2021 Pharmacy Directory

Blue Cross Blue Shield Nebraska Medicare Advantage (MA) Individual and Group 2021

This pharmacy directory was updated on 09/2020. For more recent information or other questions, please contact Blue Cross and Blue Shield of Nebraska Customer Service at:

Phone: 888-488-9850 or, for TTY users: 711 Hours are 8 a.m. to 9 p.m. CT, seven days a week from Oct. 1 through Mar. 31; 8 a.m. to 9 p.m. CT, Monday-Friday from Apr. 1 through Sep. 30. Or visit: Medicare.NebraskaBlue.com

Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at Medicare.NebraskaBlue.com. You may also call Customer Service for updated provider information.

Make the most of Medicare

Medicare.NebraskaBlue.com Discrimination is Against the Law

Blue Cross and Blue Shield of Nebraska complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Blue Cross and Blue Shield of Nebraska does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Blue Cross and Blue Shield of Nebraska: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact Customer Service at 1-888-488-9850, TTY 711.

If you believe that Blue Cross and Blue Shield of Nebraska has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Manager, Corporate Compliance Blue Cross and Blue Shield of Nebraska P.O. Box 3248 Omaha, NE 68180-0001 1-888-488-9850, TTY: 711 Fax: 1-402-392-4130 [email protected]

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Manager, Corporate Compliance, is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. Multi-language Interpreter Services

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-488-9850 (TTY: 711).

Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-488-9850 ((TTYTTY: 711).

Chinese: 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-488-9850（TTY: 711）。

ﻣﻠﻣ ﻠ ﺔظوﺣ : اإ ذ ﻛﻧ ثدﺣﺗﺗتﻛﻧ دﺣﺗﺗت ث رﻛاذ ،رﻛاذ ، ﻐاﻟﻠ ﺔﻐاﻟﻠ ﺔ ﻓ ﺎتﻣدﺧﺈنﻓ ﻣدﺧﺈن ﺎت دﻋﺎﺳﻣاﻟ ةدﻋﺎﺳﻣاﻟ ة رﻓاﺗوﺗﺔﯾﻐوﻠﻟا ﻠﻟا ﻐ وﯾ ﺔ ﺗﺗ وا رﻓ ﻟك نﺟﺎﻣﻟﺑﺎ . رﺑلﺻﺗا ﻗمرﺑلﺻﺗا ﻗم :Arabic 98985050-488-888888-1-1 ( رﻗم فﺗھ ھﺎ فﺗ ﻛمﺑﻟاوﺻمﻟا ﻟا مﺻ ﺑﻟاو ﻛ م : 711))..

KKaren: ymfolOymfo; : erhIuwd: unDusdmf , yS:uwd:r:pU:wI tvJwtdObO e>ItdOvUe*DIvD:. qJ;usU Call 1-888-488-9850 (TTY: 711) wuhI.

French: ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-488-9850 (ATS: 711).

Cushite: XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-888-488-9850 (TTY: 711).

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-488-9850 ((TTY:TTY: 711).

Korean: 주의: 한국어를 사용하시는 경우 , 언어 지원 서비스를 무료로 이용하실 수 있습니다 . 1-888-488-9850 ((TTYTTY: 711) 번으로 전화해 주십시오 .

֟ᱨ֛֗֞ ֡ उपल녍ध ᭣։֔᭨շի֌ ֊ नेपाली֧֧ ֎֫֔֠֌֞ बो쥍नु�ꅍछ᭨֊ ᱟ᭠ս֏֊֡ भने,֧ तपा�को लािग भाषा सहायता֑֚֞֞ֆ֛֚֞֞֙֏֞֟չ֔շ֫֞ᲊֆ֌ सेवाह�֧ िन:शु쥍क֘֊Nepali: 鵍यान֞᭟֑ ֊ᳰֈ֊ �दनुहोस्: ֡ ֛֚֫ ֭ य�द तपा�ले֔ᲊֆ֌֑֞ᳰֈ ֿ֭ ֛֚֫ ֿ֭ 1-8881-888-488-9850-488-9850 (TTY: 711) मा फोनչ֊֞֍֫֊֐ गनु셍होस्।֡ᭅ ս֊छन्।

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-488-9850 (телетайп: 711).

Laotian: ໂປດຊາບ: ຖ້ ້ າວ່ ່ າ ທ ່ ່ ານເົ ົວ້ ້ າພາສາ ລາວ, ການໍ ໍບິິລກ ານຊ່ ່ ວຍເຫືືຼ ຼ ອດ້ ້ ານພາສາ, ໂດຍບໂດຍບເສໍ່ໍ່ ເສັັ ຽຄ່ ່ າ, ແມນມ່່ ີີ ພ້້ ອມໃຫ ້້ ທ່່ ານ. ໂທຣ 1-888-488-9850 ((TTY:TTY: 711).

یاردﮔﺎﺋﺎ : ﮕﮭﺋﮭ ﺮﮕﮭﺋﮭ ﺮ ﺑﮭ ﺎﻧزﻣ ﯽﺎﻧزﻣ ﯽ یدﮐﻮر ﮭﻗ ﯽﮭﺘرﻣﺎﯾﯽﺎﻧﮑﮭرﯾازﻮﮕﺘﺰﻣﮭﺧﺖﯿەﮐﮭد،ﺴﮭﮭﻗ ﮭﺘرﻣﺎﯾﯽﺎﻧﮑﮭرﯾازﻮﮕﺘﺰﻣﮭﺧﺖﯿەﮐﮭد،ﺴﮭ ﯽ نﻣﺎ،ز ﻣﺎ،ز ن :Kurdish اﯾڕﯚﺨ،ﺑﮭ ﯽاﯾڕﯚﺨ،ﺑﮭ ﯽ ﺑﯚ ﺗﯚ ﮭﺳﺘەدﺮﺑﮭ . یﺪەﻧﻮﭘﮭﯿ ﺪەﻧﻮﭘﮭﯿ ی ﺑﮭ TTYTTY:: 77111) 1- 1-888888-448888-9850) . ﮭﺑ ﮑ

:ﮫﻮﺟﺗ ﯽﻣﺖﺒﺻﺤﯽﺳرﺎﻓنﺎﺑزﮫﺑﺮﮔا:ﮫﻮﺟﺗ ﮔا ﺑﺮ ﺎﺑزﮫ ﺳرﺎﻓن ﺒﺻﺤﯽ ﯽﻣﺖ ﮏﮐﻤوتﺎﺪﻣﺧ،ﺪﻨﯿﮐ ﺪﻨﯿﮐ ﺎﺪﻣﺧ، ت ﮏﮐﻤو ﺎھ ﺳادﻮﺟﻮﻣﺎﻤﺷیاﺮﺑنﺎﮕﯾارﯽﻧﺎﺑزیﺎھ ﻧﺎﺑزی ﺎﮕﯾارﯽ اﺮﺑن ﻤﺷی ﻮﺟﻮﻣﺎ ﺳاد ﺖ. :Persian ﺸﯿﺑتﻋﺎﻼطاﺐﺴﮐیاﺑﺮ ﻤﺎرﺷﺑﺎﺘﺮ،ﺸﯿﺑتﻋﺎﻼطاﺐﺴﮐیاﺑﺮ ﺘﺮ، ﻤﺎرﺷﺑﺎ ه TTY:TTY: 711) 1-1-888888-488-98598500)) .ﺪﺮﯾﮕﯿﺑسﺎﺗﻤ ﺪﺮﯾﮕﯿﺑسﺎﺗﻤ .

