Traverse City, MI 49686 (989) 463-6111 (231) 941-5332 (231) 938-7051 Walgreens #10250 (P) Sam’s Pharmacy East Walgreens #07874 (P) 1420 Wright Ave #10-6419 (NP) 3900 N Us 31 South Alma, MI 48801 2401 Us 31 South Traverse City, MI 49684 (989) 463-2704 Traverse City, MI 49684 (231) 922-9277 Wal-Mart Pharmacy (231) 995-0207 Walgreens #10186 (P) #10-1422 (NP) Sixth Street Drug Inc (NP) 1029M37S 7945 Alger Road 1030 Sixth Street Traverse City, MI 49684 Alma, MI 48801 Traverse City, MI 49684 (231) 943-3147 (989) 463-3220 (231) 946-4570 Wal-Mart Pharmacy Target T-671 (P) #10-2338 (NP) ITHACA 3100 S Airport Road West 2640 Crossing Circle Traverse City, MI 49684 Traverse City, MI 49684 (231) 947-2992 (231) 933-7095 Rite Aid Pharmacy #1772 - The Medicine Shoppe (NP) Whitney Pharmacy Services Dells Plaza (P) 1128 S Garfield Avenue (NP) 1010 E Center Street Traverse City, MI 49686 4000 Eastern Sky Drive Ithaca, MI 48847 (231) 946-0900 Suite 1b (989) 875-3380 The Prescription Shop (NP) Traverse City, MI 49684 4000 Eastern Sky Drive (231) 922-2952 ST. LOUIS Traverse City, MI 49684 (231) 947-6921 WILLIAMSBURG Vcare Pharmacy (NP) Thompson Pharmacy (NP) 225 N Mill St 324 South Union Street Kmart Pharmacy #3720 (P) St. Louis, MI 48880 Traverse City, MI 49684 (989) 681-8285 (231) 947-4212 6455 Us 31 North Williamsburg, MI 49690 (231) 938-1181

20 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy HILLSDALE COUNTY LITCHFIELD #10-2192 (NP)

995 Razorback Drive PHARMACIES RETAIL HILLSDALE CDS Pharmacy (NP) Houghton, MI 49931 111 Marshall Street (906) 482-5988 Litchfield, MI 49252 Hillsdale Market Pharmacy (517) 542-7770 LAURIUM (P) 210 W Carleton Road Hillsdale, MI 49242 HOUGHTON COUNTY Aspirus Keweenaw (517) 439-9325 Pharmacy - Laurium Kroger Co Of Michigan 205 Osceola #681 (P) CALUMET Laurium, MI 49913 290 W Carlton (906) 337-6575 Hillsdale, MI 49242 Shopko Pharmacy #606 (P) (517) 439-0930 56835 Station Dr HURON COUNTY Long Term Care - Nash Calumet, MI 49913 Drugs (906) 337-2698 32 N Howell St BAD AXE Hillsdale, MI 49242 (517) 437-4497 HANCOCK Nash Drugs (P) Kmart Pharmacy #9745 (P) 30 N Howell Street Apothecary - Hancock (NP) 760 N Van Dyke Hillsdale, MI 49242 500 Campus Drive Bad Axe, MI 48413 (517) 437-4497 Hancock, MI 49930 (989) 269-9517 Rite Aid Pharmacy #4380 (906) 483-1919 Northgate Pharmacy Inc. (P) Copper Country (NP) 300 West Carleton Rd Apothecary 721 N Van Dyke Suite 1 Hillsdale, MI 49242 500 Campus Drive Bad Axe, MI 48413 (517) 437-3373 Hancock, MI 49930 (989) 269-8061 Walgreens #10288 (P) (906) 483-1901 Walgreens #09450 (P) 196 W Carlton Rd 830 North Van Dyke Road Bad Axe, MI 48413 Hillsdale, MI 49242 HOUGHTON (517) 439-4255 (989) 269-6973 Wal-Mart Pharmacy #10-1592 (NP) JONESVILLE Apothecary - Houghton (NP) 901 North Van Dyke 600 Macinnes Drive Bad Axe, MI 48413 Nash Drugs (P) Houghton, MI 49931 (989) 269-9746 237 E Chicago Road (906) 483-1818 Jonesville, MI 49250 Shopko Pharmacy #2123 (P) CASEVILLE (517) 849-9804 900 West Memorial Drive Wal-Mart Pharmacy Houghton, MI 49931 #10-1809 (NP) (906) 487-9797 Scheurer Family Pharmacy 701 Olds (NP) Jonesville, MI 49250 6568 Main Street (517) 849-7011 Caseville, MI 48725 (989) 856-2900

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 21 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #1482 - INGHAM COUNTY ELKTON Brookfield Plz Shop Ctr (P) 1399 East Grand River Scheurer Family Pharmacy EAST LANSING East Lansing, MI 48823 (NP) (517) 337-1385 4970 Railroad Street 1399 East Grand River Elkton, MI 48731 Kroger Co Of Michigan East Lansing, MI 48823 (989) 375-2121 #890 (P) (517) 337-1385 1550 W Lake Lansing Road East Lansing, MI 48823 Rite Aid Pharmacy #1611 HARBOR BEACH (517) 351-9445 (P) 2489 Lake Lansing Rd RETAIL PHARMACIES 1550 W Lake Lansing Road East Lansing, MI 48823 Harbor Drug (NP) East Lansing, MI 48823 (517) 332-0888 (517) 351-9445 114 S Huron Ave 2489 Lake Lansing Rd Harbor Beach, MI 48441 Meijer Pharmacy #052 (P) East Lansing, MI 48823 (989) 479-3241 1350 Lake Lansing Road (517) 332-0888 East Lansing, MI 48823 (517) 332-8851 Rite Aid Pharmacy #4011 PIGEON (P) 1350 Lake Lansing Road 111 East Saginaw Street East Lansing, MI 48823 East Lansing, MI 48823 Orrs Drug Store (NP) (517) 332-8851 (517) 333-0825 26 South Main Meijer Pharmacy #253 (P) Pigeon, MI 48755 111 East Saginaw Street (989) 453-2234 7157 E Saginaw St East Lansing, MI 48823 East Lansing, MI 48823 (517) 333-0825 Scheurer Family Pharmacy (517) 885-9010 (NP) 168 N Caseville Road 7157 E Saginaw St HASLETT Pigeon, MI 48755 East Lansing, MI 48823 (989) 453-2535 (517) 885-9010 MSU Clinical Center Haslett Pharmacy (P) Pharmacy (NP) 1641 Haslett Rd SEBEWAING 138 E Service Rd Rm A118 Haslett, MI 48840 East Lansing, MI 48824 (517) 339-0300 Scheurer Family Pharmacy (517) 353-4930 1641 Haslett Rd (NP) 138 E Service Rd Rm A118 Haslett, MI 48840 8866 Unionville Road East Lansing, MI 48824 (517) 339-0300 Sebewaing, MI 48759 (517) 353-4930 Rite Aid Pharmacy #4599 - (989) 883-3850 MSU Olin Health Center Shoptown Center (P) (NP) 1589 Haslett Road North Campus - East Circle Haslett, MI 48840 Drive (517) 339-5832 East Lansing, MI 48824 1589 Haslett Road (517) 353-9165 Haslett, MI 48840 North Campus - East Circle (517) 339-5832 Drive East Lansing, MI 48824 (517) 353-9165

22 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Biomed Pharmacy Lake Knight Drugs - Lansing Inc. HOLT Lansing (P) 1540 Lake Lansing Road

1515 Lake Lansing Rd Lansing, MI 48912 PHARMACIES RETAIL CVS Pharmacy #8054 (NP) Suite B2 (517) 485-9633 2240 Cedar Street Lansing, MI 48912 1540 Lake Lansing Road Holt, MI 48842 (517) 371-3300 Lansing, MI 48912 (517) 694-1994 1515 Lake Lansing Rd (517) 485-9633 2240 Cedar Street Suite B2 Kroger Co Of Michigan Holt, MI 48842 Lansing, MI 48912 #884 (P) (517) 694-1994 (517) 371-3300 921 W Holmes Street Kroger Co Of Michigan Clinical Pharmacy Services Lansing, MI 48910 #887 (P) Of Mid-Michigan (NP) (517) 393-7009 2495 North Cedar Street 6250 South Cedar St Suite 2 921 W Holmes Street Holt, MI 48842 Lansing, MI 48911 Lansing, MI 48910 (517) 694-8412 (517) 887-3539 (517) 393-7009 2495 North Cedar Street 6250 South Cedar St Suite 2 Kroger Co Of Michigan Holt, MI 48842 Lansing, MI 48911 #888 (P) (517) 694-8412 (517) 887-3539 6430 W Saginaw Highway Rite Aid Pharmacy #1612 CVS Pharmacy #8278 (NP) Lansing, MI 48917 (P) 5118 S Martin Luther King (517) 886-1323 Blvd 2263 Cedar St 6430 W Saginaw Highway Lansing, MI 48911 Holt, MI 48842 Lansing, MI 48917 (517) 272-5424 (517) 694-2179 (517) 886-1323 2263 Cedar St 5118 S Martin Luther King Lansing Community Holt, MI 48842 Blvd Pharmacy (P) (517) 694-2179 Lansing, MI 48911 925 East Kalamazoo Street (517) 272-5424 Lansing, MI 48912 CVS Pharmacy #8282 (517) 372-5760 LANSING 240 Mac East Lansing, MI 48823 925 East Kalamazoo Street (517) 336-8317 Lansing, MI 48912 Apothecary Shop (NP) (517) 372-5760 737 N Grand Ave 240 Mac East McLaren Drug Shop - Irmcg Lansing, MI 48906 Lansing, MI 48823 (P) (517) 482-0882 (517) 336-8317 401 West Greenlawn Avenue 737 N Grand Ave Kmart Pharmacy #4382 Lansing, MI 48910 Lansing, MI 48906 5400 S Cedar Street (517) 975-6675 (517) 482-0882 Lansing, MI 48911 (517) 393-6804 401 West Greenlawn Avenue Lansing, MI 48910 5400 S Cedar Street (517) 975-6675 Lansing, MI 48911 (517) 393-6804

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 23 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

McLaren Drug Shop - Irmcp Rite Aid Pharmacy #1615 Sam’s Pharmacy #10-8137 2727 South Pennsylvania (P) 340 East Edgewood Blvd Avenue 1004 E Michigan Avenue Lansing, MI 48911 Lansing, MI 48910 Lansing, MI 48912 (517) 882-1142 (517) 975-2290 (517) 485-4381 340 East Edgewood Blvd 2727 South Pennsylvania 1004 E Michigan Avenue Lansing, MI 48911 Avenue Lansing, MI 48912 (517) 882-1142 Lansing, MI 48910 (517) 485-4381 Sparrow Hospital Pharmacy (517) 975-2290 Rite Aid Pharmacy #3967 1215 E Michigan Avenue Meijer Pharmacy #023 (P) 1019 W Saginaw St Lansing, MI 48912 5125 West Saginaw Lansing, MI 48915 (517) 364-2405 RETAIL PHARMACIES Lansing, MI 48917 (517) 374-6103 1215 E Michigan Avenue (517) 886-8133 1019 W Saginaw St Lansing, MI 48912 5125 West Saginaw Lansing, MI 48915 (517) 364-2405 Lansing, MI 48917 (517) 374-6103 Sparrow Pharmacy Plus #1 (517) 886-8133 Rite Aid Pharmacy #4232 1100 West Saginaw Street Meijer Pharmacy #024 (P) 3106 E Saginaw Street Lansing, MI 48915 6200 S Pennsylvania Lansing, MI 48912 (517) 364-7474 Lansing, MI 48911 (517) 337-1681 1100 West Saginaw Street (517) 394-7720 3106 E Saginaw Street Lansing, MI 48915 6200 S Pennsylvania Lansing, MI 48912 (517) 364-7474 Lansing, MI 48911 (517) 337-1681 Sparrow Pharmacy Plus #10 (517) 394-7720 Rite Aid Pharmacy #4482 - 915 E Michigan Avenue Patient Careway Pharmacy Edgemont Shopping Lansing, MI 48912 3955 Patient Care Way Center (517) 364-3079 Lansing, MI 48911 3700 W Saginaw Street 915 E Michigan Avenue (517) 393-1000 Lansing, MI 48917 Lansing, MI 48912 3955 Patient Care Way (517) 321-7746 (517) 364-3079 Lansing, MI 48911 3700 W Saginaw Street Sparrow Pharmacy Plus #11 (517) 393-1000 Lansing, MI 48917 (NP) Remindadose Pharmacy (517) 321-7746 1200 E Michigan Ave Ste 310 2730 Alpha Access Ste B Rite Aid Pharmacy #4770 Lansing, MI 48912 Lansing, MI 48910 2701 S Cedar Street (517) 364-5380 (517) 708-7750 Lansing, MI 48910 1200 E Michigan Ave Ste 310 Rite Aid Pharmacy #1486 - (517) 272-9190 Lansing, MI 48912 Colonial Vlg Shopping Ct 2701 S Cedar Street (517) 364-5380 (P) Lansing, MI 48910 St. John Pharmacy (NP) 1705 West Mt Hope (517) 272-9190 812 E Jolly Rd Ste 208 Lansing, MI 48910 Sam’s Pharmacy #10-4781 Lansing, MI 48910 (517) 372-6700 (NP) (517) 394-5019 1705 West Mt Hope 2925 Tower Centre Blvd 812 E Jolly Rd Ste 208 Lansing, MI 48910 Lansing, MI 48912 Lansing, MI 48910 (517) 372-6700 (517) 482-1803 (517) 394-5019 2925 Tower Centre Blvd Lansing, MI 48912 (517) 482-1803

24 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Target T-0361 Pgpa Pharmacy Inc. 500 East Edgewood Blvd MASON 3544 Meridian Crossings Ste

Lansing, MI 48911 120 PHARMACIES RETAIL (517) 882-4845 Meijer Pharmacy #174 Okemos, MI 48864 500 East Edgewood Blvd 550 Hull Road (517) 381-7472 Lansing, MI 48911 Mason, MI 48854 3544 Meridian Crossings Ste (517) 882-4845 (517) 244-1910 120 Walgreens #05503 550 Hull Road Okemos, MI 48864 3435 East Saginaw Street Mason, MI 48854 (517) 381-7472 Lansing, MI 48912 (517) 244-1910 Rite Aid Pharmacy #1609 (517) 351-0249 Rite Aid Pharmacy #4323 (P) 3435 East Saginaw Street 610 N Cedar Street Suite A 1664 W Grand River Ave Lansing, MI 48912 Mason, MI 48854 Okemos, MI 48864 (517) 351-0249 (517) 676-4421 (517) 349-4410 Walgreens #05841 610 N Cedar Street Suite A 1664 W Grand River Ave 3404 S Martin Luther King Mason, MI 48854 Okemos, MI 48864 Blvd (517) 676-4421 (517) 349-4410 Lansing, MI 48910 Wares Drug Store Target Pharmacy T-365 (P) (517) 393-5784 304 S Jefferson 4890 Marsh Road 3404 S Martin Luther King Mason, MI 48854 Okemos, MI 48864 Blvd (517) 676-9199 (517) 347-9955 Lansing, MI 48910 304 S Jefferson 4890 Marsh Road (517) 393-5784 Mason, MI 48854 Okemos, MI 48864 Walgreens #06369 (517) 676-9199 (517) 347-9955 410 East Jolly Tom’s Pharmacy Lansing, MI 48910 1619 W Grand River (517) 882-2732 OKEMOS Okemos, MI 48864 410 East Jolly (517) 488-0607 Lansing, MI 48910 Kroger Co Of Michigan 1619 W Grand River (517) 882-2732 #793 (P) Okemos, MI 48864 Wal-Mart Pharmacy 4884 Marsh Road (517) 488-0607 #10-2867 (NP) Okemos, MI 48864 Walgreens #11286 3225 Towns Centre Blvd (517) 347-0102 2131 W Grand River Ave Lansing, MI 48912 4884 Marsh Road Okemos, MI 48864 (517) 487-9161 Okemos, MI 48864 (517) 347-4632 3225 Towns Centre Blvd (517) 347-0102 2131 W Grand River Ave Lansing, MI 48912 Meijer Pharmacy #025 (P) Okemos, MI 48864 (517) 487-9161 2055 W Grand River (517) 347-4632 Okemos, MI 48864 Wal-Mart Pharmacy (517) 347-9133 LESLIE #10-2866 (NP) 2055 W Grand River 5110 Times Square Okemos, MI 48864 Okemos, MI 48864 Leslie Welcome Pharmacy (517) 347-9133 (517) 381-8267 826 West Bellevue 5110 Times Square Leslie, MI 49251 Okemos, MI 48864 (517) 589-8291 (517) 381-8267

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 25 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4326 IONIA COUNTY STOCKBRIDGE (P) 431 W Lincoln Avenue Stockbridge Pharmacy BELDING Ionia, MI 48846 110 South Clinton (616) 527-4300 Stockbridge, MI 49285 431 W Lincoln Avenue (517) 851-7575 Leppinks Pharmacy Ionia, MI 48846 115 South Pearl Street (616) 527-4300 110 South Clinton Belding, MI 48809 Stockbridge, MI 49285 (616) 794-4053 Walgreens #07952 (P) (517) 851-7575 2450 South State Road 115 South Pearl Street Ionia, MI 48846 RETAIL PHARMACIES Belding, MI 48809 (616) 567-4239 WEBBERVILLE (616) 794-4053 2450 South State Road Rite Aid Pharmacy #1470 Ionia, MI 48846 Village Drug Shop (P) (616) 567-4239 100 Covered Village Mall 113 W Grand River Ave Wal-Mart Pharmacy Webberville, MI 48892 Belding, MI 48809 (616) 794-2200 #10-5411 (517) 521-3484 3026 South State Road 113 W Grand River Ave 100 Covered Village Mall Ionia, MI 48846 Webberville, MI 48892 Belding, MI 48809 (616) 527-3904 (616) 794-2200 (517) 521-3484 3026 South State Road The Belding Apothecary Ionia, MI 48846 240 Covered Village (616) 527-3904 WILLIAMSTON Belding, MI 48809 (616) 794-2290 LAKE ODESSA D & W Pharmacy #1903 240 Covered Village 151 W Grand River Belding, MI 48809 Williamston, MI 48895 (616) 794-2290 Walker’s Pharmacy (517) 655-1372 838 4th Avenue 151 W Grand River IONIA Lake Odessa, MI 48849 Williamston, MI 48895 (616) 374-3190 (517) 655-1372 838 4th Avenue Sparrow Pharmacy Plus #2 Meijer Pharmacy #303 (P) Lake Odessa, MI 48849 129 S Putman 2750 South State Road (616) 374-3190 Williamston, MI 48895 Ionia, MI 48846 (517) 655-2420 (616) 527-5133 OSCODA 129 S Putman 2750 South State Road Williamston, MI 48895 Ionia, MI 48846 (517) 655-2420 (616) 527-5133 Kmart Pharmacy #9593 (P) 5719 North Us 23 Oscoda, MI 48750 (989) 739-1485 5719 North Us 23 Oscoda, MI 48750 (989) 739-1485

26 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #2473 ISABELLA COUNTY PORTLAND (P)

5280 North Huron Road PHARMACIES RETAIL Rite Aid Pharmacy #4740 Oscoda, MI 48739 MT. PLEASANT (P) (989) 739-4255 1339 E Grand River Ave Portland, MI 48875 TAWAS CITY Ambulatory Infusion Care (517) 647-4704 121 E Broadway St Ste C Mt. Pleasant, MI 48858 1339 E Grand River Ave Rite Aid Pharmacy #4502 (989) 773-4879 Portland, MI 48875 (P) (517) 647-4704 Cardinal Pharmacy (NP) 211 West Lake Street 2410 S Leaton Rd Suite 8 Tom’s Pharmacy LLC Tawas City, MI 48763 Mt. Pleasant, MI 48858 1462 East Grand River (989) 362-3439 (989) 317-3700 Portland, MI 48875 Sav-Mor Super Drugs Tawas (517) 647-7373 Cmu Health Service (NP) Pharmacy 1462 East Grand River 306 West Lake Street Foust Hall Cmu Health Serv - Portland, MI 48875 Tawas City, MI 48763 Attn: Phcy (517) 647-7373 (989) 362-3311 Mt. Pleasant, MI 48858 Wal-Mart Pharmacy (989) 774-6590 IOSCO COUNTY #10-5376 (NP) CVS Pharmacy #10098 (NP) 621 East Lake Street 1306 S Mission St Tawas City, MI 48763 Mt. Pleasant, MI 48858 EAST TAWAS (989) 984-0924 (989) 772-1945 Downtown Drugs (P) IRON COUNTY 121 E Broadway The Medicine Shoppe Mt. Pleasant, MI 48858 #1189 (NP) (989) 773-5544 133 Newman Street East Tawas, MI 48730 CRYSTAL FALLS Ithaca Pharmacy (P) (989) 362-7415 121 E Broadway - Suite D Mt. Pleasant, MI 48858 Crystal Falls Pharmacy (NP) (989) 773-4879 1340 W Us-2 HALE Kmart Pharmacy #7014 (P) Crystal Falls, MI 49920 (906) 875-3601 2125 S Mission Street Hale Pharmacy (NP) Mt. Pleasant, MI 48858 3270 M-65 (989) 773-6991 Hale, MI 48739 IRON RIVER Kroger Co Of Michigan (989) 728-9711 #889 (P) 4080 East Bluegrass Snyder Pharmacy (P) Mt. Pleasant, MI 48858 OSCODA 933 Riverside Plaza (989) 773-3047 Iron River, MI 49935 (906) 265-5149 Meijer Pharmacy #069 (P) 1015 Pickard Street Gilberts Drug Store (P) The Corner Drug Store (NP) 212 S State Street Mt. Pleasant, MI 48858 128 West Genesee (989) 773-3123 Oscoda, MI 48750 Iron River, MI 49935 (989) 739-7585 (906) 265-2312

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 27 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Mission Pharmacy (P) Savmor #58 Weatherwax - CVS Pharmacy #8268 (NP) 926 S Mission St Brooklyn (P) 605 North West Avenue Mt. Pleasant, MI 48858 105 N Main Street Jackson, MI 49202 (989) 773-8200 Brooklyn, MI 49230 (517) 841-4201 Nimkee Pharmacy (517) 592-8505 Kmart Pharmacy #3938 (P) 2591 South Leaton Road 3555 Oneil Drive Mt. Pleasant, MI 48858 GRASS LAKE Jackson, MI 49202 (989) 775-4608 (517) 789-7988 Rite Aid Pharmacy #4505 Kmart Pharmacy #4066 (P) (P) Grass Lake Community 3001 E Michigan Avenue 117 North Mission Road Pharmacy (P) Jackson, MI 49202 RETAIL PHARMACIES Mt. Pleasant, MI 48858 112 E Michigan Ave (517) 784-6129 Grass Lake, MI 49240 (989) 773-9935 Kroger Co Of Michigan (517) 522-4100 Sam’s Pharmacy #10-4982 #680 (P) (NP) 1100 Argyle 4850 Encore Blvd JACKSON Jackson, MI 49202 Mt. Pleasant, MI 48858 (517) 788-5476 (989) 773-5814 Longe Drugs 1, Inc. (NP) Advanced Care Pharmacy Walgreens #07247 (P) 900 East Ganson Services (P) 1309 S Mission Street Jackson, MI 49201 Mt. Pleasant, MI 48858 2136 Robinson Road Suite 2 (517) 787-3194 (989) 775-8098 Jackson, MI 49203 (517) 750-2180 Meijer Pharmacy #030 (P) Walgreens #12346 (P) 2777 Airport Road Advanced Care Pharmacy 903 N Mission St Jackson, MI 49202 Mt. Pleasant, MI 48858 Services - Jackson (P) (517) 783-0033 (989) 772-0291 1200 N West Ave Suite 500 Jackson, MI 49202 Meijer Pharmacy #056 (P) Wal-Mart Pharmacy (517) 789-8579 3333 E Michigan Avenue #10-1428 (NP) Jackson, MI 49202 Allegiance Health Pharmacy 4208 E Blue Grass Road Rt 9 (517) 787-3356 #7369 (P) Mt. Pleasant, MI 48858 Rite Aid Pharmacy #1265 (989) 772-6302 2200 Springport Road Jackson, MI 49202 (P) (517) 787-4761 2255 South Jackson Road Jackson, MI 49203 JACKSON COUNTY Allegiance Health Pharmacy (517) 780-9535 #7371 (NP) 205 N East Avenue Rite Aid Pharmacy #4350 BROOKLYN Jackson, MI 49201 (P) (517) 841-1402 3100 East Michigan Avenue Jackson, MI 49202 Country Market Pharmacy Allegiance Health Pharmacy (517) 782-9382 #66 (P) #7743 2200 Springport Road Rite Aid Pharmacy #4424 - 11301 Brooklyn Rd Jackson Plaza (P) Brooklyn, MI 49230 Jackson, MI 49202 1089 Wisner North (517) 592-2475 (517) 787-7053 Jackson, MI 49202 CVS Pharmacy #8041 (NP) Center For Family Health (517) 782-0574 414 S Main (NP) Brooklyn, MI 49230 505 North Jackson St (517) 592-2115 Jackson, MI 49201 (517) 748-5400

28 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4539 - Spring Arbor Shop Ctr. (P) MICHIGAN CENTER KALAMAZOO

1733 Spring Arbor PHARMACIES RETAIL Jackson, MI 49203 Commet Plaza Pharmacy Arcadia Pharmacy (NP) (517) 789-6630 4646 Page Avenue 418 W Kalamazoo Ave Rose City Pharmacy (P) Michigan Center, MI 49254 Kalamazoo, MI 49007 300 W Washington (517) 764-0400 (269) 553-6000 Jackson, MI 49203 (517) 784-3430 418 W Kalamazoo Ave SPRING ARBOR Kalamazoo, MI 49007 Sam’s Pharmacy #10-6658 (269) 553-6000 (NP) Borgess Outpatient 3600 Oneill Drive Sav-Mor #19 Weatherwax - Pharmacy (P) Jackson, MI 49202 Spring Arbor (P) (517) 788-5961 1521 Gull Road 8012 Spring Arbor Rd Kalamazoo, MI 49001 Savmor #68 Weatherwax - Spring Arbor, MI 49283 (269) 226-8336 Hinckley (P) (517) 750-2550 210 Hinckley Blvd 1521 Gull Road Jackson, MI 49203 Kalamazoo, MI 49001 (517) 784-3184 KALAMAZOO COUNTY (269) 226-8336 Target T-0673 (P) Bronson Outpatient Pharmacy 1076 Jackson Crossing AUGUSTA Jackson, MI 49202 601 John Street (517) 788-5359 Kalamazoo, MI 49007 (269) 341-6990 Walgreens #05707 (P) Asklers Augusta Pharmacy 3040 East Michigan Avenue N More D & W Pharmacy 1575 Jackson, MI 49202 108 S Webster 2103 Parkview Ave (517) 768-9002 Augusta, MI 49012 Kalamazoo, MI 49008 (269) 731-2400 (269) 344-2513 Walgreens #09133 (P) 1314 N West Avenue 108 S Webster 2103 Parkview Ave Jackson, MI 49202 Augusta, MI 49012 Kalamazoo, MI 49008 (517) 783-1803 (269) 731-2400 (269) 344-2513 Wal-Mart Pharmacy Family Health Center #10-5160 (NP) GALESBURG Pharmacy 1700 West Michigan Avenue 117 W Patterson Jackson, MI 49202 Kalamazoo, MI 49007 (517) 817-0378 Galesburg Village Drug (269) 488-0850 Welcome Pharmacy South 9880 East Michigan 117 W Patterson 303 West Prospect Galesburg, MI 49053 Kalamazoo, MI 49007 Jackson, MI 49203 (269) 665-9727 (269) 488-0850 (517) 787-2132 9880 East Michigan Family Health Center Galesburg, MI 49053 Pharmacy-South (269) 665-9727 2918 Portage Road Kalamazoo, MI 49001 (269) 488-8516

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 29 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Gull Pointe Pharmacy MSU Kalamazoo Ctr. For Walgreens #03147 (P) 5585 Gull Road Ste 120 Med. Studies Pharm. (NP) 918 Riverview Drive Kalamazoo, MI 49048 1000 Oakland Drive Kalamazoo, MI 49048 (269) 553-5000 Kalamazoo, MI 49008 (269) 382-8181 5585 Gull Road Ste 120 (269) 337-6330 918 Riverview Drive Kalamazoo, MI 49048 1000 Oakland Drive Kalamazoo, MI 49048 (269) 553-5000 Kalamazoo, MI 49008 (269) 382-8181 Harding’s Pharmacy (P) (269) 337-6330 Walgreens #04991 (P) 400 W Howard Optimed Specialty 3016 South Westnedge Kalamazoo, MI 49001 Pharmacy Avenue (269) 382-4399 154 South Kalamazoo Mall Kalamazoo, MI 49008 RETAIL PHARMACIES 5165 W Main Kalamazoo, MI 49007 (269) 552-1518 Kalamazoo, MI 49003 (269) 337-6330 3016 South Westnedge (269) 381-0270 154 South Kalamazoo Mall Avenue 400 W Howard Kalamazoo, MI 49007 Kalamazoo, MI 49008 Kalamazoo, MI 49001 (269) 337-6330 (269) 552-1518 (269) 382-4399 Rite Aid Pharmacy #1478 - Walgreens #07430 (P) Cork Lane Shopping Ctr. 5020 West Main Street 5165 W Main 1032 East Cork Street Kalamazoo, MI 49009 Kalamazoo, MI 49003 (269) 345-8507 (269) 381-0270 Kalamazoo, MI 49001 (269) 344-0131 Kalamazoo Long Term Care 5020 West Main Street 535 S Burdick - Suite 220 1032 East Cork Street Kalamazoo, MI 49009 Kalamazoo, MI 49007 Kalamazoo, MI 49001 (269) 345-8507 (269) 388-4850 (269) 344-0131 Walgreens #07894 Kalamazoo Psychiatric Sindecuse Health Center 5815 Gull Road Hospital Pharmacy (NP) Kalamazoo, MI 49048 (269) 226-9433 1312 Oakland Drive Gilkison Drive Kalamazoo, MI 49008 Kalamazoo, MI 49008 5815 Gull Road (269) 337-3106 (269) 387-3301 Kalamazoo, MI 49048 Meijer Pharmacy #021 (P) Gilkison Drive (269) 226-9433 5800 Gull Road Kalamazoo, MI 49008 Walgreens #12849 Kalamazoo, MI 49048 (269) 387-3301 6649 W Main St (269) 337-2933 Target T-0901 (P) Kalamazoo, MI 49009 (269) 372-0273 5800 Gull Road 5350 W Main St Kalamazoo, MI 49048 Kalamazoo, MI 49009 6649 W Main St (269) 337-2933 (616) 349-6148 Kalamazoo, MI 49009 Meijer Pharmacy #119 (P) 5350 W Main St (269) 372-0273 6660 W Main Street Kalamazoo, MI 49009 Wal-Mart Pharmacy Kalamazoo, MI 49009 (616) 349-6148 #10-5064 (269) 372-9110 Walgreens #03053 6065 Gull Road 6660 W Main Street 1722 W Main Street Kalamazoo, MI 49048 Kalamazoo, MI 49009 Kalamazoo, MI 49006 (269) 373-1367 (269) 372-9110 (269) 344-1185 6065 Gull Road 1722 W Main Street Kalamazoo, MI 49048 Kalamazoo, MI 49006 (269) 373-1367 (269) 344-1185

30 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy Harding’s Pharmacy (P) Sam’s Pharmacy #10-6661 #10-5065 (NP) 3750 West Centre Street (NP)

501 N 9th Street Portage, MI 49024 7021 S Westnedge Avenue PHARMACIES RETAIL Kalamazoo, MI 49009 (269) 323-7380 Portage, MI 49002 (269) 544-2943 6330 S Westnedge (269) 327-2579 501 N 9th Street Portage, MI 49081 7021 S Westnedge Avenue Kalamazoo, MI 49009 (269) 327-4508 Portage, MI 49002 (269) 544-2943 3750 West Centre Street (269) 327-2579 Westside Medical Pharmacy Portage, MI 49024 Target T-0604 (P) 6565 West Main Street (269) 323-7380 6839 South Westnedge Kalamazoo, MI 49009 Avenue (269) 375-1700 6330 S Westnedge Portage, MI 49002 Portage, MI 49081 (269) 327-9646 6565 West Main Street (269) 327-4508 Kalamazoo, MI 49009 Meijer Pharmacy #022 6839 South Westnedge (269) 375-1700 5121 S Westnedge Avenue Portage, MI 49008 Portage, MI 49002 (269) 327-9646 PARCHMENT (269) 343-4621 Walgreens #10080 (P) 5121 S Westnedge 7920 Shaver Rd Portage, MI 49008 Hometown Pharmacy Ltc Portage, MI 49024 (269) 343-4621 714 Shoppers Lane (269) 324-9988 Meijer Pharmacy #196 (P) Parchment, MI 49004 7920 Shaver Rd (269) 349-7322 8850 Shaver Road Portage, MI 49024 Portage, MI 49024 (269) 321-4310 (269) 324-9988 PORTAGE Walgreens #10081 (P) 8850 Shaver Road 5933 S Westnedge Portage, MI 49024 Portage, MI 49002 Advanced Care Pharmacy (269) 321-4310 (269) 381-4862 7916 Oakland Dr Portage Pharmacy Portage, MI 49024 7966 Lovers Lane 5933 S Westnedge (269) 271-2561 Portage, MI 49002 Portage, MI 49002 (269) 381-4862 7916 Oakland Dr (269) 327-0033 Portage, MI 49024 Wal-Mart Pharmacy 7966 Lovers Lane #10-5280 (269) 271-2561 Portage, MI 49002 8350 Shaver Road (269) 327-0033 D & W Pharmacy 1588 (P) Portage, MI 49024 525 Romence Road Rite Aid Pharmacy #1822 (269) 323-3959 Portage, MI 49024 (P) (269) 329-3205 1950 W Center Avenue 8350 Shaver Road Portage, MI 49024 Portage, MI 49024 525 Romence Road (269) 323-3959 Portage, MI 49024 (269) 323-9400 (269) 329-3205 West Lake Drug 1950 W Center Avenue 8822 Portage Road Portage, MI 49024 Portage, MI 49002 (269) 323-9400 (269) 327-3049 8822 Portage Road Portage, MI 49002 (269) 327-3049

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 31 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Woodbridge Pharmacy 7901 Angling Road VICKSBURG KENT COUNTY Portage, MI 49024 (269) 324-8409 Fred’s Vicksburg ADA 7901 Angling Road Community Pharmacy (NP) Portage, MI 49024 121 West Prairie Street (269) 324-8409 Vicksburg, MI 49097 Ada Hillside Pharmacy (NP) (269) 649-0660 6745 E Fulton Avenue Ada, MI 49301 RICHLAND 121 West Prairie Street (616) 682-9100 Vicksburg, MI 49097 (269) 649-0660 RETAIL PHARMACIES Richland Village Drugs (NP) Hills Pharmacy Of BYRON CENTER 8900 Gull Road Vicksburg Richland, MI 49083 110 S Main Street (269) 629-9550 Family Fare Pharmacy #115 Vicksburg, MI 49097 (P) 8900 Gull Road (269) 649-1476 701 68th Street Sw Suite 410 Richland, MI 49083 110 S Main Street Byron Center, MI 49315 (269) 629-9550 Vicksburg, MI 49097 (616) 281-7605 (269) 649-1476 Family Fare Pharmacy #119 SCHOOLCRAFT (P) 2245 84th Street Sw KALKASKA COUNTY Byron Center, MI 49315 Harding’s Pharmacy (P) (616) 878-6047 139 N Grand Schoolcraft, MI 49087 KALKASKA Family Pharmacy Sw (269) 679-4222 Campus (NP) 2373 64th St Sw - Suite 1100 139 N Grand Glen’s Pharmacy #1513 (P) Byron Center, MI 49315 Schoolcraft, MI 49087 784 S Cedar Street (616) 643-3950 (269) 679-4222 Kalkaska, MI 49646 Kmart Pharmacy #4851 (P) Red Crown Pharmacy (NP) (231) 258-8681 701 68th Street 311 N Grand St Rite Aid Pharmacy #3966 Byron Center, MI 49315 Schoolcraft, MI 49087 (P) (616) 281-8212 (269) 679-2000 902 North Cedar Street Walgreens #10129 (P) 311 N Grand St Kalkaska, MI 49646 8364 Byron Center Ave Sw Schoolcraft, MI 49087 (231) 258-5511 Byron Center, MI 49315 (269) 679-2000 Shopko Pharmacy #2656 (P) (616) 878-0497 784 S Cedar St Kalkaska, MI 49646 (231) 258-0139 CALEDONIA

D & W Pharmacy 1577 (P) 9375 Cherry Valley Ave Se Caledonia, MI 49316 (616) 891-7898

32 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Meijer Pharmacy #199 (P) Wal-Mart Pharmacy CVS Pharmacy #8293 (NP) 1801 Marketplace Drive #10-1923 (NP) 1550 Lake Road Se

Caledonia, MI 49316 3999 Alpine Avenue Grand Rapids, MI 49506 PHARMACIES RETAIL (616) 656-6110 Comstock Park, MI 49321 (616) 235-0747 Professional Pharmacy (P) (616) 784-1619 D & W Pharmacy #1591 (P) 9175 Cherry Valley Road 2022 Apple Orchard Ave Caledonia, MI 49316 GRAND RAPIDS Grand Rapids, MI 49525 (616) 891-1116 (616) 361-3676 Rite Aid Pharmacy #1532 D & W Pharmacy 1573 (P) (P) Cancer & Hematology 6425 28th Street Se 9377 Cherry Valley Road Centers Of Western Grand Rapids, MI 49546 Caledonia, MI 49316 Michigan (NP) (616) 949-0340 (616) 891-1256 145 Michigan St Ne Ste 3100 D & W Pharmacy 1576 (P) Grand Rapids, MI 49503 Target T-2015 (P) 2181 Wealthy St Se (616) 954-9800 1925 Market Place Drive Grand Rapids, MI 49506 Caledonia, MI 49316 CHCWM - St. Mary’s (NP) (616) 451-3404 (616) 698-1186 250 Cherry Street Se Diplomat Specialty Grand Rapids, MI 49503 Pharmacy (NP) (616) 685-5600 CEDAR SPRINGS 214 East Fulton Street Coram Alternate Site Srvs. Grand Rapids, MI 49503 4334 Brockton Dr Suite D (616) 356-1800 Grand Rapids, MI 49512 Family Fare Pharmacy #335 Family Fare Pharmacy (616) 698-0272 (P) #1586 (P) 4175 17 Mile Road Costco Pharmacy #784 (P) 4325 Breton Rd Se Cedar Springs, MI 49319 5100 28th Street Se Grand Rapids, MI 49512 (616) 696-9198 Grand Rapids, MI 49508 (616) 281-5442 (616) 233-4428 Meijer Pharmacy #248 (P) Family Fare Pharmacy 3700 17 Mile Road Ne Curo #1587 (P) Cedar Springs, MI 49319 3876 East Paris Ave Se Ste 1415 E Fulton Street (616) 696-4633 13 Grand Rapids, MI 49503 Rite Aid Pharmacy #1526 Grand Rapids, MI 49512 (616) 774-9422 (616) 977-9700 (P) Family Fare Pharmacy #254 4117 17 Mile Road CVS Pharmacy #05610 (NP) (P) Cedar Springs, MI 49319 3590 Plainfield Ave Ne 1225 Leonard Avenue Ne (616) 696-9040 Grand Rapids, MI 49525 Grand Rapids, MI 49505 (616) 447-2563 (616) 459-6203 COMSTOCK PARK CVS Pharmacy #8291 (NP) Family Fare Pharmacy #339 727 28th Street (P) Grand Rapids, MI 49548 2755 Lake Michigan Drive Sam’s Pharmacy #10-6359 (616) 514-5602 Nw (NP) CVS Pharmacy #8292 (NP) Grand Rapids, MI 49504 3901 Alpine Avenue Nw 1155 Fuller (616) 791-4777 Comstock Park, MI 49321 Grand Rapids, MI 49503 Family Fare Pharmacy #636 (616) 647-9302 (616) 774-1041 (P) 5241 Northland Dr Ne Grand Rapids, MI 49525 (616) 447-2788

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 33 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Family Fare-Forest Hills Pharmerica # 7112 St. Mary’s Home Infusion Pharmacy (P) 4575 44th Street Se Suite A Program 4668 Cascade Rd Grand Rapids, MI 49512 360 Division South Ste 1d Grand Rapids, MI 49546 (616) 954-6833 Grand Rapids, MI 49503 (616) 949-0170 Rite Aid Pharmacy #1466 (616) 685-1111 Heart Of The City Pharmacy (P) St. Mary’s Ltc Pharmacy (NP) 1029 Four Mile Nw 360 Division Ave S Ste 1c 100 Cherry Street Grand Rapids, MI 49544 Grand Rapids, MI 49503 Grand Rapids, MI 49503 (616) 784-4400 (616) 685-1070 (616) 965-8278 Rite Aid Pharmacy #1517 Target T-2014 (P) Kay Pharmacy (P) (P) 5120 28th Street Se RETAIL PHARMACIES 2178 Plainfield Ne 1830 Brenton Road Se Grand Rapids, MI 49512 Grand Rapids, MI 49505 Grand Rapids, MI 49506 (616) 222-4890 (616) 361-7319 (616) 949-5710 The Chemist Shoppe Ltd (P) Keystone Pharmacy Rite Aid Pharmacy #1519 - 1900 Wealthy Se Ste 105 4021 Cascade Road Se Edison Plaza (P) Grand Rapids, MI 49506 Grand Rapids, MI 49546 2036 Lake Michigan Drive (616) 774-7799 (616) 974-9792 Grand Rapids, MI 49504 Village Pharmacy Of Grand Kmart Pharmacy #7205 (P) (616) 453-2473 Rapids (NP) 4111 North Kent Mall Rite Aid Pharmacy #1521 - 4252 Kalamazoo Ave Sw Grand Rapids, MI 49505 Gaslight Village (P) Grand Rapids, MI 49508 (616) 364-6147 2130 Wealthy Se (616) 281-1323 Meijer Pharmacy #011 (P) Grand Rapids, MI 49506 Walgreens #02581 (P) 1540 28th Street Se (616) 451-0711 1601 Kalamazoo Avenue Grand Rapids, MI 49508 Specialized Pharmacy West Grand Rapids, MI 49507 (616) 248-2633 400 Ann Street Nw Suite 104 (616) 247-5521 Meijer Pharmacy #020 (P) Grand Rapids, MI 49504 Walgreens #02806 (P) 2425 Alpine Nw (616) 365-9702 800 West Leonard Grand Rapids, MI 49544 Spectrum Outpatient Grand Rapids, MI 49504 (616) 365-6033 Pharmacy (NP) (616) 458-8300 Meijer Pharmacy #050 (P) 100 Michigan Ne Walgreens #03426 (P) 5531 28th Street Se Grand Rapids, MI 49503 3610 Plainfield Avenue Ne Grand Rapids, MI 49512 (616) 391-1638 Grand Rapids, MI 49525 (616) 949-0772 St. Marys Cathedral Square (616) 365-1221 Meijer Pharmacy #158 (P) Pharmacy Walgreens #04413 (P) 1997 East Beltline Ne 360 Division Ave S Ste 1a 6790 Cascade Rd Grand Rapids, MI 49525 Grand Rapids, MI 49503 Grand Rapids, MI 49546 (616) 447-1510 (616) 685-1147 (616) 954-2408 Meijer Pharmacy #216 (P) St. Mary’s Family Pharmacy Walgreens #04726 (P) 315 Wilson Avenue Wege Cntr/Hlth Learning 8 68th Street Sw Grand Rapids, MI 49544 (NP) Grand Rapids, MI 49548 (616) 735-2133 300 Lafayette Se (616) 827-0270 Meijer Pharmacy #312 (P) Grand Rapids, MI 49503 Walgreens #05095 (P) 3757 Plainfield Ne (616) 685-6105 1964 Fuller Avenue Ne Grand Rapids, MI 49525 Grand Rapids, MI 49505 (616) 364-9497 (616) 364-7071

34 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #07140 (P) Meijer Pharmacy #221 (P) Lincare Inc. 5100 East Beltline Road 3434 Century Drive Sw 3631 44th Street Se Ste C

Grand Rapids, MI 49306 Grandville, MI 49418 Kentwood, MI 49512 PHARMACIES RETAIL (616) 361-1758 (616) 724-2810 (616) 554-3530 Walgreens #09131 (P) Walgreens #03012 (P) Ltc Pharmacy 2643 Kalamazoo Ave Se 3191 28th St Sw 4477 E Paris Ave Grand Rapids, MI 49507 Grandville, MI 49418 Kentwood, MI 49512 (616) 452-4870 (616) 534-5533 (616) 214-8011 Walgreens #12561 (P) Walgreens #07160 (P) Rite Aid Pharmacy #4242 4550 Cascade Rd Se 4445 Ivanrest Ave Sw (P) Grand Rapids, MI 49546 Grandville, MI 49418 5995 Kalamazoo Ave Se (616) 957-8934 (616) 532-1065 Kentwood, MI 49508 Walgreens #12777 (P) Wal-Mart Pharmacy (616) 827-9906 4365 Lake Michigan Drive #10-2567 (NP) Rite Aid Pharmacy #4395 Nw 4542 Kenowa Avenue (P) Grand Rapids, MI 49506 Grandville, MI 48418 4410 South Division Avenue (616) 791-1655 (616) 667-9713 Kentwood, MI 49548 Walgreens #15007 (P) (616) 532-9241 425 Fuller Ave Ne KENT Sam’s Pharmacy #10-6319 Grand Rapids, MI 49503 (NP) (616) 776-9925 4326 28th Street Se Walker Street Pharmacy (P) Grand Rapids Home For Kentwood, MI 49512 1181 Walker Street Nw Veterans (616) 285-3346 Grand Rapids, MI 49504 3000 Monroe Avenue Nw Walgreens #05534 (P) (616) 458-9640 Kent, MI 49505 6020 Kalamazoo Avenue Se (616) 364-5300 Wal-Mart Pharmacy Kentwood, MI 49508 #10-2493 (NP) (616) 698-9165 5859 28th Street KENT CITY Walgreens #10803 (P) Grand Rapids, MI 49546 2425 44th Street Se (616) 949-9892 Kentwood, MI 49512 Woodpointe Pharmacy (P) Grices Pharmacy (P) (616) 455-5151 2500 East Beltline Avenue Se 6 S Main Street Kent City, MI 49330 Suite O LOWELL Grand Rapids, MI 49546 (616) 678-5380 (616) 949-4499 KENTWOOD Meijer Pharmacy #205 (P) GRANDVILLE 11901 Fulton Street Lowell, MI 49331 CVS Pharmacy #8297 (NP) (616) 897-4710 5225 Eastern Avenue Family Fare Pharmacy Rite Aid Pharmacy #1529 Kentwood, MI 49508 #1579 (P) (P) (616) 261-3662 3960 44th Street Sw 1401 W Main Street Grandville, MI 49418 Family Fare Pharmacy #265 Lowell, MI 49331 (616) 534-9649 (P) (616) 897-9221 6127 Kalamazoo Se Kentwood, MI 49508 (616) 698-8234

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 35 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens # 12893 (P) Parkwood Pharmacy (NP) 11980 Fulton St E WALKER 1106 Burton Street Sw Lowell, MI 49331 Wyoming, MI 49509 (616) 897-3160 Target Pharmacy T-397 (P) (616) 245-2463 3248 Alpine Avenue Nw Target Pharmacy T-1052 (P) ROCKFORD Walker, MI 49544 5455 Clyde Park Sw (616) 784-7601 Wyoming, MI 49509 Walgreens #10351 (P) (616) 530-5525 D & W Pharmacy 1572 (P) 3596 Apline Ave Nw Walgreens #02714 (P) 201 Marcell Dr Ne Walker, MI 49544 4425 S Division Avenue Rockford, MI 49341 (616) 647-2260 Wyoming, MI 49548 RETAIL PHARMACIES (616) 863-9376 (616) 531-9494 Hometown Pharmacy Ltc WYOMING Walgreens #04299 (P) 4382 14 Mile Road 2829 S Division Rockford, MI 49341 Wyoming, MI 49548 (616) 785-2100 Costco Pharmacy #744 (P) (616) 248-9030 Meijer Pharmacy Inc. #226 4901 Wilson Avenue Sw Walgreens #11249 (P) (P) Wyoming, MI 49418 1550 36th St Sw Ste A 2799 10 Mile Road Ne (616) 406-2678 Wyoming, MI 49509 Rockford, MI 49341 CVS Pharmacy #07549 (NP) (616) 249-7887 (616) 863-3410 5603 Byron Center Avenue Walgreens #11801 (P) Rite Aid Pharmacy #1468 Sw 5575 Byron Center Ave Sw (P) Wyoming, MI 49519 Wyoming, MI 49519 511 10 Mile Road Rum Creek (616) 530-2338 (616) 534-5175 Mall CVS Pharmacy #8290 (NP) Rockford, MI 49341 3601 Clyde Park Sw (616) 866-4420 Wyoming, MI 49509 LAKE COUNTY (616) 257-6641 SPARTA CVS Pharmacy #8306 (NP) BALDWIN 2375 28th Street Sw Wyoming, MI 49519 Family Fare Pharmacy #408 (616) 249-7174 Pattie Drug Of Baldwin (P) (NP) 565 South State Road Family Fare Pharmacy #107 (P) 868 Michigan Avenue Sparta, MI 49345 Baldwin, MI 49304 (616) 887-8861 1148 28th Street Sw Wyoming, MI 49509 (231) 745-4697 Mombers Drug Store (P) (616) 724-1944 133 Division East Sparta, MI 49345 Family Fare Pharmacy LAPEER COUNTY (616) 887-7323 #1580 (P) 2900 Burlingame Ave Sw Rite Aid Pharmacy #3520 Wyoming, MI 49509 ALMONT (P) (616) 538-1490 11 E Division Street Sparta, MI 49345 Meijer Pharmacy #036 (P) Rite Aid Pharmacy #7740 (616) 887-0600 5500 Clyde Park Sw (P) Wyoming, MI 49509 860 N Van Dyke Road (616) 531-9629 Almont, MI 48003 (810) 798-8501

36 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Meijer Pharmacy #140 (P) LEELANAU COUNTY IMLAY CITY 1555 Demille Road

Lapeer, MI 48446 PHARMACIES RETAIL Kroger Pharmacy #465 (P) (810) 667-8110 GLEN ARBOR 1821 South Cedar Rite Aid Pharmacy #3887 - Imlay City, MI 48444 Knollwood Clinic (P) (810) 721-3262 1254 N Main The Prescription Shop Of Glen Arbor (NP) Narayan Drugs And Lapeer, MI 48446 6404 Western Avenue Pharmacy (NP) (810) 664-1932 Rite Aid Pharmacy #4309 Glen Arbor, MI 49636 6800 Newark Rd Ste 200 (231) 334-6608 Imlay City, MI 48444 (P) (810) 721-8705 1022 W Genesee Street Rite Aid Pharmacy #4330 Lapeer, MI 48446 SUTTONS BAY (P) (810) 664-4578 557 North Cedar Street Rogers Pharmacy, Inc. (P) Bay Shore Pharmacy (NP) Imlay City, MI 48444 316 W Nepessing St 93 A 4th Street (810) 724-0576 Lapeer, MI 48446 (810) 664-0600 Suttons Bay, MI 49682 Sav On Drugs #8 (P) (231) 271-6111 2040 S Cedar Street Walgreens #12971 (P) Prescription Shop Of Imlay City, MI 48444 571 S Main St Suttons Bay Inc. (NP) (810) 724-7692 Lapeer, MI 48446 (810) 538-0014 321 B North St Joseph Street Suttons Bay, MI 49682 LAPEER Wal-Mart Pharmacy (231) 271-3881 #10-1987 (NP) 555 East Genesee Hometown Pharmacy Of Lapeer, MI 48446 LENAWEE COUNTY Lapeer PLLC (P) (810) 664-8360 944 Baldwin Road Suite C ADDISON Lapeer, MI 48446 METAMORA (810) 245-6967 Kroger Co Of Michigan Addison Pharmacy (NP) #600 (P) Rite Aid Pharmacy #3356 114 E Main Street 540 S Main Street (P) Addison, MI 49220 Lapeer, MI 48446 3939 South Lapeer (517) 547-6686 (810) 664-0391 Metamora, MI 48455 Lapeer Community (810) 678-2331 ADRIAN Pharmacy LLC (P) 700 South Main Street #109 NORTH BRANCH Lapeer, MI 48446 Country Market Pharmacy (810) 664-4700 (P) McLaren Drug Shop - Lrmc Ehardt’s Pharmacy Inc #6 1535 West Maumee Street (P) (NP) Adrian, MI 49221 1375 N Main St 6002 N Lapeer Road (517) 265-9162 Lapeer, MI 48446 North Branch, MI 48461 (810) 793-5006 CVS Pharmacy #8013 (NP) (810) 667-5970 1003 N Main St Adrian, MI 49221 (517) 265-1565

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 37 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #3959 (P) Shopko Pharmacy #2648 (P) 1416 South Main Street CLINTON 2655 W Chicago Blvd Building 100 Tecumseh, MI 49286 Adrian, MI 49221 Schmidt & Sons Pharmacy (517) 423-4420 (517) 263-4286 Of Clinton Inc. (P) Walgreens #12820 (P) Meijer Pharmacy #045 (P) 140 W Michigan Avenue 1330 W Chicago Blvd 217 East Us 223 Clinton, MI 49236 Tecumseh, MI 49286 Adrian, MI 49221 (517) 456-4150 (517) 423-3560 (517) 265-8530 Rite Aid Pharmacy #4405 HUDSON LIVINGSTON COUNTY (P) RETAIL PHARMACIES 1200 South Main Street Adrian, MI 49221 Hudson Pharmacy (P) BRIGHTON (517) 263-0603 325 Railroad Street Walgreens #07319 (P) Hudson, MI 49247 706 South Main Street (517) 448-3111 CVS Pharmacy #8111 (NP) Adrian, MI 49221 5757 Whitmore Lake Road # (517) 265-6675 100 MORENCI Brighton, MI 48116 Wal-Mart Pharmacy (810) 229-9772 #10-1836 (NP) 1601 East Us 223 Mike’s Pharmacy (P) CVS Pharmacy #8204 (NP) Adrian, MI 49221 213 W Main Street 106 W Grand River (517) 265-9686 Morenci, MI 49256 Brighton, MI 48116 (810) 220-8804 Wheelock Drugs (NP) (517) 458-2261 700 East Church Health Plus Pharmacy Of Adrian, MI 49221 ONSTED Brighton (P) (517) 263-7175 2305 Genoa Business Park Ste 140 Wheelock Pharmacy North Brighton, MI 48114 Town Commons (NP) The Medicine Shoppe (810) 229-4420 1325 North Main Street #1822 (P) Adrian, MI 49221 400 N Main - Suite C Kroger Co Of Michigan (517) 263-2400 Onsted, MI 49265 #638 (P) (517) 467-7225 9968 E Grand River Ave Brighton, MI 48116 BLISSFIELD (810) 225-2275 TECUMSEH Meijer Pharmacy #046 (P) Schmidt & Sons Pharmacy 8650 W Grand River Of Blissfield (P) CVS Pharmacy #8025 (NP) Brighton, MI 48116 177 W Brooke Lane 807 W Chicago Blvd (810) 227-3603 Blissfield, MI 49228 Tecumseh, MI 49286 Rite Aid Pharmacy #4314 (517) 486-2145 (517) 423-6676 (P) Schmidt & Sons Pharmacy 8701 W Grand River Of Tecumseh Inc. (P) Brighton, MI 48116 120 E Chicago Blvd (810) 220-5840 Tecumseh, MI 49286 (517) 423-3250

38 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Target T-0922 (P) Target Pharmacy T-1971 (P) 8043 Challis Road HARTLAND TOWNSHIP 10025 E Highland Rd

Brighton, MI 48116 Howell, MI 48843 PHARMACIES RETAIL (810) 229-4264 Meijer Pharmacy #245 (P) (810) 632-2317 VG’s Pharmacy #1931 (P) 2160 Hartland Rd VG’s Pharmacy #1920 (P) 9870 E Grand River Hartland Township, MI 48353 2400 W Grand River Brighton, MI 48116 (810) 632-4210 Howell, MI 48843 (810) 229-0323 Wal-Mart Pharmacy 10-4584 (517) 548-7070 Walgreens #05170 (P) (NP) Walgreens #01910 (P) 8720 West Grand River 10400 Highland Road 2321 East Grand River Avenue Hartland Township, MI 48353 Avenue Brighton, MI 48116 (810) 632-9017 Howell, MI 48843 (810) 225-4530 (517) 546-5716 Walgreens #12310 (P) HOWELL Wal-Mart Pharmacy 5505 S Old Us 23 #10-1754 (NP) Brighton, MI 48116 3850 East Grand River (810) 229-5466 CVS Pharmacy #8046 (NP) Avenue 2235 E Grand River Ave Howell, MI 48843 (517) 548-9511 FOWLERVILLE Howell, MI 48843 (517) 548-2401 CVS Pharmacy #8295 (NP) PINCKNEY Fowlerville Pharmacy (NP) 10073 Highland Road 119 E Grand River Howell, MI 48843 Fowlerville, MI 48836 (810) 632-9432 Kroger Co #16721 (P) (517) 223-9832 CVS Pharmacy #8308 (NP) 9700 Chilson Commons Circle Wal-Mart Pharmacy 3960 E Highland Rd Pinckney, MI 48169 #10-4540 (NP) Howell, MI 48843 (734) 213-7980 970 Gehringer Drive (517) 545-7525 Rite Aid Pharmacy #7877 Fowlerville, MI 48836 Kroger Co Of Michigan (517) 223-1106 (P) #18720 (P) 75 S Dexter St 3663 Grand River Avenue Pinckney, MI 48169 Howell, MI 48843 GREEN OAK TOWNSHIP (734) 878-2047 (517) 546-3773 Kroger Pharmacy #444 (P) Costco Pharmacy #786 (P) 10059 Highland Rd WHITMORE LAKE 6700 Whitmore Lake Road Howell, MI 48843 Green Oak Township, MI (810) 991-2352 48116 Proos Pharmacy Of (810) 220-8977 Meijer Pharmacy #172 (P) Whitmore Lake (P) 3883 East Grand River 11912 Whitmore Lake Road Howell, MI 48843 Whitmore Lake, MI 48189 HARTLAND (517) 552-6610 (734) 449-0004 Rite Aid Pharmacy #4420 Walgreens #10499 (P) (P) 10081 E Highland Rd 1002 E Grand River Ave Hartland, MI 48353 Howell, MI 48843 (810) 632-9192 (517) 546-8701

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 39 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Mackinac Straits Hospital Target T-0945 (P) LUCE COUNTY Pharmacy (NP) 51400 Gratiot Avenue 220 Burdette Street Chesterfield, MI 48051 NEWBERRY St. Ignace, MI 49781 (586) 598-4770 (906) 643-0447 CHESTERFIELD TOWNSHIP Newberry Hometown Pharmacy (P) MACOMB COUNTY 2013 S Newberry Ave CVS Pharmacy #8238 (NP) Newberry, MI 49868 ARMADA 47011 Gratiot (906) 293-9900 Chesterfield Township, MI

RETAIL PHARMACIES Snyder Drug #208 (P) 48051 7293 M-123 Armada Pharmacy (P) (586) 421-1021 Newberry, MI 49868 23032 E Main St Henry Ford Macomb (906) 293-8571 Armada, MI 48005 Ambulatory Pharmacy #2 (586) 784-9222 (P) 30795 23 Mile Road MACKINAC COUNTY CENTERLINE Chesterfield Township, MI 48047 (586) 421-3020 CEDARVILLE Binsons Pharmacy (NP) Meijer Pharmacy #105 (P) 26834 Lawrence 27255 23 Mile Road Arfstrom Pharmacy (NP) Centerline, MI 48015 Chesterfield Township, MI 4 East M-134 Hwy (586) 757-2755 48051 Cedarville, MI 49719 Centerline City Pharmacy (586) 598-9348 (906) 484-3355 LLC (P) Rite Aid Pharmacy #4361 8033 E Ten Mile Rd Ste 103 (P) CURTIS Centerline, MI 48015 50290 Gratiot Avenue (586) 427-5344 Chesterfield Township, MI CVS Pharmacy #8032 (NP) 48051 Curtis Family Pharmacy 7333 E 10 Mile Road (586) 949-6110 (NP) Centerline, MI 48015 Walgreens #04452 (P) W17220 Main St (586) 759-5100 51008 Gratiot Ave Curtis, MI 49820 Rite Aid Pharmacy #4897 Chesterfield Township, MI (906) 586-3333 (P) 48051 25425 Van Dyke Ave (586) 948-0119 ST. IGNACE Centerline, MI 48015 Wal-Mart Pharmacy (586) 757-6179 #10-2692 (NP) 45400 Marketplace Blvd Bay Pharmacy (NP) CHESTERFIELD Chesterfield Township, MI 112 S State Street 48051 St. Ignace, MI 49781 (586) 421-1265 (906) 643-7725 CVS Pharmacy #8272 (NP) Lambert Health Clinic 52950 Gratiot Avenue Pharmacy (P) Chesterfield, MI 48051 225 Waseh Drive (586) 598-2328 St. Ignace, MI 49781 (906) 643-8689

40 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #4405 (P) Target T-819 (P) CLINTON TOWNSHIP 34800 Groesbeck Highway 33860 Gratiot Avenue South

Clinton Township, MI 48035 Clinton Township, MI 48035 PHARMACIES RETAIL CVS Pharmacy #8016 (NP) (586) 791-6464 (586) 913-0294 40925 Garfield Road Kroger Co Of Michigan Value Center Pharmacy I (P) Clinton Township, MI 48038 #528 (P) 37155 Harper Avenue (586) 263-4070 41941 Garfield Clinton Township, MI 48036 CVS Pharmacy #8092 (NP) Clinton Township, MI 48038 (586) 954-9100 37050 Gratiot (586) 263-0238 Walgreens #04608 (P) Clinton Township, MI 48036 Lakeshore Medical 1045 South Gratiot Avenue (586) 463-3110 Pharmacy (P) Clinton Township, MI 48036 CVS Pharmacy #8093 (NP) 33720 Harper Ave (586) 954-4905 36540 Garfield Clinton Township, MI 48035 Walgreens #05968 (P) Clinton Township, MI 48035 (586) 415-4825 16741 Canal Road (586) 790-2415 Meijer Pharmacy #243 (P) Clinton Township, MI 48038 CVS Pharmacy #8173 (NP) 40445 S Groesbeck Hwy (586) 286-5753 15255 17 Mile Road Clinton Township, MI 48036 Walgreens #06175 (P) Clinton Township, MI 48038 (586) 239-7010 34899 Groesbeck Highway (586) 412-6755 Northeast Pharmacy (P) Clinton Township, MI 48035 DMC Pharmacy Stilson (P) 43900 Garfield Suite 102 (586) 741-0105 42700 Garfield Rd Ste 130 Clinton Township, MI 48038 Walgreens #07768 (P) Clinton Township, MI 48038 (586) 263-6400 39040 Garfield (586) 416-1644 Premier Pharmacy (P) Clinton Township, MI 48038 Franks Pharmacy Advanced 34025 Harper Ave Ste B (586) 286-5351 Care (NP) Clinton Township, MI 48035 Wal-Mart Pharmacy # 39023 Harper (586) 741-4850 10-4660 (NP) Clinton Township, MI 48036 Rite Aid Pharmacy #4316 18400 Hall Road (586) 464-2000 (P) Clinton Township, MI 48038 Garfield Pharmacy Inc. (P) 37165 Groesbeck Highway (586) 263-7690 42645 Garfield Road Clinton Township, MI 48036 (586) 468-1428 Suite 102 EASTPOINTE Clinton Township, MI 48038 Rite Aid Pharmacy #4318 (586) 416-1100 (P) Henry Ford Macomb 35250 South Gratiot Avenue CVS Pharmacy #8011 (NP) Ambulatory Pharmacy #1 Clinton Township, MI 48035 16000 E 10 Mile Road (NP) (586) 791-1550 Eastpointe, MI 48021 16151 Nineteen Mile Road - Rite Aid Pharmacy #4537 (586) 777-7570 Suite 100 (P) CVS Pharmacy #8170 (NP) Clinton Township, MI 48038 36485 Garfield Road 18140 Nine Mile Road (586) 263-2677 Clinton Township, MI 48035 Eastpointe, MI 48021 Kmart Pharmacy #3546 (P) (586) 791-0738 (586) 447-4370 41601 Garfield Sunshine Pharmacy (P) CVS Pharmacy #8197 (NP) Clinton Township, MI 48038 43614 Garfield Road 24931 Kelly (586) 263-0950 Clinton Township, MI 48038 Eastpointe, MI 48021 (586) 286-5005 (586) 447-4375

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 41 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Etel - Rx Walgreens #04255 (P) Target T 2113 (P) 21811 Kelly Road Suite 103 31100 Groesbeck Hwy 20877 Hall Rd Eastpointe, MI 48021 Fraser, MI 48026 Macomb, MI 48044 (586) 498-7600 (586) 294-5729 (586) 464-1129 Fairway Drugs (P) Walgreens #07509 (P) Walgreens #07527 (P) 19332 E Ten Mile Road 15267 E 14 Mile Road 21828 23 Mile Road Eastpointe, MI 48021 Fraser, MI 48026 Macomb, MI 48042 (586) 771-0030 (586) 294-5463 (586) 421-1897 Medpointe Pharmacy (P) Walgreens #11264 (P) 16546 E 9 Mile Road HARRISON TOWNSHIP 21790 21 Mile Rd Eastpointe, MI 48021 Macomb, MI 48044 RETAIL PHARMACIES (586) 533-2835 (586) 469-0254 Pay Less Drugs (P) CVS Pharmacy #8095 (NP) 26220 Crocker 20804 Gratiot Ave MACOMB TOWNSHIP Eastpointe, MI 48021 Harrison Township, MI 48045 (586) 222-2224 (586) 954-0800 Rite Aid Pharmacy #4490 AHS St John Pharmacy 23 (P) LENOX Mile (NP) 22600 Gratiot 17900 23 Mile Road Eastpointe, MI 48021 Suite 104 (586) 772-6699 Meijer Pharmacy #242 (P) Macomb Township, MI 48044 36865 26 Mile Rd (586) 868-9050 Rx Pharmacy (NP) Lenox, MI 48048 18801 E 9 Mile Rd CVS Pharmacy #00445 (NP) (586) 716-5833 Eastpointe, MI 48021 51000 Romeo Plank Rd (586) 552-5672 Macomb Township, MI 48042 (586) 992-8570 Walgreens #04795 (P) MACOMB 25016 Gratiot Avenue CVS Pharmacy #8287 (NP) Eastpointe, MI 48021 21777 21 Mile Road (586) 498-8426 CVS Pharmacy #05406 (NP) Macomb Township, MI 48044 50980 North Avenue (586) 949-2082 Walgreens #05083 (P) Macomb, MI 48042 Kroger Co Of Michigan 17755 8 Mile Road (586) 949-7323 Eastpointe, MI 48021 #683 (P) (586) 778-7582 CVS Pharmacy #8158 (NP) 15251 23 Mile Road 46850 Romeo Plank Macomb Township, MI 48042 Macomb, MI 48044 (586) 677-0968 FRASER (586) 412-1113 Kroger Co Of Michigan Lakeside Pharmacy (P) #684 (P) 15959 Hall Rd - Suite 101 CVS Pharmacy #8091 (NP) 21555 21 Mile Road Macomb, MI 48044 33021 Garfield Macomb Township, MI 48044 (586) 532-4141 Fraser, MI 48026 (586) 421-9877 (586) 293-5012 Rite Aid Pharmacy #3880 Kroger Pharmacy 18716 (P) (P) Meijer Pharmacy #145 (P) 16450 26 Mile Rd 15250 24 Mile Road 34835 Utica Rd Macomb Township, MI 48042 Macomb, MI 48042 Fraser, MI 48026 (586) 677-8730 (586) 677-1108 (586) 415-6410

42 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #1025 Rite Aid Pharmacy #4695 Kmart Pharmacy #3570 (P) (P) (P) 67300 Main Street

46977 Romeo Plank Road 28350 S River Road Richmond, MI 48062 PHARMACIES RETAIL Macomb Township, MI 48044 Mt. Clemens, MI 48043 (586) 727-2754 (586) 286-4285 (586) 463-8661 Kroger Co Of Michigan St. John Pharmacy - #706 (P) Macomb Township (NP) NEW BALTIMORE 66900 Gratiot 46591 Romeo Plank Richmond, MI 48062 Suite 125 (586) 727-4946 Macomb Township, MI 48044 CVS Pharmacy #8108 (NP) Rite Aid Pharmacy #4270 (586) 226-6060 33920 23 Mile Road (P) Walgreens #04453 (P) New Baltimore, MI 48047 66711 Gratiot Ave 47100 Hayes Road (586) 725-3900 Richmond, MI 48062 Macomb Township, MI 48044 CVS Pharmacy #8261 (NP) (586) 727-9715 (586) 532-8161 37100 Green Road Village Family Pharmacy, New Baltimore, MI 48047 Inc. (P) (586) 716-1202 MEMPHIS 31505 32 Mile Road Kroger Co #16724 (P) Richmond, MI 48062 35000 23 Mile Road (586) 727-0090 Memphis Drugs (P) New Baltimore, MI 48047 80850 Main Street (586) 725-6903 ROMEO Memphis, MI 48041 Rite Aid Pharmacy #4833 (810) 392-2424 (P) 35350 23 Mile Road CVS Pharmacy #8179 (NP) MT. CLEMENS New Baltimore, MI 48047 71220 Van Dyke (586) 725-3640 Romeo, MI 48065 Walgreens #05227 (P) (586) 336-1905 Break Thru Medical (NP) 51200 Washington Street 350 Church St New Baltimore, MI 48047 ROSEVILLE Mt. Clemens, MI 48043 (586) 716-3187 (586) 469-1928 McLaren Drug Shop - Costco Pharmacy #394 (P) NEW HAVEN Mcrmc (P) 27118 Gratiot Ave 1000 Harrington Roseville, MI 48066 Mt. Clemens, MI 48043 Rite Aid Pharmacy #04022 (586) 447-1436 (586) 493-2800 (P) CVS Pharmacy #8062 (NP) Phil’s Pharmacy (NP) 59010 Gratiot Avenue 28774 Gratiot 35 N Walnut New Haven, MI 48048 Roseville, MI 48066 Mt. Clemens, MI 48043 (586) 749-0009 (586) 777-6350 (586) 468-0597 Doctors Pharmacy (NP) Rite Aid Pharmacy #4404 RICHMOND 18801 E Ten Mile Road (P) Roseville, MI 48066 5 South Grosebeck Highway (586) 777-2190 Mt. Clemens, MI 48043 CVS Pharmacy #8024 (NP) Kmart Pharmacy #4998 (P) (586) 468-0978 67181 Main Street 17580 Frazho Richmond, MI 48062 Roseville, MI 48066 (586) 727-2781 (586) 498-3359

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 43 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kroger Co Of Michigan Ap Specialty Medications, Pharmascript Of Shelby (P) #663 (P) LLC (NP) 50505 Schoenherr Rd Ste 26130 Gratiot Avenue 12316 Twenty-Four Mile 130 Roseville, MI 48066 Road Shelby Township, MI 48315 (586) 776-8583 Shelby Township, MI 48315 (586) 803-0800 Kroger Pharmacy #455 (P) (586) 254-3568 Rite Aid Pharmacy #4321 30851 Gratiot Costco Pharmacy #374 (P) (P) Roseville, MI 48066 45460 Market Street 51037 Van Dyke Avenue (586) 541-3314 Shelby Township, MI 48315 Shelby Township, MI 48316 Meijer Pharmacy #063 (P) (586) 580-2002 (586) 739-1100 30800 Little Mack CVS Pharmacy #8113 (NP) Target T-1466 (P) RETAIL PHARMACIES Roseville, MI 48066 2115 25 Mile Road 8200 26 Mile Road (586) 296-5577 Shelby Township, MI 48316 Shelby Township, MI 48317 Rite Aid Pharmacy #4426 (248) 652-2227 (586) 677-2611 (P) CVS Pharmacy #8144 (NP) Walgreens #05291 (P) 25996 Gratiot Avenue 46960 Van Dyke Avenue 13664 23 Mile Road Roseville, MI 48066 Shelby Township, MI 48317 Shelby Township, MI 48315 (586) 774-1070 (586) 726-9220 (586) 247-1199 Sam’s Pharmacy #10-6662 CVS Pharmacy #8154 (NP) Walgreens #11395 (P) (NP) 50840 Shelby 56805 Van Dyke Ave 31940 Gratiot Avenue Shelby Township, MI 48317 Shelby Township, MI 48316 Roseville, MI 48066 (586) 731-6660 (586) 786-1856 (586) 415-9980 CVS Pharmacy #8156 (NP) Wal-Mart Pharmacy Wal-Mart Pharmacy 15121 24 Mile Rd #10-3487 (NP) #10-2959 (NP) Shelby Township, MI 48315 51450 Shelby Parkway 28804 Gratiot Avenue (586) 677-4015 Shelby Township, MI 48315 Roseville, MI 48066 CVS Pharmacy #8189 (NP) (586) 997-9524 (586) 777-9475 13500 22 Mile Rd Shelby Township, MI 48315 ST. CLAIR SHORES SHELBY TOWNSHIP (586) 997-2050 CVS Pharmacy #8416 (NP) 53069 Van Dyke Collie Drugs (P) Advanced Care Infusion - Shelby Township, MI 48316 21722 Harper Shelby (586) 781-2655 St. Clair Shores, MI 48080 (586) 776-6122 50680 Corporate Dr - Suite 1 Kmart Pharmacy #3126 (P) Shelby Township, MI 48315 7601 23 Mile Road CVS Pharmacy #8040 (NP) (586) 323-8280 Shelby Township, MI 48316 27700 Harper Avenue Advanced Care Pharmacy (586) 739-4200 St. Clair Shores, MI 48081 (586) 773-0500 Services - Shelby (NP) Kroger Co Of Michigan 50680 Corporate Drive #704 (P) CVS Pharmacy #8100 (NP) Shelby Township, MI 48315 2058 25 Mile Road 24001 Harper (586) 323-8270 Shelby Township, MI 48316 St. Clair Shores, MI 48080 (248) 651-9752 (586) 774-1570 CVS Pharmacy #8130 (NP) 31240 Harper St. Clair Shores, MI 48082 (586) 415-8002

44 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

CVS Pharmacy #8183 (NP) St. John Pharmacy - St. CVS Pharmacy #8080 (NP) 22515 Greater Mack Clair Shores (NP) 13475 15 Mile Road

St. Clair Shores, MI 48080 21000 12 Mile Rd Ste 124 Sterling Heights, MI 48312 PHARMACIES RETAIL (586) 447-4368 St. Clair Shores, MI 48081 (586) 268-2900 Henry Ford Medical Center (586) 447-5030 CVS Pharmacy #8191 (NP) Pharmacy - St.clair Shrs Walgreens #01610 (P) 4025 18 Mile Road (NP) 21211 Harper Avenue Sterling Heights, MI 48314 24725 E Jefferson St. Clair Shores, MI 48080 (586) 803-6271 St. Clair Shores, MI 48080 (586) 776-7052 CVS Pharmacy #8300 (NP) (586) 447-3680 Walgreens #04308 (P) 43611 Schoenherr Kmart Pharmacy #4177 (P) 32201 Harper Avenue Sterling Heights, MI 48313 22801 Harper Avenue St. Clair Shores, MI 48082 (586) 254-8418 St. Clair Shores, MI 48080 (586) 293-5152 Franklin Discount Pharmacy (586) 779-4340 Walgreens #06529 (P) (NP) Kroger Pharmacy #495 (P) 29520 Harper Avenue 2101 17 Mile Rd 23191 Marter Road St. Clair Shores, MI 48081 Sterling Heights, MI 48310 St. Clair Shores, MI 48080 (586) 447-3208 (586) 698-0017 (586) 541-1370 Walgreens #07787 (P) Henry Ford Medical Center Kroger Pharmacy #445 (P) 25015 Little Mack Avenue Pharmacy - Lakeside (NP) 22332 Nine Mile St. Clair Shores, MI 48080 14500 Hall Road St. Clair Shores, MI 48080 (586) 498-9540 Sterling Heights, MI 48313 (586) 541-1042 (586) 247-2990 Lakeview Specialty STERLING HEIGHTS Henry Ford Medical Center Pharmacy (NP) Pharmacy - Sterling Hts 21400 E 11 Mile Road (NP) St. Clair Shores, MI 48081 Atlantic Medical Pharmacy 3500 15 Mile Road (586) 777-4100 (NP) Sterling Heights, MI 48310 Park Pharmacy #2 (NP) 37300 Dequindre Rd Ste 122 (586) 977-9971 20225 E Nine Mile Road Sterling Heights, MI 48310 Holiday Pharmacy P.L.L.C. St. Clair Shores, MI 48080 (586) 698-2264 (P) (586) 285-9600 Canal Pharmacy (P) 37771 Schoenherr Pharmor Pharmacy - St. 13721 19 Mile Road Sterling Heights, MI 48312 Clair Shores (NP) Sterling Heights, MI 48313 (586) 274-4332 28001 Harper Ave (586) 566-9400 Kmart Pharmacy #3327 (P) St. Clair Shores, MI 48080 Caremont Pharmacy (NP) 2051 18 Mile Road (586) 443-5180 44344 Dequindre Rd Ste 120 Sterling Heights, MI 48314 Rite Aid Pharmacy #4375 Sterling Heights, MI 48314 (586) 739-2733 (P) (586) 323-6400 Kroger Co Of Michigan 23201 Marter CVS Pharmacy #8014 (NP) #673 (P) St. Clair Shores, MI 48080 3815 E 15 Mile Road 2260 Eighteen Mile Rd (586) 773-1100 Sterling Heights, MI 48310 Sterling Heights, MI 48314 Rite Aid Pharmacy #4500 (586) 977-3610 (586) 977-9230 (P) CVS Pharmacy #8078 (NP) Kroger Pharmacy #449 (P) 25100 Harper Avenue 15142 Hall Rd 43893 Schoenherr Rd St. Clair Shores, MI 48080 Sterling Heights, MI 48313 Sterling Heights, MI 48313 (586) 445-8181 (586) 247-5610 (586) 685-1346

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 45 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Macomb Pharmacy (NP) Target Pharmacy T-605 (P) 2405 E 14 Mile Rd 35700 Van Dyke Avenue UTICA Sterling Heights, MI 48310 Sterling Heights, MI 48312 (586) 979-9020 (586) 795-0682 Meijer Pharmacy #065 (P) Meijer Pharmacy #055 (P) Target T-2254 (P) 15055 Hall Road 36600 Van Dyke 2310 Metropolitan Pkwy Utica, MI 48315 Sterling Heights, MI 48312 Sterling Heights, MI 48310 (810) 566-0330 (586) 978-7640 (586) 698-1028 Sam’s Pharmacy #10-6664 Plumbrook Prescription The Medicine Shoppe (NP) Centre (NP) 3979 17 Mile Rd 45600 Utica Park Blvd 39880 Van Dyke Sterling Heights, MI 48310 Utica, MI 48315 RETAIL PHARMACIES Sterling Heights, MI 48313 (586) 268-6266 (586) 739-5472 (586) 939-9580 Walgreens #01246 (P) Target T-0278 (P) Rite Aid Pharmacy #4339 13700 Canal Road 13221 Hall Road (P) Sterling Heights, MI 48313 Utica, MI 48315 11743 15 Mile Rd (586) 532-9761 (586) 254-7226 Sterling Heights, MI 48312 Walgreens #04661 (P) (586) 979-3100 4019 Metropolitan Parkway WARREN Rite Aid Pharmacy #4360 Sterling Heights, MI 48310 (P) (586) 446-8104 13500 19 Mile Road Walgreens #06636 (P) Advanced Care Pharmacy Sterling Heights, MI 48313 13901 Metro Parkway Services Of Metro Detroit (586) 323-0286 Sterling Heights, MI 48312 (NP) Rite Aid Pharmacy #4389 (586) 446-8770 24788 Forterra Drive (P) Walgreens #07033 (P) Warren, MI 48089 43034 Dequindre Road 43250 Van Dyke Avenue (586) 758-7000 Sterling Heights, MI 48314 Sterling Heights, MI 48314 AHS St. John Pharmacy Ltc (586) 254-1021 (586) 803-1602 (NP) Rite Aid Pharmacy #4703 Wal-Mart Pharmacy 31700 Van Dyke Ste 190 (P) #10-2558 (NP) Warren, MI 48093 37900 Van Dyke 44575 Mound Road (586) 276-8040 Sterling Heights, MI 48312 Sterling Heights, MI 48314 American Mail Order (586) 268-2500 (586) 323-2570 Pharmacy Inc (NP) Sav On Drugs #5 (P) Wal-Mart Pharmacy 23290 Schoenherr 43500 Van Dyke #10-2559 (NP) Warren, MI 48089 Sterling Heights, MI 48314 33201 Van Dyke Avenue (586) 772-6872 (586) 739-1450 Sterling Heights, MI 48093 BC Of Michigan Pharmacy Sav-Mor #97 Kashat (586) 939-8171 (NP) Pharmacy Troy (P) Warren Pharmacy And 4050 E Twelve Mile Rd 34644 Dequindre - Sunrise Medical Supplies, P.C. (NP) Warren, MI 48092 Professional Bldg 35450 Dequindre Rd Ste (586) 578-0220 Sterling Heights, MI 48310 102a Berkley Pharmacy (P) (586) 698-0336 Sterling Heights, MI 48310 28577 Schoenherr Road Taleens Pharmacy (NP) (248) 541-5800 Warren, MI 48088 38300 Van Dyke Ave (586) 573-8300 Sterling Heights, MI 48312 (586) 977-3822

46 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Brightsky (NP) Hera Pharmacy (NP) Medsmart Pharmacy (NP) 23247 Pinewood St 28716 Ryan Rd 27101 Schoenherr Rd Ste

Warren, MI 48091 Warren, MI 48092 100 PHARMACIES RETAIL (866) 576-5040 (586) 510-4252 Warren, MI 48088 Community Rx Pharmacy (P) Hoover Pharmacy LLC (P) (586) 298-6795 27124 Dequindre Road 28111 Hoover Rd Ste 5a Meijer Pharmacy #237 (P) Warren, MI 48092 Warren, MI 48093 29505 Mound Road (586) 920-2225 (586) 558-8081 Warren, MI 48092 CVS Pharmacy #8039 (NP) Kmart Pharmacy #4204 (P) (586) 573-2933 13608 East 9 Mile Road 31200 Schoenherr Road New Michigan Pharmacy (P) Warren, MI 48089 Warren, MI 48088 7239 E 9 Mile Road (586) 771-9700 (586) 294-0110 Warren, MI 48091 CVS Pharmacy #8045 (NP) Kmart Pharmacy #4206 (P) (586) 757-9402 25109 Ryan Road 2000 Ten Mile Road Noor Pharmacy (NP) Warren, MI 48091 Warren, MI 48091 4092 E 14 Mile Rd Ste 200 (586) 756-8900 (586) 756-7680 Warren, MI 48092 CVS Pharmacy #8050 (NP) Kroger Co Of Michigan (586) 268-3900 31111 Schoenherr #486 (P) Pharmerica Warren, MI 48093 26233 Hoover Road 3410 East Twelve Mile Road (586) 276-4501 Warren, MI 48089 Warren, MI 48092 CVS Pharmacy #8069 (NP) (586) 754-1191 (586) 573-0458 26081 Hoover Kroger Co Of Michigan Pharmor Pharmacy - Warren Warren, MI 48089 #602 (P) (NP) (586) 754-7080 28250 Dequindre 27379 Van Dyke Ave CVS Pharmacy #8135 (NP) Warren, MI 48092 Warren, MI 48093 4239 Twelve Mile Road (586) 558-1089 (586) 757-9100 Warren, MI 48092 Kroger Co Of Michigan Rite Aid Pharmacy #2509 (586) 558-5560 #674 (P) (P) CVS Pharmacy #8146 (NP) 13700 14 Mile Road 32983 Ryan Road 15051 Thirteen Mile Road Warren, MI 48093 Warren, MI 48092 Warren, MI 48088 (586) 285-9487 (586) 264-2724 (586) 415-6565 Ltc Med Ex Direct (P) Rite Aid Pharmacy #4385 CVS Pharmacy #8214 (NP) 13201 Stephens Rd Ste C (P) 13488 E Eleven Mile Road Warren, MI 48089 2003 E Twelve Mile Road Warren, MI 48089 (877) 899-6337 Warren, MI 48092 (586) 759-5243 Med Ex Direct (P) (586) 751-3600 Dollar Mart Pharmacy (NP) 13201 Stephens Rd Ste B Rite Aid Pharmacy #4390 13465 12 Mile Rd Warren, MI 48089 (P) Warren, MI 48088 (586) 619-5322 11585 E Twelve Mile Road (586) 576-0334 Medicap Pharmacy #182 Warren, MI 48093 (586) 751-0300 Focus Pharmacy (NP) (NP) 7635 E 8 Mile Road 11460 12 Mile Road Rite Aid Pharmacy #4402 Warren, MI 48091 Warren, MI 48093 (P) (586) 756-0512 (586) 582-9670 4110 E Nine Mile Road Warren, MI 48091 (586) 756-8070

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 47 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Ryan Pharmacy (NP) Village Sav-Mor Pharmacy St. John Pharmacy - Romeo 23421 Ryan Rd Great Lakes (NP) Warren, MI 48091 6213 Chicago Rd Ste 200 64580 Van Dyke Suite G (586) 755-0040 Warren, MI 48092 Washington, MI 48095 St. John Pharmacy - (586) 751-7979 (586) 336-0772 Warren-Schoenherr (NP) 6213 Chicago Rd Ste 200 27450 Schoenherr Rd Ste Warren, MI 48092 WASHINGTON TOWNSHIP 600 (586) 751-7979 Warren, MI 48088 Walgreens #04512 (P) (586) 582-7800 22950 Van Dyke Avenue Meijer Pharmacy #177 (P) St. John Pharmacy - Warren, MI 48089 8401 26 Mile Road RETAIL PHARMACIES Windermere (NP) (586) 759-1391 Washington Township, MI 31700 Van Dyke Suite 180 48094 Walgreens #04932 (P) (586) 677-8010 Warren, MI 48093 4010 East Thirteen Mile Road (586) 276-8030 Warren, MI 48092 Orchard View Pharmacy St. John Pharmacy Warren - (586) 575-9346 (NP) Hoover (NP) 12150 30 Mile Rd Suite 104 Walgreens #05082 (P) Washington Township, MI 11800 E Twelve Mile Road 1921 East Eight Mile Road Warren, MI 48093 48095 Warren, MI 48091 (586) 336-9552 (586) 573-5850 (586) 755-3046 Sterling Warren Pharmacy Rite Aid Pharmacy #4317 Walgreens #05322 (P) (P) (NP) 11635 East 13 Mile Road 30834 Schoenherr 66900 Van Dyke Road Warren, MI 48093 Washington Township, MI Warren, MI 48088 (586) 446-0853 (586) 775-1221 48095 Walgreens #05971 (P) (586) 752-3561 Sussex Pharmacy (NP) 24900 Schoenherr 22835 Van Dyke Warren, MI 48089 Warren, MI 48089 (586) 774-3385 MANISTEE COUNTY (586) 757-6505 Target T 2544 (P) 28800 Dequindre Rd WASHINGTON BEAR LAKE Warren, MI 48092 (586) 353-1151 Kroger Pharmacy #461 (P) Richmond Drug (NP) Tri Unity Infusions Services, 64660 Van Dyke 7717 Lake Street LLC Washington, MI 48095 Bear Lake, MI 49614 28653 Hoover Rd (586) 540-8004 (231) 864-3114 Warren, MI 48093 Rite Aid Pharmacy #4068 (586) 486-5278 (P) MANISTEE Universal Pharmacy (P) 63033 Van Dyke Road 4600 14 Mile Road - Suite 2 Washington, MI 48095 Warren, MI 48092 (586) 752-8905 Glen’s Pharmacy #647 (P) (586) 274-9030 Rite Aid Pharmacy #4886 1057 Us 31 South (P) Manistee, MI 49660 7887 26 Mile Road (231) 398-3202 Washington, MI 48094 (810) 677-3438

48 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #4845 (P) 1560 Us 31 South MARQUETTE NEGAUNEE

Manistee, MI 49660 PHARMACIES RETAIL (231) 723-8500 Campus Pharmacy (P) Snyder Pharmacy (P) Rite Aid Pharmacy #4407 1015 N Third St 390 Us 41 East (P) Marquette, MI 49855 Negaunee, MI 49866 1243 Us 31 South (906) 485-5592 (906) 475-9967 Manistee, MI 49660 D.J. Jacobetti Home For (231) 723-9438 Veterans MASON COUNTY Walgreens #11310 (P) 425 Fisher St 1525 Manistee Hwy Marquette, MI 49855 Manistee, MI 49660 (906) 226-3576 LUDINGTON (231) 398-0348 Marquette General Hospital Pharmacy Meijer Pharmacy #193 (P) MARQUETTE COUNTY 420 W Magnetic St Marquette, MI 49855 3900 West Us 10 (906) 225-3498 Ludington, MI 49431 (231) 845-3710 GWINN Peninsula Pharmacy (NP) 1414 W Fair Ave Suite 133 Rite Aid Pharmacy #4567 - Marquette, MI 49855 Thunder Bay Plaza (P) Snyder Drug #104 (P) (906) 225-3902 936 East Ludington Avenue 130 East Highway M-35 Ludington, MI 49431 Shopko Pharmacy #2010 (P) Gwinn, MI 49841 (231) 845-7332 (906) 346-0104 1150 W Washington Marquette, MI 49855 Walgreens #05560 (P) (906) 228-8380 33 South Pere Marquette Highway ISHPEMING Snyder Pharmacy (P) Ludington, MI 49431 5091 Us 41 South (231) 845-5399 Morrisons Drug Store (NP) Marquette, MI 49855 (906) 249-1441 Wal-Mart Pharmacy 901 Lakeshore Drive #10-2102 (NP) Target T-1334 (P) Suite 202 4854 West Us Highway 10 3250 Us Highway 41 West Ishpeming, MI 49849 Ludington, MI 49431 Marquette, MI 49855 (906) 486-4443 (231) 845-5873 Shopko Pharmacy #610 (P) (906) 226-0095 650 Us Highway 41 W University Health Center Ishpeming, MI 49849 Pharmacy (NP) MECOSTA COUNTY (906) 486-4413 1401 Presque Isle Marquette, MI 49855 Snyder Pharmacy (P) BIG RAPIDS 1330 Us 41 West (906) 227-1605 Ishpeming, MI 49849 Walgreens # 12776 (P) (906) 485-5592 1115 W Washington St Kmart Pharmacy #3805 (P) Snyder Rx Express (P) Marquette, MI 49855 1250 Perry Street 110 South Main St (906) 226-1046 Big Rapids, MI 49307 Ishpeming, MI 49849 Wal-Mart Pharmacy (231) 796-5252 (906) 486-4405 #10-2079 (NP) 3225 Us Highway 41 West Marquette, MI 49855 (906) 226-5015

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 49 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Martz & Shapley Pharmacy (P) STANWOOD WILSON 120 N Michigan Big Rapids, MI 49307 Eastside Family Medical (Dr. Hannahville Health Center (231) 796-7621 Dubois) (P) Pharmacy (NP) Mecosta County Medical 8540 105th Avenue N 15019 Hannahville B-1 Rd Center Stanwood, MI 49346 Wilson, MI 49896 605 Oak St (231) 972-2710 (906) 466-9201 Big Rapids, MI 49307 (231) 592-4228 Meijer Pharmacy #203 (P) MENOMINEE COUNTY MIDLAND COUNTY RETAIL PHARMACIES 15400 Waldron Way Big Rapids, MI 49307 MENOMINEE COLEMAN (231) 527-0210 Rite Aid Pharmacy #7810 (P) CVS Pharmacy #08549 (NP) Coleman Family Pharmacy, 842 S State Street 1015 13th Street Inc. Big Rapids, MI 49307 Menominee, MI 49858 211 East Railway (231) 796-8659 (906) 863-2697 Coleman, MI 48618 Student Health Center Kmart Pharmacy #7031 (P) (989) 465-6661 Pharmacy 1101 Seventh Avenue 1019 Campus Drive Menominee, MI 49858 MIDLAND Big Rapids, MI 49307 (906) 863-4471 (231) 591-5964 Glovers Rexall Pharmacy Walgreens #07416 (P) SPALDING 1010 S State Street (NP) Big Rapids, MI 49307 4000 Jefferson Street (231) 592-0385 Uparhs Pharmacy (NP) Midland, MI 48640 (989) 839-9975 Wal-Mart Pharmacy N16088 S Balsam Lane #10-1719 (NP) Spalding, MI 49886 Great Lakes Pharmacy Of 21400 Perry Street (906) 497-5516 Midland (P) Big Rapids, MI 49307 1120 Eastman Ave Midland, MI 48640 (231) 796-3691 STEPHENSON (989) 835-7911 Integrated Pharmacy REMUS Bay Area Medical Center - Network Stephenson Pharmacy (P) 215 Fast Ice Drive Remus Pharmacy (NP) S 927 Us Hwy 41 Midland, MI 48642 144 W Wheatland Stephenson, MI 49887 (888) 837-3636 Remus, MI 49340 (906) 753-4703 Kmart Pharmacy #7068 (P) (989) 967-3360 1820 S Saginaw Road Midland, MI 48640 (989) 631-3600

50 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kroger Co Of Michigan #277 (P) SANFORD LAMBERTVILLE

2808 Ashman PHARMACIES RETAIL Midland, MI 48640 Sanford Family Pharmacy Kroger Co Of Michigan (989) 835-1612 (NP) #16864 (P) Meijer Pharmacy #108 (P) 28 W Saginaw Road 3462 West Sterns Road 7300 Eastman Road Sanford, MI 48657 Lambertville, MI 48144 Midland, MI 48642 (989) 687-2612 (734) 854-2690 (989) 839-5959 Onecare Rx (P) Mid Michigan Infusion Care 7375 Secor Road Suite A MISSAUKEE COUNTY 4008 W Wackerly - Suite 108 Lambertville, MI 48144 Midland, MI 48640 (734) 568-6400 (989) 631-3636 LAKE CITY Rite Aid Pharmacy #7700 Rite Aid Pharmacy #1574 (P) (P) 7358 Secor Road 2006 N Saginaw Road Jerry’s Pharmacy (NP) Lambertville, MI 48144 Midland, MI 48640 5760 W Houghton Lake Rd (734) 856-9160 (989) 631-4321 Lake City, MI 49651 The Medicine Shoppe (P) (231) 839-5800 Rite Aid Pharmacy #4382 7473 Secor Road Suite C (P) Shopko Pharmacy #2514 (P) Lambertville, MI 48144 2910 Ashman Street 1960 South Morey Road (734) 856-9123 Midland, MI 48640 Lake City, MI 49651 Walgreens #10804 (P) (231) 839-7207 (989) 631-0700 7420 Secor Rd Sabourins Pharmacy M-20 Lambertville, MI 48144 (P) MONROE COUNTY (734) 856-2083 1543 Washington St Midland, MI 48640 MILAN (989) 839-2402 CARLETON The Apothecary Shoppe Downtown (P) CVS Pharmacy #00028 (NP) 244 East Main St Carleton Pharmacy (NP) 1249 Dexter Street Midland, MI 48640 201 Medical Center Drive Milan, MI 48160 (989) 835-3636 Carleton, MI 48117 (734) 439-3000 (734) 654-6252 Walgreens #06559 (P) 931 South Saginaw Road MONROE Midland, MI 48640 DUNDEE (989) 631-0910 Walgreens #09079 (P) CVS Pharmacy #8198 (NP) Kroger Co #16577 (P) 1615 North Saginaw Road 919 South Monroe Street 571 East Monroe Street Midland, MI 48640 Monroe, MI 48161 Dundee, MI 48131 (989) 832-2491 (734) 384-9559 (734) 529-2753 Foodtown Drugs (P) Walgreens #12288 (P) 211 N Telegraph Road 100 Cabelas Blvd E Monroe, MI 48162 Dundee, MI 48131 (734) 241-2046 (734) 529-5395

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 51 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Hira’s Pharmacy (NP) Rite Aid Pharmacy #4331 Rite Aid Pharmacy #1528 905 N Macomb Street (P) (P) Suite 1 507 South Telegraph Road 10767 Carson City Road Monroe, MI 48161 Monroe, MI 48161 Carson City, MI 48811 (734) 241-0606 (734) 243-6700 (989) 584-3077 Kmart Pharmacy #4098 (P) Walgreens #02023 (P) 1290 N Monroe 1285 N Monroe Street EDMORE Monroe, MI 48162 Monroe, MI 48162 (734) 243-9060 (734) 457-2336 Kroger Co #16578 (P) Walgreens #05321 (P) Countryside Drug Co III 850 South Monroe Street 484 Telegraph Road (NP) RETAIL PHARMACIES Monroe, MI 48161 Monroe, MI 48161 540 East Main (734) 457-1078 (734) 240-2954 Edmore, MI 48829 (989) 427-5141 Kroger Co #16579 (P) Wal-Mart Pharmacy 3833 North Dixie Highway #10-1790 (NP) Hansen Pharmacy (NP) Monroe, MI 48162 2155 North Telegraph Road 326 E Main (734) 289-6310 Monroe, MI 48162 Edmore, MI 48829 (989) 427-5275 Meijer Pharmacy #067 (P) (734) 242-2385 1700 Telegraph Road Yinger Pharmacy Shoppe Monroe, MI 48162 (P) GREENVILLE (734) 457-1925 1036 North Monroe Street Mercy Memorial Macomb Monroe, MI 48162 Pharmacy (NP) (734) 384-7044 Kmart Pharmacy #4796 (P) 205 S Greenville W Drive 730 N Macomb Street Yinger Pharmacy Shoppe Suite 305 Greenville, MI 48838 Inc. (P) (616) 754-1875 Monroe, MI 48162 1704 South Custer Road (734) 240-4100 Monroe, MI 48161 Meijer Pharmacy #201 (P) Monroe Med/Rx Pharmacy (734) 243-5451 606 South Greenville West (NP) Drive Greenville, MI 48838 337 Stewart Rd Ste 1 TEMPERANCE (616) 225-7710 Monroe, MI 48162 (734) 240-3466 Rite Aid Pharmacy #1527 Professional Village Crary Drug (NP) (P) Pharmacy (P) 8946 Lewis Avenue 507 N Lafayette Street Greenville, MI 48838 128 Cole Road Temperance, MI 48182 (616) 754-3625 Monroe, MI 48162 (734) 847-6788 (734) 242-2966 Walgreens #09132 (P) 1420 W Washington Street 15521 S Dixie Highway MONTCALM COUNTY Greenville, MI 48838 Monroe, MI 48161 (616) 754-3255 (734) 243-5656 CARSON CITY Wal-Mart Pharmacy 1397 N Monroe Street #10-3328 (NP) Monroe, MI 48162 10772 West Carson City (734) 243-6301 Carson Apothecary Shoppe Road 811 N Macomb 245 S Second Street Greenville, MI 48838 Monroe, MI 48162 Carson City, MI 48811 (616) 754-5203 (734) 242-9011 (989) 584-3272

52 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Hackley Healthcare Eqpt. HOWARD CITY LEWISTON Pharmacy (P)

6401 Prairie St Suite 1100 PHARMACIES RETAIL Leppinks Pharmacy (NP) Rite Aid Pharmacy #2683 Muskegon, MI 49444 730 West Shaw Street (P) (231) 727-7968 Howard City, MI 49329 2757 South County Road 489 Hackley Pharmacy - (231) 937-5282 Lewiston, MI 49756 Glenside (P) (989) 786-2239 1663 W Sherman Muskegon, MI 49441 LAKEVIEW (231) 755-2443 MUSKEGON COUNTY Hackley Pharmacy - Wolf Countryside Drug Co. #2 Lake (NP) (NP) FRUITPORT 5483 Apple Avenue 9695 Ngreenville Rd Muskegon, MI 49442 Lakeview, MI 48850 (231) 788-4087 (989) 352-8168 Grover Pharmacy (NP) Hackley Professional 10 S Third Avenue Pharmacy (NP) Fruitport, MI 49415 STANTON 1675 Leahy Street (231) 865-3345 Muskegon, MI 49442 (231) 728-5888 Countryside Drug Co. (NP) MONTAGUE Kmart Pharmacy #3351 (P) 217 E Main Street 1501 E Apple Avenue Stanton, MI 48888 Muskegon, MI 49442 (989) 831-4140 Mike’s Family Pharmacy (P) (231) 773-9188 First Choice Pharmacy (NP) 8718 Water Street Ste A Meijer Pharmacy #019 (P) 215 N State Street Montague, MI 49437 700 W Norton Avenue Stanton, MI 48888 (231) 894-8633 Muskegon, MI 49441 (989) 831-8363 (231) 733-5733 MUSKEGON Meijer Pharmacy #232 (P) MONTMORENCY COUNTY 5300 South Harvey Street Muskegon, MI 49444 Benson Drug Co. (P) (231) 799-6933 961 Spring Street ATLANTA Muskegon, MI 49442 Muskegon Family Care (231) 722-3210 Pharmacy (NP) 2201 South Getty St Thunder Bay Pharmacy (NP) CHCWM - Muskegon (P) Muskegon, MI 49444 11899 M-32 1440 E Sherman Blvd Ste (231) 737-1706 Atlanta, MI 49709 200 (989) 785-5535 Muskegon, MI 49444 Rite Aid Pharmacy #4462 (231) 332-5871 (P) 730 Seminole HILLMAN CVS Pharmacy #06804 (NP) Muskegon, MI 49441 2010 East Apple Ave (231) 780-4706 Muskegon, MI 49444 Hillman Pharmacy (NP) (231) 767-1122 Rite Aid Pharmacy #4977 601 N State (P) Hillman, MI 49746 2635 Henry Street (989) 742-3527 Muskegon, MI 49441 (231) 755-0500

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 53 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Sam’s Pharmacy #10-6562 (NP) MUSKEGON HEIGHTS WHITEHALL 1707 East Sherman Blvd Muskegon, MI 49444 Community Care Pharmacy Pitkin Rexall Drug (P) (231) 830-9203 (NP) 101 West Colby Walgreens #04835 (P) 2700 Baker St - 1st Floor Whitehall, MI 49461 1000 South Getty Street Muskegon Heights, MI 49444 (231) 893-5495 Muskegon, MI 49442 (231) 737-9510 Rite Aid Pharmacy #2274 (231) 767-9212 Patterson’s Drug Store (NP) (P) Walgreens #05315 (P) 2144 Hoyt Street 3263 E Colby Road 840 West Sherman Muskegon Heights, MI 49444 Whitehall, MI 49461 RETAIL PHARMACIES Muskegon, MI 49441 (231) 722-2564 (231) 893-0310 (231) 759-8587 Shopko Pharmacy #2645 (P) Walgreens #06279 (P) N. MUSKEGON 3165 Holton - Whitehall 1991 E Apple Ave Road Muskegon, MI 49442 Whitehall, MI 49461 (231) 773-1540 Hometown Pharmacy #35 (231) 894-2635 Walgreens #10079 (P) (P) Walgreens #11417 (P) 1171 E Sherman Blvd 1900 Ruddiman Avenue 3284 Colby Rd Muskegon, MI 49444 N. Muskegon, MI 49445 Whitehall, MI 49461 (231) 733-8465 (231) 744-4718 (231) 893-1361 Wal-Mart Pharmacy Meijer Pharmacy #071 (P) #10-2238 (NP) 1800 Holton Road 1879 E Sherman Blvd N. Muskegon, MI 49445 NEWAYGO COUNTY Muskegon, MI 49444 (231) 744-7633 (231) 739-5519 Walgreens #07461 (P) FREMONT Wal-Mart Pharmacy 1771 Holton Road #10-3876 (NP) N. Muskegon, MI 49445 3267 Henry Street (231) 744-1391 Country Squire Ltc Muskegon, MI 49441 Pharmacy, LLC 26 E Main Suite B (231) 739-4724 NORTON SHORES Watkins Pharmacy And Fremont, MI 49412 Surgical Supply (NP) (231) 924-2120 1391 E Sherman Blvd Target T-2327 (P) Rite Aid Pharmacy #1524 Muskegon, MI 49444 5057 Harvey St (P) (231) 739-7158 Norton Shores, MI 49444 924 W Main Street Westshore Professional (231) 798-7507 Fremont, MI 49412 Pharmacy (NP) (231) 924-3790 1150 E Sherman Blvd #1400 RAVENNA The Country Squire Muskegon, MI 49444 Discount Pharmacy (NP) (231) 672-2204 30 E Main Street Hometown Pharmacy #33 Fremont, MI 49412 (P) (231) 924-2120 12441 Stafford Walgreens #12533 (P) Ravenna, MI 49451 819 W Main St (231) 853-2261 Fremont, MI 49412 (231) 924-2360

54 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy Ultimate Medical Pharmacy OAKLAND COUNTY #10-1791 (NP) (NP)