Japanese: 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。 1-888-488-9850（TTY: 711）まで、お電話にてご連絡ください。 Introduction

This booklet provides a list of Blue Cross and Blue Shield of Nebraska Medicare Advantage’s (MA) network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Blue Cross and Blue Shield of Nebraska MA’s formulary. When this pharmacy directory refers to “we,” “us,” or “our,” it means Blue Cross and Blue Shield of Nebraska. When it refers to “plan” or “our plan,” it means Blue Cross and Blue Shield of Nebraska MA. We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under Blue Cross and Blue Shield of Nebraska MA 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 other 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 September 1, 2020. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all the pharmacies on this list, but your costs for some drugs may be less at pharmacies in this list that offer preferred cost-sharing. We have marked these pharmacies with “SAVE” to distinguish them from other pharmacies in our network that offer standard cost-sharing. You can get prescription drugs shipped to your home through our network mail order delivery program. For more information, please contact us or see the mail order section of this pharmacy directory. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact Blue Cross and Blue Shield of Nebraska MA. Pharmacies are listed alphabetically by city and by type of pharmacy. The types of pharmacies in this directory appear in this order:

• Mail Order Pharmacy • Retail Pharmacies, Including Chain Pharmacies • Long-term Care Pharmacies • Home Infusion Pharmacies • Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies • Specialty Pharmacies

Under each listing we also list additional pharmacy features. These features are identified on each page with the following key:

• SAVE = Preferred cost-sharing. Drugs from these pharmacies may cost less than other pharmacies in our network.

• 90 = 90-day supply. These are retail pharmacies that offer an extended (90-day) supply of medications.

• 90+SAVE = 90-day supply with Preferred Cost Sharing. Drugs from these extended supply retail pharmacies may cost less than other pharmacies in our network.

• 24HR = Pharmacy is open 24-hours.

• eRX = Pharmacy accepts electronic prescriptions from prescribers. Mail Order Pharmacy

AllianceRx Walgreens Prime (855) 457-1350 (TTY users: 711) 24 hours a day, seven days a week www.alliancerxwp.com You can get prescription drugs shipped to your home through our network mail order delivery program. For refills of your mail order prescriptions, please contact us 10 to 20 days before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. Typically, you should expect to receive your prescription drugs within 5-8 business days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at: (855) 457-1350, (TTY users: 711), 24 hours a day, seven days a week, or visit www.alliancerxwp.com.

ADAMS Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. ADAMS NELIGH HASTINGS HILLTOP DRUGS ETC...... (402) 887-5551 ALLEN DISCOUNT PHARMACY...... (402) 463-2240 108 W 11TH ST • 68756 1115 W 2ND ST • 68901 SAVE, 90, 90+SAVE, eRX 90, eRX WANEK PHARMACY...... (402) 887-5426 BERTS PHARMACY...... (402) 462-4466 410 MAIN STREET • 68756 1021 W 14TH ST • 68901 SAVE, 90, 90+SAVE, eRX 90, eRX TILDEN BERTS PHARMACY...... (402) 462-4343 TILDEN PHARMACY...... (402) 368-5385 700 W 2ND ST • 68901 103 E 2ND STREET • POB 190 • 68781 90, eRX SAVE, 90, 90+SAVE, eRX CROSIER PARK PHARMACY...... (402) 462-4600 BOONE 405 EAST 14TH STREET • 68901 ALBION SAVE, 90, 90+SAVE, eRX GOOD LIFE PHARMACY...... (402) 395-3353 KEITHS DRIVE IN DRUG...... (402) 462-6101 124 S 4TH ST • 68620 500 N HASTINGS • 68901 SAVE, 90, 90+SAVE, eRX 90, eRX WELLS DRUG...... (402) 395-2184 KEITHS MEDICAL PARK 113 S 4TH ST • 68620 PHARMACY...... (402) 463-0515 90, eRX 2115 N KANSAS AVE • 68901 BOX BUTTE 90, eRX ALLIANCE REDLINE SPECIALTY PHARMACY...(402) 462-2929 2415 OSBORNE DRIVE EAST, STE 100 • 68901 ALLIANCE COMMUNITY SAVE, 90, 90+SAVE, eRX PHARMACY...... (308) 629-1045 315 BOXBUTTE AVE • 69301 RUSS'S MARKET PHARMACY #7..... (402) 463-8503 90, eRX 611 N BURLINGTON AVE • 68901 SAVE, 90, 90+SAVE, eRX DAVE'S PHARMACY...... (308) 762-4811 223 BOX BUTTE AVE • 69301 WALGREENS #03269...... (402) 463-4554 SAVE, 90, 90+SAVE, eRX 705 N BURLINGTON AVE • 68901 SAVE, 90, 90+SAVE, eRX SAFEWAY PHARMACY #0549...... (308) 762-1258 500 E. THIRD STREET • 69301 WALMART PHARMACY 10-1460...... (402) 462-6100 SAVE, 90, 90+SAVE, eRX 3803 OSBORNE DRIVE WEST • 68901 SAVE, 90, 90+SAVE, eRX HEMINGFORD ANTELOPE DAVE'S PHARMACY...... (308) 487-5212 508 NIOBRARA AVE • 69348 ELGIN SAVE, 90, 90+SAVE, eRX ELGIN PHARMACY...... (402) 843-5555 112 S. 2ND STREET • 68636 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 2