7083 West 48th Street 2049 N Opdyke Rd PHARMACIES RETAIL Fremont, MI 49412 AUBURN HILLS Auburn Hills, MI 48326 (231) 924-6900 (248) 370-8070 Wal-Mart Pharmacy GRANT Careplus Cvs Pharmacy #10-2354 (NP) #02953 (NP) 300 North Opdyke 800 Chrysler Dr Ste W2001 Auburn Hills, MI 48326 Family Health Care Auburn Hills, MI 48326 (248) 334-9997 Pharmacy (248) 944-1638 11 N Maple Costco Pharmacy #376 (P) BERKLEY Grant, MI 49327 400 Brown Road (231) 834-1567 Auburn Hills, MI 48326 Rite Aid Pharmacy #1525 (248) 648-0002 Berkley Medical Center (P) Infusion Partners (P) Pharmacy (NP) 53 S Maple Street 3355 Bald Mountain Road 1695 W 12 Mile Road Grant, MI 49327 Unit #70 Suite 215 (231) 834-5744 Auburn Hills, MI 48326 Berkley, MI 48072 (248) 371-9322 (248) 721-8790 NEWAYGO Meijer Pharmacy #185 (P) CVS Pharmacy #8074 (NP) 800 Brown Road 1715 Coolidge Hwy Auburn Hills, MI 48326 Berkley, MI 48072 Haveman Pharmacy (P) (248) 393-5110 (248) 546-9111 40 East 82nd Street Rite Aid Pharmacy #4338 Davob Pharmacy (NP) Newaygo, MI 49337 (P) 4148 W 12 Mile Road (231) 652-6914 2480 Lapeer Road Berkley, MI 48072 Shopko Pharmacy #2643 (P) Auburn Hills, MI 48326 (248) 439-2150 91 Pine Lake Drive (248) 373-7700 Medcart Pharmacy (NP) Newaygo, MI 49337 Rite Aid Pharmacy #4515 1964 W 11 Mile Rd Ste C (231) 652-9484 (P) Berkley, MI 48072 3251 S Boulevard (248) 542-2300 WHITE CLOUD Auburn Hills, MI 48326 Premier Care Pharmacy (248) 852-5977 (NP) Sam’s Pharmacy #10-4778 28139 Woodward Ave Family Health Care (NP) Berkley, MI 48072 Pharmacy 4350 Joslyn Road (248) 544-4500 1035 E Wilcox Auburn Hills, MI 48326 Rite Aid Pharmacy #4467 White Cloud, MI 49349 (248) 391-6697 (P) (231) 689-6677 Target Pharmacy T-1251 (P) 2990 W Twelve Mile Road 1035 E Wilcox 650 Brown Road Berkley, MI 48072 White Cloud, MI 49349 Auburn Hills, MI 48326 (248) 541-0158 (231) 689-6677 (248) 393-8114 Thera Script Pharmacy Berkley, PLLC (P) 3348 W 12 Mile Rd Berkley, MI 48072 (248) 542-6337

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 55 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Fox Hills Medimart (P) BIRMINGHAM 1539 Opdyke BLOOMFIELD TOWNSHIP Bloomfield Hills, MI 48304 CVS Pharmacy #8136 (NP) (248) 858-2225 Costco Pharmacy #392 (P) 444 South Old Woodward Kmart Pharmacy #7504 (P) 2343 South Telegraph Rd Birmingham, MI 48009 2101 Telegraph Road Bloomfield Township, MI (248) 647-0790 Bloomfield Hills, MI 48302 48302 Kroger Co Of Michigan (248) 335-7852 (248) 972-0725 #685 (P) Medical Park Pharmacy (NP) 685 East Maple 799 Denison Ct 1st Floor CLARKSTON Birmingham, MI 48009 Bloomfield Hills, MI 48302 RETAIL PHARMACIES (248) 723-1156 (248) 454-6500 Mills Pharmacy & Rite Aid Pharmacy #4377 Clarkston Pharmacy (NP) Apothecary (P) (P) 5838 S Main Street 1744 W Maple Road Suite A 42931 N Woodward Avenue Clarkston, MI 48346 Birmingham, MI 48009 Bloomfield Hills, MI 48304 (248) 625-8030 (248) 644-5060 (248) 338-7191 CVS Pharmacy #8102 (NP) Onecare Pharmacy Rite Aid Pharmacy #4452 7091 Dixie Highway 1744 W Maple Rd Ste B (P) Clarkston, MI 48346 Birmingham, MI 48009 3669 Maple West (248) 620-2600 (248) 258-8800 Bloomfield Hills, MI 48301 CVS Pharmacy #8155 (NP) Rite Aid Pharmacy #4303 (248) 647-4900 5529 Sashabaw Road (P) Sav On Drugs #1 (P) Clarkston, MI 48346 597 South Adams Road 6510 Telegraph Road (248) 620-6663 Birmingham, MI 48009 Bloomfield Hills, MI 48301 Kroger Co #16709 (P) (248) 647-4470 (248) 626-2525 9741 Dixie Highway Sav-On Birmingham Drugs Star Drugs Inc. (P) Clarkston, MI 48348 (P) 1525 Opdyke (248) 922-0468 33877 Woodward Ave Bloomfield Hills, MI 48304 Kroger Co Of Michigan Birmingham, MI 48009 (248) 333-0222 #620 (P) (248) 644-3214 Target T 2178 (P) 6625 Dixie Highway Walgreens #15391 (P) 2400 S Telegraph Rd Clarkston, MI 48346 34300 Woodward Ave Bloomfield Hills, MI 48302 (248) 620-6680 Birmingham, MI 48009 (248) 409-1952 Medcenter Pharmacy (NP) (248) 593-8450 The Medicap Pharmacy (P) 7210 N Main Street 43121 Woodward Ave Suite 102 Clarkston, MI 48346 BLOOMFIELD HILLS Bloomfield Hills, MI 48302 (248) 499-9495 (248) 625-3885 Woodward Pharmacy (P) P & H Pharmacy Long Term CVS Pharmacy #8132 (NP) 42557 Woodward Ave Ste Care 4101 Telegraph Road #230 5838 S Main St - Suite B Bloomfield Hills, MI 48302 Bloomfield Hills, MI 48304 Clarkston, MI 48346 (248) 646-9132 (248) 499-7840 (248) 625-8031 CVS Pharmacy #8184 (NP) 42934 Woodward Ave Bloomfield Hills, MI 48304 (248) 334-8817

56 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Pine Knob Pharmacy #1, Inc Walgreens #09124 (P) (P) COMMERCE 2270 Union Lake Road

5701 Bow Pointe Dr Ste 130 Commerce Township, MI PHARMACIES RETAIL Clarkston, MI 48346 CVS Pharmacy #8240 (NP) 48382 (248) 384-8050 1325 Commerce Road (248) 363-0436 Pine Knob Pharmacy #3 Commerce, MI 48382 Wal-Mart Pharmacy (NP) (248) 360-5461 #10-2618 (NP) 6770 Dixie Highway DMC Pharmacy Huron 3301 Pontiac Trail Road Clarkston, MI 48346 Valley (P) Commerce Township, MI (248) 620-3588 1 William Carls Drive 48382 Rite Aid Pharmacy #4592 Commerce, MI 48382 (248) 668-0282 (P) (248) 937-5710 5789 Ortonville Road FARMINGTON Clarkston, MI 48346 (248) 625-5271 COMMERCE TOWNSHIP Rite Aid Pharmacy #7912 CVS Pharmacy #8048 (NP) (P) Costco Pharmacy #341 (P) 23391 Farmington Road 5751 Clarkston Road 3000 Commerce Crossing Farmington, MI 48336 Clarkston, MI 48348 Road (248) 474-3123 (248) 625-1015 Commerce Township, MI Farmington Village Walgreens #05171 (P) 48380 Pharmacy (NP) 7110 Dixie Hwy (248) 529-2305 32736 Grand River Ave Clarkston, MI 48346 CVS Pharmacy #8187 (NP) Farmington, MI 48336 (248) 922-1231 3053 Union Lake (248) 478-9500 Commerce Township, MI Rite Care Pharmacy (NP) 48382 23133 Orchard Lake Rd Ste CLAWSON (248) 363-3086 102 Kroger Co Of Michigan Farmington, MI 48336 CVS Pharmacy #8110 (NP) #629 (P) (248) 473-2445 110 Rochester Road 2733 Union Lake Road Tayler Prescriptions (P) Clawson, MI 48017 Commerce Township, MI 32316 Grand River (248) 588-1775 48382 Farmington, MI 48336 CVS Pharmacy #8174 (NP) (248) 366-6825 (248) 474-8290 1402 W 14 Mile Road Meijer Pharmacy #109 (P) Clawson, MI 48017 1703 Haggerty Road FARMINGTON HILLS (248) 435-7314 Commerce Township, MI Rite Aid Pharmacy #4546 48390 (P) (248) 960-7171 Advanced Care Pharmacy 1301 W 14 Mile Road Rite Aid Pharmacy #4487 Services - Detroit (NP) Clawson, MI 48017 (P) 38855 Hills Tech Dr Ste 101 (248) 435-2410 3050 Union Lake Road Farmington Hills, MI 48331 Commerce Township, MI (248) 488-8191 48382 AHS St. John Pharmacy (248) 363-4392 Farmington Hills (NP) 30055 Northwestern Farmington Hills, MI 48336 (248) 865-4222

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 57 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Botsford Outpatient Kroger Co Of Michigan Walgreens #06313 (P) Pharmacy (NP) #661 (P) 27750 Grand River Avenue 28100 Grand River Avenue 25780 Middlebelt Road Farmington Hills, MI 48336 Farmington Hills, MI 48336 Farmington Hills, MI 48336 (248) 478-4115 (248) 471-8700 (248) 471-2058 Walgreens Specialty Clarine Pharmacy (NP) Nidhal’s Pharmacy (NP) Pharmacy 33250 W 12 Mile Rd 23800 Orchard Lake Rd 27003 Hills Tech Ct Farmington Hills, MI 48334 Suite 102 Farmington Hills, MI 48331 (248) 553-2545 Farmington Hills, MI 48336 (800) 323-6961 CVS Pharmacy #8044 (NP) (248) 477-2131 Warren Prescriptions (P) 29425 Orchard Lake Road Oakland Drugs (P) 32910 Middlebelt Road RETAIL PHARMACIES Farmington Hills, MI 48334 28300 Orchard Lake Rd Ste Farmington Hills, MI 48334 (248) 539-0600 101 (248) 855-1177 CVS Pharmacy #8105 (NP) Farmington Hills, MI 48334 (248) 254-8900 37700 West 12 Mile Road FERNDALE Farmington Hills, MI 48331 Pharmascript Of Michigan (248) 489-3004 23000 Commerce Dr Ste B CVS Pharmacy #8139 (NP) Farmington Hills, MI 48335 CVS Pharmacy #8101 (NP) 27660 Middlebelt (248) 435-3500 900 W Nine Mile Road Farmington Hills, MI 48334 Rite Aid Pharmacy #4376 Ferndale, MI 48220 (248) 442-8130 (P) (248) 543-9940 CVS Pharmacy #8178 (NP) 33330 W Twelve Mile Road CVS Pharmacy #8180 (NP) 22250 Middlebelt Farmington Hills, MI 48334 539 E Nine Mile Rd Farmington Hills, MI 48336 (248) 553-4050 Ferndale, MI 48220 (248) 442-8135 Rite Aid Pharmacy #4432 (248) 414-5761 Farmington Hills Medical (P) Kroger Co Of Michigan Pharmacy (NP) 35584 Grand River #642 (P) 27970 Orchard Lake Rd Farmington Hills, MI 48335 8920 West Eight Mile Road Farmington Hills, MI 48334 (248) 474-1717 Ferndale, MI 48220 (248) 538-0010 Rite Aid Pharmacy #4548 (248) 414-7232 Health Dimensions Inc (P) (P) Rite Aid Pharmacy #3878 39303 Country Club Dr 25922 Middlebelt (P) Suite A-26 Farmington Hills, MI 48336 22346 Woodward Ave Farmington Hills, MI 48331 (248) 477-4740 Ferndale, MI 48220 (248) 489-1573 Sam’s Pharmacy #10-4812 (248) 542-1925 Kendallwood Family (NP) Royal Oak Family Pharmacy Pharmacy (NP) 32625 Northwestern Hwy (P) 33100 W 12 Mile Rd Ste 1 Farmington Hills, MI 48334 23420 Woodward Ave Farmington Hills, MI 48334 (248) 539-0458 Ferndale, MI 48220 (248) 987-7200 Target Stores T-611 (P) (248) 336-2677 Kroger Co Of Michigan 30020 Grand River Avenue Royals Pharmacy (NP) #619 (P) Farmington Hills, MI 48336 20727 Wyoming St 37550 Twelve Mile Road (248) 477-1467 Ferndale, MI 48220 Farmington Hills, MI 48331 Walgreens #05290 (P) (248) 566-0116 (248) 489-8054 24140 Orchard Lake Road Farmington Hills, MI 48336 (248) 888-9591

58 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4306 Kroger Co #16651 (P) HAZEL PARK (P) 5990 Sashabaw Road

2880 E Highland Rd Independence Township, MI PHARMACIES RETAIL Advance Care Pharmacy Highland, MI 48356 48346 (NP) (248) 887-4121 (248) 922-3704 24822 John R Rd Walgreens #09252 (P) Hazel Park, MI 48030 2821 E Highland Rd KEEGO HARBOR (248) 545-5515 Highland, MI 48356 Buckleys Pharmacy #102 (P) (248) 889-1842 20721 Dequindre Road Rite Aid Pharmacy #4477 (P) Suite B HOLLY Hazel Park, MI 48030 3000 Orchard Lake Road (248) 808-6505 Keego Harbor, MI 48320 (248) 681-1965 CVS Pharmacy #8103 (NP) Rite Aid Pharmacy #3497 33 West Nine Mile (P) Hazel Park, MI 48030 15242 N Holly Rd LAKE ORION (248) 541-1650 Holly, MI 48442 (248) 634-2961 Live Well Pharmacy (P) CVS Pharmacy #8071 (NP) 23411 John R Rd 3475 Baldwin Road Hazel Park, MI 48030 HOLLY TOWNSHIP Lake Orion, MI 48359 (248) 381-4000 (248) 391-1111 Lor Ven Pharmacy (NP) CVS Pharmacy #8241 (NP) CVS Pharmacy #8129 (NP) 116 W 8 Mile Road 4301 Grange Hall Road 295 S Broadway Hazel Park, MI 48030 Holly Township, MI 48442 Lake Orion, MI 48362 (248) 629-9847 (248) 634-8294 (248) 814-6521 Marinco Drug (P) Kmart Pharmacy #3308 (P) 21936 Vassar HUNTINGTON WOODS 1025 M-24 Hazel Park, MI 48030 Lake Orion, MI 48362 (248) 546-0494 (248) 693-6259 Medpark Pharmacy (P) Rite Aid Pharmacy #4351 Ls Pharmacy (NP) 1059 E 9 Mile Road (P) 1455 South Lapeer Road Hazel Park, MI 48030 26020 Coolidge Highway Suite 101 (248) 808-6929 Huntington Woods, MI 48070 Lake Orion, MI 48360 Rx Specialties NH, Inc. (248) 545-8020 (248) 693-6219 23751 Dequindre Road Walgreens #05675 (P) Hazel Park, MI 48030 INDEPENDENCE 450 North Park Blvd (248) 546-5500 TOWNSHIP Lake Orion, MI 48362 (248) 814-7315 HIGHLAND Walgreens #09251 (P) CVS Pharmacy #03538 (NP) 3520 South Baldwin Road 5756 Clarkston Road Lake Orion, MI 48359 CVS Pharmacy #8109 (NP) Independence Township, MI (248) 393-2934 724 Highland Road 48348 We Care Pharmacy Plus (P) Highland, MI 48357 (248) 620-2761 (248) 889-2788 1412 S Lapeer Rd Lake Orion, MI 48360 (248) 690-9686

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 59 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #3575 (P) LATHRUP VILLAGE 29101 John R Road MILFORD Madison Heights, MI 48071 IDM Pharmacy (P) (248) 546-8076 CVS Pharmacy #8004 (NP) 17653 West 12 Mile Madison Pharmacy Inc (P) 720 General Motors Road Lathrup Village, MI 48076 1385 E 12 Mile Rd Suite 105 Milford, MI 48381 (248) 595-8262 Madison Heights, MI 48071 (248) 684-1775 Med-Care Pharmacy (NP) (248) 336-8900 Health Sense Pharmacy And 28500 Southfield Road Meijer Pharmacy #222 (P) Food (P) Suite 300 1005 W Thirteen Mile Road 965 E Summit Rd Lathrup Village, MI 48076 Madison Heights, MI 48071 Milford, MI 48381 RETAIL PHARMACIES (248) 559-9901 (248) 307-4910 (248) 529-6809 Mercury Drugs (P) Kroger Co Of Michigan MADISON HEIGHTS 27301 Dequindre Rd Ste 104 #526 (P) Madison Heights, MI 48071 670 Highland Ave (248) 545-3600 Milford, MI 48381 Active Infusion Sam’s Pharmacy #10-6659 (248) 685-0100 25219 Dequindre (NP) Milford Sav-Mor Pharmacy Madison Heights, MI 48071 31020 John R Road (P) (248) 336-7051 Madison Heights, MI 48071 1191 North Milford Road Beaumont Home Infusion (248) 589-1863 Milford, MI 48381 1410 E 14 Mile Rd Sona Pharmacy (P) (248) 685-8363 Madison Heights, MI 48071 27745 Dequindre Rd Rite Aid Pharmacy #4372 (248) 208-4000 Madison Heights, MI 48071 (P) Costco Pharmacy #393 (P) (248) 808-6082 640 N Milford Road 30550 Stephenson Hwy St. John Pharmacy - Milford, MI 48381 Madison Heights, MI 48071 Madison Heights (NP) (248) 676-2497 (248) 616-0064 27351 Dequindre Walgreens #10777 (P) CVS Pharmacy #8019 (NP) Madison Heights, MI 48071 140 S Milford Road 31030 John R Rd (248) 967-7041 Milford, MI 48381 Madison Heights, MI 48071 Target T-0282 (P) (248) 685-7219 (248) 589-1554 32001 John R Road CVS Pharmacy #8033 (NP) Madison Heights, MI 48071 NEW HUDSON 27050 John R Road (248) 585-4716 Madison Heights, MI 48071 The Pharmacy Shop (P) (248) 547-0800 28411 Dequindre New Hudson Discount Healthy Living Pharmacy Madison Heights, MI 48071 Pharmacy (P) (NP) (248) 591-5555 56270 Grand River 30755 Barrington Ste B Value Center Pharmacy II New Hudson, MI 48165 Madison Heights, MI 48071 (P) (248) 486-0720 (248) 577-9903 1485 West 14 Mile Road Wal-Mart Pharmacy Home IV Care Inc. Madison Heights, MI 48071 #10-5048 (NP) 32751 Edward Street (248) 583-1854 30729 Lyon Center Drive Suite 101 Walgreens #04691 (P) East Madison Heights, MI 48071 26800 John R Road New Hudson, MI 48165 (248) 577-5670 Madison Heights, MI 48071 (248) 486-1953 (248) 546-2872

60 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Henry Ford Medical Center Target T-1465 (P) NORTHVILLE Pharmacy Columbus (NP) 27100 Wixom Road

39450 W 12 Mile Rd Ste 1b Novi, MI 48374 PHARMACIES RETAIL CVS Pharmacy #8262 (NP) Novi, MI 48377 (248) 374-0892 39350 Nine Mile Road (248) 344-0705 Walgreens #04454 (P) Northville, MI 48167 Kroger Co Of Michigan 24150 Novi Road (248) 735-6081 #632 (P) Novi, MI 48375 47650 Grand River (248) 349-6771 Novi, MI 48375 NOVI Wal-Mart Pharmacy 10-5893 (248) 374-9714 (NP) Lewis Family Pharmacy 26090 Ingersol Dr Accredo Health Group, Inc. 39475 Lewis Dr Ste 110 Novi, MI 48375 39625 Lewis Drive Ste 800 Novi, MI 48377 (248) 277-4562 Novi, MI 48377 (248) 254-3866 (248) 489-0300 Novi Drug Co. (P) OAK PARK Arbor Lane Pharmacy At 24100 Meadowbrook Road Fox Run (P) Novi, MI 48375 41100 Fox Run Road (248) 478-3000 Advanced Pharmacy Novi, MI 48377 Rite Aid Pharmacy #4534 Services (NP) (248) 668-8778 (P) 22100 Greenfield Checker Specialty Pharmacy 41820 Ten Mile Oak Park, MI 48237 (P) Novi, MI 48375 (248) 968-7500 43155 W Nine Mile Road Ste (248) 349-6150 Beacon Professional 300 Rite Aid Pharmacy #7869 Pharmacy Inc. (NP) Novi, MI 48376 (P) 23350 Greenfield (248) 305-7240 42481 W 13 Mile Rd Oak Park, MI 48237 Coram Inc. Novi, MI 48377 (248) 968-3800 28550 Cabot Dr - Suite 200 (248) 668-8208 CVS Pharmacy #8106 (NP) Novi, MI 48377 Sam’s Pharmacy #10-6657 23001 Coolidge Hwy (248) 324-6300 (NP) Oak Park, MI 48237 CVS Pharmacy #8067 (NP) 27300 Wixom Road (248) 547-8230 31250 Beck Road Novi, MI 48335 Detroit Hope Pharmacy (P) Novi, MI 48377 (248) 349-6043 24695 Coolidge Hwy (248) 624-4110 Sav-On Ltc Closed Door Oak Park, MI 48237 CVS Pharmacy #8140 (NP) Pharmacy (248) 542-8888 22240 Novi Road 24100 Meadowbrook Rd - Good Health Pharmacy (NP) Novi, MI 48375 Suite B 13821 W Nine Mile Road (248) 380-2819 Novi, MI 48375 Oak Park, MI 48237 CVS Pharmacy #8161 (NP) (888) 722-5579 (248) 541-0600 47200 Ten Mile Road St. John Pharmacy (NP) Kmart Pharmacy #3730 (P) Novi, MI 48374 26850 Providence Parkway 26200 Greenfield (248) 380-7840 Suite 100 Oak Park, MI 48237 CVS Pharmacy #8244 (NP) Novi, MI 48374 (248) 968-2140 42191 Fourteen Mile Road (248) 465-4280 Lincoln Drugs (NP) Novi, MI 48377 47601 Grand River Ave 25901 Coolidge (248) 926-2452 Novi, MI 48374 Oak Park, MI 48237 (248) 465-4679 (248) 543-7847

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 61 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Oak Park Pharmacy (P) Kroger Co Of Michigan 21675 Coolidge Hwy #649 (P) PONTIAC Suite A1 3097 South Baldwin Oak Park, MI 48237 Orion Township, MI 48360 Action Drugs #4 (NP) (248) 582-8807 (248) 393-4573 640 Auburn Road Randys Rx (NP) Pontiac, MI 48342 25950 Greenfield Road ORTONVILLE (248) 332-6840 Oak Park, MI 48237 Bloomfield Pharmacy North, (248) 397-8612 P.C. (NP) Rite Aid Pharmacy #4352 Rite Aid Pharmacy #4696 44200 Woodward Ave (P) (P) Suite 107 RETAIL PHARMACIES 24850 Greenfield 10 S Ortonville Rd Pontiac, MI 48341 Oak Park, MI 48237 Ortonville, MI 48462 (248) 334-7700 (248) 627-2888 (248) 968-2383 CVS Pharmacy #8086 (NP) The Wellness Plan - 66 E Walton Blvd Northwest Pharmacy OXFORD Pontiac, MI 48340 21040 Greenfield (248) 334-1896 Oak Park, MI 48237 Dells Prescription Center (P) (248) 967-6500 Medicine Room Progressive Pharmacy (NP) 219 Baldwin Avenue Walgreens #05425 (P) Pontiac, MI 48342 13550 West 9 Mile Road 72 South Washington St Ste 207 (248) 334-2620 Oak Park, MI 48237 Global Health Pharmacy (248) 548-4251 Oxford, MI 48371 (248) 628-7990 (NP) Meijer Pharmacy #197 (P) 135 S Telegraph Road OAKLAND TOWNSHIP 900 North Lapeer Road Pontiac, MI 48341 Oxford, MI 48371 (248) 451-1590 (248) 236-8010 Index Meds (NP) CVS Pharmacy #8234 (NP) 989 University Dr Ste 107 4816 North Adams Patterson Pharmacy (P) 1 S Washington Pontiac, MI 48342 Oakland Township, MI 48306 (248) 340-0886 (248) 276-5063 Oxford, MI 48371 (248) 628-2538 Medstar Pharmacy Kroger Co Of Michigan 161 State St #650 (P) Rite Aid Pharmacy #7761 (P) Pontiac, MI 48341 4888 North Adams (248) 333-3427 Oakland Township, MI 48363 999 Lapeer Road (248) 276-3261 Oxford, MI 48371 Omega Pharmacy (NP) (248) 628-4283 420 W Huron St. John Pharmacy Pontiac Pontiac, MI 48341 ORION TOWNSHIP LLC (NP) (248) 481-9004 385 North Lapeer Road Pine Knob Pharmacy #6 Inc. Kroger Co Of Michigan Oxford, MI 48371 (NP) #637 (P) (248) 236-2306 1701 Baldwin Road 460 North Lapeer Road Pontiac, MI 48340 Orion Township, MI 48362 (248) 253-0521 (248) 693-3284

62 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Pontiac Discount Pharmacy CVS Pharmacy #8076 (NP) (P) ROCHESTER 3010 Walton Blvd

1430 Joslyn Ave Rochester Hills, MI 48309 PHARMACIES RETAIL Pontiac, MI 48340 Crittenton Medical (248) 375-2810 (248) 377-9700 Pharmacy (NP) CVS Pharmacy #8119 (NP) Rite Aid Pharmacy #4301 1135 W University Dr 295 South Livernois (P) Rochester, MI 48307 Rochester Hills, MI 48307 360 North Martin Luther King (248) 650-2155 (248) 656-8200 Blvd Kmart Pharmacy #4488 (P) Meijer Pharmacy #057 (P) Pontiac, MI 48342 1100 Rochester Road South 3175 Rochester Road (248) 335-0602 Rochester, MI 48307 Rochester Hills, MI 48306 Rite Aid Pharmacy #4302 (248) 652-9480 (248) 853-2180 (P) Kroger Co Of Michigan Meijer Pharmacy #260 (P) 1186 Baldwin Avenue #492 (P) 3610 Marketplace Circle Pontiac, MI 48340 65 S Livernois Rochester Hills, MI 48309 (248) 333-7057 Rochester, MI 48307 (248) 844-2864 Rite Aid Pharmacy #4697 (248) 652-4700 Pharmacare Pharmacy (NP) (P) Lytle Pharmacy (NP) 1460 Walton Blvd Suite # 90 3 South Telegraph Road 340 Main Street Rochester Hills, MI 48309 Pontiac, MI 48341 Rochester, MI 48307 (248) 601-7000 (248) 338-2665 (248) 651-8511 Rite Aid Pharmacy #4315 Sav-Plus Pharmacy (P) Mortons Pharmacy (NP) (P) 775 Baldwin 118 W University 1378 Walton Boulevard Pontiac, MI 48340 Rochester, MI 48307 Rochester Hills, MI 48309 (248) 481-9299 (248) 651-4044 (248) 652-0900 St. John Pontiac Pharmacy Rite Aid Pharmacy #4528 Rochester Hills Pharmacy LLC (NP) (P) (NP) 50 North Perry 6970 Rochester Road 6700 N Rochester Rd Ste Pontiac, MI 48342 Rochester, MI 48307 101 (248) 338-5016 (248) 651-1614 Rochester Hills, MI 48306 St. Joseph Mercy (248) 601-1178 Professional Pharmacy #2 ROCHESTER HILLS Target T-0351 (P) 44405 Woodward Avenue 2887 S Rochester Rd Pontiac, MI 48341 Rochester Hills, MI 48307 (248) 858-3053 Barclay Pharmacy (P) (248) 853-1590 Thrifty Drugs (NP) 75 Barclay Circle Ste 114 Therascript Rochester (NP) 140 North Saginaw Street Rochester Hills, MI 48307 455 Barclay Circle Dr Ste C2 Pontiac, MI 48342 (248) 852-4600 Rochester Hills, MI 48307 (248) 334-1549 CVS Pharmacy #00287 (NP) (248) 289-1359 Walgreens #04601 (P) 2011 S Rochester Road Vital Pharmacare (P) 690 Martin Luther King Blvd Rochester Hills, MI 48307 1901 Star Batt Drive Pontiac, MI 48342 (248) 844-2559 Suite 200 (248) 745-8495 CVS Pharmacy #8036 (NP) Rochester Hills, MI 48309 981 E Auburn Road (248) 299-1701 Rochester Hills, MI 48307 (248) 852-2380

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 63 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #04660 (P) Kroger Co Of Michigan Kroger Co Of Michigan 2050 South Rochester Road #782 (P) #639 (P) Rochester Hills, MI 48307 30991 N Woodward 20730 Pontiac Trail (248) 652-4429 Royal Oak, MI 48073 South Lyon, MI 48178 Walgreens #07888 (P) (248) 288-0160 (248) 486-9182 2985 Crooks Road Meijer Pharmacy #034 (P) Rite Aid Pharmacy #4230 Rochester Hills, MI 48309 5150 Coolidge Highway (P) (248) 293-0627 Royal Oak, MI 48073 588 N Lafayette Street Walgreens #09085 (P) (248) 280-0560 South Lyon, MI 48178 1490 N Rochester Road Rite Aid Pharmacy #4492 (248) 486-9100 Rochester Hills, MI 48307 (P) Walgreens #10778 (P) RETAIL PHARMACIES (248) 601-1584 1026 N Main Street 22318 Pontiac Trail Walgreens #09125 (P) Royal Oak, MI 48067 South Lyon, MI 48178 1280 Walton Blvd (248) 546-4620 (248) 486-5216 Rochester Hills, MI 48307 Walgreens #04748 (P) (248) 608-0643 30852 N Woodward Ave SOUTHFIELD Wellpointe Pharmacy (NP) Royal Oak, MI 48073 1701 South Blvd Suite 105 (248) 549-2628 Rochester Hills, MI 48307 Walgreens #05426 (P) Advanced Care Pharmacy (248) 852-9355 1815 Rochester Street Services - Southfield (NP) Royal Oak, MI 48073 22170 W Nine Mile (248) 546-6572 Southfield, MI 48034 ROYAL OAK (248) 799-8125 Wm. Beaumont Hospital Pharmacy (NP) AHS St. John Pharmacy Customcare Pharmacy (NP) 3601 West 13 Mile Road Southfield (NP) 3535 W 13 Mile Road #124 Royal Oak, MI 48073 22250 Providence Drive Royal Oak, MI 48073 (248) 898-4097 Southfield, MI 48075 (248) 424-3939 (248) 551-8290 ZMC Pharmacy LLC (P) CVS Pharmacy #01150 (NP) 1041 S Main St Alert Infusion Services, Inc. 30900 Woodward Avenue Royal Oak, MI 48067 30825 Greenfield Road Royal Oak, MI 48073 (248) 280-6401 Southfield, MI 48076 (248) 549-4377 (248) 593-5821 Beacon Hill Medical CVS Pharmacy #8068 (NP) SOUTH LYON 525 Fourth Street East Pharmacy (P) Royal Oak, MI 48067 18161 W 13 Mile Road Ste (248) 548-5057 CVS Pharmacy #01748 (NP) A1-A Southfield, MI 48076 CVS Pharmacy #8127 (NP) 57090 Ten Mile Road (248) 419-1775 209 E Twelve Mile Road South Lyon, MI 48178 Royal Oak, MI 48073 (248) 446-0382 Biomed Health Solutions (248) 548-6180 CVS Pharmacy #8066 (NP) LLC (NP) Dynamic Care Pharmacy 22421 Pontiac Trail 23815 Northwestern Highway Ste 100 (NP) South Lyon, MI 48178 Southfield, MI 48075 4119 W 13 Mile Rd (248) 437-8131 (877) 790-7779 Royal Oak, MI 48073 CVS Pharmacy #8304 (NP) (248) 850-1802 61019 Silver Lake Road South Lyon, MI 48178 (248) 437-8626

64 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Cadila Pharmacy (NP) Grant Pharmacy (P) Sam’s Pharmacy #10-6454 23832 Southfield Rd 29355 Northwestern Highway (NP)

Southfield, MI 48075 Suite 220 22500 8 Mile Road PHARMACIES RETAIL (248) 557-9333 Southfield, MI 48034 Southfield, MI 48034 Chemville Pharmacy (NP) (248) 799-3900 (248) 357-2158 22100 W 10 Mile Rd Henry Ford Medical Center Target Pharmacy T-2207 (P) Southfield, MI 48033 Pharmacy - Southfield (NP) 30333 Southfield Rd (248) 356-2000 22777 W 11 Mile Road Southfield, MI 48076 CVS Pharmacy #8021 (NP) Southfield, MI 48034 (248) 430-0063 30920 Southfield (248) 358-0727 Target T-0777 (P) Southfield, MI 48076 Heritage Pharmacy Services 21400 Northwestern Hwy (248) 647-7472 21674 Melrose Blvd Southfield, MI 48075 CVS Pharmacy #8034 (NP) Southfield, MI 48075 (248) 663-4300 21911 Eleven Mile Road (248) 416-1310 Top Service Pharmacy (NP) Southfield, MI 48076 Kroger Co Of Michigan 15600 W 10 Mile Rd #1b (248) 353-9898 #658 (P) Southfield, MI 48075 CVS Pharmacy #8058 (NP) 19855 12 Mile Road (248) 569-7578 18130 West 10 Mile Road Southfield, MI 48076 Trinity Pharmacy (P) Southfield, MI 48075 (248) 559-0801 17330 Northland Parks Court (248) 569-0233 Majestic Pharmacy (NP) Ste 100a CVS Pharmacy #8063 (NP) 25861 Lahser Rd Southfield, MI 48075 19993 W 12 Mile Road Southfield, MI 48033 (248) 443-1332 Southfield, MI 48076 (248) 948-8800 Walgreens #05969 (P) (248) 559-9810 Medicine Cabinet (NP) 29030 Northwestern Hwy CVS Pharmacy #8143 (NP) 27159 Greenfield Southfield, MI 48034 26026 W 12 Mile Road Southfield, MI 48076 (248) 356-1757 Southfield, MI 48034 (248) 557-8840 Walgreens #06323 (P) (248) 350-0280 Meijer Pharmacy #231 (P) 28901 Greenfield Road CVS Pharmacy #8233 (NP) 28800 Telegraph Road Southfield, MI 48076 23881 Greenfield/Mt Vernon Southfield, MI 48034 (248) 552-0847 Southfield, MI 48075 (248) 304-9533 Walgreens #07208 (P) (248) 424-5002 Northland Medical Building 23111 Lahser Road Daring Advance Pharmacy Pharmacy (NP) Southfield, MI 48033 (NP) 20905 Greenfield (248) 945-9216 23077 Greenfield Ste 220 Southfield, MI 48075 (248) 569-0450 Southfield, MI 48075 SYLVAN LAKE (248) 559-8555 Premier Home Pharmacy, Fairlane Pharmacy Services Inc. (NP) Corp. #3 27762 Franklin Road CVS Pharmacy #8227 (NP) 21298 Melrose Southfield, MI 48034 2387 Orchard Lake Road Southfield, MI 48075 (248) 223-9734 Sylvan Lake, MI 48320 (248) 827-3370 Remedy Shop Pharmacy & (248) 682-3666 Farmbrook Pharmacy (NP) Apothecary (NP) 29877 Telegraph Road 16500 North Park Drive Southfield, MI 48034 Suite 106 (248) 354-5600 Southfield, MI 48075 (248) 809-3478

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 65 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kroger Co Of Michigan Somerset Pharmacy (NP) TROY #487 (P) 1380 Coolidge Hwy Ste 125 31 E Long Lake Road Troy, MI 48084 Beaumont Hospitals - Troy Troy, MI 48098 (248) 280-2222 44201 Dequindre Road (248) 879-6716 Target T-1313 (P) Troy, MI 48085 Kroger Pharmacy #448 (P) 1301 Coolidge Hwy (248) 964-9041 1237 Coolidge Troy, MI 48084 Caremark Inc. Therapeutic Troy, MI 48084 (248) 614-2801 Services Division (248) 519-1321 Troy Professional Pharmacy 1307-H Allen Dr Kroger Pharmacy #463 (P) Inc. (P) Troy, MI 48083 3125 John R 2891 East Maple Rd Ste 105 RETAIL PHARMACIES (248) 968-6000 Troy, MI 48083 Troy, MI 48083 CVS Pharmacy #8026 (NP) (248) 658-1710 (248) 689-0200 125 E Long Lake Road Kroger Pharmacy #464 (P) Unasource Pharmacy (NP) Troy, MI 48085 2105 South Blvd W 4600 Investment Drive Ste (248) 879-9114 Troy, MI 48098 100 CVS Pharmacy #8030 (NP) (248) 537-1011 Troy, MI 48098 1980 E Big Beaver Road Med Index Pharmacy (NP) (248) 312-0037 Troy, MI 48083 1639 E Big Beaver Rd Ste University Rx Pharmacy (248) 689-1051 101 (NP) CVS Pharmacy #8162 (NP) Troy, MI 48083 2520 Livernois 2045 W South Blvd (248) 528-0888 Troy, MI 48084 Troy, MI 48098 Medical Center Pharmacy (248) 267-5002 (248) 879-8322 (NP) Walgreens #04412 (P) CVS Pharmacy #8242 (NP) 44201 Dequindre Road 1965 E Big Beaver Rd 4963 John R Road Troy, MI 48085 Troy, MI 48083 Troy, MI 48085 (248) 828-8090 (248) 526-9775 (248) 689-2157 Rite Aid Pharmacy #2731 Walgreens #05224 Gabecare Direct Rx Inc. (P) (P) 2932 East Long Lake Road 1179 Maplelawn Drive 1981 West South Blvd Troy, MI 48085 Troy, MI 48084 Troy, MI 48098 (248) 689-2473 (248) 280-2270 (248) 813-9581 2932 East Long Lake Road Henry Ford Medical Center Rite Aid Pharmacy #4268 Troy, MI 48085 Pharmacy - Troy (NP) (P) (248) 689-2473 2825 Livernois 3968 John R Rd Wal-Mart Pharmacy Troy, MI 48083 Troy, MI 48083 #10-2873 (NP) (248) 528-2248 (248) 524-6480 2001 West Maple Road Henry Ford Pharmacy Rite Aid Pharmacy #4305 Troy, MI 48084 Advantage Southfield (P) (P) (248) 435-4556 735 John R Road Ste 150 2971 West Maple Road Troy, MI 48084 Troy, MI 48083 WALLED LAKE (800) 456-2112 (248) 288-4366 Homescripts (NP) Rx IV, Incorporated 500 Kirts Blvd 1938 Woodslee Drive CVS Pharmacy #8002 (NP) Troy, MI 48084 Troy, MI 48083 100 West Maple Road (248) 824-6300 (248) 435-9400 Walled Lake, MI 48390 (248) 624-4555

66 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kroger Co Of Michigan Kmart Pharmacy #3379 (P) Waterford Pharmacy (P) #634 (P) 5100 Dixie Highway 3560 Pontiac Lake Road

47060 Pontiac Trail Waterford, MI 48329 Waterford, MI 48328 PHARMACIES RETAIL Walled Lake, MI 48390 (248) 674-3183 (248) 674-4853 (248) 960-8297 Kmart Pharmacy #4331 (P) Pontiac Trail Pharmacy (P) 3541 Highland Road WATERFORD TOWNSHIP 620 N Pontiac Trail Waterford, MI 48328 Walled Lake, MI 48390 (248) 682-3661 (248) 669-2776 Meijer Pharmacy #053 (P) CVS Pharmacy #8166 (NP) Senior Home Health Care 4200 Highland Road 1156 W Huron Inc. (NP) Waterford, MI 48328 Waterford Township, MI 4204 Martin Road Suite E (248) 682-4001 48328 (248) 738-0459 Walled Lake, MI 48390 Rite Aid Pharmacy #4304 (800) 736-9149 (P) Kroger Co Of Michigan Target Pharmacy T-0896 (P) 3273 West Huron St #675 (P) 495 Haggerty Hwy Waterford, MI 48328 5111 Highland Road Walled Lake, MI 48390 (248) 682-9400 Waterford Township, MI (248) 960-7900 48327 Rite Aid Pharmacy #4325 (248) 673-4324 (P) Walgreens #04244 (P) WATERFORD 5983 Highland Road Waterford, MI 48327 4800 Dixie Highway (248) 666-2510 Waterford Township, MI Advanced Care Pharmacy 48329 Rite Aid Pharmacy #4476 (248) 673-6710 Services - Waterford (NP) (P) 279 Summit Ste 200 4350 Dixie Highway Waterford, MI 48328 Waterford, MI 48329 WEST BLOOMFIELD (248) 409-1105 (248) 674-0466 CVS Pharmacy #8038 (NP) Sam’s Pharmacy #10-6665 7960 Cooley Lake Road Beaumont Pharmacy West (NP) Bloomfield (P) Waterford, MI 48327 495 Summit Drive (248) 366-3101 6900 Orchard Lake Rd - Waterford, MI 48328 Suite 104 CVS Pharmacy #8049 (NP) (248) 738-2753 West Bloomfield, MI 48322 4995 Highland Road VG’s Pharmacy #1923 (P) (248) 855-5505 Waterford, MI 48328 7300 Highland Rd (248) 674-2261 CVS Pharmacy #8020 (NP) Waterford, MI 48327 4295 Orchard Lake Road CVS Pharmacy #8112 (NP) (248) 666-0382 West Bloomfield, MI 48323 4300 Dixie Hwy Walgreens #06459 (P) (248) 626-5434 Waterford, MI 48329 4400 Highland Road #M-59 (248) 673-9800 CVS Pharmacy #8084 (NP) Waterford, MI 48328 7498 Haggerty Road Highland Pharmacy (NP) (248) 673-2107 West Bloomfield, MI 48322 4000 Highland Road Walgreens #09928 (P) (248) 592-2063 Suite #113 20 S Telegraph Rd CVS Pharmacy #8239 (NP) Waterford, MI 48328 Waterford, MI 48328 (248) 977-1394 6070 Maple Road (248) 681-7636 West Bloomfield, MI 48322 (248) 865-2290

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 67 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Efros Orchard Drug Co. (P) Kmart Pharmacy #3723 (P) OCEANA COUNTY 6427 Orchard Lake Road 10951 Highland Road West Bloomfield, MI 48322 White Lake, MI 48386 (248) 626-3400 (248) 698-1904 HART Henry Ford Medical Center Kroger Co Of Michigan Pharmacy - W. Bloomfield #659 (P) (NP) 10805 Highland Road Oceana Pharmacy (P) 6777 W Maple Rd White Lake, MI 48386 39 State Street West Bloomfield, MI 48322 (248) 698-4830 Hart, MI 49420 (248) 661-6488 Meijer Pharmacy #227 (P) (231) 873-2540 Henry Ford Medical Center 6001 Highland Road Shopko Pharmacy #2651 (P) RETAIL PHARMACIES Pharmacy Farmington (NP) White Lake, MI 48383 2278 North Comfort Drive 6530 Farmington Rd (248) 889-6810 Hart, MI 49420 West Bloomfield, MI 48322 Wal-Mart Pharmacy (231) 873-1843 (248) 642-1111 #10-2700 (NP) West Shore Pharmacy Kroger Co Of Michigan 9190 Highland Road 18 State Street #679 (P) White Lake, MI 48386 Hart, MI 49420 4805 Haggerty Rd (248) 698-9680 (231) 873-3609 West Bloomfield, MI 48323 (248) 960-7535 WIXOM HESPERIA Lakes Professional Pharmacy (NP) 2300 Haggerty Road Critical Care Systems Inc Bob’s Drugs LLC (NP) Suite 1070 46998 Magellan Dr Suite 300 194 North Division West Bloomfield, MI 48323 Wixom, MI 48393 Hesperia, MI 49421 (248) 668-1212 (248) 960-8095 (231) 854-6605 Rite Aid Pharmacy #4399 CVS Pharmacy #8229 (NP) (P) 1585 Wixom Road SHELBY 5572 Drake Road Wixom, MI 48393 West Bloomfield, MI 48322 (248) 668-2261 (248) 661-0774 Meijer Pharmacy #122 (P) Shelby Pharmacy (P) Walgreens #04864 (P) 49900 Grand River Ave 178 N Michigan 7380 Orchard Lake Road Wixom, MI 48393 Shelby, MI 49455 West Bloomfield, MI 48322 (248) 449-8510 (231) 861-4341 (248) 538-8373 Rite Aid Pharmacy #4300 Walgreens #07094 (P) (P) OGEMAW COUNTY 7490 Haggerty Road 47300 Pontiac Trail West Bloomfield, MI 48322 Wixom, MI 48393 (248) 661-4409 (248) 960-0352 PRESCOTT

WHITE LAKE Roos Pharmacy North 2370 Greenwood Road Prescott, MI 48756 CVS Pharmacy #8299 (NP) (989) 873-1478 10501 Highland Road White Lake, MI 48386 (248) 698-8876

68 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

ROSE CITY ONTONAGON COUNTY OSCODA COUNTY EALPHARMACIES RETAIL Rose City Drugs (P) ONTONAGON MIO 2640 M-33 Rose City, MI 48654 (989) 685-2141 Harbor Town Pharmacy Inc Pioneer Family Pharmacy (NP) #103 (NP) 850 Greenland Road 114 South Morenci WEST BRANCH Ontonagon, MI 49953 Mio, MI 48647 (906) 884-4229 (989) 826-8989 Kmart Pharmacy #3864 (P) Rite Aid Pharmacy #1715 (P) 2110 South M-76 OSCEOLA COUNTY West Branch, MI 48661 101 South Morenci Street (989) 345-4884 Mio, MI 48647 (989) 826-3737 Pioneer Family Pharmacy EVART #101 (NP) 2206 South M-76 OTSEGO COUNTY West Branch, MI 48661 Holihans Drug Store (NP) (989) 345-5610 128 N Main Street Evart, MI 49631 Rite Aid Pharmacy #4503 (231) 734-2551 GAYLORD (P) Shopko Pharmacy #2513 (P) 501 E Houghton West Branch, MI 48661 107 North Main St Ambulatory Infusion Care - (989) 345-0080 Evart, MI 49631 North Inc. (231) 734-5581 854 N Center Ave Ste 1 Specialized Pharmacy Gaylord, MI 49735 Services North West (989) 732-4879 Branch REED CITY Glen’s Pharmacy #1510 (P) 522 East Houghton Avenue Suite 102 829 West Main West Branch, MI 48661 Cet Medical Pharmacy (P) Gaylord, MI 49735 (989) 345-2297 204 Patterson Ave (989) 731-3233 Reed City, MI 49677 Meijer Pharmacy #250 (P) Walgreens #10406 (P) (231) 832-8970 2480 E Houghton Ave 250 Meijer Drive West Branch, MI 48661 Hometown Pharmacy # 36 Gaylord, MI 49735 (989) 343-6921 (P) (989) 731-9033 130 W Upton Wal-Mart Pharmacy Otsego Memorial Hospital Reed City, MI 49677 Rx #10-5159 (NP) (231) 832-5521 2750 Cook Road 825 North Center West Branch, MI 48661 Rite Aid Pharmacy #3383 Gaylord, MI 49735 (989) 343-9761 (P) (989) 731-2164 222 S Chestnut Street Reed City, MI 49677 (231) 832-5542

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 69 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #1663 Walgreens Specialty D & W Pharmacy 1574 (P) (P) Pharmacy 50 Douglas Ave 419 W Main Street 50 South 64th Avenue Holland, MI 49424 Gaylord, MI 49735 Coopersville, MI 49404 (616) 392-9735 (989) 732-5220 (616) 997-2611 Dykstra Drug Store (NP) 419 W Main Street 91 Douglas Ave Gaylord, MI 49735 GRAND HAVEN Holland, MI 49422 (989) 732-5220 (616) 392-8878 Walgreens #10404 (P) Family Fare Pharmacy #122 1290 W Main St D & W Pharmacy 1570 (P) (P) Gaylord, MI 49735 1116 Robbins Rd 993 Butternut Drive RETAIL PHARMACIES (989) 732-0578 Grand Haven, MI 49417 Holland, MI 49424 (616) 846-7180 Wal-Mart Pharmacy (616) 399-4100 #10-1542 (NP) Dunewood Pharmacy (NP) Meijer Pharmacy #047 (P) 940 Edelweiss Parkway 1445 Sheldon Rd - Suite 104 746 16th Street Gaylord, MI 49735 Grand Haven, MI 49417 Holland, MI 49423 (989) 732-8998 (616) 842-5193 (616) 396-8042 Meijer Pharmacy #180 (P) Meijer Pharmacy #217 (P) 15000 Us 31 3320 West Shore Drive OTTAWA COUNTY Grand Haven, MI 49417 Holland, MI 49424 (616) 847-8010 (616) 994-1110 ALLENDALE Pfaff Pharmacy (P) Model Drug (NP) 1125 Washington 35 West 8th Street Grand Haven, MI 49417 Holland, MI 49423 Family Fare Pharmacy #137 (616) 842-4360 (616) 399-8815 (P) Walgreens #03349 (P) Rite Aid Pharmacy #4393 6370 Lake Michigan Dr - 510 N Beacon Blvd (P) Suite 100 Grand Haven, MI 49417 973 South Washington Allendale, MI 49401 (616) 850-9613 Avenue (616) 895-7426 Walgreens #12345 (P) Holland, MI 49423 Walgreens #11415 (P) 1045 Robbins Rd (616) 392-5161 6840 Lake Michigan Dr Grand Haven, MI 49417 Skip’s Pharmacy Of Allendale, MI 49401 (616) 844-0367 Michigan (NP) (616) 895-2200 Wal-Mart Pharmacy 700 Michigan Avenue #10-5386 (NP) Holland, MI 49423 COOPERSVILLE 14700 Us 31 (616) 392-8507 Grand Haven, MI 49417 Target T-1482 (P) (616) 844-4184 3456 West Shore Drive Rite Aid Pharmacy #2729 - Holland, MI 49424 Randall Street Square (P) (616) 820-0094 1151 West Randall HOLLAND Coopersville, MI 49404 Walgreens #02825 (P) (616) 837-6219 11236 E Lakewood Blvd CVS Pharmacy #10137 (NP) Holland, MI 49424 Taskers Drug Store (P) 132 Douglas Ave (616) 396-5523 281 Main Street Holland, MI 49424 Coopersville, MI 49404 (616) 396-3109 (616) 837-6394

70 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #02905 (P) Rite Aid Pharmacy #1472 PRESQUE ISLE COUNTY 494 Butternut (P)

Holland, MI 49424 2775 Port Sheldon Rd PHARMACIES RETAIL (616) 786-2235 Jenison, MI 49428 ONAWAY Walgreens #06911 (P) (616) 669-0970 12576 Riley Street Target Pharmacy T-399 (P) Holland, MI 49424 334 Chicago Drive Thunder Bay Pharmacy (616) 786-4417 Jenison, MI 49428 Onaway (P) Walgreens #10515 (P) (616) 457-2730 21258 West M-68 Highway 780 S Washington Ave Walgreens #05117 (P) Onaway, MI 49765 Holland, MI 49423 378 Baldwin Street (989) 733-7037 (616) 396-0098 Jenison, MI 49428 Toms Family Market (P) Wal-Mart Pharmacy (616) 667-8695 20597 State Street #10-1942 (NP) Onaway, MI 49765 (989) 733-8229 2629 North Park Drive SPRING LAKE Holland, MI 49424 (616) 393-8071 ROGERS CITY Leppinks Pharmacy (NP) 17717 174th Street HUDSONVILLE Spring Lake, MI 49456 McLean Pharmacy (P) (616) 842-4706 229 N Third Street Family Fare Pharmacy #116 Rite Aid Pharmacy #2776 Rogers City, MI 49779 (P) (P) (989) 734-4701 5221 Cherry Street 200 West Savidge Street Rite Aid Pharmacy #2606 Hudsonville, MI 49426 Spring Lake, MI 49456 (P) (616) 669-1960 (616) 842-1461 110 S Bradley Us 23 Family Fare Pharmacy #239 Rogers City, MI 49779 (989) 734-7392 (P) ZEELAND 6480 28th Avenue Hudsonville, MI 48426 ROSCOMMON COUNTY (616) 669-8518 Bunte’s Pharmacy (NP) 115 Main St Zeeland, MI 49464 HOUGHTON LAKE JENISON (616) 772-4685 Family Fare Pharmacy #108 Family Fare Pharmacy (P) Kmart Pharmacy #4795 (P) #1589 (P) 9479 Riley Street Suite 100 8171 W Houghton Lake Dr 1965 Baldwin Street Zeeland, MI 49464 Houghton Lake, MI 48629 Jenison, MI 49428 (616) 748-7384 (989) 422-6445 (616) 457-9630 Rite Aid Pharmacy #4431 Meijer Pharmacy #026 (P) (P) 0-550 Baldwin Avenue 4562 W Houghton Lake Jenison, MI 49428 Drive (616) 667-2033 Houghton Lake, MI 48629 (989) 366-9212

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 71 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy #10-2014 (NP) SAGINAW COUNTY FRANKENMUTH 3451 W Houghton Lake Drive BIRCH RUN Kroger Co Of Michigan Houghton Lake, MI 48629 #436 (P) (989) 366-6533 435 N Main Street Birch Run Drugs (P) Frankenmuth, MI 48734 PRUDENVILLE 8501 S Main (989) 652-0621 Birch Run, MI 48415 (989) 624-9231 Rite Aid Pharmacy #4507 (P) Kronner Pharmacy (P) Meijer Pharmacy #213 (P) 309 N Main Street RETAIL PHARMACIES 778 W Houghton Lake Drive 9515 Birch Run Rd Frankenmuth, MI 48734 Prudenville, MI 48651 Birch Run, MI 48415 (989) 652-2613 (989) 366-7611 (989) 624-1610 Satow Drug Store (P) Walgreens #10489 (P) 308 S Main Street 729 Houghton Lake Dr BRIDGEPORT Frankenmuth, MI 48734 Prudenville, MI 48651 (989) 652-8001 (989) 366-5324 Bridgeport Pharmacy Inc. FREELAND ROSCOMMON (P) 6224 Dixie Highway Bridgeport, MI 48722 (989) 777-2900 Freeland Pharmacy (NP) Pioneer Family Pharmacy 7620 Midland Road #104 (NP) Rite Aid Pharmacy #1551 Freeland, MI 48623 412 North Fifth Street (P) (989) 695-6500 Roscommon, MI 48653 6155 Dixie Highway (989) 275-5600 Bridgeport, MI 48722 Rite Aid Pharmacy #3320 (989) 777-3550 HEMLOCK (P) 425 N Fifth Street CHESANING Hemlock Pharmacy (NP) Roscommon, MI 48653 529 W Saginaw Street (989) 275-5161 Hemlock, MI 48626 Broad Street Pharmacy (P) (989) 301-0250 ST. HELEN 1115 West Broad Street Chesaning, MI 48616 Wrights Pharmacy (P) (989) 845-9355 147 W Saginaw St Hemlock, MI 48626 Pioneer Family Pharmacy Knight Drugs - Chesaning (989) 642-5411 #102 (NP) LLC #1705 (P) 2100 North M-76 129-133 West Broad Street St. Helen, MI 48656 Chesaning, MI 48616 SAGINAW (989) 389-7252 (989) 845-2050 Rite Aid Pharmacy #3478 Schultz Country Pharmacy Advanced Care Pharmacy (P) (P) Services - Saginaw, LLC 2010 North M-76 126 W Broad Street (NP) St. Helen, MI 48656 Chesaning, MI 48616 500 Hancock Suite 100 (989) 389-4965 (989) 845-3609 Saginaw, MI 48602 (989) 793-3130

72 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Brady Drugs (P) Meijer Pharmacy #043 (P) Sam’s Pharmacy #10-6663 7835 Gratiot Road 3360 Tittabawassee Road (NP)

Saginaw, MI 48609 Saginaw, MI 48604 5656 Bay Road PHARMACIES RETAIL (989) 781-2370 (989) 790-5120 Saginaw, MI 48604 Care Pharmacy (NP) Princings Pharmacy #1 (NP) (989) 790-8930 1320 N Michigan Ave Ste 8 333 South Michigan Target Pharmacy T-347 (P) Saginaw, MI 48602 Saginaw, MI 48602 2772 Tittabawasee Road (989) 755-7890 (989) 793-8640 Saginaw, MI 48604 Covenant Healthcare Rite Aid Pharmacy #1487 (989) 793-5701 Outpatient Pharmacy (P) Visiting Nurse Association 700 Cooper Avenue 3050 Bay Road Infusion Saginaw, MI 48602 Saginaw, MI 48603 500 South Hamilton Suite A (989) 583-6484 (989) 792-9606 Saginaw, MI 48602 Faler Pharmacy Inc. (NP) Rite Aid Pharmacy #1552 (989) 799-6020 1806 Court Street (P) Walgreens #05097 (P) Saginaw, MI 48602 5050 Gratiot Road 4989 State Street (989) 793-2445 Saginaw, MI 48603 Saginaw, MI 48603 Health Delivery Pharmacy (989) 799-2626 (989) 791-3088 (P) Rite Aid Pharmacy #1575 Walgreens #05371 (P) 1522 Janes Street (P) 2990 Bay Road Saginaw, MI 48601 1470 Tittabawassee Rd Saginaw, MI 48603 (989) 755-3633 Saginaw, MI 48604 (989) 497-9316 Kmart Pharmacy #7524 (P) (989) 754-8477 Walgreens #06009 (P) 5105 Gratiot Rite Aid Pharmacy #3568 3424 East Genesee Avenue Saginaw, MI 48603 (P) Saginaw, MI 48601 (989) 797-0990 806 West Gratiot Avenue (989) 753-9688 Kroger (P) Saginaw, MI 48602 Walgreens #06091 (P) 3860 Dixie Highway (989) 791-4221 409 West Genesee Avenue Saginaw, MI 48601 Rite Aid Pharmacy #3588 Saginaw, MI 48602 (989) 777-4080 (P) (989) 755-2251 5025 Gratiot Road 3403 E Genesee Avenue Wal-Mart Pharmacy Saginaw, MI 48603 Saginaw, MI 48601 #10-2644 (NP) (989) 791-7110 (989) 752-8240 5825 Brockway Road Kroger Co Of Michigan Rite Aid Pharmacy #4508 Saginaw, MI 48603 #18738 (P) (P) (989) 497-8112 4672 State Street 4598 State Street Wal-Mart Pharmacy Saginaw, MI 48603 Saginaw, MI 48603 #10-5097 (NP) (989) 921-6222 (989) 792-3451 5650 Bay Road Medwins Pharmacy (NP) Rite Aid Pharmacy #4564 Saginaw, MI 48604 301 E Genesee Ave Ste 100 (P) (989) 790-7431 Saginaw, MI 48607 531 West Genesee Avenue (989) 755-7998 Saginaw, MI 48602 (989) 753-2447 Meijer Pharmacy #042 (P) 8400 Gratiot Road Saginaw, MI 48609 (989) 781-4331

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 73 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Putvins Drug Store (NP) ST. CHARLES MARLETTE 211 South Cedar Manistique, MI 49854 Healthway Pharmacy (NP) Main Street Pharmacy (NP) (906) 341-5494 1008 N Saginaw 3006 Main Street Schoolcraft Memorial St. Charles, MI 48655 Marlette, MI 48453 Hospital Pharmacy (989) 865-9971 (989) 635-7777 500 Main Street Rite Aid Pharmacy #3315 Manistique, MI 49854 (P) (906) 341-3200 SANILAC COUNTY 2898 Main Street Shopko Pharmacy #2621 (P) Marlette, MI 48453 717 East Lakeshore Drive RETAIL PHARMACIES BROWN CITY (989) 635-2031 Manistique, MI 49854 (906) 341-3994 SANDUSKY Ehardt’s Pharmacy #4 (P) 4436 Main Street SHIAWASSEE COUNTY Brown City, MI 48416 Kmart Pharmacy #7660 (P) (810) 346-2637 545 West Sanilac CORUNNA Sandusky, MI 48471 CROSWELL (810) 648-5136 Rite Aid Pharmacy #4228 Meijer Pharmacy #113 (P) (P) 2591 East M-21 Ehardt’s Pharmacy #2 (P) 39 Kristian Drive Corunna, MI 48817 57 N Howard Avenue Sandusky, MI 48471 (989) 743-3432 Croswell, MI 48422 (810) 648-4668 (810) 679-3900 Sanilac Pharmacy (NP) DURAND 78 South Elk Street DECKERVILLE Sandusky, MI 48471 (810) 648-2265 Rite Aid Pharmacy #3312 (P) Wal-Mart Pharmacy 8531 Lansing Highway Harbor Drug #2 (NP) #10-3632 (NP) 2046 Black River St Ste 2 Durand, MI 48429 655 West Sanilac Road (989) 288-3101 Deckerville, MI 48427 Sandusky, MI 48471 (810) 376-8070 (810) 648-4247 Shaws Pharmacy Inc. (P) 221 N Saginaw Street LEXINGTON Durand, MI 48429 SCHOOLCRAFT COUNTY (989) 288-6886

Ehardt’s Pharmacy #1 (P) OWOSSO 7275 Huron Avenue MANISTIQUE Lexington, MI 48450 (810) 359-5322 Manistique Tribal Health Healthfirst Pharmacy (P) Clinic Pharmacy (P) 111 North Washington Street 5698 West Us 2 Owosso, MI 48867 Manistique, MI 49854 (989) 729-9355 (906) 341-8469

74 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kroger Co Of Michigan Wal-Mart Pharmacy ST. CLAIR COUNTY #795 (P) #10-1611 (NP)

1315 East Main 4475 24th Avenue PHARMACIES RETAIL Owosso, MI 48867 ALGONAC Fort Gratiot, MI 48059 (989) 729-0275 (810) 385-7747 Owosso Community Pharmacy (P) CVS Pharmacy #8148 (NP) KIMBALL 110 West Exchange Street 1025 St Clair River Drive Owosso, MI 48867 Algonac, MI 48001 (989) 725-1344 (810) 794-4941 CVS Pharmacy #8053 (NP) Rite Aid Pharmacy #4324 Kroger Pharmacy #450 (P) 4514 Gratiot (P) 2600 Pointe Tremble Rd Kimball, MI 48040 1002 East Main Street Algonac, MI 48001 (810) 364-6980 Owosso, MI 48867 (810) 671-4002 Wadhams Pharmacy (NP) (989) 723-6756 Rite Aid Pharmacy #4943 5277 Lapeer Road VG’s Pharmacy #1932 (P) (P) Kimball, MI 48074 1341 N M-52 402 Pointe Tremble Road (810) 984-8200 Owosso, MI 48867 Algonac, MI 48001 (989) 725-5141 (810) 794-4985 MARINE CITY Walgreens #11955 (P) 1001 E Main St CAPAC Owosso, MI 48867 CVS Pharmacy #8149 (NP) (989) 725-6309 1229 South Parker Marine City, MI 48039 Wal-Mart Pharmacy Capac Pharmacy Inc. (NP) (810) 765-3576 #10-1733 (NP) 136 North Main Street 1621 East M -21 Capac, MI 48014 VG’s Pharmacy #1934 (P) Owosso, MI 48867 (810) 395-2336 6764 S River Rd (989) 723-2656 Marine City, MI 48039 EAST CHINA (810) 765-3585 PERRY MARYSVILLE AHS St John Pharmacy Rite Aid Pharmacy #4765 River District (NP) (P) 4100 S River Road Ste 100 Meijer Pharmacy #229 (P) 681 North Main St East China, MI 48054 205 South Range Road Perry, MI 48872 (810) 329-5355 Marysville, MI 48040 (517) 625-3322 (810) 388-9633 Snyder’s Pharmacy (P) FORT GRATIOT Rite Aid Pharmacy #4559 520 N Main Street (P) Perry, MI 48872 1710 Gratiot Blvd (517) 625-8640 Meijer Pharmacy #163 (P) Marysville, MI 48040 4775 24th Ave (810) 364-6200 Fort Gratiot, MI 48059 (810) 385-2110 Target T-0632 (P) 4300 24th Avenue Fort Gratiot, MI 48059 (810) 385-5000

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 75 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4409 PORT HURON (P) YALE 1607 24th Street Advanced Care Pharmacy Port Huron, MI 48060 Port Huron Hospital Services - Port Huron, LLC (810) 984-5108 Pharmacy Place (NP) (P) Rite Aid Pharmacy #4574 7470 Brockway Road 3111 Electric Avenue (P) Yale, MI 48097 Port Huron, MI 48060 2910 Pine Grove Avenue (810) 387-0601 (810) 824-5120 Port Huron, MI 48060 Sheldon Pharmacy Of Yale CVS Pharmacy #8117 (NP) (810) 987-3663 (NP) 3530 Pine Grove Sam’s Pharmacy #10-6660 25 South Main RETAIL PHARMACIES Port Huron, MI 48060 (NP) Yale, MI 48097 (810) 987-7333 1237 32nd Street (810) 387-4244 CVS Pharmacy #8301 (NP) Port Huron, MI 48060 940 Lapeer Avenue (810) 982-5791 ST. JOSEPH COUNTY Port Huron, MI 48060 Walgreens #05595 (P) (810) 982-4721 1617 10th Street Kmart Pharmacy #7634 (P) Port Huron, MI 48060 COLON 1179 32nd Street (810) 987-5083 Port Huron, MI 48060 Walgreens #06053 (P) (810) 989-7610 3990 24th Avenue Colon Village Pharmacy (P) Kroger Co #16715 (P) Port Huron, MI 48060 131 S Blackstone 1215 24th Street (810) 987-4679 Colon, MI 49040 Port Huron, MI 48060 (269) 432-3435 (810) 987-7155 ST. CLAIR Kroger Co Of Michigan STURGIS #515 (P) 2907 Kraft Avenue CVS Pharmacy #8246 (NP) Port Huron, MI 48060 1545 Fred Moore Hwy Kmart Pharmacy #9026 (P) (810) 987-6346 St. Clair, MI 48079 315 S Centerville Road (810) 326-1381 Sturgis, MI 49091 Mercy Outpatient Pharmacy (269) 651-8939 (NP) Neiman’s Family Pharmacy - 2601 Electric Avenue St. Clair (P) Kroger Co Of Michigan Port Huron, MI 48060 1167 S Carney Dr #J-978 (P) (810) 966-3140 St. Clair, MI 48079 811 South Centerville (810) 329-4535 Sturgis, MI 49091 Pharmacy Place (NP) (269) 651-4625 1221 Pine Grove Ave St. Clair Pharmacy, Inc. (NP) Port Huron, MI 48061 201 N Riverside Avenue Unit Rite Aid Pharmacy #4234 (810) 989-3455 A-1 (P) St. Clair, MI 48079 102 North Centerville Port Huron Pharmacy (P) (810) 326-1233 Sturgis, MI 49091 515 10th Street (269) 651-7818 Port Huron, MI 48060 (810) 989-9550 Walgreens #09146 (P) 950 South Centerville Road Sturgis, MI 49091 (269) 651-9519

76 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy State Street Pharmacy And Rite Aid Pharmacy #1745 - #10-1771 (NP) Wellness Center (NP) Shop-Rite Shopping Ctr.

69801 S Centerville Road 192 North Street (P) PHARMACIES RETAIL Sturgis, MI 49091 Caro, MI 48723 512 Goodrich Street (269) 651-9560 (989) 672-3500 Vassar, MI 48768 VG’s Pharmacy #1922 (P) (989) 823-2391 THREE RIVERS 15200 W Caro Caro, MI 48723 VAN BUREN COUNTY (989) 673-7020 Fred’s Supermarket Wal-Mart Pharmacy Pharmacy (NP) #10-1798 (NP) BANGOR 808 W Michigan 1121 East Caro Road Three Rivers, MI 49093 Caro, MI 48723 (269) 278-2355 (989) 673-7922 Swanstra Drug Store (P) Meijer Pharmacy #175 (P) 3 W Monroe 800 South Us 131 Bangor, MI 49013 CASS CITY Three Rivers, MI 49093 (269) 427-7706 (269) 279-1210 3 W Monroe Rite Aid Pharmacy #4235 Coach Light Pharmacy (P) Bangor, MI 49013 (P) 6480 West Main St (269) 427-7706 1113 W Michigan Avenue Cass City, MI 48726 (989) 872-3613 Three Rivers, MI 49093 DECATUR (269) 279-9702 Walgreens #07934 (P) MAYVILLE 301 South Us Highway 131 Decatur Village Market Three Rivers, MI 49093 Pharmacy (NP) (269) 279-9066 Wingert’s Pharmacy (NP) 108 B East Delaware Street Wal-Mart Pharmacy 315 E Main Street Decatur, MI 49045 #10-3791 (NP) Mayville, MI 48744 (269) 423-6770 101 South Tolbert Drive (989) 843-5440 108 B East Delaware Street Three Rivers, MI 49093 Decatur, MI 49045 (269) 273-7833 REESE (269) 423-6770

TUSCOLA COUNTY Manley’s Pharmacy (NP) GOBLES 9894 Saginaw Street Reese, MI 48757 CARO Gobles Pharmacy (P) (989) 868-4102 206 South State Gobles, MI 49055 Caro Drug’s PC (P) VASSAR (269) 628-2650 1525 W Caro Rd 206 South State Caro, MI 48723 Gobles, MI 49055 (989) 672-1080 McLaren Drug Shop - Vassar (269) 628-2650 Rite Aid Pharmacy #4455 (P) (P) 181 W Huron Rd 625 State North Vassar, MI 48768 Caro, MI 48723 (989) 823-9200 (989) 673-6852

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 77 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

HARTFORD PAW PAW SOUTH HAVEN

Rite Aid Pharmacy #4240 Felpausch Paw Paw Macdonald Drug Store (NP) 302 W Main Street Pharmacy #1980 512 Phoenix Hartford, MI 49057 847 S Kalamazoo South Haven, MI 49090 (269) 621-3654 Paw Paw, MI 49079 (269) 637-1161 302 W Main Street (269) 657-1778 512 Phoenix Hartford, MI 49057 847 S Kalamazoo South Haven, MI 49090 (269) 621-3654 Paw Paw, MI 49079 (269) 637-1161 (269) 657-1778

RETAIL PHARMACIES Shoreline Pharmacy LAWTON Hills Prescription Shop 950 Blue Star Hwy 404 Hazen Street South Haven, MI 49090 Paw Paw, MI 49079 (269) 637-9476 Lawton Pharmacy (269) 657-4701 Value Drugs (NP) 350 N Main Street 404 Hazen Street 08337 M140 Unit 2 Lawton, MI 49065 Paw Paw, MI 49079 South Haven, MI 49090 (269) 624-2231 (269) 657-4701 (269) 637-3222 350 N Main Street Paw Paw Village Drugs Inc. 08337 M140 Unit 2 Lawton, MI 49065 322 East Michigan Avenue South Haven, MI 49090 (269) 624-2231 Paw Paw, MI 49079 (269) 637-3222 (269) 657-6073 Walgreens #09691 MATTAWAN 322 East Michigan Avenue 1100 Phoenix Street Paw Paw, MI 49079 South Haven, MI 49090 (269) 657-6073 (269) 637-1457 Bronson Pharmacy Mattawan Rite Aid Pharmacy #3244 - 1100 Phoenix Street 52375 North Main Street Village Of Paw Paw South Haven, MI 49090 Mattawan, MI 49071 319 E Michigan Avenue (269) 637-1457 (269) 668-6205 Paw Paw, MI 49079 Wal-Mart Pharmacy (269) 657-4440 #10-1540 52375 North Main Street 3383 73rd Street Mattawan, MI 49071 319 E Michigan Avenue South Haven, MI 49090 (269) 668-6205 Paw Paw, MI 49079 (269) 657-4440 (269) 637-7802 Medicine Tree Pharmacy 56109 Village Center Circle Walgreens #12688 3383 73rd Street Mattawan, MI 49071 848 S Kalamazoo St South Haven, MI 49090 (269) 668-6801 Paw Paw, MI 49079 (269) 637-7802 (269) 657-4984 56109 Village Center Circle Mattawan, MI 49071 848 S Kalamazoo St (269) 668-6801 Paw Paw, MI 49079 (269) 657-4984

78 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

CVS Pharmacy #8097 (NP) Meijer Pharmacy #173 (P) WASHTENAW COUNTY 2228 S Main 5645 Jackson Road

Ann Arbor, MI 48103 Ann Arbor, MI 48103 PHARMACIES RETAIL ANN ARBOR (734) 663-1811 (734) 222-0310 CVS Pharmacy #8216 (NP) Rite Aid Pharmacy #4510 1700 S Industrial & Stimson (P) Ann Arbor Home Infusion Ann Arbor, MI 48104 2603 Jackson Road Pharmacy (734) 827-7980 Ann Arbor, MI 48103 5301 East Huron River Drive Dixboro Village Pharmacy (734) 769-3494 Room 1205 (NP) Rite Aid Pharmacy #4519 Ann Arbor, MI 48106 5770 Plymouth (P) (734) 712-2492 Ann Arbor, MI 48105 2980 Packard Road Ann Arbor Professional (734) 214-1234 Ann Arbor, MI 48108 Pharmacy (NP) East Ann Arbor Pharmacy (734) 971-1013 2140 E Ellsworth Rd (NP) Rite Aid Pharmacy #4530 Ann Arbor, MI 48108 4260 Plymouth Rd (P) (734) 477-9006 Ann Arbor, MI 48109 2781 Plymouth Big House Pharmacy (NP) (734) 647-5705 Ann Arbor, MI 48105 1000 E Stadium Blvd Ste B Healthplus Specialty (734) 761-6404 Ann Arbor, MI 48104 Pharmacy (P) St. Joseph Mercy Pharmacy (734) 929-2425 3520 Green Ct Ste 175 - Towers Cascade Hemophilia Ann Arbor, MI 48105 5301 E Huron River Drive Consortium (P) (734) 769-1300 #1098 517 W William St Kec Pharmacy (NP) Ann Arbor, MI 48106 Ann Arbor, MI 48103 1000 Wall Street Room 4114 (734) 712-3333 (734) 996-3300 Ann Arbor, MI 48109 Stadium Pharmacy (P) Costco Pharmacy #1106 (P) (734) 232-8117 1930 W Stadium Blvd 771 Airport Blvd Kmart Pharmacy #4105 (P) Ann Arbor, MI 48103 Ann Arbor, MI 48108 215 N Maple Road (734) 913-4752 (734) 213-8011 Ann Arbor, MI 48103 Target T-0634 (P) CVS Pharmacy #03584 (NP) (734) 769-0758 2000 Waters Road 209 South State St Kroger Co Of Michigan Ann Arbor, MI 48103 Ann Arbor, MI 48103 #605 (P) (734) 996-0700 (734) 769-1804 2641 Plymouth Road U Of M Homemed CVS Pharmacy #07137 (NP) Ann Arbor, MI 48105 2850 S Industrial Hwy Ste 50 5449 Jackson Road (734) 994-0180 Ann Arbor, MI 48104 Ann Arbor, MI 48103 Kroger Co Of Michigan (800) 862-2731 (734) 332-3872 #688 (P) UMMC Ambulatory Care CVS Pharmacy #8006 (NP) 400 S Maple Pharmacy (NP) 3535 Plymouth Road Ann Arbor, MI 48103 1500 E Medical Center Drive Ann Arbor, MI 48105 (734) 213-5343 Ann Arbor, MI 48109 (734) 994-3636 Meijer Pharmacy #064 (P) (734) 936-8260 CVS Pharmacy #8088 (NP) 3145 Ann Arbor / Saline United Pharmacy (P) 2100 W Stadium Blvd Road 4900 Washtenaw Rd Ann Arbor, MI 48103 Ann Arbor, MI 48103 Ann Arbor, MI 48108 (734) 747-7554 (734) 769-7941 (734) 340-5454

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 79 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Village Apothecary Inc. (NP) Home Town Pharmacy Ltc Saline Pharmacy LLC (P) 1112 S University Drive 1123 S Main Street 75 E Bennett St Ann Arbor, MI 48104 Chelsea, MI 48118 Saline, MI 48176 (734) 663-5533 (734) 562-2279 (734) 316-2162 Village Pharmacy II (NP) Wal-Mart 10-5472 (NP) 325 N Maple Road DEXTER 7000 E Michigan Ann Arbor, MI 48103 Saline, MI 48176 (734) 668-9600 (734) 944-2098 Walgreens #05842 (P) Dexter Pharmacy (NP) 2820 Baker Road 3255 Washtenaw Avenue WHITMORE LAKE Ann Arbor, MI 48104 Dexter, MI 48130 RETAIL PHARMACIES (734) 975-2902 (734) 426-1600 Walgreens #11197 (P) CVS Pharmacy #05741 (NP) 2355 Jackson Avenue MANCHESTER 7488 Village Center Ann Arbor, MI 48103 Whitmore Lake, MI 48189 (734) 794-0162 (810) 231-4179 Manchester Pharmacy (P) Walgreens Specialty 128 E Main Street Pharmacy YPSILANTI Manchester, MI 48158 1350 Highland Dr Ste D (734) 428-8393 Ann Arbor, MI 48108 (734) 677-3800 Barron Pharmacy (NP) 4870 W Clark Rd Ste 108 Wenk’s Prescription Shop MILAN Ypsilanti, MI 48197 (P) (734) 528-9144 2355 E Stadium Blvd Kroger Co #16576 (P) Ann Arbor, MI 48104 Canalis Medical Pharmacy (734) 747-8080 531 West Main Street (P) Milan, MI 48160 200 Arnet St #130 (734) 439-6856 Ypsilanti, MI 48198 CHELSEA (734) 483-0952 SALINE Clark Professional Pharmacy Chelsea Pharmacy (P) (NP) 1050 S Main Street 3075 Clark Rd Chelsea, MI 48118 Center For Forensic Ypsilanti, MI 48197 (734) 475-1188 Psychiatry (734) 434-7333 8303 Platt Road CVS Pharmacy #8023 (NP) Chelseacare Pharmacy (NP) Saline, MI 48176 1415 East Michigan Avenue 14650 E Old Us 12 (734) 429-2531 Chelsea, MI 48118 Ypsilanti, MI 48198 (734) 475-3996 CVS Pharmacy #8003 (NP) (734) 482-2550 413 East Michigan Avenue CVS Pharmacy #8083 (NP) Country Market Pharmacy Saline, MI 48176 3090 Carpenter #12 (P) (734) 429-4991 1255 South Main Street Ypsilanti, MI 48197 Chelsea, MI 48118 Jensen’s Community (734) 973-7402 Pharmacy (NP) (734) 433-0075 CVS Pharmacy #8165 (NP) 968 E Michigan Ave 2151 Washtenaw CVS Pharmacy #8089 (NP) Saline, MI 48176 Ypsilanti, MI 48197 935 South Main Street (734) 429-9053 Chelsea, MI 48118 (734) 483-8900 (734) 475-2222

80 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Franks Drugs (NP) Sav-Mor #65 Eastern WAYNE COUNTY 204 W Michigan Pharmacy (NP)

Ypsilanti, MI 48197 1159 E Michigan Ave PHARMACIES RETAIL (734) 483-0411 Ypsilanti, MI 48198 ALLEN PARK Himson Pharmacy (NP) (734) 485-9900 209 S Ford Blvd Snow Health Service Ypsilanti, MI 48197 Pharmacy (P) All Care Pharmacy (P) (734) 544-0920 Eastern Michigan University 7125 Allen Road Kmart Pharmacy #4106 (P) Ypsilanti, MI 48197 Allen Park, MI 48101 3100 Washtenaw Avenue (734) 487-1003 (313) 386-2273 Ypsilanti, MI 48197 St. Joseph Mercy Pharmacy Allen Park Discount (734) 434-3566 - Reichert Pharmacy (NP) Kroger Co Of Michigan 5333 Mcauley R1010 6811 Allen Rd #520 (P) Ypsilanti, MI 48197 Allen Park, MI 48101 1771 Michigan Avenue (734) 712-4444 (313) 928-2222 Ypsilanti, MI 48198 Target Pharmacy T-1285 (P) Champaign Pharmacy (NP) (734) 482-9342 3749 Carpenter Road 14741 Champaign Road Kroger Co Of Michigan Ypsilanti, MI 48197 Allen Park, MI 48101 #689 (P) (734) 975-4675 (313) 382-1600 3200 Carpenter Road Walgreens #05398 (P) CVS Pharmacy #8181 (NP) Ypsilanti, MI 48197 2170 Washtenaw Road 15240 Southfield (734) 971-7283 Ypsilanti, MI 48197 Allen Park, MI 48101 Kroger Co Of Michigan (734) 485-3899 (313) 382-7265 #707 (P) Walgreens #11156 (P) Med / Rx (P) 2010 Whitaker Road 419 E Michigan Ave 15101 Southfield Road - Ypsilanti, MI 48197 Ypsilanti, MI 48198 Suite 101 (734) 547-1847 (734) 485-4621 Allen Park, MI 48101 (313) 928-4922 Meijer Pharmacy #027 (P) Wal-Mart Pharmacy 3825 Carpenter Road #10-1824 (NP) Meijer Pharmacy #233 (P) Ypsilanti, MI 48197 2515 Ellsworth Road 3565 Fairlane Blvd (734) 677-7133 Ypsilanti, MI 48197 Allen Park, MI 48101 Rite Aid Pharmacy #4363 (734) 434-7950 (313) 253-1133 (P) Ypsilanti Family Pharmacy Pharmor Pharmacy- Allen 753 Grove Street (P) Park (NP) Ypsilanti, MI 48198 3145 W Clark Road Ste 106 8221 Allen Road (734) 482-7430 Ypsilanti, MI 48197 Allen Park, MI 48101 Salem’s Pharmacy (NP) (734) 434-2448 (313) 388-9560 313 Ecorse Road Rite Aid Pharmacy #4445 Ypsilanti, MI 48198 YPSILANTI TWP. (P) (734) 487-8500 15411 Southfield Sam’s Pharmacy #10-6667 Allen Park, MI 48101 (NP) CVS Pharmacy #01758 (NP) (313) 386-8604 5450 Carpenter Road 5408 Whittaker Road Target T-2033 (P) Ypsilanti, MI 48197 Ypsilanti Twp., MI 48197 3100 Fairlane Drive (734) 434-2587 (734) 481-3381 Allen Park, MI 48101 (313) 768-0065

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 81 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy BELLEVILLE #10-2872 (NP) CANTON 10562 Belleville Road Andrew’s Pharmacy Belleville, MI 48111 Canton Specialty Pharmacy Belleville / Sav On Drugs (734) 697-4784 (NP) #7 (P) 305 N Lilley Road 444 Main Street BROWNSTOWN TOWNSHIP Canton, MI 48187 Belleville, MI 48111 (734) 259-6700 (734) 699-2075 CVS Pharmacy #8225 (NP) Cet Pharmacy CVS Pharmacy #00211 (NP) 1791 Haggerty Road South 504 Main St 18900 Telegraph Road Canton, MI 48188 RETAIL PHARMACIES Belleville, MI 48111 Brownstown Township, MI (734) 394-2460 (734) 699-4559 48174 (734) 941-2067 Haggerty Drugs & Medical CVS Pharmacy #8042 (NP) Supplies Inc. (P) 10915 Belleville Road CVS Pharmacy #8160 (NP) 2050 N Haggerty Road Ste Belleville, MI 48111 23800 West Road 160 (734) 697-4000 Brownstown Township, MI Canton, MI 48187 48183 (734) 981-7340 Health Smart Pharmacy (P) (734) 692-4230 10824 Belleville Road Health Plus Pharmacy (P) Belleville, MI 48111 Henry Ford Wyandotte CHS 49650 Cherry Hill Road Ste (734) 699-2228 Pharmacy (P) 140 23050 West Road Kmart Pharmacy #3155 (P) Canton, MI 48187 Brownstown Township, MI (734) 495-9600 2095 Rawsonville Road 48183 Belleville, MI 48111 (734) 671-1499 Henry Ford Medical Center (734) 487-5502 Pharmacy - Canton (NP) Kroger Co Of Michigan 6100 North Haggerty Meijer Pharmacy #072 (P) #708 (P) 9701 Belleville Canton, MI 48187 20645 Gibraltar Road (734) 981-3002 Belleville, MI 48111 Brownstown Township, MI (734) 697-1900 48183 Kroger Co Of Michigan Orchard Pharmacy Center (734) 675-0656 #671 (P) 1905 Canton Center Road (P) Kroger Pharmacy #458 (P) 19731 Sumpter Rd Canton, MI 48187 23849 West Road (734) 844-2677 Belleville, MI 48111 Brownstown Township, MI (734) 391-8284 48134 Meijer Pharmacy #032 (P) Rite Aid Pharmacy #4332 (734) 561-1210 45001 Ford Road (P) Canton, MI 48187 Walgreens #05168 (P) (734) 981-0844 2039 Rawsonville Road 23007 Telegraph Road Belleville, MI 48111 Brownstown Township, MI Oakwood Pharmacy - (734) 484-0482 48134 Canton (NP) Van Buren Pharmacy (NP) (734) 675-6663 7330 Canton Center Rd Ste 11650 Belleville Rd Ste 103 115 Belleville, MI 48111 Canton, MI 48187 (734) 325-6318 (734) 454-8070 Walgreens #07275 (P) 10276 Belleville Road Belleville, MI 48111 (734) 697-4374

82 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Richardson’s Super Drugs Wal-Mart Pharmacy 10-5761 CVS Pharmacy #8005 (NP) (P) (NP) 23115 Michigan

42433 Ford Road 4555 Michigan Ave Dearborn, MI 48124 PHARMACIES RETAIL Canton, MI 48187 Canton, MI 48188 (313) 562-7612 (734) 981-3900 (734) 985-9429 CVS Pharmacy #8027 (NP) Rite Aid Pharmacy #4829 10335 W Warren Avenue (P) CANTON TOWNSHIP Dearborn, MI 48126 2240 North Canton Center (313) 581-4010 Road CVS Pharmacy #8035 (NP) Canton, MI 48187 CVS Pharmacy #8167 (NP) 13250 Ford Road (734) 844-3598 7269 Canton Center Dearborn, MI 48126 Rite Aid Pharmacy #4927 Canton Township, MI 48187 (313) 846-8890 (734) 455-5186 (P) CVS Pharmacy #8128 (NP) 180 Lilly Road CVS Pharmacy #8190 (NP) 2701 Telegraph Road Canton, MI 48187 45300 Cherry Hill Road Dearborn, MI 48124 (734) 844-0296 Canton Township, MI 48187 (313) 562-5003 (734) 981-3968 Rite Aid Pharmacy #7824 CVS Pharmacy #8152 (NP) (P) Kroger Co Of Michigan 22060 W Outer Drive 4151 S Canton Center Road #703 (P) Dearborn, MI 48124 Canton, MI 48188 45540 Michigan Avenue (313) 274-7651 (734) 394-0027 Canton Township, MI 48188 Dearborn Family Pharmacy (734) 397-2560 Sam’s Pharmacy #10-6666 LLC (P) (NP) 17000 Executive Plaza Dr. Ste 39800 Ford Road DEARBORN D Canton, MI 48187 Dearborn, MI 48126 (734) 981-5104 (313) 523-5334 Target Stores T-354 (P) A & A Pharmacy LLC (NP) Dearborn Hills Pharmacy (P) 43670 Ford Road 15343 W Warren 24755 Ford Rd Canton, MI 48187 Dearborn, MI 48126 Dearborn, MI 48128 (734) 454-2507 (313) 584-0600 (313) 915-5455 Target T-2415 (P) A And S Pharmacy, Inc. (P) Dix Drug Store (P) 47330 Michigan Ave 14716 W Warren 10066 Dix Avenue Suite #2 Canton, MI 48188 Dearborn, MI 48126 Dearborn, MI 48120 (734) 714-2013 (313) 582-1350 (313) 843-2400 Walgreens #06550 (P) Access Pharmacy (P) Dix Family Care Pharmacy 44300 Ford Road 6450 Maple Street (NP) Dearborn, MI 48126 Canton, MI 48187 10035 W Vernor Hwy (313) 216-2213 (734) 459-3875 Dearborn, MI 48120 Wal-Mart Pharmacy Cherry Hill Pharmacy (P) (313) 914-5556 #10-3476 (NP) 23100 Cherry Hill Drug Max (P) Dearborn, MI 48124 39500 Ford Road 5472 Schaefer Road (313) 274-5990 Canton, MI 48187 Dearborn, MI 48126 (734) 983-0548 CVS Pharmacy #8001 (NP) (313) 584-4600 15325 Michigan Avenue East Village Pharmacy (NP) Dearborn, MI 48126 5728 Schaefer Ste 102 (313) 582-9422 Dearborn, MI 48126 (313) 581-4626

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 83 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Eastborn Rx Pharmacy (NP) Medex Pharmacy (NP) Right Medicine (P) 7526 Wyoming St Suite 1 13530 Michigan Ave Ste 180 1338 N Telegraph Rd Dearborn, MI 48126 Dearborn, MI 48126 Dearborn, MI 48128 (313) 491-1010 (313) 846-3339 (313) 278-0500 Future Drugs Medina Pharmacy (P) Rite Aid Pharmacy #4520 14234 Warren Ave 6468 Greenfield Rd (P) Dearborn, MI 48126 Dearborn, MI 48126 5650 Schaefer (313) 945-1288 (313) 581-5600 Dearborn, MI 48126 Greenfield Pharmacy Inc. Monroe Pharmacy (P) (313) 581-3280 6050 Greenfield 2507 Monroe Rite Aid Pharmacy #4543 Dearborn, MI 48126 Dearborn, MI 48124 (P) RETAIL PHARMACIES (313) 846-9090 (313) 274-9141 22521 Michigan Avenue Hamzeh Pharmacy (P) Nadia’s Pharmacy Dearborn, MI 48124 10437 W Warren 12818 West Warren (313) 278-1515 Dearborn, MI 48126 Dearborn, MI 48126 Saad’s Healthy Living (313) 582-1670 (313) 584-7272 Pharmacy Health Care Pharmacy (P) New Schaefer Pharmacy 13734 W Warren Road 10801 W Warren Ave (NP) Dearborn, MI 48126 Dearborn, MI 48126 6635 Schaefer (313) 846-7700 (313) 357-3712 Dearborn, MI 48126 Sheba Discount Pharmacy Henry Ford Medical Center (313) 582-1800 (P) Pharmacy - Fairlane (NP) Oakman Medical Pharmacy 10136 Vernor Hwy 19401 Hubbard Drive 5280 Oakman Blvd Dearborn, MI 48120 Dearborn, MI 48126 Dearborn, MI 48126 (313) 841-8820 (313) 982-8245 (313) 846-1941 South Dearborn Pharmacy Julias Pharmacy (P) Oakwood Pharmacy - (NP) 5220 Oakman Blvd Dearborn (NP) 9925 Dix Avenue Dearborn, MI 48126 18181 Oakwood Blvd Dearborn, MI 48120 (313) 406-3363 Suite 108 (313) 841-2272 Kings Pharmacy (P) Dearborn, MI 48124 Target T-0279 (P) 4700 Schaefer Rd Ste 162 (313) 593-7273 15901 Ford Road Dearborn, MI 48126 Palm Drugs (P) Dearborn, MI 48126 (313) 584-7800 6650 Greenfield (313) 768-0293 Kroger Co Of Michigan Dearborn, MI 48126 TLC Pharmacy Inc. (NP) #697 (P) (313) 436-0156 2959 S Telegraph Rd 23303 Michigan Avenue Patient Care Pharmacy (NP) Dearborn, MI 48124 Dearborn, MI 48124 15301 Tireman Avenue (313) 274-0800 (313) 562-2232 Dearborn, MI 48126 Trudell Pharmacy (P) La Pharmacy (P) (313) 584-2400 5711 Schaefer 7237 Chase Road Premier Home Pharmacy Of Dearborn, MI 48126 Dearborn, MI 48126 MI (P) (313) 581-2424 (313) 581-6100 23874 Kean Street Suite 120 Walgreens #04992 (P) Maya Pharmacy (NP) Dearborn, MI 48124 15450 Michigan Avenue 15400 Michigan Ave Ste 2 (313) 887-9111 Dearborn, MI 48126 Dearborn, MI 48126 (313) 584-5820 (313) 945-8000

84 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #05032 (P) Family Center Pharmacy (P) Walgreens #04367 (P) 13601 West Warren Avenue 4245 South Beech Daly Road 8706 N Telegraph Road

Dearborn, MI 48126 Dearborn Heights, MI 48125 Dearborn Heights, MI 48127 PHARMACIES RETAIL (313) 624-9530 (313) 563-1700 (313) 724-9078 Wal-Mart Pharmacy Family Drugs Pharmacy #3 Walgreens #07206 (P) #10-4383 (NP) Inc. (P) 5709 S Telegraph Road 5851 Mercury Drive 20217 Ann Arbor Trail Dearborn Heights, MI 48125 Dearborn, MI 48126 Suite A (313) 292-1599 (313) 441-2841 Dearborn Heights, MI 48127 Walgreens #11456 (P) Well Care Pharmacy (NP) (313) 336-9333 25700 Ford Rd 5237 Oakman Blvd Ford Tel Drugs (NP) Dearborn Heights, MI 48127 Dearborn, MI 48126 23800 Ford Road (313) 359-9640 (313) 846-8040 Dearborn Heights, MI 48127 (313) 274-4647 West Village Pharmacy (NP) DETROIT 2040 Monroe St Ste 201 Kroger Pharmacy #441 (P) Dearborn, MI 48124 26400 Ford Rd (313) 561-9700 Dearborn Heights, MI 48127 7 Van Drugs (NP) Westborn Pharmacy 8 (P) (313) 827-3716 7701 E 7 Mile Rd Ste A 1800 Grindley Park St Ste 1 Marshall Pharmacy (NP) Detroit, MI 48234 Dearborn, MI 48124 25022 W Warren (313) 733-8587 (313) 438-6476 Dearborn Heights, MI 48127 A & H Pharmacy Services, Woodhaven Medical Center (313) 278-8620 Inc. (NP) Pharmacy (P) River Oaks Pharmacy (P) 15000 Gratiot Avenue 4700 Greenfield 20145 Ann Arbor Trail Detroit, MI 48205 Dearborn, MI 48126 Dearborn Heights, MI 48127 (313) 521-7000 (313) 581-8200 (313) 271-3770 A & M Pharmacy (P) Sav On Drugs #4 (P) 8282 Woodward Detroit, MI 48202 DEARBORN HEIGHTS 5688 N Telegraph Road Dearborn Heights, MI 48127 (313) 875-9010 (313) 565-9357 Action Drugs #2 (NP) Arbor Lane Pharmacy (P) Sav-Rx Pharmacy (P) 5412 West Warren 8565 Silvery Lane Suite 404 3915 Pelham Street Detroit, MI 48210 Dearborn Heights, MI 48127 Dearborn Heights, MI 48125 (313) 894-4300 (313) 563-8090 (313) 551-3547 Advanced Care Pharmacy - CVS Pharmacy #8056 (NP) Target T-0353 (P) Em (NP) 8710 N Beech Daly 26650 Ford Rd 2925 Russel St Ste 100 Dearborn Heights, MI 48127 Dearborn Heights, MI 48127 Detroit, MI 48207 (313) 278-1000 (313) 565-0404 (313) 879-2057 CVS Pharmacy #8221 (NP) Todd’s Pharmacy Inc (NP) Advanced Care Pharmacy 25762 Vanborn 25871 Ford Rd Services - Negc (NP) Dearborn Heights, MI 48125 Dearborn Heights, MI 48127 12800 E Warren Ave (313) 299-0348 (313) 406-5279 Detroit, MI 48215 (313) 347-2035 Dearborn Heights Pharmacy Total Community Pharmacy (P) (P) 25524 Ford Road 25605 Joy Road Dearborn Heights, MI 48127 Dearborn Heights, MI 48127 (313) 724-1111 (313) 277-4546

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 85 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Advanced Care Pharmacy Buckley’s Pharmacy (P) CVS Pharmacy #8073 (NP) Services - New Center, LLC 18021 Conant 18585 E Warren (NP) Detroit, MI 48234 Detroit, MI 48236 2051 W Grand Blvd (313) 368-1000 (313) 884-4184 Detroit, MI 48208 Buenavida Pharmacy (P) CVS Pharmacy #8082 (NP) (313) 309-1084 8040 West Vernor Fwy 19900 Van Dyke Andy’s Pharmacy (P) Detroit, MI 48209 Detroit, MI 48234 2676 West Grand Blvd (313) 297-3550 (313) 368-3800 Detroit, MI 48208 Care Plus Pharmacy CVS Pharmacy #8094 (NP) (313) 871-3285 14847 Gratiot Ave 1935 Campbell Ashton Drugs (NP) Detroit, MI 48205 Detroit, MI 48209 RETAIL PHARMACIES 20500 Greenfield (313) 332-0575 (313) 842-3410 Detroit, MI 48235 14847 Gratiot Ave CVS Pharmacy #8104 (NP) (313) 340-1900 Detroit, MI 48205 19851 West Warren Atlas Pharmacy, LLC (NP) (313) 332-0575 Detroit, MI 48228 2645 West Davison Care-Mor Pharmacy (NP) (313) 271-4050 Detroit, MI 48238 17256 W 7 Mile Rd CVS Pharmacy #8115 (NP) (313) 868-0940 Detroit, MI 48235 18585 Dale St Band Prescriptions (P) (313) 838-2500 Detroit, MI 48219 14711 W Seven Mile Rd Caremore Pharmacy (P) (313) 532-6300 Detroit, MI 48235 14507 W Mcnichols CVS Pharmacy #8134 (NP) (313) 653-3333 Detroit, MI 48235 15455 Gratiot Barton’s Pharmacy (P) (313) 653-3116 Detroit, MI 48205 3950 Mt Elliott City Drugs Pharmacy Inc (P) (313) 372-7076 Detroit, MI 48207 11190 Gratiot Ave CVS Pharmacy #8141 (NP) (313) 579-5502 Detroit, MI 48213 6862 N Michigan Avenue Benstar Pharmacy PLLC (313) 521-4000 Detroit, MI 48210 (NP) Conant Plaza Pharmacy (P) (313) 849-6110 2510 E Nevada Street 3611 Carpenter Street CVS Pharmacy #8153 (NP) Detroit, MI 48234 Suite 3 8936 Tireman (313) 334-5859 Detroit, MI 48212 Detroit, MI 48204 Best Value Pharmacy (NP) (313) 366-1221 (313) 491-5019 7310 Woodward Ave 4th CVS Pharmacy #07385 (NP) CVS Pharmacy #8159 (NP) Floor 200 Renaissance Center 15640 W Warren Detroit, MI 48202 Detroit, MI 48243 Detroit, MI 48228 (313) 483-3910 (313) 567-3523 (313) 584-0808 Blain Pharmacy (NP) CVS Pharmacy #08399 (NP) CVS Pharmacy #8175 (NP) 2141 East Jefferson 15521 West Seven Mile Road 18600 Livernois Detroit, MI 48207 Detroit, MI 48235 Detroit, MI 48221 (313) 393-2323 (313) 272-3296 (313) 345-6020 Blue Pharmacy (P) CVS Pharmacy #8047 (NP) CVS Pharmacy #8186 (NP) 6240 Michigan Ave 8115 W Vernor Highway 18500 Grand River Ave Detroit, MI 48210 Detroit, MI 48209 Detroit, MI 48223 (313) 899-4120 (313) 841-9700 (313) 272-5256

86 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

CVS Pharmacy #8194 (NP) CVS Pharmacy #8275 (NP) Dexter Pharmacy And 12707 Dexter 10011 West Mcnichols Medical Supplies (NP)

Detroit, MI 48238 Detroit, MI 48221 9212 Dexter PHARMACIES RETAIL (313) 491-0291 (313) 340-2893 Detroit, MI 48206 CVS Pharmacy #8196 (NP) CVS Pharmacy #8276 (NP) (313) 894-0300 16800 Schaefer Rd 22001 West 8 Mile Road DMC Pharmacy Sinai Grace Detroit, MI 48235 Detroit, MI 48219 (P) (313) 864-9660 (313) 255-3337 6001 W Outer Drive CVS Pharmacy #8199 (NP) CVS Pharmacy #8277 (NP) Suite 110 18901 Eight Mile Rd 12907 East Jefferson Avenue Detroit, MI 48235 Detroit, MI 48219 Detroit, MI 48214 (313) 966-2979 (313) 387-4120 (313) 926-8918 DMC Pharmacy Children’s CVS Pharmacy #8200 (NP) CVS Pharmacy #8283 (NP) (P) 3200 E Jefferson 10652 Gratiot Avenue 3901 Beaubien Rm 108 Detroit, MI 48207 Detroit, MI 48213 Detroit, MI 48201 (313) 396-5481 (313) 571-0441 (313) 745-0436 CVS Pharmacy #8222 (NP) CVS Pharmacy #8284 (NP) DMC Pharmacy Chm Psc (P) 13600 East Seven Mile Road 3011 Gratiot 3950 Beaubien St Ste 1010 Detroit, MI 48205 Detroit, MI 48207 Detroit, MI 48201 (313) 245-7101 (313) 922-6344 (313) 993-8011 CVS Pharmacy #8230 (NP) CVS Pharmacy #8307 (NP) DMC Pharmacy Detroit 7451 Woodward Avenue 1037 Woodward Avenue Receiving Hospital (P) Detroit, MI 48202 Detroit, MI 48226 4201 St Antoine (313) 872-7737 (313) 963-1007 Detroit, MI 48201 (313) 966-8230 CVS Pharmacy #8231 (NP) Davis Cut Rate Drugs (NP) 350 East Warren 14039 W Mcnichols DMC Pharmacy Harper (P) Detroit, MI 48201 Detroit, MI 48235 3990 John R Suite 1460 (313) 833-0201 (313) 861-9300 Detroit, MI 48201 (313) 966-3148 CVS Pharmacy #8247 (NP) Desh Pharmacy LLC (NP) 9360 East Greenfield 12170 Conant St Ste E DMC Pharmacy Hutzel (P) Detroit, MI 48228 Detroit, MI 48212 4727 St Antoine Ste 100a (313) 272-7037 (313) 366-3800 Detroit, MI 48201 (313) 745-7444 CVS Pharmacy #8267 (NP) Detroit Community Health 2590 West Grand Boulevard Connection Pharmacy (NP) DMC Pharmacy Sinai Lobby Detroit, MI 48208 7900 Kercheval (P) (313) 875-4457 Detroit, MI 48214 6071 W Outer Drive CVS Pharmacy #8269 (NP) (313) 924-9798 Suite M110 Detroit, MI 48235 13580 Grand River Detroit Medical Pharmacy (313) 966-9134 Detroit, MI 48227 (P) (313) 653-3427 500 E Warren Eastside Pharmacy (P) CVS Pharmacy #8270 (NP) Detroit, MI 48201 11854 E Warren Ave (313) 831-2400 Detroit, MI 48214 10301 Woodward Avenue (313) 579-1755 Detroit, MI 48202 Devz Pharmacy (NP) (313) 852-3651 22523 Plymouth Road Detroit, MI 48239 (313) 534-9300

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 87 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Eddies Medical Pharmacy Friendz Pharmacy Henry Ford New Center (P) 13848 W Mcnichols Rd Pharmacy (NP) 7304 Michigan Ave Detroit, MI 48235 3031 West Grand Blvd Detroit, MI 48210 (313) 397-1103 Detroit, MI 48202 (313) 551-0600 Gateway Pharmacy Inc. (P) (313) 916-9661 Elux Pharmacy (NP) 15690 Joy Road Henry Ford One Ford Place 13457 Schaefer Hwy Detroit, MI 48228 Pharmacy (NP) Detroit, MI 48227 (313) 835-9999 1 Ford Place (313) 270-2700 Grand Value Pharmacy (P) Detroit, MI 48209 Evergreen Pharmacy (P) 10920 Grand River (313) 874-4118 20010 West Warren Detroit, MI 48204 Henry Ford Pharmacy RETAIL PHARMACIES Detroit, MI 48228 (313) 931-0010 Advantage Main Campus (313) 336-3500 Griswold Pharmacy (NP) (P) Excel Community Pharmacy 1218 Griswold 2799 W Grand Blvd (P) Detroit, MI 48226 Suite 100b 17723 E Warren (313) 237-9000 Detroit, MI 48202 (313) 916-1666 Detroit, MI 48224 Harper Drugs (P) (313) 308-4500 16461 Harper Ave Heyden Pharmacy (NP) Excel Pharmacy (NP) Detroit, MI 48224 20201 W Seven Mile Road 17731 East Warren (313) 647-9420 Detroit, MI 48219 (313) 533-8200 Detroit, MI 48224 Healthy Choice Pharmacy (313) 308-4500 (P) Indian Village Pharmacy 17731 East Warren 7811 Gratiot Ave 8415 East Jefferson Avenue Detroit, MI 48224 Detroit, MI 48213 Detroit, MI 48214 (313) 308-4500 (313) 579-5700 (313) 331-2000 Family Drugs Inc. (P) Henry Ford Medical Center Jefferson Pharmacy (NP) 18611 W Warren Ste A Pharmacy - Detroit East 9911 E Jefferson Ave Detroit, MI 48228 (NP) Detroit, MI 48214 (313) 441-6666 4401 Conner (313) 331-1200 Family Drugs Pharmacy (P) Detroit, MI 48215 Jordan’s Discount Pharmacy 10809 Mack Avenue (313) 823-9897 (NP) Detroit, MI 48214 Henry Ford Medical Center 13205 Dexter (313) 822-0626 Pharmacy - Detroit Nw Detroit, MI 48238 (313) 931-3301 Farmacia Garcia (NP) (NP) 6680 Michigan Ave 7800 West Outer Drive Junction Clinic Pharmacy Detroit, MI 48210 Detroit, MI 48235 (NP) (313) 262-6059 (313) 653-2200 4771 Michigan Henry Ford Medical Center Detroit, MI 48210 Fortune Medical Pharmacy (313) 898-6946 (P) Pharmacy - K-15 (NP) 13535 Puritan St 2799 West Grand Blvd - K-15 KD Pharmacy Inc. #1704 (P) Detroit, MI 48227 Detroit, MI 48202 3130 Gratiot Avenue (313) 493-8868 (313) 916-1233 Detroit, MI 48207 (313) 924-0092 Fraser Drugs #52 (P) Henry Ford Medical Center 7350 Grand River Pharmacy - Lobby (NP) King Pharmacy (NP) Detroit, MI 48204 2799 West Grand Blvd 12871 Jefferson Avenue (313) 895-0357 Detroit, MI 48202 Detroit, MI 48215 (313) 916-1231 (313) 331-8484