Nebraska Pharmacy Listing CASS

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. BROWN VALLEY PHARMACY INC...... (308) 234-3300 AINSWORTH 211 W 33RD ST • 68845 90, eRX AINSWORTH DRUG...... (402) 376-5959 255 N MAIN ST • 69210 WALGREENS #03716...... (308) 236-8547 SAVE, 90, 90+SAVE, eRX 2516 2ND AVE • 68847 BUFFALO SAVE, 90, 90+SAVE, 24HR, eRX GIBBON WALMART PHARMACY 10-0598...... (308) 234-6681 5411 N. SECOND AVENUE • 68847 LAMBERT'S FAMILY PHARMACY.....(308) 468-5210 SAVE, 90, 90+SAVE, eRX 814 1ST ST • 68840 RAVENNA SAVE, 90, 90+SAVE, eRX KEARNEY SVANDA PHARMACY...... (308) 452-3672 314 GRAND AVE • 68869 ABC DRUG...... (308) 237-2178 SAVE, 90, 90+SAVE, eRX 2123 CENTRAL AVE • 68847 BURT SAVE, 90, 90+SAVE, eRX OAKLAND CVS PHARMACY #16297...... (308) 237-2002 4800 3RD AVE • 68845 CORNER DRUG...... (402) 685-5883 90, eRX 301 N OAKLAND AVENUE • 68045 SAVE, 90, 90+SAVE, eRX FAMILY FRESH MKT. PHARMACY... (308) 234-6086 3920 2ND AVENUE • 68847 TEKAMAH SAVE, 90, 90+SAVE, eRX TEKAMAH DRUG COMPANY...... (402) 374-2500 HAEBERLE'S GRAND CENTRAL 412 S 13TH ST • 68061 PHARMACY...... (308) 237-2545 90, eRX 7 W 25TH ST • 68847 BUTLER SAVE, 90, 90+SAVE, eRX DAVID CITY HEARTLAND ONCOLOGY DAVID CITY DISCOUNT PHARMACY(402) 367-3068 PHARMACY...... (308) 865-2303 422 5TH ST • 68632 412 W. 42ND ST • 68845 90, eRX SAVE, 90, 90+SAVE, eRX CASS HY-VEE PHARMACY (1323)...... (308) 236-0022 LOUISVILLE 5212 3RD AVENUE • 68845 SAVE, 90, 90+SAVE, eRX BLAKE'S PHARMACY...... (402) 234-3025 213 MAIN ST • 68037 MEDICAP PHARMACY...... (308) 234-8056 SAVE, 90, 90+SAVE, eRX 2706 2ND AVE • STE A • 68847 90, eRX PLATTSMOUTH U-SAVE PHARMACY...... (308) 455-1555 HY-VEE PHARMACY (1527)...... (402) 296-6900 3611 2ND AVE • 68847 16418 WESTSIDE DRIVE • 68048 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 3

CEDAR Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. CEDAR COLFAX HARTINGTON SCHUYLER STEFFEN DRUG...... (402) 254-3549 SCHUYLER PHARMACY...... (402) 352-3020 214 NORTH BROADWAY • 68739 122 W. 16TH STREET • 68661 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX LAUREL CUMING MAIN ST APOTHECARY...... (402) 256-3511 WEST POINT 201 E 2ND ST • 68745 HY-VEE PHARMACY (7090)...... (402) 380-0046 SAVE, 90, 90+SAVE, eRX 500 PLAZA DRIVE • 68788 CHASE SAVE, 90, 90+SAVE, eRX IMPERIAL TOMS REXALL DRUG...... (402) 372-2108 ADAMS DRUG COMPANY INC...... (308) 882-4949 124 N MAIN ST • 68788 513 BROADWAY • 69033 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WEST POINT APOTHECARY...... (402) 372-1034 CHERRY 303 PLAZA DR • 68788 VALENTINE 90, eRX WISNER HEART CITY DRUG...... (402) 376-5959 110 N MAIN ST • 69201 WISNER APOTHECARY...... (402) 529-3550 SAVE, 90, 90+SAVE, eRX 1024 AVENUE E STE 100 • 68791 CHEYENNE 90, eRX CUSTER SIDNEY BROKEN BOW SAFEWAY PHARMACY #2555...... (308) 254-4531 1944 ILLINOIS ST • 69162 FRONTIER FAMILY PHARMACY...... (308) 872-5231 SAVE, 90, 90+SAVE, eRX 540 S 8TH AVE • 68822 90, eRX WALMART PHARMACY 10-5170...... (308) 254-9149 3001 SILVERBERG DRIVE • 69162 VARNEY HEALTH MART...... (308) 872-2321 SAVE, 90, 90+SAVE, eRX 744 SOUTH E ST • 68822 SAVE, 90, 90+SAVE, eRX WESTERN DRUG...... (308) 254-2032 806 ILLINIOS • 69162 CALLAWAY eRX SEVEN VALLEYS HEALTH MART.....(308) 836-2219 CLAY 200 E PACIFIC ST • 68825 SUTTON SAVE, 90, 90+SAVE, eRX DAKOTA SUTTON PHARMACY...... (402) 773-4300 210 NORTH SAUNDERS AVENUE • 68979 EMERSON eRX EMERSON APOTHECARY...... (402) 695-8100 1003 S MAIN ST STE 2 • 68733 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 4

Nebraska Pharmacy Listing DODGE

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. SOUTH SIOUX CITY WALMART PHARMACY 10-0637...... (308) 324-7437 HY-VEE PHARMACY (1620)...... (402) 494-3021 200 FRONTIER STREET • 68850 2501 CORNHUSKER PLAZA • 68776 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX DEUEL WALGREENS #10502...... (402) 494-8827 CHAPPELL 1030 W 21ST ST • 68776 OUR TOWN PHARMACY...... (308) 874-2428 SAVE, 90, 90+SAVE, eRX 733 2ND ST • 69129 WALMART PHARMACY 10-1332...... (402) 494-8850 SAVE, 90, 90+SAVE, eRX 1601 CORNHUSKERS DRIVE • 68776 DIXON SAVE, 90, 90+SAVE, eRX PONCA DAWES KELLER PHARMACY...... (402) 755-2216 CHADRON 101 W 3RD ST • 68770 PETERSEN DRUG...... (308) 432-2400 SAVE, 90, 90+SAVE, eRX 302 MAIN ST • 69337 DODGE 90, eRX FREMONT SAFEWAY PHARMACY #2563...... (308) 432-2070 A & A DRUG COMPANY...... (402) 721-7634 230 MOREHEAD ST • 69337 1612 N BELL • 68025 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-2579...... (308) 432-6995 BAKERS PHARMACY...... (402) 727-1995 510 LINDEN STREET • 69337 1531 N BELL ST • 68025 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX DAWSON HY-VEE PHARMACY (1185)...... (402) 753-2460 COZAD 840 EAST 23RD STREET • 68025 SERVICE DRUG STORE...... (308) 784-2238 SAVE, 90, 90+SAVE, eRX 133 E 8TH ST • 69130 KUBAT PHARMACY FREMONT...... (402) 727-4044 SAVE, 90, 90+SAVE, eRX 350 WEST 23RD STREET • 68025 U SAVE PHARMACY COZAD...... (308) 784-3500 90, eRX 312 W 8TH ST • 69130 METHODIST FREMONT HEALTH SAVE, 90, 90+SAVE, eRX PHARMACY...... (402) 727-3820 GOTHENBURG 450 E 23RD ST • 68025 90, eRX GOTHENBURG DISCOUNT PHARMACY...... (308) 537-7155 UROLOGY CLINIC PC...... (402) 727-5000 902 AVENUE D • 69138 2735 N CLARKSON ST • 68025 SAVE, 90, 90+SAVE, eRX 90, eRX LEXINGTON WALGREENS #09899...... (402) 721-8872 U SAVE PHARMACY INC...... (308) 324-6325 1525 E 23RD ST • 68025 603 N WASHINGTON • 68850 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 5

DOUGLAS Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. WALMART PHARMACY 10-0776...... (402) 727-8772 BAKERS PHARMACY...... (402) 556-5600 3010 E 23RD AVE N • 68025 888 SADDLECREEK RD • 68106 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX NORTH BEND BAKERS PHARMACY...... (402) 333-5351 MEDICINE MAN PHARMACY...... (402) 652-3217 17370 LAKESIDE HILLS PLAZA • 68130 748 MAIN ST • 68649 SAVE, 90, 90+SAVE, eRX 90, eRX BAKERS PHARMACY...... (402) 964-0888 SCRIBNER 505 N 155TH PLAZA • 68154 SAVE, 90, 90+SAVE, eRX SCRIBNER DRUGSTORE...... (402) 664-3133 416 MAIN ST • 68057 BAKERS PHARMACY...... (402) 571-3122 90, eRX 4405 N 72ND ST • 68134 DOUGLAS SAVE, 90, 90+SAVE, eRX BENNINGTON BAKERS PHARMACY...... (402) 333-6500 12025 W CENTER RD • 68144 HEALTH MART PHARMACY...... (402) 932-5556 SAVE, 90, 90+SAVE, eRX 15817 C W HADAN DR • 68007 SAVE, 90, 90+SAVE, eRX CHI HEALTH PHARMACY - BERGAN MERCY...... (402) 398-6781 ELKHORN 7710 MERCY RD • STE 110 • 68124 U SAVE PHARMACY...... (402) 289-2576 SAVE, 90, 90+SAVE, eRX 940 N. 204TH AVE • STE 270 • 68022 CHI HEALTH PHARMACY - SAVE, 90, 90+SAVE, eRX FLORENCE...... (402) 451-2125 WALGREENS #11204...... (402) 289-0520 8613 N 30TH ST • 68112 20201 MANDERSON ST • 68022 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX CHI HEALTH PHARMACY - OMAHA IMMANUEL...... (402) 572-2300 ADULT & PEDIATRIC UROLOGY PC (402) 397-7989 6901 N 72ND ST • 68122 10707 PACIFIC ST STE 101 • 68114 SAVE, 90, 90+SAVE, eRX eRX CHI HEALTH PHARMACY - 132ND AND BAKER'S PHARMACY #316...... (402) 451-3980 CENTER...... (402) 717-9410 7312 N 30TH ST • 68112 13315 W CENTER RD • SUITE 101 • 68144 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX BAKERS PHARMACY...... (402) 573-0947 CHI HEALTH PHARMACY - 161ST AND 5555 N 90TH ST • 68134 MAPLE...... (402) 717-9770 SAVE, 90, 90+SAVE, eRX 16101 EVANS STREET • SUITE 101 • 68116 SAVE, 90, 90+SAVE, eRX BAKERS PHARMACY...... (402) 965-8339 13250 W MAPLE RD • 68164 CHI HEALTH PHARMACY - 42ND AND SAVE, 90, 90+SAVE, eRX L...... (402) 717-7055 4220 L ST • 68107 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 6

Nebraska Pharmacy Listing DOUGLAS

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. CHI HEALTH PHARMACY - CVS PHARMACY #17105...... (402) 573-2221 LAKESIDE...... (402) 758-5006 6636 N 73RD PLZ • 68122 16909 LAKESIDE HILLS CT • STE 107 • 68130 90, eRX SAVE, 90, 90+SAVE, eRX CVS PHARMACY #17208...... (402) 390-8881 CHI HEALTH SPECIALTY 7200 DODGE ST • 68114 PHARMACY...... (402) 398-5503 90, eRX 7710 MERCY RD STE 102 • 68124 CVS PHARMACY #17392...... (402) 970-1001 SAVE, 90, 90+SAVE, eRX 16959 EVANS PLAZA • 68116 COSTCO PHARMACY #1012...... (402) 952-3249 90, eRX 12300 W DODGE RD • 68154 CVS PHARMACY #17446...... (402) 201-2660 SAVE, 90, 90+SAVE, eRX 12500 K PLAZA • 68137 CREIGHTON UNIVERSITY MEDICAL CENTER 90, eRX CLINIC PHARMACY...... (402) 449-4560 CVS/PHARMACY # 04929...... (402) 493-3257 2412 CUMING ST STE 201 • CUMC CLINIC 10770 FORT ST • 68134 PHARMACY • 68131 90, eRX SAVE, 90, 90+SAVE, eRX CVS/PHARMACY # 05863...... (402) 493-0443 CVS PHARMACY # 02931...... (402) 895-0181 14460 W MAPLE RD • 68116 14303 U ST • 68137 90, eRX 90, eRX DEPOT DRUG...... (402) 544-3740 CVS PHARMACY # 03478...... (402) 334-6933 1400 DOUGLAS ST • STOP 0050 • 68179 2609 S 132ND ST • 68144 90, eRX 90, eRX DIABETES SUPPLY CENTER OF THE CVS PHARMACY # 05634...... (402) 393-2557 MIDLANDS...... (402) 399-8444 8315 W CENTER RD • 68124 2910 S 84TH ST • 68124 90, eRX SAVE, 90, 90+SAVE, eRX CVS PHARMACY # 06733...... (402) 391-2072 DOUGLAS COUNTY HEALTH CENTER 1919 N 90TH ST • 68114 PHARMACY...... (402) 444-7403 90, eRX 4102 WOOLWORTH • 68105 CVS PHARMACY #05714...... (402) 558-2000 90, eRX 4840 DODGE ST • 68132 ELMWOOD PHARMACY...... (402) 551-5200 90, eRX 808 S 52ND • 68106 CVS PHARMACY #16146...... (402) 431-9161 SAVE, 90, 90+SAVE, eRX 4001 N 132ND ST • 68164 FAMILY FARE PHARMACY #3811.....(402) 896-1450 90, eRX 1221 SOUTH 203RD STREET • 68130 CVS PHARMACY #16903...... (402) 697-4876 SAVE, 90, 90+SAVE, eRX 17810 W CENTER RD • 68130 HEMATOLOGY & ONCOLOGY CONSULTANTS 90, eRX PHARMACY...... (402) 572-3524 6901 N 72ND ST STE 2244 • 68122 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 7