88 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #9814 (P) Liberty Pharmacy Inc. (NP) Minal Pharmacy (NP) 19990 Telegraph Rd 503 W Grand Blvd 13031 Conant Street

Detroit, MI 48219 Detroit, MI 48216 Detroit, MI 48212 PHARMACIES RETAIL (313) 537-8010 (313) 841-1990 (313) 893-3339 Knight Detroit Medical Livernois Express Pharmacy Motor City Pharmacy Corp. Center Pharmacy #1039 (P) (P) (P) 15530 Puritan 20526 Plymouth Road Ste D 3800 Woodward Avenue Detroit, MI 48227 Detroit, MI 48228 Detroit, MI 48201 (313) 659-1622 (313) 838-2555 (313) 832-5800 Livernois Family Pharmacy Neighborhood Pharmacy Knight Drugs - Davison (NP) (NP) #1001 (P) 18254 Livernois Avenue 6508 Woodward Ave 4059 W Davison Detroit, MI 48221 Detroit, MI 48202 Detroit, MI 48238 (313) 341-3511 (313) 870-9810 (313) 933-6740 M & D Pharmacy New Hope Pharmacy (NP) Knight Drugs - Grand River 14525 Mack Avenue 19940 Conant St Ste D #0745 (P) Detroit, MI 48215 Detroit, MI 48234 8317 Grand River (313) 881-2890 (313) 334-5203 Detroit, MI 48204 Mack’s Discount Pharmacy New Mo-Town Pharmacy (P) (313) 898-2450 (NP) 3040 East Seven Mile Road Knight Drugs - Greenfield 16003 Mack Ave Detroit, MI 48234 #1010 (P) Detroit, MI 48224 (313) 891-2253 19141 Greenfield (313) 640-9766 Nottingham Pharmacy (NP) Detroit, MI 48235 Martin K Pharmacy (NP) 15800 East Warren (313) 836-5400 18200 Wyoming Detroit, MI 48224 Knight Drugs - Mcnichols Detroit, MI 48221 (313) 885-3363 #1700 (P) (313) 341-8888 Obi Medical Pharmacy (P) 4321 E Mcnichols McNichols Drugstore LLC 13701 West 7 Mile Rd Detroit, MI 48212 (P) Detroit, MI 48235 (313) 369-4399 10123 W Mcnichols Rd W (313) 273-6123 Knight Drugs Inc. #0741 (P) Detroit, MI 48221 Park Medical Pharmacy (P) 9149 East Jefferson (313) 340-4242 20720 Plymouth Rd Detroit, MI 48214 Medex Health Mart (P) Detroit, MI 48228 (313) 822-2260 13970 Wyoming St (313) 651-5887 Knight Prescription Ltd Detroit, MI 48238 People Medical Pharmacy #1000 (P) (313) 397-2054 8706 Schaefer Highway 4420 E Davison Medplus Care Pharmacy Detroit, MI 48228 Detroit, MI 48212 LLC (P) (313) 933-2300 (313) 891-7500 14071 E. 7 Mile Road People Pharmacy (NP) Lafayette Drugs (NP) Detroit, MI 48205 17150 Schaefer Hwy 670 Chene (313) 371-9000 Detroit, MI 48235 Detroit, MI 48207 Mercury Pharmacy (NP) (313) 341-0606 (313) 259-0090 18606 Fenkell St Peoples Pharmacy (NP) Lances Pharmacy (NP) Detroit, MI 48223 7608 Gratiot Ave 8656 Wyoming St (313) 272-6900 Detroit, MI 48213 Detroit, MI 48204 (313) 925-8000 (313) 646-4148

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 89 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Pharmacy 4 Less II (NP) Platinum Care Pharmacy (P) Rite Aid Pharmacy #4485 - 13233 East 7 Mile 8500 14th Street Harbortown (P) Detroit, MI 48205 Detroit, MI 48206 3456 East Jefferson (313) 372-4100 (313) 894-0451 Detroit, MI 48207 Pharmacy 4 Less III (NP) Qol Meds (313) 259-6520 16700 Harper Ave 1700 Waterman Rite Aid Pharmacy #4498 Detroit, MI 48224 Detroit, MI 48209 (P) (313) 886-3536 (313) 842-9660 13939 Livernois Avenue Pharmacy 4 Less LLC (NP) 24424 W Mc Nichols Rd Detroit, MI 48238 8110 E 7 Mile Rd Detroit, MI 48219 (313) 934-0150 Detroit, MI 48234 (313) 989-0249 Rite Aid Pharmacy #4512 RETAIL PHARMACIES (313) 368-2831 (P) 5716 Michigan Ave Pharmor Pharmacy - Carson Detroit, MI 48210 18430 Fenkell Center (NP) (313) 989-0536 Detroit, MI 48223 8000 W. Outer Drive Suite B (313) 837-2340 Quick Serve Pharmacy (P) Detroit, MI 48235 Rite Aid Pharmacy #4526 - (313) 693-4695 13433 West 8 Mile Road Detroit, MI 48235 Belmont Shopping Center Pharmor Pharmacy - (313) 341-8948 (P) Doctors (NP) 1900 E 8 Mile Road Redford Pharmacy (NP) 3169 Woodward Ave Detroit, MI 48234 Detroit, MI 48201 17364 Lahser (313) 892-4600 (313) 832-4810 Detroit, MI 48219 (313) 532-5920 Rite Aid Pharmacy #4595 Pharmor Pharmacy - (P) Reid’s Drug (NP) Evergreen (NP) 4612 Woodward Avenue 9938 Harper Avenue 20250 W 7 Mile Rd Detroit, MI 48201 Detroit, MI 48213 Detroit, MI 48219 (313) 832-3247 (313) 921-3536 (313) 535-9755 Rite Aid Pharmacy #4694 Rigley’s Drug Store (P) Pharmor Pharmacy-Ford (P) 12266 Gratiot Campus (NP) 19150 Wyoming Street Detroit, MI 48205 Detroit, MI 48221 2699 W Grand Blvd (313) 924-5163 Detroit, MI 48208 (313) 341-9700 (313) 875-9000 Rite Aid Pharmacy #4266 Rite Aid Pharmacy #4843 (P) Pharmor (P) 7843 W Vernor Highway Pharmacy-Lafayette (NP) 10910 Gratiot Ave Detroit, MI 48209 Detroit, MI 48213 1565 E Lafayette (313) 554-4511 Detroit, MI 48207 (313) 521-1850 (313) 396-5555 Rite Aid Pharmacy #4355 Rite Aid Pharmacy #7758 (P) Physicians Pharmacy & (P) 17150 Harper Medical Supply (P) 14820 Mack Avenue Detroit, MI 48224 Detroit, MI 48215 40 E Alexandrine (313) 881-3653 Detroit, MI 48201 (313) 331-1038 (313) 832-2050 Rite Aid Pharmacy #4414 Rosa Park Medical (P) Pickens Medical Pharmacy Pharmacy (NP) 19160 Greenfield Road (P) 8665 Rosa Parks Boulevard Detroit, MI 48235 Detroit, MI 48206 15651 W Mcnichols (313) 862-2603 Detroit, MI 48235 (313) 361-8800 (313) 544-7144

90 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rosedale Community Seven Mile Pharmacy, LLC State Pharmacy (NP) Pharmacy (P) (P) 4501 Woodward Ave

19220 Grand River Ave 14400 Gratiot Ave Suite 104a PHARMACIES RETAIL Detroit, MI 48223 Detroit, MI 48205 Detroit, MI 48201 (313) 531-0100 (313) 245-9920 (313) 832-4970 Russells Fisher Pharmacy Six Mile Pharmacy (NP) Super Mart Pharmacy (P) (NP) 7145 W Mcnichols 12230 8 Mile Rd 3011 W Grand Blvd Detroit, MI 48221 Detroit, MI 48205 Detroit, MI 48202 (313) 397-7254 (313) 371-7865 (313) 875-5384 Smart Choice Pharmacy Suttons Drug (P) Rx Care Pharmacy (NP) (NP) 13336 East Jefferson Ave 16311 Grand River Ave 14379 Livernois Avenue Detroit, MI 48215 Detroit, MI 48227 Detroit, MI 48238 (313) 822-4085 (313) 838-1100 (313) 491-7450 The New Prescription Samaritan Pharmacy PC (P) Southwest Discount Corner (P) 5575 Conner St Suite 1a Pharmacy 15525 W Warren Ave Pavilion 5851 West Vernor Detroit, MI 48228 Detroit, MI 48213 Detroit, MI 48209 (313) 584-3377 (313) 835-3521 (313) 841-8000 The Wellness Plan - East Sam’s Drugs (NP) Springwells Clinical Pharmacy 14200 Fenkell Pharmacy 4909 East Outer Drive Detroit, MI 48227 2117 Springwells Detroit, MI 48202 (313) 493-1400 Detroit, MI 48209 (313) 369-3979 Sav-Mart Pharmacy II (NP) (313) 841-8000 The Wellness Plan Gateway 7011 Gratiot Ave St. John Pharmacy - 1st Flr. Detroit, MI 48207 Emergency Center (NP) 2888 West Grand Blvd (313) 923-0007 22101 Moross Road Detroit, MI 48202 Sav-Max Glory Pharmacy Suite G1502 (313) 875-5220 (NP) Detroit, MI 48236 Tony’s Pharmacy (NP) 9731 Harper Ave (313) 343-4720 18360 Fenkel St Detroit, MI 48213 St. John Pharmacy - Detroit, MI 48223 (313) 921-1002 Professional Bldg. (NP) (313) 272-3744 Sav-Max Pharmacy-Mazen 22151 Moross Road Town Pharmacy (P) (NP) Suite G25 6170 Vernor Hwy 12740 Gratiot Ave Detroit, MI 48236 Detroit, MI 48209 Detroit, MI 48205 (313) 343-3776 (313) 297-6617 (313) 371-3300 St. John Pharmacy - United Care Pharmacy (P) Savon Medical Pharmacy, Riverview Outpatient (NP) 22046 W Seven Mile Road LLC (NP) 7633 E Jefferson - Suite 130 Detroit, MI 48219 18000 Livernois Ave Detroit, MI 48214 (313) 362-1862 (313) 499-4031 Detroit, MI 48221 University Pharmacy (P) (313) 862-8800 St. Paul Pharmacy (NP) 5254 Anthony Wayne Dr Serv-U-Well Pharmacy (NP) 9934 Harper Rd Detroit, MI 48202 18250 West Warren Avenue Detroit, MI 48213 (313) 831-2008 Detroit, MI 48228 (313) 921-3537 (313) 240-9700

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 91 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Victoria Pharmacy (NP) Garden City Hospital 20001 Livernois Ste 100 ECORSE Outpatient Pharmacy (NP) Detroit, MI 48221 6255 N Inkster Road (313) 397-2480 CVS Pharmacy #8123 (NP) Suite 106 Walgreens #04369 (P) 3859 Jefferson Avenue Garden City, MI 48135 19800 Plymouth Road Ecorse, MI 48229 (734) 458-4224 Detroit, MI 48228 (313) 383-0555 Garden Drugs P.C. (P) (313) 273-9219 30615 Ford Rd Garden City, MI 48135 Walgreens #04501 (P) FLAT ROCK 22380 Moross Rd (734) 266-0600 Detroit, MI 48236 Healthy Drugs (NP) RETAIL PHARMACIES (313) 642-1129 CVS Pharmacy #8072 (NP) 827 Inkster Rd Walgreens #04797 (P) 27000 N Telegraph Road Garden City, MI 48135 6331 East Jefferson Avenue Flat Rock, MI 48134 (734) 261-4100 Detroit, MI 48207 (734) 782-2438 Joy Pharmacy (NP) (313) 567-4239 Flatrock City Pharmacy (P) 27543 W Warren Walgreens #05084 (P) 25620 Gibraltar Road Garden City, MI 48135 24133 Grand River Avenue Flat Rock, MI 48134 (734) 266-9018 Detroit, MI 48219 (734) 789-8950 Kmart Pharmacy #4000 (P) (313) 541-0794 Rite Aid Pharmacy #4362 29600 Ford Road Walgreens #06360 (P) (P) Garden City, MI 48135 20001 West Seven Mile Road 28659 Telegraph Road (734) 525-7838 Detroit, MI 48219 Flat Rock, MI 48134 Kroger Co Of Michigan (313) 537-3284 (734) 783-2572 #700 (P) Walgreens #06708 (P) 5866 Middlebelt Road 15516 Grand River Avenue GARDEN CITY Garden City, MI 48135 Detroit, MI 48227 (734) 522-2052 (313) 493-0807 My Solutions Pharmacy (P) Wayne Campus Pharmacy Andrew’s Drug Store (P) 6204 Middlebelt Rd (P) 29436 Ford Road Garden City, MI 48135 1131 W Warren Garden City, MI 48135 (734) 338-9650 Detroit, MI 48201 (734) 421-1900 Quickmed Pharmacy (NP) (313) 833-6000 Comprehensive Meds 235 Inkster Woodland Pharmacy (NP) Pharmacy (P) Garden City, MI 48135 22341 W 8 Mile Road 29521 Ford Road (734) 525-5335 Detroit, MI 48219 Garden City, MI 48135 Rite Aid Pharmacy #4466 (313) 387-1700 (734) 338-2064 (P) Young Pharmacy (P) CVS Pharmacy #8075 (NP) 29447 Ford Road 79 W Alexandrine St #Ll 24735 Ford Road Garden City, MI 48135 Detroit, MI 48201 Garden City, MI 48135 (734) 525-3246 (313) 324-8563 (734) 513-2255 Walgreens #07854 (P) CVS Pharmacy #8209 (NP) 31415 Ford Road 29901 Ford Rd Garden City, MI 48135 Garden City, MI 48135 (734) 367-0962 (734) 513-9874

92 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4368 GIBRALTAR (P) HAMTRAMCK

107 Kercheval PHARMACIES RETAIL Gibraltar Pharmacy Inc. (P) Grosse Pointe Farms, MI Azaal Discount Pharmacy 29255 W Jefferson 48236 (NP) Gibraltar, MI 48173 (313) 886-5655 9834 Conant St (734) 675-0000 Hamtramck, MI 48212 GROSSE POINTE PARK (313) 872-0021 GROSSE ILE Better Care Neighborhood Pharmacy (NP) Beacon Pointe Pharmacy, 12111 Conant Road Sav On Drugs #6 (P) Inc. (NP) Hamtramck, MI 48212 8900 Macomb 15200 East Jefferson Ave Ste (313) 892-2300 102 Grosse Ile, MI 48138 Campau Pharmacy (P) (734) 676-6000 Grosse Pointe Park, MI 48230 12169 Jospeh Campau St Ste (313) 822-5474 101 GROSSE POINTE Hamtramck, MI 48212 Park Pharmacy (NP) (313) 365-2400 15126 Kercheval Ave Caniff Pharmacy (P) Beaumont Hospital Grosse Grosse Pointe Park, MI 48230 3004 Caniff Street Pointe (P) (313) 822-0100 Hamtramck, MI 48212 468 Cadieux Rd (313) 285-9063 Grosse Pointe, MI 48230 Care Max Pharmacy (NP) (313) 343-1646 GROSSE POINTE WOODS 9222 Joseph Campau CVS Pharmacy #8081 (NP) Suite B 17120 Kercheval CVS Pharmacy #8107 (NP) Hamtramck, MI 48212 Grosse Pointe, MI 48230 (313) 874-1234 (313) 886-3300 20460 Mack Avenue Grosse Pointe Woods, MI Carpenter Pharmacy (NP) Kroger Pharmacy #454 (P) 48236 3120 Carpenter Street 20422 Mack Avenue (313) 881-2500 Suite 101 Grosse Pointe, MI 48236 Hamtramck, MI 48212 (313) 308-1033 Merit Woods Pharmacy (P) 19325 Mack Avenue (313) 893-3000 Notre Dame Pharmacy (NP) Grosse Pointe Woods, MI CVS Pharmacy #8137 (NP) 16926 Kercheval Avenue 48236 9300 Joseph Campau Grosse Pointe, MI 48230 (313) 882-0922 Hamtramck, MI 48212 (313) 885-2154 Pharmor Pharmacy (313) 874-5300 Mack-Moross (NP) Frd Sav-Mor Pharmacy (P) GROSSE POINTE FARMS 19251 Mack Avenue 9811 Conant Suite M-155 Hamtramck, MI 48212 Grosse Pointe Woods, MI (313) 871-1115 Henry Ford Medical Center 48236 Hamtramck Drugs Pharmacy (NP) (313) 642-1800 10300 Joseph Campau 131 Kercheval Suite 110 Hamtramck, MI 48212 Grosse Pointe Farms, MI (313) 873-2366 48236 (313) 640-2591

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 93 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Pharmor Pharmacy - New Millennium Drugs (P) Hamtramck (NP) HIGHLAND PARK 211 Henry Ruff 3301 Holbrook St Ste B Inkster, MI 48141 Hamtramck, MI 48212 CVS Pharmacy #8210 (NP) (734) 721-2100 (313) 871-1010 14140 Woodward Avenue Walgreens #04430 (P) Pharmor Pharmacy - Joseph Highland Park, MI 48203 120 S Inkster Campau (NP) (313) 867-5293 Inkster, MI 48141 9023 Joseph Campau St Franklin Medical Pharmacy (313) 724-8382 Hamtramck, MI 48212 (P) (313) 871-2020 17950 Woodward Ave LINCOLN PARK Rite Aid Pharmacy #4489 Highland Park, MI 48203 RETAIL PHARMACIES (P) (313) 866-4660 9215 Joseph Campau Knight Drugs - Highland CVS Pharmacy #8122 (NP) Hamtramck, MI 48212 Park #1007 (P) 3647 Dix (313) 873-5200 13820 Woodward Avenue Lincoln Park, MI 48146 Thera-Script Pharmacy (NP) Highland Park, MI 48203 (313) 383-6776 9740 Conant (313) 868-5800 CVS Pharmacy #8131 (NP) Hamtramck, MI 48212 Pharmor 2400 Fort Street (313) 875-7979 Pharmacy-Woodward Place Lincoln Park, MI 48146 (NP) (313) 381-2400 HARPER WOODS 15131 Woodward Fort Street Pharmacy (NP) Highland Park, MI 48203 2255 Fort Street (313) 957-0099 Lincoln Park, MI 48146 CVS Pharmacy #8052 (NP) Pro Care Pharmacy #3 (NP) (313) 357-7500 19818 Kelly Road 13111 Woodward Ave Gog Pharmacy (P) Harper Woods, MI 48225 Highland Park, MI 48203 752 Southfield Rd (313) 526-7900 (313) 865-9900 Lincoln Park, MI 48146 Hunter’s Pharmacy (P) Walgreens #05226 (P) (313) 382-3996 20352 Harper Avenue 14048 Woodward Avenue Jana Drugs (NP) Harper Woods, MI 48225 Highland Park, MI 48203 1684 Fort Street (313) 884-5400 (313) 869-2177 Lincoln Park, MI 48146 Kroger Co Of Michigan (313) 383-5700 #710 (P) INKSTER Kroger Co Of Michigan 20903 Harper #693 (P) Harper Woods, MI 48225 2060 Dix Avenue (313) 642-0942 Belavista Pharmacy (P) Lincoln Park, MI 48146 Pharmor Pharmacy - Harper 347 Inkster Road (313) 386-5355 Woods (NP) Inkster, MI 48141 Meijer Inc. #208 (P) 19700 Kelly Road (313) 563-5300 3710 Dix Highway Harper Woods, MI 48225 CVS Pharmacy #8017 (NP) Lincoln Park, MI 48146 (313) 245-9000 27365 Cherry Hill (313) 294-1733 Target T-0776 (P) Inkster, MI 48141 Pharmor Pharmacy - Lincoln 18000 Vernier Rd (313) 274-6240 Park (NP) Harper Woods, MI 48225 Inkster Pharmacy (NP) 4150 Dix Hwy (313) 308-1006 27422 Michigan Avenue Lincoln Park, MI 48146 Inkster, MI 48141 (313) 382-3802 (313) 274-2200

94 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Walgreens #04749 (P) Farmington Drugs And Medcart Specialty 1765 Fort Street Medical Supplies (P) Pharmacy (NP)

Lincoln Park, MI 48146 20434 Farmington Road 32131 Industrial Rd PHARMACIES RETAIL (313) 928-8638 Livonia, MI 48152 Livonia, MI 48150 Walgreens #10906 (P) (248) 478-3922 (734) 762-6600 1901 Southfield Rd Heartland Home Health Meijer Pharmacy #188 (P) Lincoln Park, MI 48146 Care And Hospice 13000 Middlebelt (313) 382-3578 38035 Schoolcraft Rd Livonia, MI 48150 Livonia, MI 48150 (734) 367-0010 (866) 222-3808 LIVONIA Merriman Drugs (NP) Henry Ford Medical Center 31320 Five Mile Road Pharmacy - Livonia (NP) Livonia, MI 48154 AHS St. John Pharmacy 29200 Schoolcraft Rd (734) 427-3430 Livonia (NP) Livonia, MI 48150 Professional Village 37595 West Seven Mile Road (734) 523-1710 Pharmacy Livonia (P) Livonia, MI 48152 Kmart Pharmacy #4430 (P) 11589 Farmington Road (734) 432-7720 33400 W Seven Mile Road Livonia, MI 48150 Complete Infusion Services Livonia, MI 48152 (734) 427-2400 31555 Industrial Rd Ste 200 (248) 474-8813 Rays Drugs (P) Livonia, MI 48150 Kroger Co Of Michigan 37672 Professional Ctr Dr Ste (734) 425-2550 #615 (P) 130b Costco Pharmacy #390 (P) 33528 Eight Mile Road Livonia, MI 48154 13700 Middlebelt Rd Livonia, MI 48152 (734) 432-2015 Livonia, MI 48150 (248) 473-8240 Rite Aid Pharmacy #4320 (734) 427-2866 Kroger Co Of Michigan (P) Costco Pharmacy #391 (P) #618 (P) 37399 Six Mile Road 20000 Haggerty Rd 30935 W Five Mile Road Livonia, MI 48152 Livonia, MI 48152 Livonia, MI 48154 (734) 464-7960 (734) 464-8545 (734) 422-3784 Rite Aid Pharmacy #4345 CVS Pharmacy #8015 (NP) Lifecare Pharmacy (P) (P) 29500 5 Mile Road 8810 Middlebelt Rd 27401 W Six Mile Rd Livonia, MI 48154 Livonia, MI 48150 Livonia, MI 48152 (734) 261-1030 (734) 261-4400 (734) 762-0627 CVS Pharmacy #8031 (NP) Livonia Care Pharmacy (P) Rite Aid Pharmacy #4460 19120 Middlebelt Road 16989 Farmington Rd (P) Livonia, MI 48152 Livonia, MI 48154 37355 8 Mile Rd (248) 476-5085 (734) 437-1956 Livonia, MI 48152 CVS Pharmacy #8121 (NP) Med Right Pharmacy LLC (248) 474-8659 37340 Five Mile Road (P) Rite Aid Pharmacy #4523 Livonia, MI 48154 15132 Levan Rd (P) (734) 953-2727 Livonia, MI 48154 33251 Plymouth CVS Pharmacy #8176 (NP) (734) 432-5900 Livonia, MI 48150 8811 Newburgh Medcart Pharmacy (734) 425-9708 Livonia, MI 48150 Solutions (734) 432-1975 32131 Industrial Rd Ste 200 Livonia, MI 48150 (734) 762-6622

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 95 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Rite Aid Pharmacy #4801 Wal-Mart Pharmacy Kroger Pharmacy #442 (P) (P) #10-2631 (NP) 17447 Haggerty 31245 Eight Mile Rd 13507 Middlebelt Northville, MI 48168 Livonia, MI 48152 Livonia, MI 48150 (248) 662-3032 (248) 426-6248 (734) 524-0568 Meijer Pharmacy #054 (P) Specialized Pharmacy Wal-Mart Pharmacy 10-5844 20401 Haggerty Road Services South Livonia (NP) Northville, MI 48167 33510 Schoolcraft Road 29574 7 Mile Rd (248) 349-2707 Livonia, MI 48150 Livonia, MI 48152 Northville Pharmacy (NP) (734) 422-3310 (248) 957-0959 116 W Main Street Target Pharmacy T-2230 (P) Northville, MI 48167 RETAIL PHARMACIES 29451 Plymouth Road MELVINDALE (248) 924-3752 Livonia, MI 48150 (734) 793-0638 NORTHVILLE TOWNSHIP Target T-872 (P) CVS Pharmacy #8055 (NP) 20100 Haggerty Road 18340 Allen Road Livonia, MI 48152 Melvindale, MI 48122 CVS Pharmacy #00103 (NP) (734) 452-0020 (313) 928-2559 44300 Five Mile Rd Top Care Pharmacy (P) Melvindale Pharmacy (NP) Northville Township, MI 27493 Six Mile Rd 18287 Allen Road 48167 Livonia, MI 48152 Melvindale, MI 48122 (734) 416-1883 (734) 762-1500 (313) 386-0830 CVS Pharmacy #8163 (NP) Walgreens #04298 (P) Rite Aid Pharmacy #4685 16855 Haggerty 29200 6 Mile Rd (P) Northville Township, MI Livonia, MI 48152 4016 Oakwood Blvd 48168 (734) 427-3237 Melvindale, MI 48122 (734) 420-3089 (313) 386-8345 Walgreens #04933 (P) 8850 Newburgh Road PLYMOUTH Livonia, MI 48150 NEW BOSTON (734) 524-9663 CVS Pharmacy #8077 (NP) Walgreens #06312 (P) New Boston Rx Pharmacy 40900 Ann Arbor Road East 29370 Plymouth Road (NP) Plymouth, MI 48170 Livonia, MI 48150 (734) 455-7981 (734) 261-2816 19162 Huron River Dr New Boston, MI 48164 CVS Pharmacy #8085 (NP) Walgreens #06359 (P) (734) 753-2000 1400 Sheldon Road 33333 Six Mile Road Plymouth, MI 48170 Livonia, MI 48152 (734) 453-5807 (734) 513-5078 NORTHVILLE CVS Pharmacy #8208 (NP) Walgreens #10359 (P) 49485 Ann Arbor Rd 17007 Newburgh Rd CVS Pharmacy #8009 (NP) Plymouth, MI 48170 Livonia, MI 48154 133 East Dunlap (734) 354-9220 (734) 462-1707 Northville, MI 48167 Henry Ford Medical Center Walgreens #12267 (P) (248) 348-2010 Pharmacy (NP) 33239 W 8 Mile Road Hawthorn Center 14300 Beck Road Livonia, MI 48152 18471 Haggerty Road Plymouth, MI 48170 (248) 476-7294 Northville, MI 48167 (734) 354-5950 (248) 735-5994

96 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Kmart Pharmacy #4481 (P) CVS Pharmacy #8172 (NP) 40855 Ann Arbor Road 25700 West 7 Mile Road RIVERVIEW

Plymouth, MI 48170 Redford, MI 48240 PHARMACIES RETAIL (734) 455-5027 (313) 592-1202 Galleria Pharmacy (NP) Kroger Co Of Michigan Family Drugs Pharmacy (P) 14720 King Road Ste C #670 (P) 25241 Grand River Ave Riverview, MI 48193 44525 Ann Arbor Road Redford, MI 48240 (734) 675-7900 Plymouth, MI 48170 (313) 531-9200 Rite Aid Pharmacy #4334 (734) 414-9348 Glory Care Pharmacy (P) (P) Rite Aid Pharmacy #3657 27144 Joy Rd 19016 Fort Street (P) Redford, MI 48239 Riverview, MI 48192 800 Ann Arbor West (313) 937-6301 (734) 479-2010 Plymouth, MI 48170 Metropolitan Pharmacy Walgreens #04585 (P) (734) 737-0218 (NP) 17071 Fort Street Rxperts Pharmacy - 26380 Plymouth Rd Riverview, MI 48193 Michigan LLC Redford, MI 48239 (734) 281-2927 9131 General Ct #150 (313) 937-1100 Plymouth, MI 48170 Precare Pharmacy (NP) ROCKWOOD (734) 416-1717 25045 Grand River Ave Wiltse Community Redford, MI 48240 Pharmacy (P) (313) 255-4420 Rite Aid Pharmacy #4322 330 South Main Street Redford Discount Pharmacy (P) Plymouth, MI 48170 (P) 32905 Fort Street (734) 453-4848 25850 Grand River Ave Rockwood, MI 48173 Redford, MI 48240 (734) 379-9633 REDFORD (313) 533-7920 Rockwood Pharmacy (P) Walgreens #11607 (P) 32825 Fort Rd 25905 Five Mile Rd Rockwood, MI 48173 Advanced Homecare Redford, MI 48239 (734) 379-6815 Pharmacy (313) 535-8480 Susan’s Total Care Drug 12699 Farley Store (P) Redford, MI 48239 REDFORD TOWNSHIP 22432 N Huron River Dr (313) 532-4500 Rockwood, MI 48173 Crown Pharmacy (NP) (734) 379-7000 24401 Plymouth Road CVS Pharmacy #8151 (NP) Redford, MI 48239 8900 Telegraph ROMULUS (313) 532-3784 Redford Township, MI 48239 CVS Pharmacy #8007 (NP) (313) 538-0289 27350 Plymouth Road Family Pharmacy (P) Redford, MI 48239 RIVER ROUGE 36567 Goddard Road (313) 937-2500 Romulus, MI 48174 CVS Pharmacy #8157 (NP) (734) 941-0755 25380 Five Mile Road Rouge Drugs (NP) Redford, MI 48239 10507 W Jefferson (313) 592-6357 River Rouge, MI 48218 (313) 842-2080

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 97 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Meijer Pharmacy #123 (P) CVS Pharmacy #8125 (NP) SOUTHGATE 16300 Fort Street 26101 Eureka Road Southgate, MI 48195 Taylor, MI 48180 Belavista Drugs (NP) (734) 284-4250 (734) 942-0025 15830 Fort Street Suite 5 Northline Drugs One (P) CVS Pharmacy #8218 (NP) Southgate, MI 48195 13894 Northline 22300 Goddard Street (734) 282-1940 Southgate, MI 48195 Taylor, MI 48180 Bio Script Pharmacy (NP) (734) 285-9496 (313) 299-3404 15348 Fort St Oakwood Pharmacy Er Drugs (P) Southgate, MI 48195 Southgate (NP) 27260 Eureka Road (734) 324-4000 15777 Northline Rd - Taylor, MI 48180 RETAIL PHARMACIES Byron Drugs (P) Suite 100a (734) 955-9110 13355 Dix Toledo Road Southgate, MI 48195 Goddard Discount Drugs (P) Southgate, MI 48195 (734) 324-9606 25410 Goddard Rd (734) 283-0100 Sam’s Pharmacy #10-6412 Taylor, MI 48180 CVS Pharmacy #8028 (NP) (NP) (313) 908-7515 11125 Allen Road 15700 Northline Road Goddard Discount Southgate, MI 48195 Southgate, MI 48195 Pharmacy (P) (734) 287-4030 (734) 281-4863 25418 Goddard CVS Pharmacy #8114 (NP) Sav-Mor #100 (P) Taylor, MI 48180 15300 Eureka Road 13101 Allen Rd Ste 511 (313) 299-3300 Southgate, MI 48195 Southgate, MI 48195 Henry Ford Medical Center (734) 283-9500 (734) 374-2335 Pharmacy - Taylor-364415 CVS Pharmacy #8213 (NP) Southgate Pharmacy (NP) (NP) 13545 Eureka Road 12870 Northline 24555 Haig Rd Southgate, MI 48195 Southgate, MI 48195 Taylor, MI 48180 (734) 283-2367 (734) 284-9240 (313) 292-6260 Eagle Drugs Pharmacy (P) The Rite Pharmacy (NP) Kmart Pharmacy #4059 (P) 14657 Northline 15150 Fort St 21111 Van Born Road Southgate, MI 48195 Southgate, MI 48195 Taylor, MI 48180 (734) 281-9200 (734) 720-4477 (313) 278-2380 Falcon Health-Mart Drugs Wal-Mart Pharmacy Kroger Co Of Michigan (P) #10-5842 (NP) #686 (P) 15600 Northline Road 14900 Dix Toledo Rd 7000 Monroe Southgate, MI 48195 Southgate, MI 48195 Taylor, MI 48180 (734) 250-8168 (734) 283-4502 (313) 299-1943 Kmart Pharmacy #4995 (P) Meijer Pharmacy #035 (P) 16705 Fort Street TAYLOR 14640 Pardee Road Southgate, MI 48195 Taylor, MI 48180 (734) 324-2473 (734) 287-3443 CVS Pharmacy #8051 (NP) Menard Pharmacy (NP) Kroger Co Of Michigan 22000 Ecorse Road #695 (P) 23241 Eureka Road Taylor, MI 48180 Taylor, MI 48180 13333 Eureka Road (313) 295-3031 Southgate, MI 48195 (734) 287-3880 (734) 324-7964

98 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Pharmax Drugs (P) Walgreens #05596 (P) Walgreens #05169 (P) 10501 Telegraph Road 15009 Telegraph Road 1700 West Road

Taylor, MI 48180 Taylor, MI 48180 Trenton, MI 48183 PHARMACIES RETAIL (313) 357-2700 (734) 374-2101 (734) 675-2997 Pioneer Medical Pharmacy Walgreens #06261 (P) West Grange Drugs (P) (P) 20030 Ecorse Road 3390 West Road 12701 Telegraph Rd Taylor, MI 48180 Trenton, MI 48183 Taylor, MI 48180 (734) 294-0849 (734) 676-6622 (734) 250-8858 Walgreens #06546 (P) Rite Aid Pharmacy #4346 9100 Telegraph Road WAYNE (P) Taylor, MI 48180 5811 Telegraph Rd (313) 299-4475 Taylor, MI 48180 Wal-Mart Pharmacy CVS Pharmacy #8138 (NP) (313) 291-2697 #10-2912 (NP) 2950 Newburgh Rite Aid Pharmacy #4366 7555 Telegraph Road Wayne, MI 48184 (P) Taylor, MI 48180 (734) 728-6500 9155 S Telegraph (313) 292-5014 CVS Pharmacy #8211 (NP) Taylor, MI 48180 31450 Van Born Rd (313) 291-6050 Wayne, MI 48184 TRENTON Sax Discount Pharmacy (NP) (734) 728-4295 22525 Wick Road Oakwood Pharmacy Wayne Taylor, MI 48180 CVS Pharmacy #8064 (NP) (NP) (313) 292-3755 1625 King Street 33155 Annapolis Street Seaway Pharmacy (NP) Trenton, MI 48183 Wayne, MI 48184 8750 Telegraph Road Ste 104 (734) 671-4302 (734) 467-2560 Taylor, MI 48180 CVS Pharmacy #8232 (NP) Pharmor Pharmacy - Wayne (313) 291-2182 3575 West Road City (NP) Target T-0280 (P) Trenton, MI 48183 4811 Venoy Rd 14099 Pardee Road (734) 362-0441 Wayne, MI 48184 Taylor, MI 48180 Kingsway Medical (734) 326-6600 (734) 288-0005 Pharmacy (NP) Rite Aid Pharmacy #4358 Taylor Discount Pharmacy 1675 Kingsway Court (P) (P) Trenton, MI 48183 35101 East Michigan Avenue 9320 S Telegraph Rd (734) 493-3127 Wayne, MI 48184 Taylor, MI 48180 Oakwood Pharmacy Trenton (734) 729-7810 (313) 299-8810 (NP) Venoy Medical Pharmacy True Care Pharmacy (P) 5450 Fort Street (NP) 7130 Pardee Trenton, MI 48183 4020 Venoy Rd Ste 200a Taylor, MI 48180 (734) 642-2190 Wayne, MI 48184 (313) 292-2716 Rite Aid Pharmacy #4335 (734) 729-2882 Walgreens #04498 (P) (P) Walgreens #04631 (P) 20090 Goddard Rd 25050 Allen Rd 32732 Michigan Avenue Taylor, MI 48180 Trenton, MI 48183 Wayne, MI 48184 (313) 299-1584 (734) 675-6110 (734) 595-9956

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 99 Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wayne Professional Good Neighbors Family Scriptway Pharmacy (P) Pharmacy (NP) Pharmacy (P) 1207 S Wayne Rd 35216 E Michigan Ave 1956 Venoy Road Westland, MI 48186 Wayne, MI 48184 Westland, MI 48186 (734) 729-7979 (734) 728-8306 (734) 722-8774 Target Pharmacy T-0281 (P) Heartland Drugs (NP) 35401 Warren Rd WESTLAND 34414 Ford Road Westland, MI 48185 Westland, MI 48185 (734) 728-6031 (734) 729-9797 Value Pharmacy (NP) Cobb Clinic Pharmacy #57 Kmart Pharmacy #4163 (P) 1629 Merriman Road (NP) 165 Wayne Road Westland, MI 48186 RETAIL PHARMACIES 8623 N Wayne Rd Westland, MI 48186 (734) 405-2300 Westland, MI 48185 (734) 326-5200 Walgreens #04297 (P) (248) 348-1570 Kroger Co Of Michigan 7210 Middlebelt Rd CVS Pharmacy #0927 (NP) #630 (P) Westland, MI 48185 37530 Cherry Hill 31300 Michigan Ave (734) 427-5958 Westland, MI 48185 Westland, MI 48186 Walter Reuther Psychiatric (734) 727-0322 (734) 326-7345 Hospital CVS Pharmacy #8008 (NP) Kroger Co Of Michigan 30901 Palmer Road 29347 Ann Arbor Trail #691 (P) Westland, MI 48186 Westland, MI 48185 36430 Ford Road (734) 367-8576 (734) 522-5200 Westland, MI 48185 Wayne Family Pharmacy (P) CVS Pharmacy #8010 (NP) (734) 595-7002 244 North Wayne Road 31411 Cherry Hill Meijer Pharmacy #068 (P) Westland, MI 48185 Westland, MI 48186 37201 Warren Road (734) 728-6400 (734) 326-2990 Westland, MI 48185 Westland Maple Drugs (P) CVS Pharmacy #8059 (NP) (734) 728-3550 1949 Wayne Rd 1750 S Wayne Road Oakwood Pharmacy - Westland, MI 48185 Westland, MI 48186 Westland Ambulatory (NP) (734) 729-2200 (734) 721-3444 2001 S Merriman Suite 200 CVS Pharmacy #8065 (NP) Westland, MI 48186 WOODHAVEN 6501 N Wayne Road (734) 727-1040 Westland, MI 48185 Rite Aid Pharmacy #4966 (734) 729-9210 (P) Henry Ford Medical Center CVS Pharmacy #8164 (NP) 35363 Ford Road Pharmacy - Woodhaven 7250 Venoy Westland, MI 48185 (NP) Westland, MI 48185 (734) 728-7392 22505 Allen Road (734) 422-5150 Rx Express Pharmacy (P) Woodhaven, MI 48183 CVS Pharmacy #8212 (NP) 6149 N Wayne Rd (734) 676-7474 31501 Joy Rd Westland, MI 48185 Meijer Pharmacy #070 (P) Westland, MI 48185 (734) 525-6000 22600 Allen Road (734) 427-9100 Sav On Checker Pharmacy Woodhaven, MI 48183 Dial Drugs (P) (P) (734) 692-8181 8226 N Merriman Road 190 S Wayne Road Target T-0923 (P) Westland, MI 48185 Westland, MI 48186 23555 Allen Road (734) 427-2850 (734) 728-5200 Woodhaven, MI 48183 (734) 672-0005

100 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available Out of State Pharmacies = (NP) Non-Preferred RETAIL PHARMACIES

Wal-Mart Pharmacy Wal-Mart Pharmacy WEXFORD COUNTY #10-3336 (NP) #10-1432 (NP)

23800 Allen Road 2200 N Mitchell Street PHARMACIES RETAIL Woodhaven, MI 48183 BUCKLEY Cadillac, MI 49601 (734) 675-4815 (231) 775-9699 Woodhaven Pharmacy (P) 22981 Hall Road Buckley Family Pharmacy MANTON Woodhaven, MI 48183 (NP) (734) 675-2211 11293 N M37 Suite C Buckley, MI 49620 Bostick’s Drug Store (NP) (231) 269-3400 117 W Main Street WYANDOTTE Manton, MI 49663 CADILLAC (231) 824-6465 CVS Pharmacy #8029 (NP) 2025 Fort Street MESICK Wyandotte, MI 48192 Cadillac Family Pharmacy (734) 283-9640 LLC (P) CVS Pharmacy #8118 (NP) 108 North Mitchell Street Mesick Pharmacy (NP) 131 Elm Street Cadillac, MI 49601 112 Mesick Avenue Wyandotte, MI 48192 (231) 775-8200 Mesick, MI 49668 (734) 283-7007 Cobbs Street Pharmacy (P) (231) 885-1751 Family Care Pharmacy (P) 520 Cobbs Street 2211 Fort Street Cadillac, MI 49601 Wyandotte, MI 48192 (231) 876-6740 (734) 324-5790 Glen’s Pharmacy #648 (P) Henry Ford Wyandotte 602 Mitchell Ambulatory Pharmacy (P) Cadillac, MI 49601 2333 Biddle Ave (231) 775-6383 Wyandotte, MI 48192 Meijer Pharmacy #171 (P) (734) 246-9499 8605 East 34 Road Rite Aid Pharmacy #4545 Cadillac, MI 49601 (P) (231) 876-2810 1998 Biddle Avenue Mercy Hospital Pharmacy Wyandotte, MI 48192 (NP) (734) 285-4100 400 Hobart Street Walgreens #01265 (P) Cadillac, MI 49601 3221 Fort Street (231) 876-7373 Wyandotte, MI 48192 Rite Aid Pharmacy #4506 (734) 284-1733 (P) Wyandotte Drugs (P) 720 South Mitchell Street 364 Eureka Road Cadillac, MI 49601 Wyandotte, MI 48192 (231) 775-3423 (734) 282-2877 Walgreens #07660 (P) 1220 N Mitchell Street Cadillac, MI 49601 (231) 775-9166

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 101 Out of State Pharmacies = (NP) Non-Preferred MAIL ORDER PHARMACIES

Express Scripts, Inc. Toll-free: (800) 903-8346 Walgreens Mail Service Toll-free: (866) 877-2392 MAIL ORDER PHARMACIES

102 HOME INFUSION PHARMACIES

Medicare Plus Blue PPO will cover home infusion therapy if your prescription drug: Ⅲ Is on the Medicare Plus Blue PPO formulary or you have a formulary exception, and Ⅲ Is written by an authorized prescriber.

BARAGA COUNTY GENESEE COUNTY GRAND TRAVERSE COUNTY BARAGA FLINT TRAVERSE CITY Keweenaw Bay Indian Dort Longway Pharmacy Community 2700 Robert T Longway Ste Munson Hospital Pharmacy 102 Superior Ave B

1105 W Sixth Street PHARMACIES INFUSION HOME Baraga, MI 49908 Flint, MI 48503 Traverse City, MI 49684 (906) 353-4555 (810) 235-2800 (231) 935-5678 Genesys Health Enterprises Inc. BERRIEN COUNTY 3909 Beecher Road ISABELLA COUNTY Flint, MI 48532 (810) 762-4420 BENTON HARBOR MT. PLEASANT H-Care Pharmacy G-4433 Miller Road Ste 102 Lakeland Home Infusion Flint, MI 48507 Ambulatory Infusion Care 2550 Meadowbrook Ste 106 (810) 733-6653 121 E Broadway St Ste C Benton Harbor, MI 49022 McLaren Home Medical Mt. Pleasant, MI 48858 (269) 985-4422 2284-1 S Ballenger Hwy (989) 773-4879 Flint, MI 48503 (800) 774-6999 DELTA COUNTY JACKSON COUNTY

GOGEBIC COUNTY ESCANABA JACKSON

WAKEFIELD Eldercare Pharmacy Allegiance Health Pharmacy 1823 7th Ave N #7369 Escanaba, MI 49829 Wakefield Pharmacy 2200 Springport Road (906) 789-4451 408 Sunday Lake Street Jackson, MI 49202 Wakefield, MI 49968 (517) 787-4761 DICKINSON COUNTY (906) 229-5966

IRON MOUNTAIN

The Drug Store 1112 S Stephenson Ave Iron Mountain, MI 49801 (906) 774-3654

103 HOME INFUSION PHARMACIES

KENT COUNTY WARREN OAKLAND COUNTY

GRAND RAPIDS Pharmerica AUBURN HILLS 3410 East Twelve Mile Road Warren, MI 48092 Coram Alternate Site Srvs. (586) 573-0458 Infusion Partners 4334 Brockton Dr Suite D 3355 Bald Mountain Road Grand Rapids, MI 49512 Tri Unity Infusions Services, Unit #70 (616) 698-0272 LLC Auburn Hills, MI 48326 28653 Hoover Rd (248) 371-9322 Specialized Pharmacy West Warren, MI 48093 400 Ann Street Nw Suite 104 (586) 486-5278 Grand Rapids, MI 49504 BIRMINGHAM (616) 365-9702 St. Mary’s Home Infusion MARQUETTE COUNTY Program Onecare Pharmacy 360 Division South Ste 1d 1744 W Maple Rd Ste B Grand Rapids, MI 49503 MARQUETTE Birmingham, MI 48009 (616) 685-1111 (248) 258-8800 Marquette General Hospital KENTWOOD Pharmacy FARMINGTON HILLS 420 W Magnetic St Marquette, MI 49855 Lincare Inc. (906) 225-3498 Walgreens Specialty 3631 44th Street Se Ste C Pharmacy Peninsula Pharmacy 27003 Hills Tech Ct Kentwood, MI 49512 1414 W Fair Ave Suite 133 (616) 554-3530 Farmington Hills, MI 48331 Marquette, MI 49855 (800) 323-6961 (906) 225-3902 MACOMB COUNTY MADISON HEIGHTS MIDLAND COUNTY

CLINTON TOWNSHIP Active Infusion MIDLAND

HOME INFUSION PHARMACIES 25219 Dequindre St. John Health System Madison Heights, MI 48071 (248) 336-7051 Home Service Integrated Pharmacy 37650 Garfield Network Beaumont Home Infusion Clinton Township, MI 48036 215 Fast Ice Drive 1410 E 14 Mile Rd (800) 248-2298 Midland, MI 48642 Madison Heights, MI 48071 (888) 837-3636 (248) 208-4000 SHELBY TOWNSHIP Mid Michigan Infusion Care Home IV Care Inc. 4008 W Wackerly - Suite 108 32751 Edward Street Midland, MI 48640 Suite 101 Advanced Care Infusion - (989) 631-3636 Madison Heights, MI 48071 Shelby (248) 577-5670 50680 Corporate Dr - Suite 1 Shelby Township, MI 48315 (586) 323-8280

104 HOME INFUSION PHARMACIES

NOVI WIXOM SAGINAW COUNTY

Accredo Health Group, Inc. Critical Care Systems Inc SAGINAW 39625 Lewis Drive Ste 800 46998 Magellan Dr Suite 300 Novi, MI 48377 Wixom, MI 48393 (248) 489-0300 (248) 960-8095 Visiting Nurse Association Infusion Coram Inc. 500 South Hamilton Suite A 28550 Cabot Dr - Suite 200 OGEMAW COUNTY Saginaw, MI 48602 Novi, MI 48377 (989) 799-6020 (248) 324-6300 WEST BRANCH SOUTHFIELD WASHTENAW COUNTY OEIFSO PHARMACIES INFUSION HOME Specialized Pharmacy Alert Infusion Services, Inc. Services North West ANN ARBOR 30825 Greenfield Road Branch Southfield, MI 48076 522 East Houghton Avenue (248) 593-5821 Suite 102 Ann Arbor Home Infusion West Branch, MI 48661 Pharmacy Fairlane Pharmacy Services (989) 345-2297 5301 East Huron River Drive Corp. #3 Room 1205 21298 Melrose Ann Arbor, MI 48106 Southfield, MI 48075 OTSEGO COUNTY (734) 712-2492 (248) 827-3370 Cascade Hemophilia Premier Home Pharmacy, Consortium Inc. GAYLORD 517 W William St 27762 Franklin Road Ann Arbor, MI 48103 Southfield, MI 48034 (734) 996-3300 (248) 223-9734 Ambulatory Infusion Care - North Inc. Dixboro Village Pharmacy 854 N Center Ave Ste 1 5770 Plymouth TROY Gaylord, MI 49735 Ann Arbor, MI 48105 (989) 732-4879 (734) 214-1234 U Of M Homemed Caremark Inc. Therapeutic 2850 S Industrial Hwy Ste 50 Services Division OTTAWA COUNTY Ann Arbor, MI 48104 1307-H Allen Dr (800) 862-2731 Troy, MI 48083 (248) 968-6000 COOPERSVILLE Walgreens Specialty Pharmacy Rx IV, Incorporated 1350 Highland Dr Ste D 1938 Woodslee Drive Walgreens Specialty Ann Arbor, MI 48108 Troy, MI 48083 Pharmacy (734) 677-3800 (248) 435-9400 50 South 64th Avenue Coopersville, MI 49404 (616) 997-2611

105 HOME INFUSION PHARMACIES

WAYNE COUNTY SOUTHGATE

ALLEN PARK The Rite Pharmacy 15150 Fort St Southgate, MI 48195 Oakwood Residential Care (734) 720-4477 Pharmacy 1633 Fairlane Circle Suite 165 Allen Park, MI 48101 (313) 996-3290

DETROIT

St. Paul Pharmacy 9934 Harper Rd Detroit, MI 48213 (313) 921-3537

LIVONIA

Complete Infusion Services 31555 Industrial Rd Ste 200 Livonia, MI 48150 (734) 425-2550 Heartland Home Health Care And Hospice 38035 Schoolcraft Rd Livonia, MI 48150 (866) 222-3808

HOME INFUSION PHARMACIES Livonia Care Pharmacy 16989 Farmington Rd Livonia, MI 48154 (734) 437-1956 Medcart Specialty Pharmacy 32131 Industrial Rd Livonia, MI 48150 (734) 762-6600 Specialized Pharmacy Services South Livonia 33510 Schoolcraft Road Livonia, MI 48150 (734) 422-3310

106 LONG-TERM CARE PHARMACIES

Residents of a long-term care facility may access their prescription drugs covered under Medicare Plus Blue PPO through the facility’s long-term care pharmacy or another network long-term care pharmacy. TTY/TDD users should call the TRS relay number 711 to contact the pharmacy of their choice.