DOUGLAS Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. HY-VEE DRUGSTORE (7062)...... (402) 451-8842 KOHLL'S RX...... (402) 895-3102 8404 N 30TH STREET • 68112 12741 Q ST • 68137 SAVE, 90, 90+SAVE, eRX eRX HY-VEE PHARMACY #1 (1465)...... (402) 553-4143 KOHLL'S RX...... (402) 553-8901 5150 CENTER • 68106 5002 DODGE ST • 68132 SAVE, 90, 90+SAVE, eRX eRX HY-VEE PHARMACY #10 (1474)...... (402) 445-6109 KOHLL'S RX...... (402) 733-2001 3410 NORTH 156TH STREET • 68116 5108 L ST • 68117 SAVE, 90, 90+SAVE, eRX eRX HY-VEE PHARMACY #11 (1478)...... (402) 334-4922 KUBAT PHARMACY...... (402) 731-4333 1000 SOUTH 178TH STREET • 68118 2401 N ST • 68107 SAVE, 90, 90+SAVE, eRX 90, eRX HY-VEE PHARMACY #1535...... (402) 339-3054 KUBAT PHARMACY...... (402) 558-8888 9707 Q STREET • 68127 4924 CENTER ST • 68106 SAVE, 90, 90+SAVE, eRX 90, eRX HY-VEE PHARMACY #2 (1466)...... (402) 697-0928 MEDICINE MAN PHARMACY...... (402) 496-9757 14591 STONY BROOK BLVD. • 68137 15615 PACIFIC ST STE 8 • 68118 SAVE, 90, 90+SAVE, eRX 90, eRX HY-VEE PHARMACY #3 (1469)...... (402) 384-9085 NCS OUTPATIENT PHARMACY...... (402) 691-5102 8809 W CENTER ROAD • 68124 17201 WRIGHT ST STE 200 • 68130 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX HY-VEE PHARMACY #4 (1467)...... (402) 493-2323 NEB. MEDICINE PHARMACY AT LAURITZEN 10808 FORT STREET • 68164 OUTPATIENT CENTER...... (402) 552-7999 SAVE, 90, 90+SAVE, eRX 4014 LEAVENWORTH ST • 68198 SAVE, 90, 90+SAVE, eRX HY-VEE PHARMACY #5 (1470)...... (402) 384-8767 7910 CASS STREET • 68114 NEBRASKA ORTHOPAEDIC HOSPITAL RETAIL SAVE, 90, 90+SAVE, eRX PHARMACY...... (402) 609-3344 2808 S 143RD PLZ • 68144 HY-VEE PHARMACY #7062 LTC...... (402) 451-8842 SAVE, 90, 90+SAVE, eRX 8404 N. 30TH • SUITE 100 • 68112 SAVE, 90, 90+SAVE, eRX ONE WORLD PHARMACY...... (402) 502-5832 4920 S 30TH ST • STE 105 • 68107 HY-VEE PHARMACY #8 (1471)...... (402) 493-3110 SAVE, 90, 90+SAVE, eRX 747 NORTH 132ND STREET • 68154 SAVE, 90, 90+SAVE, eRX PHARMACY EXPRESS SERVICES INC...... (402) 932-8709 HY-VEE PHARMACY #9 (1472)...... (402) 891-0600 349 N 78TH STREET • 68114 17810 WELCH PLAZA • 68135 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX QUANTUM MED PHARMACY...... (402) 339-4036 KOHLL'S RX...... (402) 342-6548 3744 S 132ND ST • 68144 2915 LEAVENWORTH ST • 68105 SAVE, 90, 90+SAVE, eRX eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 8

Nebraska Pharmacy Listing DOUGLAS

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. STEIER PHARMACY...... (402) 572-3553 WALGREENS #04443...... (402) 393-8451 6828 N 72ND ST • STE 2160 • 68122 9001 W CENTER RD • 68124 90, eRX SAVE, 90, 90+SAVE, eRX SUPER SAVER PHARMACY #20...... (402) 895-5644 WALGREENS #04772...... (402) 451-7201 5710 S 144TH ST • 68137 3005 LAKE ST • 68111 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX THE NEBRASKA MEDICAL CENTER CLINIC WALGREENS #04974...... (402) 551-6205 PHARMACY NEBRASKA MEDICIN... (402) 559-5215 5038 CENTER ST • 68106 989200 NEBRASKA MEDICAL CENTER • 68198 SAVE, 90, 90+SAVE, 24HR, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #05059...... (402) 496-2214 THINK AKSARBEN PHARMACY 10725 FORT ST • 68134 LLC...... (402) 506-9010 SAVE, 90, 90+SAVE, eRX 7100 W CENTER RD • 68106 WALGREENS #05143...... (402) 558-8551 SAVE, 90, 90+SAVE, eRX 7151 CASS ST • 68132 UNIMED PHARMACY...... (402) 827-6080 SAVE, 90, 90+SAVE, eRX 7915 N 30TH ST • 68112 WALGREENS #05190...... (402) 738-8061 90, eRX 2323 L STREET • 68107 UROLOGY CANCER CENTER...... (402) 991-8468 SAVE, 90, 90+SAVE, eRX 17607 GOLD PLAZA • 68130 WALGREENS #05360...... (402) 861-6966 SAVE, 90, 90+SAVE, eRX 5062 S 155TH ST • 68137 UROLOGY CENTER PC...... (402) 397-9800 SAVE, 90, 90+SAVE, eRX 105 S 90TH ST • 68114 WALGREENS #05741...... (402) 342-3301 90, eRX 3001 DODGE ST • 68131 VIARX...... (402) 614-6363 SAVE, 90, 90+SAVE, eRX 825 N 90TH ST • 68114 WALGREENS #05966...... (402) 697-9393 SAVE, 90, 90+SAVE, eRX 2605 S 171ST ST • 68130 WALGREENS #02472...... (402) 408-2342 SAVE, 90, 90+SAVE, 24HR, eRX 18040 R PLAZA • 68135 WALGREENS #06802...... (402) 408-1078 SAVE, 90, 90+SAVE, eRX 15525 SPAULDING PLAZA • 68116 WALGREENS #03186...... (402) 431-0655 SAVE, 90, 90+SAVE, eRX 3701 NORTH 132ND ST • 68164 WALGREENS #06962...... (402) 345-7178 SAVE, 90, 90+SAVE, eRX 3121 S 24TH ST • 68108 WALGREENS #03202...... (402) 457-5615 SAVE, 90, 90+SAVE, eRX 7202 NORTH 30TH ST • 68112 WALGREENS #07272...... (402) 334-9134 SAVE, 90, 90+SAVE, eRX 13155 W CENTER RD • 68144 WALGREENS #03621...... (402) 393-8056 SAVE, 90, 90+SAVE, 24HR, eRX 9001 BLONDO STREET • 68134 WALGREENS #07563...... (402) 393-2029 SAVE, 90, 90+SAVE, 24HR, eRX 8989 W DODGE RD • 68114 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 9

DUNDY Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. WALGREENS #07693...... (402) 551-1797 WALMART PHARMACY 10-4138...... (402) 686-2058 225 N SADDLE CREEK RD • 68131 13105 BIRCH DR • 68164 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #10437...... (402) 408-0304 WALMART PHARMACY 10-4139...... (402) 970-6492 5225 N 90TH ST • 68134 360 N SADDLE CREEK RD • 68131 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #13137...... (402) 895-1619 WALMART PHARMACY 10-4358...... (402) 393-9560 13510 Q ST • 68137 1606 SOUTH 72ND STREET • 68124 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #15237...... (402) 551-6151 WALMART PHARMACY 10-5141...... (402) 289-9276 2929 N 60TH ST • 68106 16960 WEST MAPLE ROAD • 68116 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #16270...... (402) 397-5906 WALMART PHARMACY 10-5361...... (402) 697-1742 240 S 77TH ST • 68114 12850 L STREET • 68137 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS PHARMACY #11203... (402) 289-0808 VALLEY 17909 BURKE ST • 68118 VALLEY PHARMACY...... (402) 359-2284 SAVE, 90, 90+SAVE, eRX 123 E GARDINER ST • 68064 WALGREENS PHARMACY #11205... (402) 201-2729 SAVE, 90, 90+SAVE, eRX 6005 N 72ND ST • 68134 DUNDY SAVE, 90, 90+SAVE, eRX BENKELMAN WALMART PHARMACY 10-1637...... (402) 492-9349 BENKELMAN PHARMACY...... (308) 423-2759 6304 NORTH 99TH STREET • 68122 509 S CHIEF • 69021 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-3151...... (402) 970-9304 FILLMORE 5018 AMES AVE • 68104 SAVE, 90, 90+SAVE, eRX GENEVA WALMART PHARMACY 10-3152...... (402) 397-5853 WEAVER PHARMACY...... (402) 759-4433 2451 N 90TH ST • 68134 1014 G ST • 68361 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX FRANKLIN WALMART PHARMACY 10-3153...... (402) 609-5710 6710 S 167TH ST • 68135 FRANKLIN SAVE, 90, 90+SAVE, eRX FRANKLIN DRUG...... (308) 425-3004 WALMART PHARMACY 10-3172...... (402) 541-0823 635 15TH AVE • 68939 5051 L ST • 68117 90, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-3267...... (402) 330-3650 18201 WRIGHT ST. • 68130 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 10

Nebraska Pharmacy Listing HALL

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. FRONTIER GARDEN CURTIS OSHKOSH CURTIS DISCOUNT PHARMACY...... (308) 367-5100 CAMPBELL DRUG...... (308) 772-3333 115 CENTER AVE • 69025 311 MAIN ST • 69154 SAVE, 90, 90+SAVE, eRX 90, eRX FURNAS GARFIELD ARAPAHOE BURWELL ARAPAHOE PHARMACY...... (308) 962-7895 BURWELL PHARMACY...... (308) 346-4747 507 NEBRASKA AVE • 68922 137 GRAND AVE • 68823 SAVE, 90, 90+SAVE, eRX 90, eRX CAMBRIDGE GREELEY MARKS PHARMACY CAMBRIDGE... (308) 697-3400 SPALDING 624 PATTERSON ST • 69022 SPALDING PHARMACY...... (308) 497-2250 90, eRX 230 W ST JOSEPH • 68665 GAGE 90, eRX ADAMS HALL LAKE CREST PHARMACY...... (402) 988-7145 GRAND ISLAND 620 MAIN STREET • STE B • 68301 CVS/PHARMACY # 10243...... (308) 384-4089 90, eRX 1710 W 2ND ST • 68803 BEATRICE 90, eRX CLABAUGH PHARMACY...... (402) 223-3591 EMPLOYER'S HEALTH CARE 501 COURT ST • 68310 PHARMACY...... (308) 381-2225 90, eRX 810 N DIERS AVE • 68803 SAVE, 90, 90+SAVE, eRX DEINES PHARMACY...... (402) 223-4779 910 E COURT ST • 68310 HY-VEE PHARMACY (1221)...... (308) 381-0328 SAVE, 90, 90+SAVE, eRX 115 WILMAR AVE • 68803 SAVE, 90, 90+SAVE, eRX NEBRASKA LONG TERM CARE LLC...... (402) 223-4779 SUPER SAVER PHARMACY #28...... (308) 398-0940 910 COURT ST • STE D • 68310 710 WEST STATE ST • 68801 eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-2784...... (402) 228-4594 U SAVE PHARMACY SOUTH...... (308) 382-3784 3620 NORTH 6TH STREET • 68310 2105 S LOCUST ST • 68801 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WYMORE U SAVE PHARMACY 4TH STREET... (308) 384-7372 ARBOR STATE PHARMACY...... (402) 645-3080 423 W 4TH ST • 68801 203 S 7TH ST STE B • 68466 SAVE, 90, 90+SAVE, eRX eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 11