Shopko Pharmacy #2624 ALLEGAN COUNTY CALHOUN COUNTY 15900 Picture Bay Trl L’Anse, MI 49946 PLAINWELL (906) 524-7032 BATTLE CREEK

Campbell Pharmacy BAY COUNTY Genoa Pharmacy Michigan, 102 South Main Street LLC Plainwell, MI 49080 BAY CITY 3630 Capital Avenue Sw (269) 685-6808 Battle Creek, MI 49015 (269) 979-7822 McLaren Long Term Care ALPENA COUNTY Pharmacy MARSHALL 3140 W Campus Drive ALPENA Bay City, MI 48706 (989) 316-4280 Remedi Seniorcare 1600 S Kalamazoo Ave Ste 2 The Drug Store Marshall, MI 49068 BERRIEN COUNTY

2236 Us 23 South (937) 473-3333 PHARMACIES CARE LONG-TERM Alpena, MI 49707 (989) 354-2171 BERRIEN CENTER CASS COUNTY

ARENAC COUNTY Lakeland Pharmacy Berrien DOWAGIAC 6418 Deans Hill Road STANDISH Berrien Center, MI 49102 (269) 473-3082 Shopko Pharmacy #2650 56419 Pokagon Street Shopko Pharmacy #2646 NILES Dowagiac, MI 49047 3825 S Huron Dr (269) 782-0280 Standish, MI 48658 (989) 846-0749 Nile Family Pharmacy 70 E Main St CLARE COUNTY Niles, MI 49120 BARAGA COUNTY (269) 683-1400 CLARE

L’ANSE Shopko Pharmacy #2644 11250 N Mission Road L’Anse Pharmacy Inc. Clare, MI 48617 18341 Us Highway 41 (989) 802-0354 L’Anse, MI 49946 (906) 524-6202

107 LONG-TERM CARE PHARMACIES

CRAWFORD COUNTY GENESEE COUNTY MT. MORRIS

GRAYLING FLINT Union Prescription Center 11830 N Saginaw St Mt. Morris, MI 48458 Mercy Hospital Grayling Advanced Care Pharmacy (810) 686-2900 Pharmacy Services - Genesee LLC 1100 E Michigan Avenue 420 West Fifth Avenue Grayling, MI 49738 Flint, MI 48503 SWARTZ CREEK (989) 348-0800 (810) 496-4876 Advanced Specialty Rx VPH Pharmacy 1260 S Linden Rd Ste 2 DELTA COUNTY 5376 Miller Road Flint, MI 48532 Swartz Creek, MI 48473 (888) 444-5309 (810) 877-7170 ESCANABA All American Pharmacy 3104-06 Flushing Rd Flint, MI 48504 GLADWIN COUNTY Eldercare Pharmacy (810) 234-0480 1823 7th Ave N Dort Longway Pharmacy GLADWIN Escanaba, MI 49829 2700 Robert T Longway Ste (906) 789-4451 B The People’s Drug Store Flint, MI 48503 Shopko Pharmacy #2653 1208 Ludington Street (810) 235-2800 174 James Robertson Dr Escanaba, MI 49829 Kirk’s Family Pharmacy Gladwin, MI 48624 (906) 786-1731 G-4444 Fenton Road (989) 426-7020 Flint, MI 48507 (810) 235-7995 EMMETT COUNTY GOGEBIC COUNTY

GOODRICH PETOSKEY WAKEFIELD Pharmd Co Pharmacy Northern Michigan Hospital 8191 S State Road Wakefield Pharmacy Pharmacy Goodrich, MI 48438 408 Sunday Lake Street 416 Connable Ave (810) 636-2979 Wakefield, MI 49968

LONG-TERM CARE PHARMACIES Petoskey, MI 49770 (906) 229-5966 (231) 487-4770 MONTROSE

Sav On Montrose Pharmacy 225 E State Street Montrose, MI 48457 (810) 639-2071

108 LONG-TERM CARE PHARMACIES

Downtown Drugs GRAND TRAVERSE INGHAM COUNTY 121 E Broadway COUNTY Mt. Pleasant, MI 48858 LANSING (989) 773-5544 TRAVERSE CITY Clinical Pharmacy Services JACKSON COUNTY Munson Community Health Of Mid-Michigan Ctr Pharmacy 6250 South Cedar St Suite 2 GRASS LAKE 550 Munson Avenue Lansing, MI 48911 Suite G-100 (517) 887-3539 Traverse City, MI 49686 Remindadose Pharmacy Grass Lake Community (231) 935-8730 2730 Alpha Access Ste B Pharmacy Lansing, MI 48910 112 E Michigan Ave (517) 708-7750 Grass Lake, MI 49240 HILLSDALE COUNTY (517) 522-4100 IONIA COUNTY HILLSDALE JACKSON

LAKE ODESSA Long Term Care - Nash Advanced Care Pharmacy Drugs Services - Jackson 32 N Howell St Walker’s Pharmacy 1200 N West Ave Suite 500 Hillsdale, MI 49242 838 4th Avenue Jackson, MI 49202

(517) 437-4497 Lake Odessa, MI 48849 (517) 789-8579 PHARMACIES CARE LONG-TERM (616) 374-3190 Allegiance Health Pharmacy #7369 HOUGHTON COUNTY 2200 Springport Road IRON COUNTY Jackson, MI 49202 HANCOCK (517) 787-4761 IRON RIVER Copper Country KALAMAZOO COUNTY Apothecary The Corner Drug Store 500 Campus Drive 128 West Genesee KALAMAZOO Hancock, MI 49930 Iron River, MI 49935 (906) 483-1901 (906) 265-2312 Kalamazoo Long Term Care 535 S Burdick - Suite 220 HURON COUNTY ISABELLA COUNTY Kalamazoo, MI 49007 (269) 388-4850 HARBOR BEACH MT. PLEASANT Kalamazoo Psychiatric Hospital 1312 Oakland Drive Harbor Drug Ambulatory Infusion Care Kalamazoo, MI 49008 114 S Huron Ave 121 E Broadway St Ste C (269) 337-3106 Harbor Beach, MI 48441 Mt. Pleasant, MI 48858 (989) 479-3241 (989) 773-4879

109 LONG-TERM CARE PHARMACIES

PARCHMENT KENT TECUMSEH

Hometown Pharmacy Ltc Grand Rapids Home For Shopko Pharmacy #2648 714 Shoppers Lane Veterans 2655 W Chicago Blvd Parchment, MI 49004 3000 Monroe Avenue Nw Tecumseh, MI 49286 (269) 349-7322 Kent, MI 49505 (517) 423-4420 (616) 364-5300 KALKASKA COUNTY LIVINGSTON COUNTY KENTWOOD

KALKASKA HOWELL Ltc Pharmacy 4477 E Paris Ave Shopko Pharmacy #2656 Kentwood, MI 49512 Genoa Healthcare 784 S Cedar St (616) 214-8011 2280 East Grand River Room Kalkaska, MI 49646 122 (231) 258-0139 Howell, MI 48843 ROCKFORD (517) 258-0002 KENT COUNTY Hometown Pharmacy Ltc MACKINAC COUNTY 4382 14 Mile Road GRAND RAPIDS Rockford, MI 49341 (616) 785-2100 ST. IGNACE Curo 3876 East Paris Ave Se Ste LAKE COUNTY Mackinac Straits Hospital 13 Pharmacy Grand Rapids, MI 49512 220 Burdette Street BALDWIN (616) 977-9700 St. Ignace, MI 49781 Pharmerica # 7112 (906) 643-0447 4575 44th Street Se Suite A Pattie Drug Of Baldwin Grand Rapids, MI 49512 868 Michigan Avenue MACOMB COUNTY (616) 954-6833 Baldwin, MI 49304 Specialized Pharmacy West (231) 745-4697 400 Ann Street Nw Suite 104 CENTERLINE LONG-TERM CARE PHARMACIES Grand Rapids, MI 49504 LENAWEE COUNTY (616) 365-9702 St. Mary’s Ltc Pharmacy Centerline City Pharmacy LLC 360 Division Ave S Ste 1c MORENCI Grand Rapids, MI 49503 8033 E Ten Mile Rd Ste 103 (616) 685-1070 Centerline, MI 48015 Mike’s Pharmacy (586) 427-5344 213 W Main Street Morenci, MI 49256 (517) 458-2261

110 LONG-TERM CARE PHARMACIES

Village Sav-Mor Pharmacy CLINTON TOWNSHIP ST. CLAIR SHORES Great Lakes 6213 Chicago Rd Ste 200 Lakeshore Medical Lakeview Specialty Warren, MI 48092 Pharmacy Pharmacy (586) 751-7979 33720 Harper Ave 21400 E 11 Mile Road Clinton Township, MI 48035 St. Clair Shores, MI 48081 MARQUETTE COUNTY (586) 415-4825 (586) 777-4100 Premier Pharmacy Park Pharmacy #2 34025 Harper Ave Ste B 20225 E Nine Mile Road ISHPEMING Clinton Township, MI 48035 St. Clair Shores, MI 48080 (586) 741-4850 (586) 285-9600 Morrisons Drug Store Value Center Pharmacy I 901 Lakeshore Drive 37155 Harper Avenue WARREN Suite 202 Clinton Township, MI 48036 Ishpeming, MI 49849 (586) 954-9100 (906) 486-4443 Advanced Care Pharmacy Services Of Metro Detroit EASTPOINTE 24788 Forterra Drive MARQUETTE Warren, MI 48089 (586) 758-7000 Etel - Rx D.J. Jacobetti Home For 21811 Kelly Road Suite 103 AHS St. John Pharmacy Ltc Veterans Eastpointe, MI 48021 31700 Van Dyke Ste 190 425 Fisher St (586) 498-7600 Warren, MI 48093 Marquette, MI 49855 PHARMACIES CARE LONG-TERM Pay Less Drugs (586) 276-8040 (906) 226-3576 20804 Gratiot Ave BC Of Michigan Pharmacy Eastpointe, MI 48021 4050 E Twelve Mile Rd (586) 222-2224 Warren, MI 48092 NEGAUNEE Rx Pharmacy (586) 578-0220 18801 E 9 Mile Rd Ltc Med Ex Direct Lt Pharmacare Eastpointe, MI 48021 13201 Stephens Rd Ste C 380 Us 41 East (586) 552-5672 Warren, MI 48089 Negaunee, MI 49866 (877) 899-6337 (906) 475-4424 SHELBY TOWNSHIP Medsmart Pharmacy 27101 Schoenherr Rd Ste 100 MIDLAND COUNTY Advanced Care Pharmacy Warren, MI 48088 (586) 298-6795 Services - Shelby MIDLAND 50680 Corporate Drive Pharmerica Shelby Township, MI 48315 3410 East Twelve Mile Road (586) 323-8270 Warren, MI 48092 Great Lakes Pharmacy Of Pharmascript Of Shelby (586) 573-0458 Midland 50505 Schoenherr Rd Ste Sterling Warren Pharmacy 1120 Eastman Ave 130 30834 Schoenherr Midland, MI 48640 Shelby Township, MI 48315 Warren, MI 48088 (989) 835-7911 (586) 803-0800 (586) 775-1221

111 LONG-TERM CARE PHARMACIES

Integrated Pharmacy Network NEWAYGO COUNTY BLOOMFIELD HILLS 215 Fast Ice Drive Midland, MI 48642 FREMONT Fox Hills Medimart (888) 837-3636 1539 Opdyke Bloomfield Hills, MI 48304 Country Squire Ltc (248) 858-2225 MISSAUKEE COUNTY Pharmacy, LLC 26 E Main Suite B CLARKSTON LAKE CITY Fremont, MI 49412 (231) 924-2120 P & H Pharmacy Long Term Shopko Pharmacy #2514 NEWAYGO Care 1960 South Morey Road 5838 S Main St - Suite B Lake City, MI 49651 Clarkston, MI 48346 (231) 839-7207 Shopko Pharmacy #2643 (248) 625-8031 91 Pine Lake Drive Newaygo, MI 49337 MONROE COUNTY (231) 652-9484 FARMINGTON HILLS

LAMBERTVILLE OAKLAND COUNTY Advanced Care Pharmacy Services - Detroit 38855 Hills Tech Dr Ste 101 Onecare Rx AUBURN HILLS Farmington Hills, MI 48331 7375 Secor Road Suite A (248) 488-8191 Lambertville, MI 48144 Botsford Outpatient (734) 568-6400 Ultimate Medical Pharmacy Pharmacy 2049 N Opdyke Rd 28100 Grand River Avenue Auburn Hills, MI 48326 MONROE Farmington Hills, MI 48336 (248) 370-8070 (248) 471-8700 Pharmascript Of Michigan Professional Village BIRMINGHAM Pharmacy 23000 Commerce Dr Ste B 128 Cole Road Farmington Hills, MI 48335 (248) 435-3500 Monroe, MI 48162 Mills Pharmacy & (734) 242-2966 Apothecary

LONG-TERM CARE PHARMACIES 1744 W Maple Road Suite A HAZEL PARK Birmingham, MI 48009 MUSKEGON COUNTY (248) 644-5060 Buckleys Pharmacy #102 Onecare Pharmacy 20721 Dequindre Road 1744 W Maple Rd Ste B WHITEHALL Suite B Birmingham, MI 48009 Hazel Park, MI 48030 (248) 258-8800 (248) 808-6505 Shopko Pharmacy #2645 3165 Holton - Whitehall Lor Ven Pharmacy Road 116 W 8 Mile Road Whitehall, MI 49461 Hazel Park, MI 48030 (231) 894-2635 (248) 629-9847

112 LONG-TERM CARE PHARMACIES

Rx Specialties NH, Inc. 23751 Dequindre Road PONTIAC SOUTHFIELD Hazel Park, MI 48030 (248) 546-5500 Dells Prescription Center Advanced Care Pharmacy 219 Baldwin Avenue Services - Southfield LAKE ORION Pontiac, MI 48342 22170 W Nine Mile (248) 334-2620 Southfield, MI 48034 Index Meds (248) 799-8125 We Care Pharmacy Plus 989 University Dr Ste 107 Cadila Pharmacy 1412 S Lapeer Rd Pontiac, MI 48342 23832 Southfield Rd Lake Orion, MI 48360 (248) 340-0886 Southfield, MI 48075 (248) 690-9686 Medstar Pharmacy (248) 557-9333 161 State St Farmbrook Pharmacy MADISON HEIGHTS Pontiac, MI 48341 29877 Telegraph Road (248) 333-3427 Southfield, MI 48034 (248) 354-5600 Value Center Pharmacy II Omega Pharmacy 1485 West 14 Mile Road 420 W Huron Grant Pharmacy Madison Heights, MI 48071 Pontiac, MI 48341 29355 Northwestern Highway (248) 583-1854 (248) 481-9004 Suite 220 Pontiac Discount Pharmacy Southfield, MI 48034 1430 Joslyn Ave (248) 799-3900 MILFORD Pontiac, MI 48340 Heritage Pharmacy Services (248) 377-9700 21674 Melrose Blvd

Milford Sav-Mor Pharmacy Southfield, MI 48075 PHARMACIES CARE LONG-TERM (248) 416-1310 1191 North Milford Road ROCHESTER HILLS Milford, MI 48381 Trinity Pharmacy (248) 685-8363 17330 Northland Parks Court Vital Pharmacare Ste 100a 1901 Star Batt Drive Southfield, MI 48075 NOVI Suite 200 (248) 443-1332 Rochester Hills, MI 48309 (248) 299-1701 Checker Specialty Pharmacy TROY 43155 W Nine Mile Road Ste 300 ROYAL OAK Novi, MI 48376 Med Index Pharmacy (248) 305-7240 1639 E Big Beaver Rd Ste Sav-On Ltc Closed Door Dynamic Care Pharmacy 101 Pharmacy 4119 W 13 Mile Rd Troy, MI 48083 (248) 528-0888 24100 Meadowbrook Rd - Royal Oak, MI 48073 Suite B (248) 850-1802 Novi, MI 48375 WALLED LAKE (888) 722-5579 Pontiac Trail Pharmacy 620 N Pontiac Trail Walled Lake, MI 48390 (248) 669-2776

113 LONG-TERM CARE PHARMACIES

WATERFORD OSCEOLA COUNTY SCHOOLCRAFT COUNTY

Advanced Care Pharmacy EVART MANISTIQUE Services - Waterford 279 Summit Ste 200 Waterford, MI 48328 Shopko Pharmacy #2513 Shopko Pharmacy #2621 (248) 409-1105 107 North Main St 717 East Lakeshore Drive Evart, MI 49631 Manistique, MI 49854 (231) 734-5581 (906) 341-3994 WEST BLOOMFIELD

OTTAWA COUNTY ST. CLAIR COUNTY Beaumont Pharmacy West Bloomfield 6900 Orchard Lake Rd - GRAND HAVEN PORT HURON Suite 104 West Bloomfield, MI 48322 (248) 855-5505 Dunewood Pharmacy Advanced Care Pharmacy 1445 Sheldon Rd - Suite 104 Services - Port Huron, LLC Grand Haven, MI 49417 3111 Electric Avenue OCEANA COUNTY (616) 842-5193 Port Huron, MI 48060 (810) 824-5120 Port Huron Pharmacy HART SAGINAW COUNTY 515 10th Street Port Huron, MI 48060 Shopko Pharmacy #2651 SAGINAW (810) 989-9550 2278 North Comfort Drive Hart, MI 49420 TUSCOLA COUNTY (231) 873-1843 Advanced Care Pharmacy Services - Saginaw, LLC 500 Hancock Suite 100 CARO OGEMAW COUNTY Saginaw, MI 48602 (989) 793-3130 Healthsource Saginaw Inc. Caro Center WEST BRANCH 3340 Hospital Road 2000 Chambers Road Saginaw, MI 48608 Caro, MI 48723

LONG-TERM CARE PHARMACIES Specialized Pharmacy (989) 790-7729 (989) 673-3191 Services North West Branch SANILAC COUNTY WASHTENAW COUNTY 522 East Houghton Avenue Suite 102 West Branch, MI 48661 DECKERVILLE ANN ARBOR (989) 345-2297

Harbor Drug #2 Big House Pharmacy 2046 Black River St Ste 2 1000 E Stadium Blvd Ste B Deckerville, MI 48427 Ann Arbor, MI 48104 (810) 376-8070 (734) 929-2425

114 LONG-TERM CARE PHARMACIES

Dixboro Village Pharmacy Dearborn Hills Pharmacy WAYNE COUNTY 5770 Plymouth 24755 Ford Rd Ann Arbor, MI 48105 Dearborn, MI 48128 (734) 214-1234 ALLEN PARK (313) 915-5455 Healthplus Specialty Future Drugs Pharmacy 14234 Warren Ave 3520 Green Ct Ste 175 Oakwood Residential Care Dearborn, MI 48126 Ann Arbor, MI 48105 Pharmacy (313) 945-1288 (734) 769-1300 1633 Fairlane Circle Julias Pharmacy Village Pharmacy II Suite 165 5220 Oakman Blvd 325 N Maple Road Allen Park, MI 48101 Dearborn, MI 48126 Ann Arbor, MI 48103 (313) 996-3290 (313) 406-3363 (734) 668-9600 La Pharmacy BELLEVILLE 7237 Chase Road CHELSEA Dearborn, MI 48126 (313) 581-6100 Cet Pharmacy 504 Main St Patient Care Pharmacy Home Town Pharmacy Ltc 15301 Tireman Avenue 1123 S Main Street Belleville, MI 48111 (734) 699-4559 Dearborn, MI 48126 Chelsea, MI 48118 (313) 584-2400 (734) 562-2279 Premier Home Pharmacy Of CANTON MI SALINE 23874 Kean Street Suite 120 Dearborn, MI 48124 Canton Specialty Pharmacy PHARMACIES CARE LONG-TERM (313) 887-9111 Center For Forensic 305 N Lilley Road West Village Pharmacy Psychiatry Canton, MI 48187 2040 Monroe St Ste 201 8303 Platt Road (734) 259-6700 Richardson’s Super Drugs Dearborn, MI 48124 Saline, MI 48176 (313) 561-9700 (734) 429-2531 42433 Ford Road Canton, MI 48187 Westborn Pharmacy 8 (734) 981-3900 1800 Grindley Park St Ste 1 YPSILANTI Dearborn, MI 48124 (313) 438-6476 DEARBORN Ypsilanti Family Pharmacy 3145 W Clark Road Ste 106 DETROIT Ypsilanti, MI 48197 A & A Pharmacy LLC (734) 434-2448 15343 W Warren Dearborn, MI 48126 Advanced Care Pharmacy - (313) 584-0600 Em Dearborn Family Pharmacy 2925 Russel St Ste 100 LLC Detroit, MI 48207 17000 Executive Plaza Dr. Ste (313) 879-2057 D Advanced Care Pharmacy Dearborn, MI 48126 Services - Negc (313) 523-5334 12800 E Warren Ave Detroit, MI 48215 (313) 347-2035

115 LONG-TERM CARE PHARMACIES

Advanced Care Pharmacy Seven Mile Pharmacy, LLC Services - New Center, LLC 14400 Gratiot Ave INKSTER 2051 W Grand Blvd Detroit, MI 48205 Detroit, MI 48208 (313) 245-9920 New Millennium Drugs (313) 309-1084 St. Paul Pharmacy 211 Henry Ruff Andy’s Pharmacy 9934 Harper Rd Inkster, MI 48141 2676 West Grand Blvd Detroit, MI 48213 (734) 721-2100 Detroit, MI 48208 (313) 921-3537 (313) 871-3285 LIVONIA Best Value Pharmacy FLAT ROCK 7310 Woodward Ave 4th Floor Medcart Pharmacy Detroit, MI 48202 Flatrock City Pharmacy Solutions (313) 483-3910 25620 Gibraltar Road 32131 Industrial Rd Ste 200 Eddies Medical Pharmacy Flat Rock, MI 48134 Livonia, MI 48150 7304 Michigan Ave (734) 789-8950 (734) 762-6622 Detroit, MI 48210 Medcart Specialty (313) 551-0600 GARDEN CITY Pharmacy McNichols Drugstore LLC 32131 Industrial Rd 10123 W Mcnichols Rd W Livonia, MI 48150 Detroit, MI 48221 Healthy Drugs (734) 762-6600 (313) 340-4242 827 Inkster Rd Specialized Pharmacy Garden City, MI 48135 Medplus Care Pharmacy Services South Livonia (734) 261-4100 LLC 33510 Schoolcraft Road 14071 E. 7 Mile Road Quickmed Pharmacy Livonia, MI 48150 Detroit, MI 48205 235 Inkster (734) 422-3310 (313) 371-9000 Garden City, MI 48135 (734) 525-5335 Qol Meds NORTHVILLE 24424 W Mc Nichols Rd Detroit, MI 48219 GROSSE POINTE PARK (313) 989-0249 Hawthorn Center 18471 Haggerty Road 5716 Michigan Ave Park Pharmacy Detroit, MI 48210 Northville, MI 48167 15126 Kercheval Ave (248) 735-5994 (313) 989-0536 Grosse Pointe Park, MI 1700 Waterman 48230

LONG-TERM CARE PHARMACIES Detroit, MI 48209 (313) 822-0100 PLYMOUTH (313) 842-9660 Rosedale Community HAMTRAMCK Rxperts Pharmacy - Pharmacy Michigan LLC 19220 Grand River Ave 9131 General Ct #150 Detroit, MI 48223 Frd Sav-Mor Pharmacy Plymouth, MI 48170 (313) 531-0100 9811 Conant (734) 416-1717 Sav-Max Glory Pharmacy Hamtramck, MI 48212 9731 Harper Ave (313) 871-1115 Detroit, MI 48213 (313) 921-1002

116 LONG-TERM CARE PHARMACIES

Goddard Discount Drugs REDFORD 25410 Goddard Rd Taylor, MI 48180 Advanced Homecare (313) 908-7515 Pharmacy Pioneer Medical Pharmacy 12699 Farley 12701 Telegraph Rd Redford, MI 48239 Taylor, MI 48180 (313) 532-4500 (734) 250-8858 Glory Care Pharmacy Sax Discount Pharmacy 27144 Joy Rd 22525 Wick Road Redford, MI 48239 Taylor, MI 48180 (313) 937-6301 (313) 292-3755 Seaway Pharmacy ROCKWOOD 8750 Telegraph Road Ste 104 Taylor, MI 48180 (313) 291-2182 Susan’s Total Care Drug Store TRENTON 22432 N Huron River Dr Rockwood, MI 48173 (734) 379-7000 West Grange Drugs 3390 West Road ROMULUS Trenton, MI 48183 (734) 676-6622 OGTR AEPHARMACIES CARE LONG-TERM

Family Pharmacy WESTLAND 36567 Goddard Road Romulus, MI 48174 (734) 941-0755 Value Pharmacy 1629 Merriman Road SOUTHGATE Westland, MI 48186 (734) 405-2300 Walter Reuther Psychiatric Falcon Health-Mart Drugs Hospital 15600 Northline Road 30901 Palmer Road Southgate, MI 48195 Westland, MI 48186 (734) 250-8168 (734) 367-8576 Wayne Family Pharmacy TAYLOR 244 North Wayne Road Westland, MI 48185 (734) 728-6400 Er Drugs Westland Maple Drugs 27260 Eureka Road 1949 Wayne Rd Taylor, MI 48180 Westland, MI 48185 (734) 955-9110 (734) 729-2200

117 INDIAN/TRIBAL/URBAN PHARMACIES

Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through Medicare Plus Blue PPO’s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). TTY/TDD users should call the TRS relay number 711 to contact the pharmacy of their choice.

BARAGA COUNTY SAULT STE. MARIE MACKINAC COUNTY

BARAGA Slt. Ste. Marie Tribal Health ST. IGNACE Center Pharmacy 2864 Ashmun Keweenaw Bay Indian Sault Ste. Marie, MI 49783 Lambert Health Clinic Community (906) 632-5226 Pharmacy 102 Superior Ave 225 Waseh Drive Baraga, MI 49908 St. Ignace, MI 49781 (906) 353-4555 GOGEBIC COUNTY (906) 643-8689

CASS COUNTY WATERSMEET MENOMINEE COUNTY

DOWAGIAC Lac Vieux Desert Health WILSON Center Pharmacy 23560 E Choate Rd Pokagon Health Services Watersmeet, MI 49969 Hannahville Health Center Pharmacy (906) 358-4588 Pharmacy 57392 M-51 South N 15019 Hannahville B-1 Rd Dowagiac, MI 49047 Wilson, MI 49896 (269) 782-4570 ISABELLA COUNTY (906) 466-9201

CHIPPEWA COUNTY MT. PLEASANT SCHOOLCRAFT COUNTY INDIAN/TRIBAL/URBAN PHARMACIES BRIMLEY Cardinal Pharmacy MANISTIQUE 2410 S Leaton Rd Suite 8 Mt. Pleasant, MI 48858 Bay Mills Pharmacy (989) 317-3700 Manistique Tribal Health 12124 West Lakeshore Drive Clinic Pharmacy Nimkee Pharmacy Brimley, MI 49715 5698 West Us 2 (906) 248-2031 2591 South Leaton Road Manistique, MI 49854 Mt. Pleasant, MI 48858 (906) 341-8469 (989) 775-4608

118 INDEX OF PHARMACIES

Advanced Care Pharmacy Advanced Specialty Rx . . .16 7 Services - Jackson (P) ....28 AHS St John Pharmacy 23 Advanced Care Pharmacy Mile (NP) ...... 42 7 Van Drugs (NP) ...... 85 Services - Negc ...... 115 AHS St. John Pharmacy Advanced Care Pharmacy Farmington Hills (NP) ....57 Services - Negc (NP) .....85 AHS St. John Pharmacy A Advanced Care Pharmacy Livonia (NP) ...... 95 Services - New Center, AHS St. John Pharmacy A & A Pharmacy LLC.....115 LLC...... 116 Ltc...... 111 A & A Pharmacy LLC (NP) .83 Advanced Care Pharmacy AHS St. John Pharmacy Ltc A & H Pharmacy Services, Services - New Center, LLC (NP) ...... 46 Inc. (NP) ...... 85 (NP) ...... 86 AHS St John Pharmacy River A & M Pharmacy (P) ...... 85 Advanced Care Pharmacy District (NP) ...... 75 A And S Pharmacy, Inc. (P).83 Services - Port Huron, AHS St. John Pharmacy ABC Discount Pharmacy LLC...... 114 Southfield (NP) ...... 64

(P)...... 15 Advanced Care Pharmacy Alcona Health Center PHARMACIES OF INDEX Access Pharmacy (P) ...... 83 Services - Port Huron, LLC Pharmacy (P) ...... 2 Accredo Health Group, (P)...... 76 Alcona Health Center Inc...... 105 Advanced Care Pharmacy Pharmacy Services (NP)....3 Accredo Health Group, Inc. Services - Saginaw, LLC .114 Alert Infusion Services, ...... 61 Advanced Care Pharmacy Inc...... 105 Action Drugs #2 (NP) .....85 Services - Saginaw, LLC Alert Infusion Services, Inc. Action Drugs #4 (NP) .....62 (NP) ...... 72 ...... 64 Active Infusion ...... 104 Advanced Care Pharmacy Alexander’s Drug Store Active Infusion ...... 60 Services - Shelby ...... 111 (NP) ...... 2 Ada Hillside Pharmacy Advanced Care Pharmacy All American Pharmacy. . .108 (NP) ...... 32 Services - Shelby (NP) ....44 All American Pharmacy (P) .16 Addison Pharmacy (NP) . . .37 Advanced Care Pharmacy All Care Pharmacy (P) .....81 Advance Care Pharmacy Services - Southfield . . . .113 Allegan Community (NP) ...... 59 Advanced Care Pharmacy Pharmacy (NP)...... 2 Advanced Care Infusion - Services - Southfield (NP).64 Allegan Medical Center Shelby...... 104 Advanced Care Pharmacy Pharmacy (P) ...... 2 Advanced Care Infusion - Services - Waterford . . . .114 Allegiance Health Pharmacy Shelby ...... 44 Advanced Care Pharmacy #7369 ...... 103, 109 Advanced Care Pharmacy .31 Services - Waterford (NP) .67 Allegiance Health Pharmacy Advanced Care Pharmacy - Advanced Care Pharmacy #7369 (P) ...... 28 Em...... 115 Services Of Metro Allegiance Health Pharmacy Advanced Care Pharmacy - Detroit ...... 111 #7371 (NP)...... 28 Em (NP) ...... 85 Advanced Care Pharmacy Allegiance Health Pharmacy Advanced Care Pharmacy Services Of Metro Detroit #7743 ...... 28 Services - Detroit ...... 112 (NP) ...... 46 Allen Park Discount Advanced Care Pharmacy Advanced Care Pharmacy Pharmacy (NP) ...... 81 Services - Detroit (NP)....57 Services (P) ...... 28 Alpena Regional Medical Advanced Care Pharmacy Advanced Homecare Center (P)...... 3 Services - Genesee LLC .108 Pharmacy ...... 117 Ambulatory Infusion Advanced Care Pharmacy Advanced Homecare Care...... 103, 109 Services - Genesee LLC Pharmacy ...... 97 Ambulatory Infusion Care .27 (NP) ...... 16 Advanced Pharmacy Services Ambulatory Infusion Care - Advanced Care Pharmacy (NP) ...... 61 North Inc...... 105 Services - Jackson ...... 109 Advanced Specialty Rx . . .108

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 119 INDEX OF PHARMACIES

Ambulatory Infusion Care - Barclay Pharmacy (P) ...... 63 Biomed Health Solutions LLC North Inc...... 69 Barron Pharmacy (NP) .....80 (NP) ...... 64 American Mail Order Barton’s Pharmacy (P) .....86 Biomed Pharmacy Lake Pharmacy Inc (NP) ...... 46 Bay Area Medical Center - Lansing (P) ...... 23 Anderson Pharmacy (NP) . . .5 Stephenson Pharmacy (P).50 Birch Run Drugs (P) ...... 72 Andrew’s Drug Store (P) . . .92 Bay Mills Pharmacy ...... 118 Blain Pharmacy (NP) ...... 86 Andrew’s Pharmacy Belleville Bay Mills Pharmacy (NP) . . .11 Bloomfield Pharmacy North, / Sav On Drugs #7 (P) ....82 Bay Pharmacy (NP)...... 40 P.C. (NP) ...... 62 Andy’s Pharmacy ...... 116 Bay Shore Pharmacy (NP). .37 Blue Pharmacy (P) ...... 86 Andy’s Pharmacy (P) ...... 86 BC Of Michigan Bob’s Drugs LLC (NP) .....68 Ann Arbor Home Infusion Pharmacy ...... 111 Borden’s Pharmacy (NP) . . .15 Pharmacy ...... 105 BC Of Michigan Pharmacy Borgess Outpatient Ann Arbor Home Infusion (NP) ...... 46 Pharmacy (P) ...... 29 Pharmacy ...... 79 Beacon Hill Medical Bosley Pharmacy #2 Inc. (P) .4 Ann Arbor Professional Pharmacy (P) ...... 64 Bostick’s Drug Store (NP).101 Pharmacy (NP) ...... 79 Beacon Pointe Pharmacy, Inc. Botsford Outpatient Ap Specialty Medications, (NP) ...... 93 Pharmacy ...... 112 LLC (NP) ...... 44 Beacon Professional Botsford Outpatient Apothecary - Hancock Pharmacy Inc. (NP)...... 61 Pharmacy (NP) ...... 58 (NP) ...... 21 Beaumont Home Infusion.104 Brady Drugs (P)...... 73 Apothecary - Houghton Beaumont Home Infusion .60 Break Thru Medical (NP). . .43 (NP) ...... 21 Beaumont Hospital Grosse Bridgeport Pharmacy Inc. Apothecary Shop At Grand Pointe (P) ...... 93 (P)...... 72 Ledge ...... 13 Beaumont Hospitals - Troy Brightsky (NP) ...... 47 Apothecary Shop (NP) ....23 ...... 66 Bristol Pharmacy (NP) .....16 Arbor Lane Pharmacy At Fox Beaumont Pharmacy West Broad Street Pharmacy (P) .72 INDEX OF PHARMACIES Run(P)...... 61 Bloomfield ...... 114 Bronson Outpatient Arbor Lane Pharmacy (P) . .85 Beaumont Pharmacy West Pharmacy ...... 29 Arcadia Pharmacy (NP) ....29 Bloomfield (P) ...... 67 Bronson Pharmacy Mattawan Arfstrom Pharmacy (NP) . .11, Belavista Drugs (NP) ...... 98 ...... 78 40 Belavista Pharmacy (P) ....94 Brothers Pharmacy Inc Armada Pharmacy (P) .....40 Belfy Drug Store (NP) ...... 8 (NP) ...... 16 Ashton Drugs (NP) ...... 86 Bellaire Pharmacy (NP) .....3 Buckley Family Pharmacy Asklers Augusta Pharmacy N Belsay Medical Pharmacy (NP)...... 101 More ...... 29 (NP) ...... 15 Buckleys Pharmacy #102 .112 Aspirus Keweenaw Pharmacy Benson Drug Co. (P) ...... 53 Buckleys Pharmacy #102 - Laurium ...... 21 Benstar Pharmacy PLLC (P)...... 59 Atlantic Medical Pharmacy (NP) ...... 86 Buckley’s Pharmacy (P) ....86 (NP) ...... 45 Berkley Medical Center Buenavida Pharmacy (P) . . .86 Atlas Pharmacy, LLC (NP) . .86 Pharmacy (NP) ...... 55 Bunte’s Pharmacy (NP) ....71 Augres Pharmacy (P) ...... 4 Berkley Pharmacy (P)...... 46 Byron Drugs (P)...... 98 Azaal Discount Pharmacy Best Value Pharmacy .....116 (NP) ...... 93 Best Value Pharmacy (NP) .86 Better Care Neighborhood C Pharmacy (NP) ...... 93 B Big House Pharmacy .....114 Cadila Pharmacy...... 113 Big House Pharmacy (NP) .79 Cadila Pharmacy (NP) .....65 Ballenger Health - Mart Binsons Pharmacy (NP) ....40 Cadillac Family Pharmacy LLC Pharmacy (NP) ...... 16 Bio Script Pharmacy (NP) . .98 (P)...... 101 Band Prescriptions (P) .....86 Campau Pharmacy (P) .....93

120 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Campbell Pharmacy...... 107 Centerline City Pharmacy Community Drug Of Campbell Pharmacy (P) .....2 LLC(P)...... 40 Benzonia (NP) ...... 6 Campus Pharmacy (P) .....49 Central Drug Store (NP) . . .10 Community Drugs Of Canal Pharmacy (P) ...... 45 Central Lake Pharmacy Inc Frankfort (NP) ...... 6 Canalis Medical Pharmacy (NP) ...... 3 Community Pharmacy .....3 (P)...... 80 Cet Medical Pharmacy (P) .69 Community Rx Pharmacy Cancer & Hematology Cet Pharmacy ...... 115 (P)...... 47 Centers Of Western Cet Pharmacy ...... 82 Complete Infusion Michigan (NP) ...... 33 Champaign Pharmacy Services ...... 106 Caniff Pharmacy (P) ...... 93 (NP) ...... 81 Complete Infusion Services Canton Specialty CHCWM - Muskegon (P) . .53 ...... 95 Pharmacy ...... 115 CHCWM - St. Mary’s (NP) .33 Comprehensive Meds Canton Specialty Pharmacy Checker Specialty Pharmacy (P) ...... 92 (NP) ...... 82 Pharmacy ...... 113 Conant Plaza Pharmacy (P).86 Capac Pharmacy Inc. (NP) .75 Checker Specialty Pharmacy Copper Country

Cardinal Pharmacy ...... 118 (P)...... 61 Apothecary ...... 109 PHARMACIES OF INDEX Cardinal Pharmacy (NP) . . .27 Chelsea Pharmacy (P) .....80 Copper Country Apothecary Care Max Pharmacy (NP) . .93 Chelseacare Pharmacy ...... 21 Care Pharmacy (NP)...... 73 (NP) ...... 80 Coram Alternate Site Care Plus Pharmacy ...... 86 Chemville Pharmacy (NP) . .65 Srvs...... 104 Caremark Inc. Therapeutic Cherry Hill Pharmacy (P) . . .83 Coram Alternate Site Srvs. Services Division...... 105 City Drugs Pharmacy Inc ...... 33 Caremark Inc. Therapeutic (P)...... 86 Coram Inc...... 105 Services Division ...... 66 Clarine Pharmacy (NP) ....58 Coram Inc...... 61 Caremont Pharmacy (NP) . .45 Clark Professional Pharmacy Corner Druggist (NP)...... 3 Care-Mor Pharmacy (NP) . .86 (NP) ...... 80 Costco Pharmacies (P)...... 1 Caremore Pharmacy (P) . . .86 Clarkston Pharmacy (NP) . .56 Costco Pharmacy #1106 Careplus Cvs Pharmacy Clinical Pharmacy Services Of (P)...... 79 #02953 (NP)...... 55 Mid-Michigan ...... 109 Costco Pharmacy #341 (P) .57 Carleton Pharmacy (NP) . . .51 Clinical Pharmacy Services Of Costco Pharmacy #374 (P) .44 Carman Pharmacy ...... 2 Mid-Michigan (NP) ...... 23 Costco Pharmacy #376 (P) .55 Caro Drug’s PC (P)...... 77 Clinton Memorial Hospital Costco Pharmacy #390 (P) .95 Caro Center...... 114 Phfarmacy (NP) ...... 12 Costco Pharmacy #391 (P) .95 Carpenter Pharmacy (NP). .93 Clio Road Pharmacy (P) . . .16 Costco Pharmacy #392 (P) .56 Carson Apothecary Shoppe Cmu Health Service Costco Pharmacy #393 (P) .60 ...... 52 Pharmacy ...... 27 Costco Pharmacy #394 (P) .43 Cascade Hemophilia Coach Light Pharmacy (P) .77 Costco Pharmacy #744 (P) .36 Consortium ...... 105 Cobb Clinic Pharmacy #57 Costco Pharmacy #784 (P) .33 Cascade Hemophilia (NP)...... 100 Costco Pharmacy #786 (P) .39 Consortium (P) ...... 79 Cobbs Street Pharmacy Country Drugs (NP) ...... 5 CDS Pharmacy (NP) ...... 21 (P)...... 101 Country Market Pharmacy Center For Family Health Coleman Family Pharmacy, #12(P)...... 80 (NP) ...... 28 Inc...... 50 Country Market Pharmacy Center For Forensic Collie Drugs (P)...... 44 #66(P)...... 28 Psychiatry...... 115 Colon Village Pharmacy Country Market Pharmacy Center For Forensic (P)...... 76 (P)...... 37 Psychiatry ...... 80 Commet Plaza Pharmacy . .29 Country Squire Ltc Pharmacy, Centerline City Pharmacy Community Care Pharmacy LLC...... 112 LLC...... 110 (NP) ...... 54 Country Squire Ltc Pharmacy, LLC...... 54

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 121 INDEX OF PHARMACIES

Countryside Drug Co. #2 CVS Pharmacy #06804 CVS Pharmacy #8031 (NP) .95 (NP) ...... 53 (NP) ...... 53 CVS Pharmacy #8032 (NP) .40 Countryside Drug Co III CVS Pharmacy #06843 CVS Pharmacy #8033 (NP) .60 (NP) ...... 52 (NP) ...... 19 CVS Pharmacy #8034 (NP) .65 Countryside Drug Co. CVS Pharmacy #07137 CVS Pharmacy #8035 (NP) .83 (NP) ...... 53 (NP) ...... 79 CVS Pharmacy #8036 (NP) .63 Covenant Healthcare CVS Pharmacy #07385 CVS Pharmacy #8038 (NP) .67 Outpatient Pharmacy ....73 (NP) ...... 86 CVS Pharmacy #8039 (NP) .47 Crary Drug (NP) ...... 52 CVS Pharmacy #07549 CVS Pharmacy #8040 (NP) .44 Critical Care Systems Inc . .68 (NP) ...... 36 CVS Pharmacy #8041 (NP) .28 Critical Care Systems Inc .105 CVS Pharmacy #08399 CVS Pharmacy #8042 (NP) .82 Crittenton Medical Pharmacy (NP) ...... 86 CVS Pharmacy #8044 (NP) .58 (NP) ...... 63 CVS Pharmacy #08549 CVS Pharmacy #8045 (NP) .47 Crown Pharmacy (NP) .....97 (NP) ...... 50 CVS Pharmacy #8046 (NP) .39 Crystal Falls Pharmacy CVS Pharmacy #0927 CVS Pharmacy #8047 (NP) .86 (NP) ...... 27 (NP)...... 100 CVS Pharmacy #8048 (NP) .57 Curo...... 110 CVS Pharmacy #10098 CVS Pharmacy #8049 (NP) .67 Curo...... 33 (NP) ...... 27 CVS Pharmacy #8050 (NP) .47 Curtis Family Pharmacy CVS Pharmacy #10137 CVS Pharmacy #8051 (NP) .98 (NP) ...... 40 (NP) ...... 70 CVS Pharmacy #8052 (NP) .94 Customcare Pharmacy CVS Pharmacy #8001 (NP) .83 CVS Pharmacy #8053 (NP) .75 (NP) ...... 64 CVS Pharmacy #8002 (NP) .66 CVS Pharmacy #8054 (NP) .23 CVS Pharmacies (NP ...... 1 CVS Pharmacy #8003 (NP) .80 CVS Pharmacy #8055 (NP) .96 CVS Pharmacy #00028 CVS Pharmacy #8004 (NP) .60 CVS Pharmacy #8056 (NP) .85 (NP) ...... 51 CVS Pharmacy #8005 (NP) .83 CVS Pharmacy #8058 (NP) .65 CVS Pharmacy #00103 CVS Pharmacy #8006 (NP) .79 CVS Pharmacy #8059 INDEX OF PHARMACIES (NP) ...... 96 CVS Pharmacy #8007 (NP) .97 (NP)...... 100 CVS Pharmacy #00211 CVS Pharmacy #8008 CVS Pharmacy #8062 (NP) .43 (NP) ...... 82 (NP)...... 100 CVS Pharmacy #8063 (NP) .65 CVS Pharmacy #00287 CVS Pharmacy #8009 (NP) .96 CVS Pharmacy #8064 (NP) .99 (NP) ...... 63 CVS Pharmacy #8010 CVS Pharmacy #8065 CVS Pharmacy #00445 (NP)...... 100 (NP)...... 100 (NP) ...... 42 CVS Pharmacy #8011 (NP) .41 CVS Pharmacy #8066 (NP) .64 CVS Pharmacy #01150 CVS Pharmacy #8013 (NP) .37 CVS Pharmacy #8067 (NP) .61 (NP) ...... 64 CVS Pharmacy #8014 (NP) .45 CVS Pharmacy #8068 (NP) .64 CVS Pharmacy #01748 CVS Pharmacy #8015 (NP) .95 CVS Pharmacy #8069 (NP) .47 (NP) ...... 64 CVS Pharmacy #8016 (NP) .41 CVS Pharmacy #8071 (NP) .59 CVS Pharmacy #01758 CVS Pharmacy #8017 (NP) .94 CVS Pharmacy #8072 (NP) .92 (NP) ...... 81 CVS Pharmacy #8019 (NP) .60 CVS Pharmacy #8073 (NP) .86 CVS Pharmacy #03538 CVS Pharmacy #8020 (NP) .67 CVS Pharmacy #8074 (NP) .55 (NP) ...... 59 CVS Pharmacy #8021 (NP) .65 CVS Pharmacy #8075 (NP) .92 CVS Pharmacy #03584 CVS Pharmacy #8023 (NP) .80 CVS Pharmacy #8076 (NP) .63 (NP) ...... 79 CVS Pharmacy #8024 (NP) .43 CVS Pharmacy #8077 (NP) .96 CVS Pharmacy #05406 CVS Pharmacy #8025 (NP) .38 CVS Pharmacy #8078 (NP) .45 (NP) ...... 42 CVS Pharmacy #8026 (NP) .66 CVS Pharmacy #8080 (NP) .45 CVS Pharmacy #05610 CVS Pharmacy #8027 (NP) .83 CVS Pharmacy #8081 (NP) .93 (NP) ...... 33 CVS Pharmacy #8028 (NP) .98 CVS Pharmacy #8082 (NP) .86 CVS Pharmacy #05741 CVS Pharmacy #8029 CVS Pharmacy #8083 (NP) .80 (NP) ...... 80 (NP)...... 101 CVS Pharmacy #8084 (NP) .67 CVS Pharmacy #8030 (NP) .66 CVS Pharmacy #8085 (NP) .96

122 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

CVS Pharmacy #8086 (NP) .62 CVS Pharmacy #8144 (NP) .44 CVS Pharmacy #8212 CVS Pharmacy #8087 .....13 CVS Pharmacy #8146 (NP) .47 (NP)...... 100 CVS Pharmacy #8088 (NP) .79 CVS Pharmacy #8148 (NP) .75 CVS Pharmacy #8213 (NP) .98 CVS Pharmacy #8089 (NP) .80 CVS Pharmacy #8149 (NP) .75 CVS Pharmacy #8214 (NP) .47 CVS Pharmacy #8091 (NP) .42 CVS Pharmacy #8151 (NP) .97 CVS Pharmacy #8216 (NP) .79 CVS Pharmacy #8092 (NP) .41 CVS Pharmacy #8152 (NP) .83 CVS Pharmacy #8218 (NP) .98 CVS Pharmacy #8093 (NP) .41 CVS Pharmacy #8153 (NP) .86 CVS Pharmacy #8221 (NP) .85 CVS Pharmacy #8094 (NP) .86 CVS Pharmacy #8154 (NP) .44 CVS Pharmacy #8222 (NP) .87 CVS Pharmacy #8095 (NP) .42 CVS Pharmacy #8155 (NP) .56 CVS Pharmacy #8225 (NP) .82 CVS Pharmacy #8097 (NP) .79 CVS Pharmacy #8156 (NP) .44 CVS Pharmacy #8227 (NP) .65 CVS Pharmacy #8100 (NP) .44 CVS Pharmacy #8157 (NP) .97 CVS Pharmacy #8229 (NP) .68 CVS Pharmacy #8101 (NP) .58 CVS Pharmacy #8158 (NP) .42 CVS Pharmacy #8230 (NP) .87 CVS Pharmacy #8102 (NP) .56 CVS Pharmacy #8159 (NP) .86 CVS Pharmacy #8231 (NP) .87 CVS Pharmacy #8103 (NP) .59 CVS Pharmacy #8160 (NP) .82 CVS Pharmacy #8232 (NP) .99 CVS Pharmacy #8104 (NP) .86 CVS Pharmacy #8161 (NP) .61 CVS Pharmacy #8233 (NP) .65

CVS Pharmacy #8105 (NP) .58 CVS Pharmacy #8162 (NP) .66 CVS Pharmacy #8234 (NP) .62 PHARMACIES OF INDEX CVS Pharmacy #8106 (NP) .61 CVS Pharmacy #8163 (NP) .96 CVS Pharmacy #8238 (NP) .40 CVS Pharmacy #8107 (NP) .93 CVS Pharmacy #8164 CVS Pharmacy #8239 (NP) .67 CVS Pharmacy #8108 (NP) .43 (NP)...... 100 CVS Pharmacy #8240 (NP) .57 CVS Pharmacy #8109 (NP) .59 CVS Pharmacy #8165 (NP) .80 CVS Pharmacy #8241 (NP) .59 CVS Pharmacy #8110 (NP) .57 CVS Pharmacy #8166 (NP) .67 CVS Pharmacy #8242 (NP) .66 CVS Pharmacy #8111 (NP) .38 CVS Pharmacy #8167 (NP) .83 CVS Pharmacy #8244 (NP) .61 CVS Pharmacy #8112 (NP) .67 CVS Pharmacy #8170 (NP) .41 CVS Pharmacy #8246 (NP) .76 CVS Pharmacy #8113 (NP) .44 CVS Pharmacy #8172 (NP) .97 CVS Pharmacy #8247 (NP) .87 CVS Pharmacy #8114 (NP) .98 CVS Pharmacy #8173 (NP) .41 CVS Pharmacy #8261 (NP) .43 CVS Pharmacy #8115 (NP) .86 CVS Pharmacy #8174 (NP) .57 CVS Pharmacy #8262 (NP) .61 CVS Pharmacy #8117 (NP) .76 CVS Pharmacy #8175 (NP) .86 CVS Pharmacy #8267 (NP) .87 CVS Pharmacy #8118 CVS Pharmacy #8176 (NP) .95 CVS Pharmacy #8268 (NP) .28 (NP)...... 101 CVS Pharmacy #8178 (NP) .58 CVS Pharmacy #8269 (NP) .87 CVS Pharmacy #8119 (NP) .63 CVS Pharmacy #8179 (NP) .43 CVS Pharmacy #8270 (NP) .87 CVS Pharmacy #8121 (NP) .95 CVS Pharmacy #8180 (NP) .58 CVS Pharmacy #8272 (NP) .40 CVS Pharmacy #8122 (NP) .94 CVS Pharmacy #8181 (NP) .81 CVS Pharmacy #8275 (NP) .87 CVS Pharmacy #8123 (NP) .92 CVS Pharmacy #8183 (NP) .45 CVS Pharmacy #8276 (NP) .87 CVS Pharmacy #8125 (NP) .98 CVS Pharmacy #8184 (NP) .56 CVS Pharmacy #8277 (NP) .87 CVS Pharmacy #8126 (NP) . .8 CVS Pharmacy #8186 (NP) .86 CVS Pharmacy #8278 (NP) .23 CVS Pharmacy #8127 (NP) .64 CVS Pharmacy #8187 (NP) .57 CVS Pharmacy #8282 .....23 CVS Pharmacy #8128 (NP) .83 CVS Pharmacy #8189 (NP) .44 CVS Pharmacy #8283 (NP) .87 CVS Pharmacy #8129 (NP) .59 CVS Pharmacy #8190 (NP) .83 CVS Pharmacy #8284 (NP) .87 CVS Pharmacy #8130 (NP) .44 CVS Pharmacy #8191 (NP) .45 CVS Pharmacy #8287 (NP) .42 CVS Pharmacy #8131 (NP) .94 CVS Pharmacy #8194 (NP) .87 CVS Pharmacy #8290 (NP) .36 CVS Pharmacy #8132 (NP) .56 CVS Pharmacy #8196 (NP) .87 CVS Pharmacy #8291 (NP) .33 CVS Pharmacy #8134 (NP) .86 CVS Pharmacy #8197 (NP) .41 CVS Pharmacy #8292 (NP) .33 CVS Pharmacy #8135 (NP) .47 CVS Pharmacy #8198 (NP) .51 CVS Pharmacy #8293 (NP) .33 CVS Pharmacy #8136 (NP) .56 CVS Pharmacy #8199 (NP) .87 CVS Pharmacy #8295 (NP) .39 CVS Pharmacy #8137 (NP) .93 CVS Pharmacy #8200 (NP) .87 CVS Pharmacy #8297 (NP) .35 CVS Pharmacy #8138 (NP) .99 CVS Pharmacy #8204 (NP) .38 CVS Pharmacy #8299 (NP) .68 CVS Pharmacy #8139 (NP) .58 CVS Pharmacy #8208 (NP) .96 CVS Pharmacy #8300 (NP) .45 CVS Pharmacy #8140 (NP) .61 CVS Pharmacy #8209 (NP) .92 CVS Pharmacy #8301 (NP) .76 CVS Pharmacy #8141 (NP) .86 CVS Pharmacy #8210 (NP) .94 CVS Pharmacy #8304 (NP) .64 CVS Pharmacy #8143 (NP) .65 CVS Pharmacy #8211 (NP) .99 CVS Pharmacy #8306 (NP) .36

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 123 INDEX OF PHARMACIES

CVS Pharmacy #8307 (NP) .87 Dial Drugs (P) ...... 100 CVS Pharmacy #8308 (NP) .39 Diplomat Specialty Pharmacy E CVS Pharmacy #8416 (NP) .44 (NP) ...... 16, 33 Discount Rx (NP) ...... 16 Eagle Drugs Pharmacy (P) .98 Dix Drug Store (P) ...... 83 Eagle Pharmacy Of Farwell D Dix Family Care Pharmacy PC (NP)...... 11 (NP) ...... 83 East Ann Arbor Pharmacy D & W Pharmacy 1570 (P) .70 Dixboro Village (NP) ...... 79 D & W Pharmacy 1572 (P) .36 Pharmacy ...... 105, 115 East Jordan Family Pharmacy D & W Pharmacy 1573 (P) .33 Dixboro Village Pharmacy (P)...... 10 D & W Pharmacy 1574 (P) .70 (NP) ...... 79 East Village Pharmacy D & W Pharmacy 1575 . . .29 D.J. Jacobetti Home For (NP) ...... 83 D & W Pharmacy 1576 (P) .33 Veterans ...... 111 Eastborn Rx Pharmacy D & W Pharmacy 1577 (P) .32 D.J. Jacobetti Home For (NP) ...... 84 D & W Pharmacy 1588 (P) .31 Veterans ...... 49 Eastside Family Medical (Dr. D & W Pharmacy #1591 DMC Pharmacy Children’s Dubois) (P) ...... 50 (P)...... 33 (P)...... 87 Eastside Pharmacy (P) .....87 D & W Pharmacy #1903 . .26 DMC Pharmacy Chm Psc Eddies Medical Daring Advance Pharmacy (P)...... 87 Pharmacy ...... 116 (NP) ...... 65 DMC Pharmacy Detroit Eddies Medical Pharmacy Davis Cut Rate Drugs (NP).87 Receiving Hospital (P) ....87 (P)...... 88 Davob Pharmacy (NP) .....55 DMC Pharmacy Harper (P) .87 Efros Orchard Drug Co. Dearborn Family Pharmacy DMC Pharmacy Huron Valley (P)...... 68 LLC...... 115 (P)...... 57 Ehardt’s Pharmacy #1 (P) . .74 Dearborn Family Pharmacy DMC Pharmacy Hutzel (P) .87 Ehardt’s Pharmacy #2 (P) . .74 LLC(P)...... 83 DMC Pharmacy Sinai Grace Ehardt’s Pharmacy #4 (P) . .74 INDEX OF PHARMACIES Dearborn Heights Pharmacy (P)...... 87 Ehardt’s Pharmacy Inc #6 (P)...... 85 DMC Pharmacy Sinai Lobby (NP) ...... 37 Dearborn Hills Pharmacy .115 (P)...... 87 Eldercare Pharmacy .103, 108 Dearborn Hills Pharmacy DMC Pharmacy Stilson (P) .41 Eldercare Pharmacy ...... 12 (P)...... 83 Doctors Pharmacy (NP)....43 Elmer’s Pharmacy (P) ...... 12 Decatur Village Market Dollar Mart Pharmacy (NP).47 Elux Pharmacy (NP) ...... 88 Pharmacy (NP) ...... 77 Dorr Community Pharmacy Er Drugs...... 117 Dells Prescription Center (NP) ...... 2 Er Drugs (P) ...... 98 (P)...... 62 Dort Longway Pharmacy .103, Etel-Rx...... 111 Dells Prescription Center .113 108 Etel-Rx ...... 42 Delton Family Pharmacy, Inc. Dort Longway Pharmacy Evergreen Pharmacy (P) . . .88 (P)...... 4 (P)...... 16 Excel Community Pharmacy Desh Pharmacy LLC (NP) . .87 Downtown Drugs ...... 109 (P)...... 88 Detroit Community Health Downtown Drugs (P) ...... 27 Excel Pharmacy (NP) ...... 88 Connection Pharmacy Drug Max (P)...... 83 Express Scripts, Inc...... 102 (NP) ...... 87 Dunewood Pharmacy . . . .114 Detroit Hope Pharmacy Dunewood Pharmacy (NP) .70 (P)...... 61 Dykstra Drug Store (NP) . . .70 F Detroit Medical Pharmacy Dynamic Care Pharmacy. .113 (P)...... 87 Dynamic Care Pharmacy Fairlane Pharmacy Services Devz Pharmacy (NP) ...... 87 (NP) ...... 64 Corp. #3...... 105 Dexter Pharmacy And Fairlane Pharmacy Services Medical Supplies (NP) ....87 Corp. #3 ...... 65 Dexter Pharmacy (NP).....80 Fairway Drugs (P) ...... 42

124 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Falcon Health-Mart Family Fare Pharmacy 1992 Ford Tel Drugs (NP) ...... 85 Drugs ...... 117 (P)...... 9 Fort Street Pharmacy (NP) .94 Falcon Health-Mart Drugs Family Fare Pharmacy #239 Fortune Medical Pharmacy (P)...... 98 (P)...... 71 (P)...... 88 Faler Pharmacy Inc. (NP). . .73 Family Fare Pharmacy #254 Fowlerville Pharmacy (NP) .39 Family Care Pharmacy (P).101 (P)...... 33 Fox Hills Medimart ...... 112 Family Center Pharmacy Family Fare Pharmacy #265 Fox Hills Medimart (P).....56 (P)...... 85 (P)...... 35 Franklin Discount Pharmacy Family Drugs Inc. (P) ...... 88 Family Fare Pharmacy #335 (NP) ...... 45 Family Drugs Pharmacy #3 (P)...... 33 Franklin Medical Pharmacy Inc. (P)...... 85 Family Fare Pharmacy #339 (P)...... 94 Family Drugs Pharmacy (P)...... 33 Franks Drugs (NP) ...... 81 (P)...... 88, 97 Family Fare Pharmacy #408 Franks Pharmacy Advanced Family Fare Pharmacy #107 (P)...... 36 Care (NP) ...... 41 (P)...... 36 Family Fare Pharmacy #636 Fraser Drugs #52 (P) ...... 88

Family Fare Pharmacy #108 (P)...... 33 Frd Sav-Mor Pharmacy . . .116 PHARMACIES OF INDEX (P)...... 71 Family Fare-Forest Hills Frd Sav-Mor Pharmacy (P) .93 Family Fare Pharmacy #115 Pharmacy (P) ...... 34 Fred’s Supermarket Pharmacy (P)...... 32 Family Health Care Pharmacy (NP) ...... 77 Family Fare Pharmacy #116 ...... 55 Fred’s Vicksburg Community (P)...... 71 Family Health Center Pharmacy (NP) ...... 32 Family Fare Pharmacy #119 Pharmacy ...... 29 Freeland Pharmacy (NP) . . .72 (P)...... 32 Family Health Center Friendz Pharmacy ...... 88 Family Fare Pharmacy #122 Pharmacy-South ...... 29 Fruin Pharmacy ...... 13 (P)...... 70 Family Pharmacy ...... 117 Future Drugs...... 115 Family Fare Pharmacy #123 Family Pharmacy (P)...... 97 Future Drugs ...... 84 (P)...... 2 Family Pharmacy Sw Campus Family Fare Pharmacy #137 (NP) ...... 32 (P)...... 70 Farmacia Garcia (NP)...... 88 G Family Fare Pharmacy #1579 Farmbrook Pharmacy . . . .113 (P)...... 35 Farmbrook Pharmacy (NP) .65 Gabecare Direct Rx Inc. Family Fare Pharmacy #1580 Farmington Drugs And (P)...... 66 (P)...... 36 Medical Supplies (P) .....95 Galesburg Village Drug . . .29 Family Fare Pharmacy #1586 Farmington Hills Medical Galleria Pharmacy (NP) ....97 (P)...... 33 Pharmacy (NP) ...... 58 Garden City Hospital Family Fare Pharmacy #1587 Farmington Village Pharmacy Outpatient Pharmacy (P)...... 33 (NP) ...... 57 (NP) ...... 92 Family Fare Pharmacy #1589 Felpausch Coldwater Garden Drugs P.C. (P) .....92 (P)...... 71 Pharmacy #1955 (P) ...... 8 Garfield Pharmacy Inc. (P) .41 Family Fare Pharmacy #1904 Felpausch Eaton Rapids Gateway Pharmacy Inc. (P).88 (P)...... 9 Pharmacy #1994 (P) ...... 13 Gateway Pharmacy Of Clare, Family Fare Pharmacy #1972 Felpausch Paw Paw Inc. (NP) ...... 11 (P)...... 9 Pharmacy #1980 ...... 78 Genesys Health Enterprises Family Fare Pharmacy 1975 Fife Lake Pharmacy (NP). . .19 Inc...... 103 ...... 10 First Choice Pharmacy Genesys Health Enterprises Family Fare Pharmacy #1979 (NP) ...... 53 Inc...... 16 (P)...... 9 Flatrock City Pharmacy . . .116 Genesys Regional Medical Family Fare Pharmacy #1990 Flatrock City Pharmacy (P) .92 Center ...... 18 (P)...... 4 Focus Pharmacy (NP)...... 47 Genoa Healthcare ...... 110 Foodtown Drugs (P)...... 51 Genoa Healthcare ...... 6

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 125 INDEX OF PHARMACIES

Genoa Pharmacy Michigan, Great Lakes Pharmacy Of Hawthorn Center ...... 96 LLC...... 107 Midland ...... 111 Hawthorn Center ...... 116 Genoa Pharmacy Michigan, Great Lakes Pharmacy Of H-Care Pharmacy ...... 103 LLC...... 9 Midland (P) ...... 50 H-Care Pharmacy (P) ...... 16 Gibraltar Pharmacy Inc. (P).93 Greenfield Pharmacy Inc. .84 Health Care Pharmacy (P). .84 Gilberts Drug Store (P) ....27 Grices Pharmacy (P)...... 35 Health Delivery Pharmacy Gillespie Pharmacy ...... 7 Griswold Pharmacy (NP) . . .88 (P)...... 73 Glen’s Pharmacy #1504 (P).10 Grover Pharmacy (NP).....53 Health Dimensions Inc (P). .58 Glen’s Pharmacy #1507 Gull Pointe Pharmacy .....30 Health Plus Pharmacy Of (Brooks Pharmacy) (P) .....4 Brighton (P) ...... 38 Glen’s Pharmacy #1510 (P).69 Health Plus Pharmacy (P) . .82 Glen’s Pharmacy #1511 (P).12 H Health Sense Pharmacy And Glen’s Pharmacy #1512 (P).20 Food (P) ...... 60 Glen’s Pharmacy #1513 (P).32 Hackley Healthcare Eqpt. Health Smart Pharmacy (P).82 Glen’s Pharmacy #1517 (P).10 Pharmacy (P) ...... 53 Health System Pharmacy Glen’s Pharmacy #1523 (P).11 Hackley Pharmacy - Glenside (NP) ...... 9 Glens Pharmacy #1524 (P) .19 (P)...... 53 Healthfirst Pharmacy (P) . . .74 Glen’s Pharmacy #1531 (P).11 Hackley Pharmacy - Wolf Healthplus Specialty Glen’s Pharmacy #641 (P). .19 Lake (NP) ...... 53 Pharmacy ...... 115 Glen’s Pharmacy #645 (P) . . .3 Hackley Professional Healthplus Specialty Glen’s Pharmacy #647 (P). .48 Pharmacy (NP) ...... 53 Pharmacy (P) ...... 79 Glen’s Pharmacy #648 (P).101 Haggerty Drugs & Medical Healthsource Saginaw Global Health Pharmacy Supplies Inc. (P) ...... 82 Inc...... 114 (NP) ...... 62 Hale Pharmacy (NP)...... 27 Healthway Pharmacy (NP) .74 Glory Care Pharmacy . . . .117 Hamilton Burton Pharmacy Healthy Choice Pharmacy Glory Care Pharmacy (P). . .97 ...... 15 (P)...... 88 INDEX OF PHARMACIES Glovers Rexall Pharmacy Hamilton Family Pharmacy Healthy Drugs...... 116 (NP) ...... 50 (P)...... 2 Healthy Drugs (NP) ...... 92 Gobles Pharmacy (P) ...... 77 Hamilton Main Pharmacy .16 Healthy Living Pharmacy Goddard Discount Drugs .117 Hamtramck Drugs ...... 93 (NP) ...... 60 Goddard Discount Drugs Hamzeh Pharmacy (P) .....84 Heart Of The City Pharmacy (P)...... 98 Hannahville Health Center (NP) ...... 34 Goddard Discount Pharmacy Pharmacy ...... 118 Heartland Drugs (NP) . . . .100 (P)...... 98 Hannahville Health Center Heartland Home Health Care Gog Pharmacy (P) ...... 94 Pharmacy (NP) ...... 50 And Hospice ...... 106 Good Health Pharmacy Hansen Pharmacy (NP) ....52 Heartland Home Health Care (NP) ...... 61 Harbor Drug ...... 109 And Hospice ...... 95 Good Neighbors Family Harbor Drug #2 ...... 114 Hemlock Pharmacy (NP) . . .72 Pharmacy (P) ...... 100 Harbor Drug #2 (NP) ...... 74 Hemmingsen Drug Store Inc. Grand Rapids Home For Harbor Drug (NP)...... 22 (P)...... 9 Veterans ...... 110 Harbor Town Pharmacy Inc Henry Ford Macomb Grand Rapids Home For (NP) ...... 69 Ambulatory Pharmacy #1 Veterans ...... 35 Harding’s Pharmacy ...... 7 (NP) ...... 41 Grand Value Pharmacy (P) .88 Harding’s Pharmacy (P) .2, 30, Henry Ford Macomb Grant Pharmacy ...... 113 31, 32 Ambulatory Pharmacy #2 Grant Pharmacy (P) ...... 65 Harper Drugs (P) ...... 88 (P)...... 40 Grass Lake Community Harvest Pharmacy Inc. Henry Ford Medical Center Pharmacy ...... 109 (NP) ...... 12 Pharmacy - Canton (NP) . .82 Grass Lake Community Haslett Pharmacy (P) ...... 22 Pharmacy (P) ...... 28 Haveman Pharmacy (P) ....55

126 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Henry Ford Medical Center Henry Ford Pharmacy Pharmacy - Detroit East Advantage Southfield (P) .66 I (NP) ...... 88 Henry Ford Wyandotte Henry Ford Medical Center Ambulatory Pharmacy IDM Pharmacy (P)...... 60 Pharmacy - Detroit Nw (P)...... 101 Index Meds ...... 113 (NP) ...... 88 Henry Ford Wyandotte CHS Index Meds (NP)...... 62 Henry Ford Medical Center Pharmacy (P) ...... 82 Indian River Village Pharmacy Pharmacy - Fairlane (NP) .84 Hera Pharmacy (NP)...... 47 (NP) ...... 11 Henry Ford Medical Center Heritage Pharmacy Indian Village Pharmacy . . .88 Pharmacy - K-15 (NP) ....88 Services ...... 113 Infusion Partners...... 104 Henry Ford Medical Center Heritage Pharmacy Services Infusion Partners (P)...... 55 Pharmacy - Lakeside (NP).45 ...... 65 Inkster Pharmacy (NP) .....94 Henry Ford Medical Center Heyden Pharmacy (NP) ....88 Integrated Pharmacy Pharmacy - Livonia (NP) . .95 Highland Pharmacy (NP). . .67 Network ...... 104, 112 Henry Ford Medical Center Hillman Pharmacy (NP) ....53 Integrated Pharmacy

Pharmacy - Lobby (NP) . . .88 Hills Pharmacy Of Vicksburg Network ...... 50 PHARMACIES OF INDEX Henry Ford Medical Center ...... 32 Ithaca Pharmacy (P) ...... 27 Pharmacy - Southfield Hills Prescription Shop ....78 (NP) ...... 65 Hillsdale Market Pharmacy Henry Ford Medical Center (P)...... 21 J Pharmacy - St.clair Shrs Himson Pharmacy (NP) ....81 (NP) ...... 45 Hira’s Pharmacy (NP) ...... 52 Jana Drugs (NP) ...... 94 Henry Ford Medical Center Holiday Pharmacy P.L.L.C. Jefferson Pharmacy (NP). . .88 Pharmacy - Sterling Hts (P)...... 45 Jensen’s Community (NP) ...... 45 Holihans Drug Store (NP) . .69 Pharmacy (NP) ...... 80 Henry Ford Medical Center Home IV Care Inc...... 104 Jerry’s Pharmacy (NP) .....51 Pharmacy - Taylor-364415 Home IV Care Inc...... 60 Jordan’s Discount Pharmacy (NP) ...... 98 Home Town Pharmacy (NP) ...... 88 Henry Ford Medical Center Ltc...... 115 Joy Pharmacy (NP)...... 92 Pharmacy - Troy (NP).....66 Home Town Pharmacy Ltc .80 Julias Pharmacy ...... 115 Henry Ford Medical Center Homescripts (NP) ...... 66 Julias Pharmacy (P) ...... 84 Pharmacy - W. Bloomfield Hometown Pharmacy # 36 Junction Clinic Pharmacy (NP) ...... 68 (P)...... 69 (NP) ...... 88 Henry Ford Medical Center Hometown Pharmacy #33 Pharmacy - Woodhaven (P)...... 54 (NP)...... 100 Hometown Pharmacy #34 .11 K Henry Ford Medical Center Hometown Pharmacy #35 Pharmacy Columbus (NP).61 (P)...... 54 Kalamazoo Long Term Henry Ford Medical Center Hometown Pharmacy Ltc .110 Care...... 109 Pharmacy Farmington Hometown Pharmacy Ltc .31, Kalamazoo Long Term Care (NP) ...... 68 36 ...... 30 Henry Ford Medical Center Hometown Pharmacy Of Kalamazoo Psychiatric Pharmacy (NP) ...... 93, 96 Lapeer PLLC (P) ...... 37 Hospital ...... 109 Henry Ford New Center Hoover Pharmacy LLC (P). .47 Kalamazoo Psychiatric Pharmacy (NP) ...... 88 Hopps Pharmacy (NP) ...... 9 Hospital ...... 30 Henry Ford One Ford Place Hudson Pharmacy (P) .....38 Kay Pharmacy (P) ...... 34 Pharmacy (NP) ...... 88 Huff Pharmacy (NP) ...... 10 KD Pharmacy Inc. #1704 Henry Ford Pharmacy Hunter’s Pharmacy (P) .....94 (P)...... 88 Advantage Main Campus Kec Pharmacy (NP) ...... 79 (P)...... 88 Kelbel Pharmacy (NP) .....14

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 127 INDEX OF PHARMACIES

Kendallwood Family Kmart Pharmacy #4163 Knight Drugs - Lansing Inc. Pharmacy (NP) ...... 58 (P)...... 100 ...... 23 Keweenaw Bay Indian Kmart Pharmacy #4177 (P).45 Knight Drugs - Mcnichols Community...... 103, 118 Kmart Pharmacy #4204 (P).47 #1700 (P) ...... 89 Keweenaw Bay Indian Kmart Pharmacy #4206 (P).47 Knight Drugs Inc. #0741 Community (P) ...... 4 Kmart Pharmacy #4331 (P).67 (P)...... 89 Keystone Pharmacy ...... 34 Kmart Pharmacy #4382 . . .23 Knight Prescription Ltd King Pharmacy (NP)...... 88 Kmart Pharmacy #4405 (P).41 #1000 (P) ...... 89 Kings Pharmacy (P) ...... 84 Kmart Pharmacy #4430 (P).95 Kroger Co #16576 (P) .....80 Kingsley Pharmacy (NP) . . .19 Kmart Pharmacy #4481 (P).97 Kroger Co #16577 (P) .....51 Kingsway Medical Pharmacy Kmart Pharmacy #4488 (P).63 Kroger Co #16578 (P) .....52 (NP) ...... 99 Kmart Pharmacy #4700 (P).16 Kroger Co #16579 (P) .....52 Kirk’s Family Pharmacy . . .108 Kmart Pharmacy #4795 (P).71 Kroger Co #16651 (P) .....59 Kirk’s Family Pharmacy (P) .16 Kmart Pharmacy #4796 (P).52 Kroger Co #16709 (P) .....56 Kmart Pharmacies (P)...... 1 Kmart Pharmacy #4845 (P).49 Kroger Co #16715 (P) .....76 Kmart Pharmacy #3009 (P).19 Kmart Pharmacy #4851 (P).32 Kroger Co #16721 (P) .....39 Kmart Pharmacy #3126 (P).44 Kmart Pharmacy #4995 (P).98 Kroger Co #16724 (P) .....43 Kmart Pharmacy #3155 (P).82 Kmart Pharmacy #4998 (P).43 Kroger Co Of Michigan #115 Kmart Pharmacy #3279 (P).15 Kmart Pharmacy #7014 (P).27 (P)...... 16 Kmart Pharmacy #3308 (P).59 Kmart Pharmacy #7031 (P).50 Kroger Co Of Michigan Kmart Pharmacy #3327 (P).45 Kmart Pharmacy #7068 (P).50 #16864 (P) ...... 51 Kmart Pharmacy #3351 (P).53 Kmart Pharmacy #7205 (P).34 Kroger Co Of Michigan Kmart Pharmacy #3379 (P).67 Kmart Pharmacy #7504 (P).56 #18720 (P) ...... 39 Kmart Pharmacy #3546 (P).41 Kmart Pharmacy #7524 (P).73 Kroger Co Of Michigan Kmart Pharmacy #3570 (P).43 Kmart Pharmacy #7634 (P).76 #18738 (P) ...... 73 Kmart Pharmacy #3575 (P).60 Kmart Pharmacy #7660 (P).74 Kroger Co Of Michigan #277 INDEX OF PHARMACIES Kmart Pharmacy #3720 (P).20 Kmart Pharmacy #7733 (P) . .3 (P)...... 51 Kmart Pharmacy #3723 (P).68 Kmart Pharmacy #9026 (P).76 Kroger Co Of Michigan #406 Kmart Pharmacy #3730 (P).61 Kmart Pharmacy #9065 (P).12 (P)...... 15 Kmart Pharmacy #3804 (P).12 Kmart Pharmacy #9245 (P).10 Kroger Co Of Michigan #436 Kmart Pharmacy #3805 (P).49 Kmart Pharmacy #9385 (P).15 (P)...... 72 Kmart Pharmacy #3819 (P) . .4 Kmart Pharmacy #9593 (P).26 Kroger Co Of Michigan #486 Kmart Pharmacy #3820 (P).10 Kmart Pharmacy #9640 (P).20 (P)...... 47 Kmart Pharmacy #3821 (P).14 Kmart Pharmacy #9745 (P).21 Kroger Co Of Michigan #487 Kmart Pharmacy #3832 (P).19 Kmart Pharmacy #9814 (P).89 (P)...... 66 Kmart Pharmacy #3833 (P).12 Knight Detroit Medical Kroger Co Of Michigan #492 Kmart Pharmacy #3841 (P).10 Center Pharmacy #1039 (P)...... 63 Kmart Pharmacy #3864 (P).69 (P)...... 89 Kroger Co Of Michigan #515 Kmart Pharmacy #3938 (P).28 Knight Drugs - Chesaning (P)...... 76 Kmart Pharmacy #3959 (P).38 LLC #1705 (P) ...... 72 Kroger Co Of Michigan #520 Kmart Pharmacy #4000 (P).92 Knight Drugs - Davison (P)...... 81 Kmart Pharmacy #4059 (P).98 #1001 (P) ...... 89 Kroger Co Of Michigan #526 Kmart Pharmacy #4065 (P) . .9 Knight Drugs - Grand Blanc (P)...... 60 Kmart Pharmacy #4066 (P).28 #1701 (P) ...... 18 Kroger Co Of Michigan #528 Kmart Pharmacy #4083 (P).16 Knight Drugs - Grand River (P)...... 41 Kmart Pharmacy #4091 (P) . .5 #0745 (P) ...... 89 Kroger Co Of Michigan #600 Kmart Pharmacy #4098 (P).52 Knight Drugs - Greenfield (P)...... 37 Kmart Pharmacy #4105 (P).79 #1010 (P) ...... 89 Kroger Co Of Michigan #602 Kmart Pharmacy #4106 (P).81 Knight Drugs - Highland Park (P)...... 47 #1007 (P) ...... 94

128 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Kroger Co Of Michigan #605 Kroger Co Of Michigan #679 Kroger Co Of Michigan #888 (P)...... 79 (P)...... 68 (P)...... 23 Kroger Co Of Michigan #615 Kroger Co Of Michigan #680 Kroger Co Of Michigan #889 (P)...... 95 (P)...... 28 (P)...... 27 Kroger Co Of Michigan #618 Kroger Co Of Michigan #681 Kroger Co Of Michigan #890 (P)...... 95 (P)...... 21 (P)...... 22 Kroger Co Of Michigan #619 Kroger Co Of Michigan #683 Kroger Co Of Michigan (P)...... 58 (P)...... 42 #J-978 (P)...... 76 Kroger Co Of Michigan #620 Kroger Co Of Michigan #684 Kroger Co Of Michigan (P)...... 56 (P)...... 42 Pharmacies (P)...... 1 Kroger Co Of Michigan #629 Kroger Co Of Michigan #685 Kroger Company Of (P)...... 57 (P)...... 56 Michigan #711 (P) ...... 18 Kroger Co Of Michigan #630 Kroger Co Of Michigan #686 Kroger (P) . . .5, 16, 17, 18, 73 (P)...... 100 (P)...... 98 Kroger Pharmacy 18716 Kroger Co Of Michigan #632 Kroger Co Of Michigan #688 (P)...... 42

(P)...... 61 (P)...... 79 Kroger Pharmacy #441 (P) .85 PHARMACIES OF INDEX Kroger Co Of Michigan #634 Kroger Co Of Michigan #689 Kroger Pharmacy #442 (P) .96 (P)...... 67 (P)...... 81 Kroger Pharmacy #444 (P) .39 Kroger Co Of Michigan #635 Kroger Co Of Michigan #691 Kroger Pharmacy #445 (P) .45 (P)...... 6 (P)...... 100 Kroger Pharmacy #448 (P) .66 Kroger Co Of Michigan #637 Kroger Co Of Michigan #693 Kroger Pharmacy #449 (P) .45 (P)...... 62 (P)...... 94 Kroger Pharmacy #450 (P) .75 Kroger Co Of Michigan #638 Kroger Co Of Michigan #695 Kroger Pharmacy #454 (P) .93 (P)...... 38 (P)...... 98 Kroger Pharmacy #455 (P) .44 Kroger Co Of Michigan #639 Kroger Co Of Michigan #697 Kroger Pharmacy #458 (P) .82 (P)...... 64 (P)...... 84 Kroger Pharmacy #461 (P) .48 Kroger Co Of Michigan #642 Kroger Co Of Michigan #700 Kroger Pharmacy #463 (P) .66 (P)...... 58 (P)...... 92 Kroger Pharmacy #464 (P) .66 Kroger Co Of Michigan #649 Kroger Co Of Michigan #703 Kroger Pharmacy #465 (P) .37 (P)...... 62 (P)...... 83 Kroger Pharmacy #495 (P) .45 Kroger Co Of Michigan #650 Kroger Co Of Michigan #704 Kroger Pharmacy #714 (P) .15 (P)...... 62 (P)...... 44 Kroger Pharmacy #811 (P) .12 Kroger Co Of Michigan #658 Kroger Co Of Michigan #706 Kronner Pharmacy (P) .....72 (P)...... 65 (P)...... 43 Kroger Co Of Michigan #659 Kroger Co Of Michigan #707 (P)...... 68 (P)...... 81 L Kroger Co Of Michigan #661 Kroger Co Of Michigan #708 (P)...... 58 (P)...... 82 La Pharmacy ...... 115 Kroger Co Of Michigan #663 Kroger Co Of Michigan #710 La Pharmacy (P) ...... 84 (P)...... 44 (P)...... 94 Labrenz Pharmacy (NP) .....6 Kroger Co Of Michigan #670 Kroger Co Of Michigan #782 Lac Vieux Desert Health (P)...... 97 (P)...... 64 Center Pharmacy ...... 118 Kroger Co Of Michigan #671 Kroger Co Of Michigan #793 Lac Vieux Desert Health (P)...... 82 (P)...... 25 Center Pharmacy (P) .....19 Kroger Co Of Michigan #673 Kroger Co Of Michigan #795 Lafayette Drugs (NP) ...... 89 (P)...... 45 (P)...... 75 Lakeland Home Infusion . .103 Kroger Co Of Michigan #674 Kroger Co Of Michigan #884 Lakeland Home Infusion . . .6 (P)...... 47 (P)...... 23 Lakeland Medical Center - St. Kroger Co Of Michigan #675 Kroger Co Of Michigan #887 Joseph ...... 8 (P)...... 67 (P)...... 23

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 129 INDEX OF PHARMACIES

Lakeland Pharmacy Livonia Care Pharmacy . . .106 Martin K Pharmacy (NP) . . .89 Berrien ...... 107 Livonia Care Pharmacy (P) .95 Martins Pharmacy #19 (P) . . .7 Lakeland Pharmacy Berrien .7 Long Term Care - Nash Martins Pharmacy #21 (P) . . .8 Lakeland Pharmacy Shoppe Drugs ...... 109 Martins Pharmacy #23 .....8 ...... 8 Long Term Care - Nash Martz & Shapley Pharmacy Lakes Professional Pharmacy Drugs ...... 21 (P)...... 50 (NP) ...... 68 Longe Drugs 1, Inc. (NP) . .28 Maya Pharmacy (NP) ...... 84 Lakeshore Medical Lor Ven Pharmacy ...... 112 McLaren Drug Shop - Amb Pharmacy ...... 111 Lor Ven Pharmacy (NP) ....59 (P)...... 5 Lakeshore Medical Pharmacy Ls Pharmacy (NP) ...... 59 McLaren Drug Shop - Brmc (P)...... 41 Lt Pharmacare...... 111 (P)...... 5 Lakeside Pharmacy (P).....42 LtcMedExDirect...... 111 McLaren Drug Shop - Irmcg Lakeview Specialty LtcMedExDirect(P).....47 (P)...... 23 Pharmacy ...... 111 Ltc Pharmacy...... 110 McLaren Drug Shop - Irmcp Lakeview Specialty Pharmacy Ltc Pharmacy ...... 35 ...... 24 (NP) ...... 45 Luea Pharmacy (NP)...... 18 McLaren Drug Shop - Lrmc Lambert Health Clinic Lytle Pharmacy (NP)...... 63 (P)...... 37 Pharmacy ...... 118 McLaren Drug Shop - Mcrmc Lambert Health Clinic (P)...... 43 Pharmacy (P) ...... 40 M McLaren Drug Shop - Mm Lances Pharmacy (NP).....89 (P)...... 6 L’Anse Pharmacy Inc...... 107 M & D Pharmacy ...... 89 McLaren Drug Shop - Mrmc L’Anse Pharmacy Inc...... 4 Macdonald Drug Store (P)...... 16 Lansing Community (NP) ...... 78 McLaren Drug Shop - Vassar Pharmacy (P) ...... 23 Mackinac Straits Hospital (P)...... 77 Lapeer Community Pharmacy Pharmacy ...... 110 McLaren Drug Shop - Wsmm INDEX OF PHARMACIES LLC(P)...... 37 Mackinac Straits Hospital (P)...... 5 Larmours Village Drug (P). . .9 Pharmacy (NP) ...... 40 McLaren Home Medical . .103 Lawton Pharmacy ...... 78 Mack’s Discount Pharmacy McLaren Home Medical . .17 Layerer’s Pharmacy (P)...... 5 (NP) ...... 89 McLaren Long Term Care Lefave Pharmacy & Home Maclean Pharmacy (P) .....11 Pharmacy ...... 107 Medical Equipment, Inc. Macomb Pharmacy (NP) . . .46 McLaren Long Term Care (P)...... 3 Madison Pharmacy Inc (P) .60 Pharmacy ...... 5 Leppinks Pharmacy ...... 26 Main Street Pharmacy McLean Pharmacy (P) .....71 Leppinks Pharmacy (NP) . .53, (NP) ...... 74 McNichols Drugstore 71 Majestic Pharmacy (NP) . . .65 LLC...... 116 Leslie Welcome Pharmacy .25 Manchester Pharmacy (P) . .80 McNichols Drugstore LLC Lewis Family Pharmacy . . .61 Manistique Tribal Health (P)...... 89 Liberty Pharmacy Inc. (NP) .89 Clinic Pharmacy ...... 118 Mecosta County Medical Lifecare Pharmacy (P) .....95 Manistique Tribal Health Center ...... 50 Lincare Inc...... 104 Clinic Pharmacy (P) ...... 74 Med/Rx(P)...... 81 Lincare Inc...... 35 Manley’s Pharmacy (NP) . . .77 MedExDirect(P)...... 47 Lincoln Drugs (NP) ...... 61 Maple Valley Pharmacy ....5 Med Index Pharmacy . . . .113 Lincoln Pharmacy (NP)...... 2 Maplewood Pharmacy (P). . .5 Med Index Pharmacy (NP) .66 Linden Pharmacy (NP) .....16 Marinco Drug (P) ...... 59 Med Right Pharmacy LLC Live Well Pharmacy (P) ....59 Marquette General Hospital (P)...... 95 Livernois Express Pharmacy Pharmacy ...... 104 Med-Care Pharmacy (NP) . .60 (P)...... 89 Marquette General Hospital Medcart Pharmacy (NP) . . .55 Livernois Family Pharmacy Pharmacy ...... 49 Medcart Pharmacy (NP) ...... 89 Marshall Pharmacy (NP) . . .85 Solutions ...... 116

130 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Medcart Pharmacy Solutions Meijer Pharmacy #034 (P). .64 Meijer Pharmacy #187 (P). . .5 ...... 95 Meijer Pharmacy #035 (P). .98 Meijer Pharmacy #188 (P). .95 Medcart Specialty Meijer Pharmacy #036 (P). .36 Meijer Pharmacy #191 (P). . .3 Pharmacy ...... 106, 116 Meijer Pharmacy #041 .....6 Meijer Pharmacy #193 (P). .49 Medcart Specialty Pharmacy Meijer Pharmacy #042 (P). .73 Meijer Pharmacy #194 ....13 (NP) ...... 95 Meijer Pharmacy #043 (P). .73 Meijer Pharmacy #195 (P). . .9 Medcenter Pharmacy (NP) .56 Meijer Pharmacy #044 (P). .17 Meijer Pharmacy #196 (P). .31 Medex Health Mart (P) ....89 Meijer Pharmacy #045 (P). .38 Meijer Pharmacy #197 (P). .62 Medex Pharmacy (NP).....84 Meijer Pharmacy #046 (P). .38 Meijer Pharmacy #199 (P). .33 Medical Center Pharmacy Meijer Pharmacy #047 (P). .70 Meijer Pharmacy #201 (P). .52 (NP) ...... 66 Meijer Pharmacy #048 (P). . .5 Meijer Pharmacy #203 (P). .50 Medical Park Pharmacy Meijer Pharmacy #050 (P). .34 Meijer Pharmacy #205 (P). .35 (NP) ...... 56 Meijer Pharmacy #052 (P). .22 Meijer Pharmacy #209 (P). .11 Medicap (NP) ...... 15 Meijer Pharmacy #053 (P). .67 Meijer Pharmacy #210 ....13 Medicap Pharmacy #182 Meijer Pharmacy #054 (P). .96 Meijer Pharmacy #213 (P). .72

(NP) ...... 47 Meijer Pharmacy #055 (P). .46 Meijer Pharmacy #216 (P). .34 PHARMACIES OF INDEX Medicine Cabinet (NP) ....65 Meijer Pharmacy #056 (P). .28 Meijer Pharmacy #217 (P). .70 Medicine Room Progressive Meijer Pharmacy #057 (P). .63 Meijer Pharmacy #221 (P). .35 Pharmacy (NP) ...... 62 Meijer Pharmacy #063 (P). .44 Meijer Pharmacy #222 (P). .60 Medicine Tree Pharmacy . .78 Meijer Pharmacy #064 (P). .79 Meijer Pharmacy #227 (P). .68 Medina Pharmacy (P)...... 84 Meijer Pharmacy #065 (P). .46 Meijer Pharmacy #229 (P). .75 Medpark Pharmacy (P) ....59 Meijer Pharmacy #067 (P). .52 Meijer Pharmacy #231 (P). .65 Medplus Care Pharmacy Meijer Pharmacy #068 Meijer Pharmacy #232 (P). .53 LLC...... 116 (P)...... 100 Meijer Pharmacy #233 (P). .81 Medplus Care Pharmacy LLC Meijer Pharmacy #069 (P). .27 Meijer Pharmacy #237 (P). .47 (P)...... 89 Meijer Pharmacy #070 Meijer Pharmacy #242 (P). .42 Medpointe Pharmacy (P) . .42 (P)...... 100 Meijer Pharmacy #243 (P). .41 Medsmart Pharmacy .....111 Meijer Pharmacy #071 (P). .54 Meijer Pharmacy #244 (P). .15 Medsmart Pharmacy (NP). .47 Meijer Pharmacy #072 (P). .82 Meijer Pharmacy #245 (P). .39 Medstar Pharmacy ...... 113 Meijer Pharmacy #105 (P). .40 Meijer Pharmacy #248 (P). .33 Medstar Pharmacy ...... 62 Meijer Pharmacy #108 (P). .51 Meijer Pharmacy #250 (P). .69 Medwins Pharmacy (NP). . .73 Meijer Pharmacy #109 (P). .57 Meijer Pharmacy #251 (P). . .8 Meijer Inc. #208 (P) ...... 94 Meijer Pharmacy #113 (P). .74 Meijer Pharmacy #253 (P). .22 Meijer Pharmacies (P) ...... 1 Meijer Pharmacy #119 (P). .30 Meijer Pharmacy #257 (P). .14 Meijer Pharmacy #011 (P). .34 Meijer Pharmacy #122 (P). .68 Meijer Pharmacy #259 (P). .18 Meijer Pharmacy #016 (P). . .9 Meijer Pharmacy #123 (P). .98 Meijer Pharmacy #260 (P). .63 Meijer Pharmacy #019 (P). .53 Meijer Pharmacy #140 (P). .37 Meijer Pharmacy #303 (P). .26 Meijer Pharmacy #020 (P). .34 Meijer Pharmacy #145 (P). .42 Meijer Pharmacy #312 (P). .34 Meijer Pharmacy #021 (P). .30 Meijer Pharmacy #158 (P). .34 Meijer Pharmacy Inc. #226 Meijer Pharmacy #022 ....31 Meijer Pharmacy #163 (P). .75 (P)...... 36 Meijer Pharmacy #023 (P). .24 Meijer Pharmacy #171 Melvindale Pharmacy (NP) .96 Meijer Pharmacy #024 (P). .24 (P)...... 101 Memphis Drugs (P) ...... 43 Meijer Pharmacy #025 (P). .25 Meijer Pharmacy #172 (P). .39 Menard Pharmacy (NP) ....98 Meijer Pharmacy #026 (P). .71 Meijer Pharmacy #173 (P). .79 Mercury Drugs (P) ...... 60 Meijer Pharmacy #027 (P). .81 Meijer Pharmacy #174 ....25 Mercury Pharmacy (NP) . . .89 Meijer Pharmacy #028 (P). .17 Meijer Pharmacy #175 (P). .77 Mercy Hospital Grayling Meijer Pharmacy #029 (P). .15 Meijer Pharmacy #177 (P). .48 Pharmacy ...... 108 Meijer Pharmacy #030 (P). .28 Meijer Pharmacy #179 (P). . .8 Mercy Hospital Grayling Meijer Pharmacy #032 (P). .82 Meijer Pharmacy #180 (P). .70 Pharmacy (NP) ...... 12 Meijer Pharmacy #033 (P). .19 Meijer Pharmacy #185 (P). .55

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 131 INDEX OF PHARMACIES

Mercy Hospital Pharmacy Munson Community Health Northern Michigan Hospital (NP)...... 101 Ctr Pharmacy ...... 109 Pharmacy ...... 108 Mercy Memorial Macomb Munson Community Health Northern Michigan Hospital Pharmacy (NP) ...... 52 Ctr Pharmacy (NP) ...... 19 Pharmacy ...... 14 Mercy Outpatient Pharmacy Munson Hospital Northgate Pharmacy Inc. (NP) ...... 76 Pharmacy ...... 103 (NP) ...... 21 Merit Woods Pharmacy (P).93 Munson Hospital Pharmacy Northland Food Center, Inc. Merriman Drugs (NP) .....95 (NP) ...... 19 (P)...... 19 Mesick Pharmacy (NP) . . .101 Muskegon Family Care Northland Medical Building Metropolitan Pharmacy Pharmacy (NP) ...... 53 Pharmacy (NP) ...... 65 (NP) ...... 97 My Solutions Pharmacy (P).92 Northline Drugs One (P). . .98 Mid Michigan Infusion Northville Pharmacy (NP) . .96 Care...... 104 Norway Pharmacy (P) .....13 Mid Michigan Infusion Care N Notre Dame Pharmacy ...... 51 (NP) ...... 93 Mike’s Family Pharmacy Nadia’s Pharmacy ...... 84 Nottingham Pharmacy (P)...... 53 Narayan Drugs And (NP) ...... 89 Mike’s Pharmacy...... 110 Pharmacy (NP) ...... 37 Novi Drug Co. (P)...... 61 Mike’s Pharmacy (P)...... 38 Nash Drugs (P) ...... 21 Milford Sav-Mor Neighborhood Pharmacy Pharmacy ...... 113 (NP) ...... 89 O Milford Sav-Mor Pharmacy Neiman’s Family Pharmacy - (P)...... 60 St. Clair (P)...... 76 Oak Park Pharmacy (P) ....62 Miller’s Pharmacy Inc. (P) . . .8 Neimans Family Pharmacy Oakland Drugs (P) ...... 58 Mills Pharmacy & (P)...... 3 Oakman Medical Pharmacy Apothecary ...... 112 New Boston Rx Pharmacy ...... 84 INDEX OF PHARMACIES Mills Pharmacy & Apothecary (NP) ...... 96 Oakwood Pharmacy - Canton (P)...... 56 New Buffalo Pharmacy (P) . .7 (NP) ...... 82 Minal Pharmacy (NP) ...... 89 New Hope Pharmacy (NP) .89 Oakwood Pharmacy - Mission Pharmacy (P)...... 28 New Hudson Discount Dearborn (NP)...... 84 Model Drug (NP) ...... 70 Pharmacy (P) ...... 60 Oakwood Pharmacy - Modern Pharmacy (NP)....10 New Michigan Pharmacy Westland Ambulatory Mombers Drug Store (P). . .36 (P)...... 47 (NP)...... 100 Monitor Pharmacy (NP).....5 New Millennium Drugs . . .116 Oakwood Pharmacy Monroe Med/Rx Pharmacy New Millennium Drugs (P) .94 Southgate (NP) ...... 98 (NP) ...... 52 New Mo-Town Pharmacy Oakwood Pharmacy Trenton Monroe Pharmacy (P) .....84 (P)...... 89 (NP) ...... 99 Morrisons Drug Store . . . .111 New Schaefer Pharmacy Oakwood Pharmacy Wayne Morrisons Drug Store (NP).49 (NP) ...... 84 (NP) ...... 99 Mortons Pharmacy (NP) . . .63 Newberry Hometown Oakwood Residential Care Motor City Pharmacy Corp. Pharmacy (P) ...... 40 Pharmacy ...... 106, 115 (P)...... 89 Nidhal’s Pharmacy (NP)....58 Obi Medical Pharmacy (P) .89 MSU Clinical Center Nile Family Pharmacy . . . .107 Oceana Pharmacy (P) .....68 Pharmacy (NP) ...... 22 Nile Family Pharmacy (P) . . .7 Olivet Pharmacy (P) ...... 14 MSU Kalamazoo Ctr. For Nimkee Pharmacy ...... 118 Omega Pharmacy ...... 113 Med. Studies Pharm. Nimkee Pharmacy ...... 28 Omega Pharmacy (NP) ....62 (NP) ...... 30 Noor Pharmacy (NP) ...... 47 Onecare Pharmacy . .104, 112 MSU Olin Health Center North Saginaw Pharmacy Onecare Pharmacy ...... 56 (NP) ...... 22 (P)...... 17 Onecare Rx ...... 112 Northeast Pharmacy (P) . . .41 Onecare Rx (P) ...... 51

132 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Optimed Specialty Pharmacy People Pharmacy (NP).....89 Pharmor Pharmacy-Ford ...... 30 Peoples Pharmacy (NP)....89 Campus (NP) ...... 90 Orchard Pharmacy Center Petertyl Drug (NP) ...... 19 Pharmor Pharmacy-Lafayette (P)...... 82 Pfaff Pharmacy (P) ...... 70 (NP) ...... 90 Orchard View Pharmacy Pgpa Pharmacy Inc...... 25 Pharmor (NP) ...... 48 Pharmacare Pharmacy Pharmacy-Woodward Place Orrs Drug Store (NP)...... 22 (NP) ...... 63 (NP) ...... 94 Ossineke Pharmacy (NP)....3 Pharmacy 4 Less II (NP)....90 Phil’s Pharmacy (NP) ...... 43 Otsego Memorial Hospital Rx Pharmacy 4 Less III (NP) . . .90 Physicians Pharmacy & ...... 69 Pharmacy 4 Less LLC (NP) .90 Medical Supply (P) ...... 90 Owosso Community Pharmacy Care Inc...... 5 Pickens Medical Pharmacy Pharmacy (P) ...... 75 Pharmacy Place (NP) ...... 76 (P)...... 90 Pharmascript Of Pine Knob Pharmacy #1, Inc Michigan ...... 112 (P)...... 57 P Pharmascript Of Michigan Pine Knob Pharmacy #3

...... 58 (NP) ...... 57 PHARMACIES OF INDEX P & H Pharmacy Long Term Pharmascript Of Shelby . .111 Pine Knob Pharmacy #6 Inc. Care...... 112 Pharmascript Of Shelby (NP) ...... 62 P & H Pharmacy Long Term (P)...... 44 Pinny Pharmacy Inc. (P) .....6 Care...... 56 Pharmax Drugs (P) ...... 99 Pioneer Family Pharmacy Palm Drugs (P) ...... 84 Pharmd Co Pharmacy . . . .108 #101 (NP)...... 69 Park Medical Pharmacy (P).89 Pharmd Co Pharmacy (NP).18 Pioneer Family Pharmacy Park Pharmacy ...... 116 Pharmerica ...... 104, 111 #102 (NP)...... 72 Park Pharmacy #2 ...... 111 Pharmerica ...... 47 Pioneer Family Pharmacy Park Pharmacy #2 (NP) ....45 Pharmerica # 7112...... 110 #103 (NP)...... 69 Park Pharmacy (NP) ...... 93 Pharmerica # 7112 ...... 34 Pioneer Family Pharmacy Parks Drug Store, Inc. (NP). .9 Pharmor Pharmacy - Carson #104 (NP)...... 72 Parkwood Pharmacy (NP) . .36 Center (NP) ...... 90 Pioneer Medical Patient Care Pharmacy . . .115 Pharmor Pharmacy - Doctors Pharmacy ...... 117 Patient Care Pharmacy (NP) ...... 90 Pioneer Medical Pharmacy (NP) ...... 84 Pharmor Pharmacy - (P)...... 99 Patient Careway Pharmacy Evergreen (NP) ...... 90 Pitkin Rexall Drug (P)...... 54 ...... 24 Pharmor Pharmacy - Platinum Care Pharmacy Patterson Pharmacy (P) ....62 Hamtramck (NP) ...... 94 (P)...... 90 Patterson’s Drug Store Pharmor Pharmacy - Harper Plumbrook Prescription (NP) ...... 54 Woods (NP) ...... 94 Centre (NP) ...... 46 Pattie Drug Of Baldwin. . .110 Pharmor Pharmacy - Joseph Pokagon Health Services Pattie Drug Of Baldwin Campau (NP)...... 94 Pharmacy ...... 118 (NP) ...... 36 Pharmor Pharmacy - Lincoln Pokagon Health Services Pauls Pharmacy (NP) ...... 2 Park (NP) ...... 94 Pharmacy ...... 10 Paw Paw Village Drugs Inc. Pharmor Pharmacy - St. Clair Pontiac Discount ...... 78 Shores (NP) ...... 45 Pharmacy ...... 113 Pay Less Drugs ...... 111 Pharmor Pharmacy - Warren Pontiac Discount Pharmacy Pay Less Drugs (P) ...... 42 (NP) ...... 47 (P)...... 63 Peninsula Pharmacy...... 104 Pharmor Pharmacy - Wayne Pontiac Trail Pharmacy . . .113 Peninsula Pharmacy (NP) . .49 City (NP)...... 99 Pontiac Trail Pharmacy (P) .67 Pennock Pharmacy - Gun Pharmor Pharmacy- Allen Port Huron Hospital Lake (P)...... 5 Park (NP) ...... 81 Pharmacy Place (NP) .....76 Pennock Pharmacy (P) ...... 4 Pharmor Pharmacy Port Huron Pharmacy . . . .114 People Medical Pharmacy .89 Mack-Moross (NP) ...... 93 Port Huron Pharmacy (P) . .76

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 133 INDEX OF PHARMACIES

Portage Pharmacy ...... 31 Redford Discount Pharmacy Rite Aid Pharmacy #1487 Potterville Pharmacy Inc. (P)...... 97 (P)...... 73 (P)...... 14 Redford Pharmacy (NP)....90 Rite Aid Pharmacy #1517 Precare Pharmacy (NP) ....97 Reid’s Drug (NP)...... 90 (P)...... 34 Premier Care Pharmacy Remedi Seniorcare...... 107 Rite Aid Pharmacy #1519 - (NP) ...... 55 Remedi Seniorcare ...... 10 Edison Plaza (P) ...... 34 Premier Home Pharmacy, Remedy Shop Pharmacy & Rite Aid Pharmacy #1521 - Inc...... 105 Apothecary (NP) ...... 65 Gaslight Village (P)...... 34 Premier Home Pharmacy, Inc. Remindadose Pharmacy . .109 Rite Aid Pharmacy #1524 (NP) ...... 65 Remindadose Pharmacy . .24 (P)...... 54 Premier Home Pharmacy Of Remus Pharmacy (NP) .....50 Rite Aid Pharmacy #1525 MI...... 115 Richard’s Pharmacy (NP) ....2 (P)...... 55 Premier Home Pharmacy Of Richardson’s Super Drugs.115 Rite Aid Pharmacy #1526 MI(P)...... 84 Richardson’s Super Drugs (P)...... 33 Premier Pharmacy ...... 111 (P)...... 83 Rite Aid Pharmacy #1527 Premier Pharmacy (P) .....41 Richland Village Drugs (P)...... 52 Prescription Shop Of Suttons (NP) ...... 32 Rite Aid Pharmacy #1528 Bay Inc. (NP) ...... 37 Richmond Drug (NP) ...... 48 (P)...... 52 Princings Pharmacy #1 Right Medicine (P) ...... 84 Rite Aid Pharmacy #1529 (NP) ...... 73 Rigley’s Drug Store (P) ....90 (P)...... 35 Pro Care Pharmacy #3 Rite Aid Pharmacies (P).....1 Rite Aid Pharmacy #1530 .14 (NP) ...... 94 Rite Aid Pharmacy #04022 Rite Aid Pharmacy #1532 Professional Pharmacy (P). .33 (P)...... 43 (P)...... 33 Professional Village Rite Aid Pharmacy #1010 Rite Aid Pharmacy #1534 Pharmacy ...... 112 (P)...... 20 (P)...... 2 Professional Village Pharmacy Rite Aid Pharmacy #1025 Rite Aid Pharmacy #1551 INDEX OF PHARMACIES Livonia (P) ...... 95 (P)...... 43 (P)...... 72 Professional Village Pharmacy Rite Aid Pharmacy #1265 Rite Aid Pharmacy #1552 (P)...... 52 (P)...... 28 (P)...... 73 Proos Pharmacy Of Whitmore Rite Aid Pharmacy #1466 Rite Aid Pharmacy #1573 Lake (P)...... 39 (P)...... 34 (P)...... 6 Putvins Drug Store (NP) .2, 74 Rite Aid Pharmacy #1468 Rite Aid Pharmacy #1574 (P)...... 36 (P)...... 51 Rite Aid Pharmacy #1470 Rite Aid Pharmacy #1575 Q (P)...... 26 (P)...... 73 Rite Aid Pharmacy #1472 Rite Aid Pharmacy #1576 Qol Meds...... 116 (P)...... 71 (P)...... 5 Qol Meds ...... 90 Rite Aid Pharmacy #1474 Rite Aid Pharmacy #1587 Quick Serve Pharmacy (P) .90 (P)...... 9 (P)...... 17 Quickmed Pharmacy .....116 Rite Aid Pharmacy #1478 - Rite Aid Pharmacy #1609 Quickmed Pharmacy (NP). .92 Cork Lane Shopping Ctr. .30 (P)...... 25 Rite Aid Pharmacy #1481 . .6 Rite Aid Pharmacy #1611 Rite Aid Pharmacy #1482 - (P)...... 22 R Brookfield Plz Shop Ctr Rite Aid Pharmacy #1612 (P)...... 22 (P)...... 23 R&RPrescription Services Rite Aid Pharmacy #1483 - Rite Aid Pharmacy #1615 ...... 14 Dewitt Shopping Center .11 (P)...... 24 Randys Rx (NP) ...... 62 Rite Aid Pharmacy #1486 - Rite Aid Pharmacy #1663 Rays Drugs (P)...... 95 Colonial Vlg Shopping Ct (P)...... 70 Red Crown Pharmacy (NP).32 (P)...... 24

134 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Rite Aid Pharmacy #1691 Rite Aid Pharmacy #3253 Rite Aid Pharmacy #4230 (P)...... 14 (P)...... 11 (P)...... 64 Rite Aid Pharmacy #1715 Rite Aid Pharmacy #3312 Rite Aid Pharmacy #4232 .24 (P)...... 69 (P)...... 74 Rite Aid Pharmacy #4233 Rite Aid Pharmacy #1729 Rite Aid Pharmacy #3315 (P)...... 10 (P)...... 17 (P)...... 74 Rite Aid Pharmacy #4234 Rite Aid Pharmacy #1740 Rite Aid Pharmacy #3320 (P)...... 76 (P)...... 5 (P)...... 72 Rite Aid Pharmacy #4235 Rite Aid Pharmacy #1745 - Rite Aid Pharmacy #3356 (P)...... 77 Shop-Rite Shopping Ctr. (P)...... 37 Rite Aid Pharmacy #4236 . .7 (P)...... 77 Rite Aid Pharmacy #3366 Rite Aid Pharmacy #4237 . .7 Rite Aid Pharmacy #1772 - (P)...... 10 Rite Aid Pharmacy #4238 Dells Plaza (P) ...... 20 Rite Aid Pharmacy #3368 . .7 (P)...... 7 Rite Aid Pharmacy #1801 Rite Aid Pharmacy #3383 Rite Aid Pharmacy #4239 . .7 (P)...... 10 (P)...... 69 Rite Aid Pharmacy #4240 .78