HAMILTON Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. U-SAVE PHARMACY NW...... (308) 384-9010 HOWARD 3224 W 13TH ST • 68803 SAINT PAUL SAVE, 90, 90+SAVE, eRX BREHM REXALL DRUG INC...... (308) 754-4611 WALGREENS #03467...... (308) 384-8290 608 HOWARD AVE • 68873 1515 W 2ND ST • 68801 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX JEFFERSON WALGREENS #12538...... (308) 384-2626 FAIRBURY 1230 N WEBB RD • 68803 SAVE, 90, 90+SAVE, eRX GLOBE REXALL DRUG...... (402) 729-2620 424 E ST • 68352 WALMART PHARMACY 10-1326...... (308) 381-0337 90, eRX 2250 NO. DIERS AVE • 68803 SAVE, 90, 90+SAVE, eRX JEFFERSON COMMUNITY HEALTH CENTER...... (402) 729-6881 WALMART PHARMACY 10-3395...... (308) 381-5859 2200 NORTH H ST • 68352 3501 SOUTH LOCUST STREET • 68801 90, eRX SAVE, 90, 90+SAVE, eRX KORBEL DRUG...... (402) 729-3104 HAMILTON 405 5TH ST • 68352 AURORA 90 JIMS U SAVE PHARMACY...... (402) 694-3187 WALMART PHARMACY 10-0418...... (402) 729-3755 219 Q STREET • 68818 2831 HWY 15 • 68352 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX HARLAN JOHNSON ALMA TECUMSEH HAYS PHARMACY...... (308) 928-2022 CHIEF DRUG...... (402) 335-3375 706 W MAIN • 68920 123 SOUTH 3RD ST • 68450 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX HOLT HASSELBALCH PHARMACY...... (402) 335-3303 ATKINSON 143 S 3RD ST • 68450 SAVE, 90, 90+SAVE, eRX WEST HOLT PHARMACY...... (402) 925-2651 313 W PEARL • 68713 KEARNEY eRX MINDEN ONEILL L. T PEDLEY DRUG...... (308) 832-2815 O'NEILL FAMILY PHARMACY...... (402) 336-2660 419 N COLORADO • 68959 317 E DOUGLAS STREET • 68763 SAVE, 90, 90+SAVE, eRX 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 12

Nebraska Pharmacy Listing LANCASTER

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. KEITH CVS PHARMACY # 00473...... (402) 477-0397 OGALLALA 1550 SOUTH ST L • 68502 90, eRX SAFEWAY PHARMACY #0557...... (308) 284-3670 611 N SPRUCE ST • 69153 CVS PHARMACY # 08610...... (402) 484-5777 SAVE, 90, 90+SAVE, eRX 2755 S 48TH ST • 68506 90, eRX U SAVE PHARMACY OGALLALA..... (308) 284-2242 23 N SPRUCE ST • 69153 CVS PHARMACY # 17371...... (402) 420-3541 SAVE, 90, 90+SAVE, eRX 8201 S 40TH ST • 68516 90, eRX WALMART PHARMACY 10-7129...... (308) 284-0118 201 PONY EXPRESS LANE • 69153 CVS PHARMACY #04033...... (402) 420-0318 SAVE, 90, 90+SAVE, eRX 5611 S 27TH ST • 68512 KIMBALL 90, eRX KIMBALL CVS PHARMACY #08615...... (402) 477-9200 1411 SUPERIOR STREET • 68521 BEMIS DRUG LLC...... (308) 235-3936 90, 24HR, eRX 129 S CHESTNUT ST • 69145 SAVE, 90, 90+SAVE, eRX CVS PHARMACY #08616...... (402) 423-3839 5566 S 56TH ST • 68516 KNOX 90, eRX BLOOMFIELD CVS PHARMACY #08626...... (402) 489-6399 BLOOMFIELD PHARMACY...... (402) 373-4411 7002 O ST • 68510 105 S BROADWAY ST STE 1 • 68718 90, 24HR, eRX SAVE, 90, 90+SAVE, eRX CVS PHARMACY #16055...... (402) 464-8066 CREIGHTON 333 N 48TH ST • 68504 MANION'S DRUG STORE...... (402) 358-3535 90, eRX 719 MAIN STREET • 68729 CVS/PHARMACY # 08294...... (402) 467-1134 SAVE, 90, 90+SAVE, eRX 4808 W O ST • 68510 LANCASTER 90, eRX HICKMAN HY-VEE PHARMACY #1 (1385)...... (402) 465-0413 5010 O STREET • 68510 MEADOWLARK PHARMACY...... (831) 277-1871 SAVE, 90, 90+SAVE, eRX 520 PRAIRIE VW • 68372 SAVE, 90, 90+SAVE, eRX HY-VEE PHARMACY #2 (1386)...... (402) 467-5157 LINCOLN 1601 N 84TH STREET • 68505 SAVE, 90, 90+SAVE, eRX ALIVATION PHARMACY, LLC...... (402) 476-5686 8550 CUTHILLS CIR • 68526 HY-VEE PHARMACY #3 (1387)...... (402) 477-5099 SAVE, 90, 90+SAVE, eRX 5020 N 27TH STREET • 68521 SAVE, 90, 90+SAVE, eRX COSTCO PHARMACY #1285...... (531) 333-7569 1620 PINE LAKE RD • 68512 HY-VEE PHARMACY #4 (1388)...... (402) 421-1040 SAVE, 90, 90+SAVE, eRX 6001 VILLAGE DRIVE • 68516 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 13

LANCASTER Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. HY-VEE PHARMACY #5 (1390)...... (402) 489-0588 SOUTHEAST NEBRASKA CANCER 7151 STACY LANE • 68516 CENTER...... (402) 420-7000 SAVE, 90, 90+SAVE, eRX 201 S 68TH STREET PL STE 200 • 68510 SAVE, 90, 90+SAVE, eRX KOHLL'S RX...... (402) 476-3342 808 N. 27TH STREET • 68503 STOCKWELL PHARMACY...... (402) 423-8588 eRX 3811 S 27TH ST • 68502 SAVE, 90, 90+SAVE, eRX LINCOLN PHARMACY...... (408) 817-7978 3300 A ST STE 100 • 68510 SUPER SAVER PHARMACY #11...... (402) 423-0870 SAVE, 90, 90+SAVE, eRX 5460 S 56TH ST • 68516 SAVE, 90, 90+SAVE, eRX NEBRASKA HEMATOLOGY-ONCOLOGY PC PHARMACY...... (402) 484-4919 SUPER SAVER PHARMACY #17...... (402) 420-8268 4004 PIONEER WOODS DR • 68506 2525 PINE LAKE ROAD • 68512 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX NEIGHBORHOOD LTC PHARMACY..(402) 488-1184 SUPER SAVER PHARMACY #27...... (402) 438-8870 1265 S COTNER BLVD STE 30 • 68510 840 FALLBROOK BLVD • 68521 eRX SAVE, 90, 90+SAVE, eRX PHARMA INNOVATIONS...... (408) 875-6195 SUPER SAVER PHARMACY #4...... (402) 464-8822 7121 STEPHANIE LN STE 104 • 68516 233 N 48TH ST • 68504 eRX SAVE, 90, 90+SAVE, eRX RELYCARE LTC LINCOLN...... (402) 466-6083 SUPER SAVER PHARMACY #9...... (402) 466-7775 1219 NORTH COTNER BLVD • 68505 2662 CORNHUSKER HWY • 68521 90, eRX SAVE, 90, 90+SAVE, eRX RELYCARE PHARMACY LINCOLN... (402) 466-7283 THE PHARMACY...... (402) 466-7283 1221 N COTNER BLVD STE 1 • 68505 1221 N COTNER BLVD • STE 1 • 68505 eRX 90, eRX RUSS'S PHARMACY #15...... (402) 489-6085 UNIV. OF NEBRASKA HEALTH CENTER 130 N 66TH ST • 68505 PHARMACY...... (402) 472-7457 SAVE, 90, 90+SAVE, eRX 550 N 19TH ST • 68588 SAVE, 90, 90+SAVE, eRX RUSS'S PHARMACY #16...... (402) 421-1333 4400 SOUTH 33RD STREET COURT • 68516 UROLOGY PC...... (402) 489-8888 SAVE, 90, 90+SAVE, eRX 5500 PINE LAKE RD • 68516 90, eRX RUSS'S PHARMACY #21...... (402) 435-8241 1550 S CODDINGTON • 68522 WALGREENS #00515...... (402) 483-2834 SAVE, 90, 90+SAVE, eRX 2600 SOUTH 48TH STREET • STE 7 • 68506 SAVE, 90, 90+SAVE, eRX RUSS'S PHARMACY 1...... (402) 474-2102 1709 WASHINGTON ST • 68502 WALGREENS #00541...... (402) 476-6898 SAVE, 90, 90+SAVE, eRX 1301 O STREET • 68508 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 14