Rite Aid Pharmacy #1822 Rite Aid Pharmacy #3452 Rite Aid Pharmacy #4242 PHARMACIES OF INDEX (P)...... 31 (P)...... 18 (P)...... 35 Rite Aid Pharmacy #2274 Rite Aid Pharmacy #3478 Rite Aid Pharmacy #4266 (P)...... 54 (P)...... 72 (P)...... 90 Rite Aid Pharmacy #2425 Rite Aid Pharmacy #3497 Rite Aid Pharmacy #4268 (P)...... 9 (P)...... 59 (P)...... 66 Rite Aid Pharmacy #2473 Rite Aid Pharmacy #3510 Rite Aid Pharmacy #4270 (P)...... 27 (P)...... 18 (P)...... 43 Rite Aid Pharmacy #2504 Rite Aid Pharmacy #3520 Rite Aid Pharmacy #4276 (P)...... 10 (P)...... 36 (P)...... 20 Rite Aid Pharmacy #2509 Rite Aid Pharmacy #3568 Rite Aid Pharmacy #4300 (P)...... 47 (P)...... 73 (P)...... 68 Rite Aid Pharmacy #2549 Rite Aid Pharmacy #3588 Rite Aid Pharmacy #4301 (P)...... 4 (P)...... 73 (P)...... 63 Rite Aid Pharmacy #2606 Rite Aid Pharmacy #3657 Rite Aid Pharmacy #4302 (P)...... 71 (P)...... 97 (P)...... 63 Rite Aid Pharmacy #2683 Rite Aid Pharmacy #3667 Rite Aid Pharmacy #4303 (P)...... 53 (P)...... 15 (P)...... 56 Rite Aid Pharmacy #2711 Rite Aid Pharmacy #3780 Rite Aid Pharmacy #4304 (P)...... 8 (P)...... 17 (P)...... 67 Rite Aid Pharmacy #2729 - Rite Aid Pharmacy #3878 Rite Aid Pharmacy #4305 Randall Street Square (P) .70 (P)...... 58 (P)...... 66 Rite Aid Pharmacy #2731 Rite Aid Pharmacy #3880 Rite Aid Pharmacy #4306 (P)...... 66 (P)...... 42 (P)...... 59 Rite Aid Pharmacy #2753 Rite Aid Pharmacy #3887 - Rite Aid Pharmacy #4309 (P)...... 12 Knollwood Clinic (P)...... 37 (P)...... 37 Rite Aid Pharmacy #2760 Rite Aid Pharmacy #3966 Rite Aid Pharmacy #4310 (P)...... 19 (P)...... 32 (P)...... 17 Rite Aid Pharmacy #2776 Rite Aid Pharmacy #3967 .24 Rite Aid Pharmacy #4314 (P)...... 71 Rite Aid Pharmacy #4011 (P)...... 38 Rite Aid Pharmacy #3234 (P)...... 22 Rite Aid Pharmacy #4315 (P)...... 11 Rite Aid Pharmacy #4068 (P)...... 63 Rite Aid Pharmacy #3244 - (P)...... 48 Rite Aid Pharmacy #4316 Village Of Paw Paw .....78 Rite Aid Pharmacy #4228 (P)...... 41 (P)...... 74

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 135 INDEX OF PHARMACIES

Rite Aid Pharmacy #4317 Rite Aid Pharmacy #4355 Rite Aid Pharmacy #4404 (P)...... 48 (P)...... 90 (P)...... 43 Rite Aid Pharmacy #4318 Rite Aid Pharmacy #4357 Rite Aid Pharmacy #4405 (P)...... 41 (P)...... 5 (P)...... 38 Rite Aid Pharmacy #4319 Rite Aid Pharmacy #4358 Rite Aid Pharmacy #4407 (P)...... 18 (P)...... 99 (P)...... 49 Rite Aid Pharmacy #4320 Rite Aid Pharmacy #4360 Rite Aid Pharmacy #4408 (P)...... 95 (P)...... 46 (P)...... 16 Rite Aid Pharmacy #4321 Rite Aid Pharmacy #4361 Rite Aid Pharmacy #4409 (P)...... 44 (P)...... 40 (P)...... 76 Rite Aid Pharmacy #4322 Rite Aid Pharmacy #4362 Rite Aid Pharmacy #4410 (P)...... 97 (P)...... 92 (P)...... 14 Rite Aid Pharmacy #4323 .25 Rite Aid Pharmacy #4363 Rite Aid Pharmacy #4414 Rite Aid Pharmacy #4324 (P)...... 81 (P)...... 90 (P)...... 75 Rite Aid Pharmacy #4366 Rite Aid Pharmacy #4420 Rite Aid Pharmacy #4325 (P)...... 99 (P)...... 39 (P)...... 67 Rite Aid Pharmacy #4368 Rite Aid Pharmacy #4424 - Rite Aid Pharmacy #4326 (P)...... 93 Jackson Plaza (P) ...... 28 (P)...... 26 Rite Aid Pharmacy #4369 - Rite Aid Pharmacy #4426 Rite Aid Pharmacy #4330 Battle Creek Plaza (P) .....9 (P)...... 44 (P)...... 37 Rite Aid Pharmacy #4372 Rite Aid Pharmacy #4431 Rite Aid Pharmacy #4331 (P)...... 60 (P)...... 71 (P)...... 52 Rite Aid Pharmacy #4375 Rite Aid Pharmacy #4432 Rite Aid Pharmacy #4332 (P)...... 45 (P)...... 58 (P)...... 82 Rite Aid Pharmacy #4376 Rite Aid Pharmacy #4438 Rite Aid Pharmacy #4333 (P)...... 58 (P)...... 17 INDEX OF PHARMACIES (P)...... 15 Rite Aid Pharmacy #4377 Rite Aid Pharmacy #4439 Rite Aid Pharmacy #4334 (P)...... 56 (P)...... 15 (P)...... 97 Rite Aid Pharmacy #4378 Rite Aid Pharmacy #4440 - Rite Aid Pharmacy #4335 (P)...... 20 Swartz Creek Plaza (P)....18 (P)...... 99 Rite Aid Pharmacy #4380 Rite Aid Pharmacy #4441 Rite Aid Pharmacy #4338 (P)...... 21 (P)...... 18 (P)...... 55 Rite Aid Pharmacy #4382 Rite Aid Pharmacy #4442 Rite Aid Pharmacy #4339 (P)...... 51 (P)...... 17 (P)...... 46 Rite Aid Pharmacy #4385 Rite Aid Pharmacy #4443 - Rite Aid Pharmacy #4340 (P)...... 47 Hamady Bros Plaza (P) . . .17 (P)...... 15 Rite Aid Pharmacy #4389 Rite Aid Pharmacy #4445 Rite Aid Pharmacy #4343 (P)...... 46 (P)...... 81 (P)...... 15 Rite Aid Pharmacy #4390 Rite Aid Pharmacy #4447 Rite Aid Pharmacy #4345 (P)...... 47 (P)...... 18 (P)...... 95 Rite Aid Pharmacy #4393 Rite Aid Pharmacy #4452 Rite Aid Pharmacy #4346 (P)...... 70 (P)...... 56 (P)...... 99 Rite Aid Pharmacy #4395 Rite Aid Pharmacy #4455 Rite Aid Pharmacy #4350 (P)...... 35 (P)...... 77 (P)...... 28 Rite Aid Pharmacy #4399 Rite Aid Pharmacy #4460 Rite Aid Pharmacy #4351 (P)...... 68 (P)...... 95 (P)...... 59 Rite Aid Pharmacy #4401 Rite Aid Pharmacy #4462 Rite Aid Pharmacy #4352 (P)...... 10 (P)...... 53 (P)...... 62 Rite Aid Pharmacy #4402 Rite Aid Pharmacy #4466 (P)...... 47 (P)...... 92

136 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Rite Aid Pharmacy #4467 Rite Aid Pharmacy #4519 Rite Aid Pharmacy #4595 (P)...... 55 (P)...... 79 (P)...... 90 Rite Aid Pharmacy #4471 Rite Aid Pharmacy #4520 Rite Aid Pharmacy #4599 - (P)...... 18 (P)...... 84 Shoptown Center (P) .....22 Rite Aid Pharmacy #4476 Rite Aid Pharmacy #4523 Rite Aid Pharmacy #4600 (P)...... 67 (P)...... 95 (P)...... 13 Rite Aid Pharmacy #4477 Rite Aid Pharmacy #4526 - Rite Aid Pharmacy #4685 (P)...... 59 Belmont Shopping Center (P)...... 96 Rite Aid Pharmacy #4482 - (P)...... 90 Rite Aid Pharmacy #4694 Edgemont Shopping Center Rite Aid Pharmacy #4528 (P)...... 90 ...... 24 (P)...... 63 Rite Aid Pharmacy #4695 Rite Aid Pharmacy #4485 - Rite Aid Pharmacy #4530 (P)...... 43 Harbortown (P) ...... 90 (P)...... 79 Rite Aid Pharmacy #4696 Rite Aid Pharmacy #4487 Rite Aid Pharmacy #4532 (P)...... 62 (P)...... 57 (P)...... 3 Rite Aid Pharmacy #4697

Rite Aid Pharmacy #4488 - Rite Aid Pharmacy #4534 (P)...... 63 PHARMACIES OF INDEX Ashcrofts Shopping Ctr. (P)...... 61 Rite Aid Pharmacy #4703 (P)...... 19 Rite Aid Pharmacy #4537 (P)...... 46 Rite Aid Pharmacy #4489 (P)...... 41 Rite Aid Pharmacy #4740 (P)...... 94 Rite Aid Pharmacy #4539 - (P)...... 27 Rite Aid Pharmacy #4490 Spring Arbor Shop Ctr. Rite Aid Pharmacy #4761 (P)...... 42 (P)...... 29 (P)...... 17 Rite Aid Pharmacy #4492 Rite Aid Pharmacy #4543 Rite Aid Pharmacy #4765 (P)...... 64 (P)...... 84 (P)...... 75 Rite Aid Pharmacy #4495 Rite Aid Pharmacy #4545 Rite Aid Pharmacy #4770 .24 (P)...... 20 (P)...... 101 Rite Aid Pharmacy #4801 Rite Aid Pharmacy #4498 Rite Aid Pharmacy #4546 (P)...... 96 (P)...... 90 (P)...... 57 Rite Aid Pharmacy #4806 - Rite Aid Pharmacy #4500 Rite Aid Pharmacy #4548 Bentley Plaza (P)...... 15 (P)...... 45 (P)...... 58 Rite Aid Pharmacy #4829 Rite Aid Pharmacy #4502 Rite Aid Pharmacy #4559 (P)...... 83 (P)...... 27 (P)...... 75 Rite Aid Pharmacy #4833 Rite Aid Pharmacy #4503 Rite Aid Pharmacy #4564 (P)...... 43 (P)...... 69 (P)...... 73 Rite Aid Pharmacy #4843 Rite Aid Pharmacy #4504 Rite Aid Pharmacy #4567 - (P)...... 90 (P)...... 17 Thunder Bay Plaza (P) ....49 Rite Aid Pharmacy #4886 Rite Aid Pharmacy #4505 Rite Aid Pharmacy #4574 (P)...... 48 (P)...... 28 (P)...... 76 Rite Aid Pharmacy #4897 Rite Aid Pharmacy #4506 Rite Aid Pharmacy #4577 (P)...... 40 (P)...... 101 (P)...... 12 Rite Aid Pharmacy #4927 Rite Aid Pharmacy #4507 Rite Aid Pharmacy #4579 (P)...... 83 (P)...... 72 (P)...... 11 Rite Aid Pharmacy #4943 Rite Aid Pharmacy #4508 Rite Aid Pharmacy #4586 (P)...... 75 (P)...... 73 (P)...... 20 Rite Aid Pharmacy #4948 Rite Aid Pharmacy #4510 Rite Aid Pharmacy #4588 (P)...... 15 (P)...... 79 (P)...... 17 Rite Aid Pharmacy #4956 Rite Aid Pharmacy #4512 Rite Aid Pharmacy #4592 (P)...... 18 (P)...... 90 (P)...... 57 Rite Aid Pharmacy #4963 Rite Aid Pharmacy #4515 Rite Aid Pharmacy #4594 (P)...... 9 (P)...... 55 (P)...... 16

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 137 INDEX OF PHARMACIES

Rite Aid Pharmacy #4966 Russells Fisher Pharmacy Sam’s Pharmacy #10-6562 (P)...... 100 (NP) ...... 91 (NP) ...... 54 Rite Aid Pharmacy #4977 Rx Care Pharmacy (NP)....91 Sam’s Pharmacy #10-6657 (P)...... 53 Rx Express Pharmacy (P) .100 (NP) ...... 61 Rite Aid Pharmacy #7700 Rx IV, Incorporated ...... 105 Sam’s Pharmacy #10-6658 (P)...... 51 Rx IV, Incorporated ...... 66 (NP) ...... 29 Rite Aid Pharmacy #7733 Rx Pharmacy ...... 111 Sam’s Pharmacy #10-6659 (P)...... 18 Rx Pharmacy (NP)...... 42 (NP) ...... 60 Rite Aid Pharmacy #7736 Rx Specialties NH, Inc. . . .113 Sam’s Pharmacy #10-6660 (P)...... 18 Rx Specialties NH, Inc. ....59 (NP) ...... 76 Rite Aid Pharmacy #7738 Rxperts Pharmacy - Michigan Sam’s Pharmacy #10-6661 (P)...... 15 LLC...... 116 (NP) ...... 31 Rite Aid Pharmacy #7740 Rxperts Pharmacy - Michigan Sam’s Pharmacy #10-6662 (P)...... 36 LLC...... 97 (NP) ...... 44 Rite Aid Pharmacy #7758 Ryan Pharmacy (NP) ...... 48 Sam’s Pharmacy #10-6663 (P)...... 90 (NP) ...... 73 Rite Aid Pharmacy #7761 Sam’s Pharmacy #10-6664 (P)...... 62 S (NP) ...... 46 Rite Aid Pharmacy #7810 Sam’s Pharmacy #10-6665 (P)...... 50 Saad’s Healthy Living (NP) ...... 67 Rite Aid Pharmacy #7824 Pharmacy ...... 84 Sam’s Pharmacy #10-6666 (P)...... 83 Sabourins Pharmacy M-20 (NP) ...... 83 Rite Aid Pharmacy #7869 (P)...... 51 Sam’s Pharmacy #10-6667 (P)...... 61 Sabourins Pharmacy (NP) . . .6 (NP) ...... 81 Rite Aid Pharmacy #7877 Salem’s Pharmacy (NP) ....81 Sam’s Pharmacy #10-8137 (P)...... 39 Saline Pharmacy LLC (P) . . .80 ...... 24 INDEX OF PHARMACIES Rite Aid Pharmacy #7912 Samaritan Pharmacy PC Sam’s Pharmacy #10-8291 (P)...... 57 (P)...... 91 (NP) ...... 17 Rite Care Pharmacy (NP) . .57 Sams Club Pharmacies (NP) .1 Sam’s Pharmacy East River Oaks Pharmacy (P). . .85 Sam’s Drugs (NP) ...... 91 #10-6419 (NP)...... 20 River Pharmacy Inc. (P) .....4 Sam’s Pharmacy #10-4778 Sanford Family Pharmacy Rochester Hills Pharmacy (NP) ...... 55 (NP) ...... 51 (NP) ...... 63 Sam’s Pharmacy #10-4781 Sanilac Pharmacy (NP).....74 Rockwood Pharmacy (P) . . .97 (NP) ...... 24 Satow Drug Store (P)...... 72 Rogers Pharmacy, Inc. (P) . .37 Sam’s Pharmacy #10-4812 Saugatuck Drug (NP) ...... 3 Roger’s Pharmacy (P) ...... 8 (NP) ...... 58 Sault Community Pharmacy Roos Pharmacy North ....68 Sam’s Pharmacy #10-4944 (NP) ...... 11 Rosa Park Medical Pharmacy (NP) ...... 18 Sav On Checker Pharmacy (NP) ...... 90 Sam’s Pharmacy #10-4982 (P)...... 100 Rose City Drugs (P) ...... 69 (NP) ...... 28 Sav On Drugs #1 (P) ...... 56 Rose City Pharmacy (P) ....29 Sam’s Pharmacy #10-6319 Sav On Drugs #4 (P) ...... 85 Rosedale Community (NP) ...... 35 Sav On Drugs #5 (P) ...... 46 Pharmacy ...... 116 Sam’s Pharmacy #10-6359 Sav On Drugs #6 (P) ...... 93 Rosedale Community (NP) ...... 33 Sav On Drugs #8 (P) ...... 37 Pharmacy (P) ...... 91 Sam’s Pharmacy #10-6412 Sav On Montrose Rottenbucher Pharmacy . .13 (NP) ...... 98 Pharmacy ...... 108 Rouge Drugs (NP) ...... 97 Sam’s Pharmacy #10-6429 . .9 Sav On Montrose Pharmacy Royal Oak Family Pharmacy Sam’s Pharmacy #10-6454 (P)...... 18 (P)...... 58 (NP) ...... 65 Sav On Westside Drugs . . .14 Royals Pharmacy (NP) .....58 Sav-Mart Pharmacy II (NP) .91

138 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Sav-Max Glory Pharmacy .116 Serv-U-Well Pharmacy Shopko Pharmacy #2651 .114 Sav-Max Glory Pharmacy (NP) ...... 91 Shopko Pharmacy #2651 (NP) ...... 91 Seven Mile Pharmacy, (P)...... 68 Sav-Max Pharmacy-Mazen LLC...... 116 Shopko Pharmacy #2653 .108 (NP) ...... 91 Seven Mile Pharmacy, LLC Shopko Pharmacy #2653 Sav-Mor #100 (P) ...... 98 (P)...... 91 (P)...... 19 Sav-Mor #19 Weatherwax - Shaws Pharmacy Inc. (P) . . .74 Shopko Pharmacy #2656 .110 Spring Arbor (P) ...... 29 Sheba Discount Pharmacy Shopko Pharmacy #2656 Savmor #58 Weatherwax - (P)...... 84 (P)...... 32 Brooklyn (P) ...... 28 Shelby Pharmacy (P) ...... 68 Shopko Pharmacy #606 Sav-Mor #65 Eastern Sheldon Pharmacy Of Yale (P)...... 21 Pharmacy (NP) ...... 81 (NP) ...... 76 Shopko Pharmacy #610 Savmor #68 Weatherwax - Shopko Pharmacy #2010 (P)...... 49 Hinckley (P) ...... 29 (P)...... 49 Shop-N-Save Pharmacy ....6 Sav-Mor #97 Kashat Shopko Pharmacy #2011 Shoreline Pharmacy ...... 78

Pharmacy Troy (P)...... 46 (P)...... 13 Sindecuse Health Center PHARMACIES OF INDEX Sav-Mor Super Drugs Tawas Shopko Pharmacy #2016 Pharmacy (NP) ...... 30 (NP) ...... 27 (P)...... 12 Six Mile Pharmacy (NP)....91 Sav-On Birmingham Drugs Shopko Pharmacy #2123 Sixth Street Drug Inc (NP) .20 (P)...... 56 (P)...... 21 Skip’s Pharmacy Of Michigan Sav-On Ltc Closed Door Shopko Pharmacy #2513 .114 (NP) ...... 70 Pharmacy ...... 113 Shopko Pharmacy #2513 Slt. Ste. Marie Tribal Health Sav-On Ltc Closed Door (P)...... 69 Center Pharmacy ...... 118 Pharmacy ...... 61 Shopko Pharmacy #2514 .112 Slt. Ste. Marie Tribal Health Savon Medical Pharmacy, Shopko Pharmacy #2514 Center Pharmacy (P) .....11 LLC (NP) ...... 91 (P)...... 51 Smart Choice Pharmacy Sav-Plus Pharmacy (P) .....63 Shopko Pharmacy #2621 .114 (NP) ...... 91 Sav-Rx Pharmacy (P) ...... 85 Shopko Pharmacy #2621 Snow Health Service Sax Discount Pharmacy. . .117 (P)...... 74 Pharmacy (P) ...... 81 Sax Discount Pharmacy Shopko Pharmacy #2624 .107 Snyder Drug #104 (P) .....49 (NP) ...... 99 Shopko Pharmacy #2624 Snyder Drug #207 (P) ...... 2 Scheurer Family Pharmacy (P)...... 4 Snyder Drug #208 (P) .....40 (NP) ...... 21, 22 Shopko Pharmacy #2643 .112 Snyder Pharmacy (P). . .27, 49 Schlipps Pharmacy Inc...... 7 Shopko Pharmacy #2643 Snyder Rx Express (P) .....49 Schmidt & Sons Pharmacy Of (P)...... 55 Snyder’s Pharmacy (P) .....75 Blissfield (P) ...... 38 Shopko Pharmacy #2644 .107 Somerset Pharmacy (NP) . .66 Schmidt & Sons Pharmacy Of Shopko Pharmacy #2644 Sona Pharmacy (P) ...... 60 Clinton Inc. (P) ...... 38 (P)...... 11 South Dearborn Pharmacy Schmidt & Sons Pharmacy Of Shopko Pharmacy #2645 .112 (NP) ...... 84 Tecumseh Inc. (P) ...... 38 Shopko Pharmacy #2645 Southgate Pharmacy (NP). .98 Schoolcraft Memorial (P)...... 54 Southside Pharmacy (NP) . . .5 Hospital Pharmacy ...... 74 Shopko Pharmacy #2646 .107 Southwest Discount Schultz Country Pharmacy Shopko Pharmacy #2646 Pharmacy ...... 91 (P)...... 72 (P)...... 4 Sparrow Hospital Pharmacy Scriptway Pharmacy (P). . .100 Shopko Pharmacy #2648 .110 ...... 24 Seaway Pharmacy ...... 117 Shopko Pharmacy #2648 Sparrow Pharmacy Plus #1 Seaway Pharmacy (NP) ....99 (P)...... 38 ...... 24 Senior Home Health Care Shopko Pharmacy #2650 .107 Sparrow Pharmacy Plus #10 Inc. (NP) ...... 67 Shopko Pharmacy #2650 ...... 24 (P)...... 10

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 139 INDEX OF PHARMACIES

Sparrow Pharmacy Plus #11 St. John Pharmacy Pontiac (NP) ...... 24 LLC (NP) ...... 62 T Sparrow Pharmacy Plus #2 St. John Pharmacy Warren - ...... 26 Hoover (NP)...... 48 Taleens Pharmacy (NP) ....46 Sparrow Pharmacy Plus #4 St. John Pontiac Pharmacy Target Pharmacies (P) ...... 1 ...... 14 LLC (NP) ...... 63 Target Pharmacy T-0281 Specialized Pharmacy St. Joseph Mercy Pharmacy - (P)...... 100 Services North West Reichert ...... 81 Target Pharmacy T-0616 . .14 Branch ...... 105, 114 St. Joseph Mercy Pharmacy - Target Pharmacy T-0896 Specialized Pharmacy Towers ...... 79 (P)...... 67 Services North West Branch St. Joseph Mercy Target Pharmacy T-1052 ...... 69 Professional Pharmacy #2 (P)...... 36 Specialized Pharmacy ...... 63 Target Pharmacy T-1251 Services South Livonia . .106, St. Marys Cathedral Square (P)...... 55 116 Pharmacy ...... 34 Target Pharmacy T-1285 Specialized Pharmacy St. Mary’s Family Pharmacy (P)...... 81 Services South Livonia . . .96 Wege Cntr/Hlth Learning Target Pharmacy T-1971 Specialized Pharmacy (NP) ...... 34 (P)...... 39 West...... 104, 110 St. Mary’s Home Infusion Target Pharmacy T-2207 Specialized Pharmacy West Program ...... 104 (P)...... 65 ...... 34 St. Mary’s Home Infusion Target Pharmacy T-2230 Spectrum Outpatient Program ...... 34 (P)...... 96 Pharmacy (NP) ...... 34 St. Mary’s Ltc Pharmacy . .110 Target Pharmacy T-347 (P) .73 Springwells Clinical Pharmacy St. Mary’s Ltc Pharmacy . . .34 Target Pharmacy T-365 (P) .25 ...... 91 St. Paul Pharmacy . . .106, 116 Target Pharmacy T-397 (P) .36 St. Clair Pharmacy, Inc. St. Paul Pharmacy (NP) ....91 Target Pharmacy T-399 (P) .71 INDEX OF PHARMACIES (NP) ...... 76 Stadium Pharmacy (P) .....79 Target Pharmacy T-605 (P) .46 St. John Health System Standish Pharmacy (P) ...... 4 Target Stores T-354 (P) ....83 Home Service ...... 104 Star Drugs Inc. (P) ...... 56 Target Stores T-611 (P) ....58 St. John Pharmacy - State Pharmacy (NP) ...... 91 Target T 2113 (P) ...... 42 Emergency Center (NP) . .91 State Street Pharmacy And Target T 2178 (P) ...... 56 St. John Pharmacy - Macomb Wellness Center (NP).....77 Target T 2544 (P) ...... 48 Township (NP) ...... 43 Sterling Warren Target T-0278 (P) ...... 46 St. John Pharmacy - Madison Pharmacy ...... 111 Target T-0279 (P) ...... 84 Heights (NP) ...... 60 Sterling Warren Pharmacy Target T-0280 (P) ...... 99 St. John Pharmacy - (NP) ...... 48 Target T-0282 (P) ...... 60 Professional Bldg. (NP) . .91 Stockbridge Pharmacy ....26 Target T-0351 (P) ...... 63 St. John Pharmacy - Student Health Center Target T-0353 (P) ...... 85 Riverview Outpatient Pharmacy ...... 50 Target T-0361 ...... 25 (NP) ...... 91 Sunshine Pharmacy (P) ....41 Target T-0604 (P) ...... 31 St. John Pharmacy - Romeo Super Mart Pharmacy (P) . .91 Target T-0610 (P)...... 9 (NP) ...... 48 Susan’s Total Care Drug Target T-0629 (P) ...... 17 St. John Pharmacy - St. Clair Store ...... 117 Target T-0631 (P)...... 5 Shores (NP) ...... 45 Susan’s Total Care Drug Target T-0632 (P) ...... 75 St. John Pharmacy - Store (P) ...... 97 Target T-0634 (P) ...... 79 Warren-Schoenherr (NP) . .48 Sussex Pharmacy (NP) .....48 Target T-0673 (P) ...... 29 St. John Pharmacy - Suttons Drug (P) ...... 91 Target T-0776 (P) ...... 94 Windermere (NP) ...... 48 Swanstra Drug Store (P) . . .77 Target T-0777 (P) ...... 65 St. John Pharmacy (NP) . . .24, Target T-0901 (P) ...... 30 61 Target T-0922 (P) ...... 39

140 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Target T-0923 (P) ...... 100 The New Prescription Corner Trinity Pharmacy ...... 113 Target T-0945 (P) ...... 40 (P)...... 91 Trinity Pharmacy (P) ...... 65 Target T-1313 (P) ...... 66 The People’s Drug Store .108 Troy Professional Pharmacy Target T-1334 (P) ...... 49 The People’s Drug Store Inc. (P)...... 66 Target T-1465 (P) ...... 61 (NP) ...... 12 Trudell Pharmacy (P) ...... 84 Target T-1466 (P) ...... 44 The Pharmacy Shop (P)....60 True Care Pharmacy (P)....99 Target T-1482 (P) ...... 70 The Prescription Shop (NP).6, Twin Valley Pharmacy (NP) . .9 Target T-2014 (P) ...... 34 20 Target T-2015 (P) ...... 33 The Prescription Shop Of Target T-2033 (P) ...... 81 Glen Arbor (NP) ...... 37 U Target T-2105 (P) ...... 16 The Rite Pharmacy...... 106 Target T-2254 (P) ...... 46 The Rite Pharmacy (NP) . . .98 U Of M Homemed...... 105 Target T-2327 (P) ...... 54 The Wellness Plan - East U Of M Homemed ...... 79 Target T-2415 (P) ...... 83 Pharmacy ...... 91 Ultimate Medical Target T-671 (P)...... 20 The Wellness Plan - Pharmacy ...... 112

Target T-819 (P)...... 41 Northwest Pharmacy ....62 Ultimate Medical Pharmacy PHARMACIES OF INDEX Target T-872 (P)...... 96 The Wellness Plan Gateway (NP) ...... 55 Taskers Drug Store (P).....70 1stFlr...... 91 UMMC Ambulatory Care Tayler Prescriptions (P) ....57 Thera Script Pharmacy Pharmacy (NP) ...... 79 Taylor Discount Pharmacy Berkley, PLLC (P) ...... 55 Unasource Pharmacy (NP) .66 (P)...... 99 Thera-Script Pharmacy Union Prescription Center The Apothecary Shoppe (NP) ...... 94 (P)...... 18 Downtown (P) ...... 51 Therascript Rochester (NP).63 Union The Beaverton Pharmacy Thompson Pharmacy (NP) .20 Prescription Center .....108 (NP) ...... 19 Thompson Pharmacy West United Care Pharmacy (P) .91 The Belding Apothecary . .26 (NP) ...... 20 United Pharmacy (P) ...... 79 The Chemist Shoppe Ltd Thompson Pharmacy-Olesons Universal Pharmacy (P) ....48 (P)...... 34 East (NP) ...... 20 University Health Center The Corner Drug Store. . .109 Thrifty Drugs (NP) .....15, 63 Pharmacy (NP) ...... 49 The Corner Drug Store Thunder Bay Pharmacy University Pharmacy (P)....91 (NP) ...... 27 (NP) ...... 53 University Rx Pharmacy The Country Squire Discount Thunder Bay Pharmacy (NP) ...... 66 Pharmacy (NP) ...... 54 Onaway (P) ...... 71 Uparhs Pharmacy (NP) ....50 The Drug Store .....103, 107 TLC Pharmacy Inc. (NP) . . .84 The Drug Store (NP) ...... 13 Todd’s Pharmacy Inc (NP). .85 The Drug Store (P) ...... 3 Toms Family Market (P)....71 V The Medicap Pharmacy Tom’s Pharmacy ...... 25 (P)...... 56 Tom’s Pharmacy LLC ...... 27 Valley Medical Pharmacy The Medicine Shoppe ....46 Tony’s Pharmacy (NP) .....91 (NP) ...... 17 The Medicine Shoppe #1174 Top Care Pharmacy (P) ....96 Value Center Pharmacy I .111 (NP) ...... 19 Top Service Pharmacy Value Center Pharmacy I The Medicine Shoppe #1189 (NP) ...... 65 (P)...... 41 (NP) ...... 27 Total Community Pharmacy Value Center Pharmacy II .113 The Medicine Shoppe #1675 (P)...... 85 Value Center Pharmacy II (NP) ...... 12 Town Center Pharmacy (P) .17 (P)...... 60 The Medicine Shoppe #1822 Town Pharmacy (P)...... 91 Value Drugs Allegan (NP) . . .2 (P)...... 38 Tri Unity Infusions Services, Value Drugs (NP) ...... 78 The Medicine Shoppe LLC...... 104 Value Pharmacy ...... 117 (NP) ...... 16, 20 Tri Unity Infusions Services, Value Pharmacy (NP) .....100 The Medicine Shoppe (P) . .51 LLC...... 48 Van Buren Pharmacy (NP). .82

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 141 INDEX OF PHARMACIES

Vans Pharmacy (NP) ...... 8 Walgreens # 12894 (P) ....20 Walgreens #04864 (P) .....68 Vcare Pharmacy (NP) ...... 20 Walgreens #01246 (P) .....46 Walgreens #04932 (P) .....48 Venoy Medical Pharmacy Walgreens #01265 (P) . . . .101 Walgreens #04933 (P) .....96 (NP) ...... 99 Walgreens #01610 (P) .....45 Walgreens #04991 (P) .....30 VG’s Pharmacy #1920 (P) . .39 Walgreens #01910 (P) .....39 Walgreens #04992 (P) .....84 VG’s Pharmacy #1921 (P) . .16 Walgreens #02023 (P) .....52 Walgreens #05032 (P) .....85 VG’s Pharmacy #1922 (P) . .77 Walgreens #02581 (P) .....34 Walgreens #05082 (P) .....48 VG’s Pharmacy #1923 (P) . .67 Walgreens #02714 (P) .....36 Walgreens #05083 (P) .....42 VG’s Pharmacy #1925 (P) . .15 Walgreens #02806 (P) .....34 Walgreens #05084 (P) .....92 VG’s Pharmacy #1926 (P) . .17 Walgreens #02825 (P) .....70 Walgreens #05095 (P) .....34 VG’s Pharmacy #1927 (P) . .16 Walgreens #02856 (P) ...... 9 Walgreens #05097 (P) .....73 VG’s Pharmacy #1929 (P) . .17 Walgreens #02905 (P) .....71 Walgreens #05117 (P) .....71 VG’s Pharmacy #1930 (P) . .15 Walgreens #03012 (P) .....35 Walgreens #05167 (P) ...... 5 VG’s Pharmacy #1931 (P) . .39 Walgreens #03053 ...... 30 Walgreens #05168 (P) .....82 VG’s Pharmacy #1932 (P) . .75 Walgreens #03147 (P) .....30 Walgreens #05169 (P) .....99 VG’s Pharmacy #1933 (P) . .15 Walgreens #03349 (P) .....70 Walgreens #05170 (P) .....39 VG’s Pharmacy #1934 (P) . .75 Walgreens #03364 ...... 7 Walgreens #05171 (P) .....57 Victoria Pharmacy (NP) ....92 Walgreens #03426 (P) .....34 Walgreens #05223 ...... 14 Village Apothecary Inc. Walgreens #04244 (P) .....67 Walgreens #05224 ...... 66 (NP) ...... 80 Walgreens #04255 (P) .....42 Walgreens #05226 (P) .....94 Village Drug Shop ...... 26 Walgreens #04297 (P) . . . .100 Walgreens #05227 (P) .....43 Village Family Pharmacy, Inc. Walgreens #04298 (P) .....96 Walgreens #05290 (P) .....58 (P)...... 43 Walgreens #04299 (P) .....36 Walgreens #05291 (P) .....44 Village Pharmacy II...... 115 Walgreens #04308 (P) .....45 Walgreens #05315 (P) .....54 Village Pharmacy II (NP) . . .80 Walgreens #04367 (P) .....85 Walgreens #05321 (P) .....52 Village Pharmacy Of Grand Walgreens #04369 (P) .....92 Walgreens #05322 (P) .....48 INDEX OF PHARMACIES Rapids (NP) ...... 34 Walgreens #04412 (P) .....66 Walgreens #05371 (P) .....73 Village Sav-Mor Pharmacy Walgreens #04413 (P) .....34 Walgreens #05398 (P) .....81 Great Lakes ...... 111 Walgreens #04430 (P) .....94 Walgreens #05425 (P) .....62 Village Sav-Mor Pharmacy Walgreens #04452 (P) .....40 Walgreens #05426 (P) .....64 Great Lakes ...... 48 Walgreens #04453 (P) .....43 Walgreens #05481 (P) .....14 Visiting Nurse Association Walgreens #04454 (P) .....61 Walgreens #05503 ...... 25 Infusion...... 105 Walgreens #04498 (P) .....99 Walgreens #05534 (P) .....35 Visiting Nurse Association Walgreens #04501 (P) .....92 Walgreens #05560 (P) .....49 Infusion ...... 73 Walgreens #04512 (P) .....48 Walgreens #05595 (P) .....76 Vital Pharmacare ...... 113 Walgreens #04536 (P) ...... 8 Walgreens #05596 (P) .....99 Vital Pharmacare (P)...... 63 Walgreens #04585 (P) .....97 Walgreens #05675 (P) .....59 VPH Pharmacy ...... 108 Walgreens #04601 (P) .....63 Walgreens #05707 (P) .....29 VPH Pharmacy ...... 18 Walgreens #04608 (P) .....41 Walgreens #05841 ...... 25 Walgreens #04631 (P) .....99 Walgreens #05842 (P) .....80 Walgreens #04660 (P) .....64 Walgreens #05917 (P) .....17 W Walgreens #04661 (P) .....46 Walgreens #05918 (P) .....17 Walgreens #04676 (P) .....17 Walgreens #05968 (P) .....41 Wackerly Pharmacy (P) .....5 Walgreens #04691 (P) .....60 Walgreens #05969 (P) .....65 Wadhams Pharmacy (NP) . .75 Walgreens #04726 (P) .....34 Walgreens #05971 (P) .....48 Wakefield Pharmacy.103, 108 Walgreens #04748 (P) .....64 Walgreens #06009 (P) .....73 Wakefield Pharmacy (P) . . .19 Walgreens #04749 (P) .....95 Walgreens #06053 (P) .....76 Walgreens # 12042 (P) .....6 Walgreens #04795 (P) .....42 Walgreens #06054 (P) .....17 Walgreens # 12776 (P) ....49 Walgreens #04797 (P) .....92 Walgreens #06091 (P) .....73 Walgreens # 12893 (P) ....36 Walgreens #04835 (P) .....54 Walgreens #06092 (P) ...... 8

142 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Walgreens #06175 (P) .....41 Walgreens #09085 (P) .....64 Walgreens #11456 (P) .....85 Walgreens #06261 (P) .....99 Walgreens #09124 (P) .....57 Walgreens #11607 (P) .....97 Walgreens #06279 (P) .....54 Walgreens #09125 (P) .....64 Walgreens #11689 (P) .....12 Walgreens #06312 (P) .....96 Walgreens #09130 (P) ...... 9 Walgreens #11801 (P) .....36 Walgreens #06313 (P) .....58 Walgreens #09131 (P) .....35 Walgreens #11887 (P) .....11 Walgreens #06323 (P) .....65 Walgreens #09132 (P) .....52 Walgreens #11953 (P) .....13 Walgreens #06359 (P) .....96 Walgreens #09133 (P) .....29 Walgreens #11954 (P) .....19 Walgreens #06360 (P) .....92 Walgreens #09146 (P) .....76 Walgreens #11955 (P) .....75 Walgreens #06369 ...... 25 Walgreens #09148 (P) ...... 3 Walgreens #12267 (P) .....96 Walgreens #06444 (P) ...... 8 Walgreens #09251 (P) .....59 Walgreens #12288 (P) .....51 Walgreens #06459 (P) .....67 Walgreens #09252 (P) .....59 Walgreens #12310 (P) .....39 Walgreens #06529 (P) .....45 Walgreens #09364 (P) .....12 Walgreens #12345 (P) .....70 Walgreens #06546 (P) .....99 Walgreens #09450 (P) .....21 Walgreens #12346 (P) .....28 Walgreens #06550 (P) .....83 Walgreens #09691 ...... 78 Walgreens #12508 (P) .....10 Walgreens #06559 (P) .....51 Walgreens #09928 (P) .....67 Walgreens #12533 (P) .....54

Walgreens #06636 (P) .....46 Walgreens #10078 (P) ...... 6 Walgreens #12534 (P) .....15 PHARMACIES OF INDEX Walgreens #06708 (P) .....92 Walgreens #10079 (P) .....54 Walgreens #12561 (P) .....35 Walgreens #06830 (P) .....17 Walgreens #10080 (P) .....31 Walgreens #12688 ...... 78 Walgreens #06911 (P) .....71 Walgreens #10081 (P) .....31 Walgreens #12777 (P) .....35 Walgreens #07033 (P) .....46 Walgreens #10129 (P) .....32 Walgreens #12820 (P) .....38 Walgreens #07065 (P) .....16 Walgreens #10186 (P) .....20 Walgreens #12849 ...... 30 Walgreens #07094 (P) .....68 Walgreens #10250 (P) .....20 Walgreens #12971 (P) .....37 Walgreens #07140 (P) .....35 Walgreens #10251 (P) .....12 Walgreens #13150 (P) .....14 Walgreens #07158 (P) ...... 9 Walgreens #10288 (P) .....21 Walgreens #15007 (P) .....35 Walgreens #07160 (P) .....35 Walgreens #10351 (P) .....36 Walgreens #15391 (P) .....56 Walgreens #07206 (P) .....85 Walgreens #10359 (P) .....96 Walgreens Mail Service. . .102 Walgreens #07208 (P) .....65 Walgreens #10404 (P) .....70 Walgreens Pharmacies (P). . .1 Walgreens #07247 (P) .....28 Walgreens #10405 (P) .....11 Walgreens Specialty Walgreens #07275 (P) .....82 Walgreens #10406 (P) .....69 Pharmacy ...... 104, 105 Walgreens #07319 (P) .....38 Walgreens #10489 (P) .....72 Walgreens Specialty Walgreens #07369 (P) .....20 Walgreens #10499 (P) .....39 Pharmacy ...... 58, 70, 80 Walgreens #07416 (P) .....50 Walgreens #10513 (P) ...... 9 Walker Street Pharmacy Walgreens #07430 (P) .....30 Walgreens #10514 (P) .....10 (P)...... 35 Walgreens #07461 (P) .....54 Walgreens #10515 (P) .....71 Walker’s Pharmacy ...... 109 Walgreens #07484 (P) ...... 3 Walgreens #10777 (P) .....60 Walker’s Pharmacy ...... 26 Walgreens #07500 (P) .....17 Walgreens #10778 (P) .....64 Wal-Mart 10-5472 (NP) ....80 Walgreens #07501 (P) .....17 Walgreens #10803 (P) .....35 Wal-Mart Pharmacies (NP) . .1 Walgreens #07509 (P) .....42 Walgreens #10804 (P) .....51 Wal-Mart Pharmacy # Walgreens #07527 (P) .....42 Walgreens #10906 (P) .....95 10-4660 (NP) ...... 41 Walgreens #07660 (P) . . . .101 Walgreens #10953 (P) .....16 Wal-Mart Pharmacy #10-1422 Walgreens #07768 (P) .....41 Walgreens #11156 (P) .....81 (NP) ...... 20 Walgreens #07770 ...... 14 Walgreens #11197 (P) .....80 Wal-Mart Pharmacy #10-1423 Walgreens #07787 (P) .....45 Walgreens #11249 (P) .....36 ...... 12 Walgreens #07854 (P) .....92 Walgreens #11264 (P) .....42 Wal-Mart Pharmacy #10-1428 Walgreens #07874 (P) .....20 Walgreens #11265 ...... 8 (NP) ...... 28 Walgreens #07888 (P) .....64 Walgreens #11286 ...... 25 Wal-Mart Pharmacy #10-1432 Walgreens #07894 ...... 30 Walgreens #11310 (P) .....49 (NP)...... 101 Walgreens #07934 (P) .....77 Walgreens #11395 (P) .....44 Wal-Mart Pharmacy #10-1540 Walgreens #07952 (P) .....26 Walgreens #11415 (P) .....70 ...... 78 Walgreens #09079 (P) .....51 Walgreens #11417 (P) .....54

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 143 INDEX OF PHARMACIES

Wal-Mart Pharmacy #10-1542 Wal-Mart Pharmacy #10-2079 Wal-Mart Pharmacy #10-2866 (NP) ...... 70 (NP) ...... 49 (NP) ...... 25 Wal-Mart Pharmacy #10-1592 Wal-Mart Pharmacy #10-2080 Wal-Mart Pharmacy #10-2867 (NP) ...... 21 (NP) ...... 9 (NP) ...... 25 Wal-Mart Pharmacy #10-1593 Wal-Mart Pharmacy #10-2100 Wal-Mart Pharmacy #10-2869 (NP) ...... 8 (NP) ...... 10 (NP) ...... 14 Wal-Mart Pharmacy #10-1611 Wal-Mart Pharmacy #10-2102 Wal-Mart Pharmacy #10-2872 (NP) ...... 75 (NP) ...... 49 (NP) ...... 82 Wal-Mart Pharmacy #10-1642 Wal-Mart Pharmacy #10-2192 Wal-Mart Pharmacy #10-2873 ...... 13 (NP) ...... 21 (NP) ...... 66 Wal-Mart Pharmacy #10-1719 Wal-Mart Pharmacy #10-2238 Wal-Mart Pharmacy #10-2912 (NP) ...... 50 (NP) ...... 54 (NP) ...... 99 Wal-Mart Pharmacy #10-1733 Wal-Mart Pharmacy #10-2273 Wal-Mart Pharmacy #10-2959 (NP) ...... 75 (NP) ...... 15 (NP) ...... 44 Wal-Mart Pharmacy #10-1752 Wal-Mart Pharmacy #10-2338 Wal-Mart Pharmacy #10-3328 (NP) ...... 5 (NP) ...... 20 (NP) ...... 52 Wal-Mart Pharmacy #10-1754 Wal-Mart Pharmacy #10-2354 Wal-Mart Pharmacy #10-3336 (NP) ...... 39 (NP) ...... 55 (NP)...... 101 Wal-Mart Pharmacy #10-1771 Wal-Mart Pharmacy #10-2358 Wal-Mart Pharmacy #10-3476 (NP) ...... 77 (NP) ...... 3 (NP) ...... 83 Wal-Mart Pharmacy #10-1790 Wal-Mart Pharmacy #10-2417 Wal-Mart Pharmacy #10-3487 (NP) ...... 52 (NP) ...... 15 (NP) ...... 44 Wal-Mart Pharmacy #10-1791 Wal-Mart Pharmacy #10-2434 Wal-Mart Pharmacy #10-3632 (NP) ...... 55 (NP) ...... 13 (NP) ...... 74 Wal-Mart Pharmacy #10-1798 Wal-Mart Pharmacy #10-2493 Wal-Mart Pharmacy #10-3726 (NP) ...... 77 (NP) ...... 35 (NP) ...... 18 INDEX OF PHARMACIES Wal-Mart Pharmacy #10-1809 Wal-Mart Pharmacy #10-2522 Wal-Mart Pharmacy #10-3791 (NP) ...... 21 (NP) ...... 12 (NP) ...... 77 Wal-Mart Pharmacy #10-1824 Wal-Mart Pharmacy #10-2558 Wal-Mart Pharmacy #10-3876 (NP) ...... 81 (NP) ...... 46 (NP) ...... 54 Wal-Mart Pharmacy #10-1836 Wal-Mart Pharmacy #10-2559 Wal-Mart Pharmacy #10-4243 (NP) ...... 38 (NP) ...... 46 (NP) ...... 15 Wal-Mart Pharmacy #10-1923 Wal-Mart Pharmacy #10-2567 Wal-Mart Pharmacy #10-4383 (NP) ...... 33 (NP) ...... 35 (NP) ...... 85 Wal-Mart Pharmacy #10-1928 Wal-Mart Pharmacy #10-2618 Wal-Mart Pharmacy #10-4540 (NP) ...... 17 (NP) ...... 57 (NP) ...... 39 Wal-Mart Pharmacy #10-1936 Wal-Mart Pharmacy #10-2619 Wal-Mart Pharmacy 10-4584 (NP) ...... 11 (NP) ...... 6 (NP) ...... 39 Wal-Mart Pharmacy #10-1942 Wal-Mart Pharmacy #10-2620 Wal-Mart Pharmacy #10-5048 (NP) ...... 71 (NP) ...... 4 (NP) ...... 60 Wal-Mart Pharmacy #10-1987 Wal-Mart Pharmacy #10-2631 Wal-Mart Pharmacy #10-5064 (NP) ...... 37 (NP) ...... 96 ...... 30 Wal-Mart Pharmacy #10-2010 Wal-Mart Pharmacy #10-2644 Wal-Mart Pharmacy #10-5065 (NP) ...... 7 (NP) ...... 73 (NP) ...... 31 Wal-Mart Pharmacy #10-2014 Wal-Mart Pharmacy #10-2692 Wal-Mart Pharmacy #10-5097 (NP) ...... 72 (NP) ...... 40 (NP) ...... 73 Wal-Mart Pharmacy #10-2061 Wal-Mart Pharmacy #10-2693 Wal-Mart Pharmacy #10-5159 (NP) ...... 3 (NP) ...... 16 (NP) ...... 69 Wal-Mart Pharmacy #10-2062 Wal-Mart Pharmacy #10-2700 Wal-Mart Pharmacy #10-5160 ...... 6 (NP) ...... 68 (NP) ...... 29

144 (NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available INDEX OF PHARMACIES

Wal-Mart Pharmacy #10-5280 West Grange Drugs (P) ....99 ...... 31 West Lake Drug ...... 31 Z Wal-Mart Pharmacy #10-5376 West Shore Pharmacy ....68 (NP) ...... 27 West Village Pharmacy . . .115 ZMC Pharmacy LLC (P) ....64 Wal-Mart Pharmacy #10-5386 West Village Pharmacy (NP) ...... 70 (NP) ...... 85 Wal-Mart Pharmacy #10-5411 Westborn Pharmacy 8. . . .115 ...... 26 Westborn Pharmacy 8 (P) . .85 Wal-Mart Pharmacy #10-5444 Westland Maple Drugs . . .117 (NP) ...... 19 Westland Maple Drugs Wal-Mart Pharmacy 10-5761 (P)...... 100 (NP) ...... 83 Westshore Professional Wal-Mart Pharmacy #10-5842 Pharmacy (NP) ...... 54 (NP) ...... 98 Westside Medical Pharmacy Wal-Mart Pharmacy 10-5844 ...... 31

(NP) ...... 96 Wheelock Drugs (NP) .....38 PHARMACIES OF INDEX Wal-Mart Pharmacy 10-5893 Wheelock Pharmacy North (NP) ...... 61 Town Commons (NP).....38 Walter Reuther Psychiatric Whitney Pharmacy Services Hospital ...... 117 (NP) ...... 20 Walter Reuther Psychiatric Wilcox Pharmacy Inc. (P). . .13 Hospital ...... 100 Wiltse Community Pharmacy Wares Drug Store ...... 25 (P)...... 97 Warren Pharmacy And Wingert’s Pharmacy (NP) . .77 Medical Supplies, P.C. Wm. Beaumont Hospital (NP) ...... 46 Pharmacy (NP) ...... 64 Warren Prescriptions (P) . . .58 Woodbridge Pharmacy . . .32 Waterford Pharmacy (P) . . .67 Woodhaven Medical Center Watkins Pharmacy And Pharmacy (P) ...... 85 Surgical Supply (NP) .....54 Woodhaven Pharmacy (P).101 Wayland Village Pharmacy Woodland Pharmacy (NP). .92 (NP) ...... 3 Woodpointe Pharmacy (P) .35 Wayne Campus Pharmacy Woodward Pharmacy (P). . .56 (P)...... 92 Wrights Pharmacy (P) .....72 Wayne Family Pharmacy. .117 Wyandotte Drugs (P).....101 Wayne Family Pharmacy (P)...... 100 Wayne Professional Pharmacy Y (NP)...... 100 We Care Pharmacy Plus . .113 Yinger Pharmacy Shoppe Inc. We Care Pharmacy Plus (P)...... 52 (P)...... 59 Yinger Pharmacy Shoppe Weick’s Pharmacy (P) ...... 3 (P)...... 52 Welcome Pharmacy South Young Pharmacy (P) ...... 92 ...... 29 Youngs Pharmacy (P) ...... 9 Well Care Pharmacy (NP) . .85 Ypsilanti Family Wellpointe Pharmacy (NP) .64 Pharmacy ...... 115 Wenk’s Prescription Shop Ypsilanti Family Pharmacy (P)...... 80 (P)...... 81 West Grange Drugs...... 117

(NP)–Non-Preferred 90-day fill available (P)–Preferred 90-day fill available 145 Notes

Service Area 2014 Upper Michigan Alcona Baraga Cheboygan Delta Kalkaska Alger Benzie Chippewa Dickinson Keweenaw Alpena Charlevoix Crawford Emmet Leelanau Antrim Gogebic Luce Grand Traverse Mackinac Houghton Marquette Iron Menominee Upper Montmorency Michigan Ontonagon Oscoda Otsego North/East Michigan Presque Isle Arenac Midland Schoolcraft Bay Missaukee Clare Montcalm Oakland Genesee Oceana County Gladwin Ogemaw Gratiot Osceola Upper Macomb Huron Roscommon County Iosco Saginaw Michigan Isabella Sanilac Southwest Michigan Wayne Lake Shiawassee County Lapeer St. Clair Allegan Newaygo Manistee Tuscola Kent Ottawa Mason Wexford Muskegon North/East Mecosta Michigan Mid Michigan Barry Clinton Ionia Oakland Berrien Eaton Kalamazoo Macomb Cass Ingham Van Buren Southwest Michigan Mid South Michigan Michigan Branch Hillsdale Lenawee Monroe Calhoun Jackson Livingston St. Joseph Washtenaw South Wayne Michigan

R006545

www.bcbsm.com/medicare

R018512