Nebraska Pharmacy Listing LINCOLN

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. WALGREENS #01162...... (402) 464-8302 WALMART PHARMACY 10-2432...... (402) 975-6174 8300 NORTHERN LIGHTS DR • 68505 2501 GRAINGER PARKWAY • 68512 SAVE, 90, 90+SAVE SAVE, 90, 90+SAVE, eRX WALGREENS #01430...... (402) 435-3271 WALMART PHARMACY 10-3823...... (402) 466-0095 1701 SOUTH ST • 68502 3400 NORTH 85TH STREET • 68507 SAVE, 90, 90+SAVE, 24HR, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #02845...... (402) 421-7119 WELLNESS PHARMACY, INC...... (402) 413-9950 5701 VILLAGE BLVD • 68516 4640 CHAMPLAIN DR STE 113 • 68521 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #03182...... (402) 484-8222 WAVERLY 7045 O STREET • 68510 U-SAVE PHARMACY...... (402) 786-0225 SAVE, 90, 90+SAVE, 24HR, eRX 13851 GUILDFORD ST STE D • 68462 WALGREENS #04088...... (402) 466-1424 SAVE, 90, 90+SAVE, eRX 2502 N 48TH ST • 68504 LINCOLN SAVE, 90, 90+SAVE, eRX NORTH PLATTE WALGREENS #04753...... (402) 477-2622 DEPOT DRUG...... (308) 534-8886 1404 SUPERIOR ST • 68521 221 S JEFFERS ST STE 2 • STE 2 • 69101 SAVE, 90, 90+SAVE, 24HR, eRX 90, eRX WALGREENS #05736...... (402) 435-5151 RX EXPRESS PHARMACY...... (308) 532-7010 815 N 27TH ST • 68503 402 N JEFFERS ST • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #05874...... (402) 421-0984 U-SAVE PAVILION PHARMACY...... (308) 221-6993 2630 PINE LAKE RD • 68512 611 W FRANCIS ST STE 130 • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #06884...... (402) 489-0338 U-SAVE PHARMACY...... (308) 532-0310 4000 S 70TH ST • 68506 211 W LEOTA • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #10408...... (402) 489-2232 WALGREENS #12405...... (308) 532-4303 4811 O ST • 68510 102 E PHILIP AVE • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #11089...... (402) 421-2122 WALMART PHARMACY 10-1585...... (308) 532-5830 5500 RED ROCK LN • 68516 1401 SOUTH DEWEY ST. • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-3278...... (402) 484-6342 WESTFIELD PHARMACY...... (308) 532-5539 8700 ANDERMATT DRIVE • 68526 1845 WEST A ST • 69101 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-1943...... (402) 438-4381 4700 N 27TH STREET • 68521 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 15

MADISON Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. MADISON TRAV'S U-SAVE PHARMACY...... (308) 946-3859 NORFOLK 1414 16TH ST • 68826 SAVE, 90, 90+SAVE, eRX CVS/PHARMACY # 10293...... (402) 371-9438 1301 WEST NORFOLK AVE • 68701 MORRILL 90, eRX BRIDGEPORT FAITH REGIONAL HEALTH NEIN PHARMACY...... (308) 262-1070 SERVICES...... (402) 844-8299 1012 MAIN ST • 69336 2700 WEST NORFOLK AVE • 68701 90, eRX SAVE, 90, 90+SAVE, eRX SONNYS PHARMACY...... (308) 262-0580 HY-VEE PHARMACY #1 (1460)...... (402) 371-0610 310 N MAIN • 69336 120 E NORFOLK • 68701 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX NANCE HY-VEE PHARMACY #2 (1461)...... (402) 371-1300 FULLERTON 2107 TAYLOR AVENUE • 68701 SAVE, 90, 90+SAVE, eRX REIMER PHARMACY...... (308) 536-2641 312 BROADWAY • 68638 MEDS & MORE...... (402) 371-6673 SAVE, 90, 90+SAVE, eRX 1226 W PASEWALK AVE • 68701 GENOA SAVE, 90, 90+SAVE, eRX GENOA COMMUNITY PHARMACY... (402) 993-2400 NORTHEAST NEBRASKA LTC...... (402) 371-0172 508 WILLARD AVE. • 68640 120 N 27TH ST STE 200A • 68701 SAVE, 90, 90+SAVE, eRX 90, eRX NEMAHA U SAVE PHARMACY OF NORFOLK..(402) 379-8728 1001 W BENJAMIN AVENUE • 68701 AUBURN SAVE, 90, 90+SAVE, eRX CODY'S USAVE PHARMACY...... (402) 274-4186 WALGREENS #04531...... (402) 371-2340 2220 J STREET • 68305 1300 NORFOLK AVE • 68701 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX STONER DRUG...... (402) 274-0220 WALMART PHARMACY 10-0645...... (402) 371-6232 2115 14TH ST STE 201 • 68305 2400 PASEWALK AVE • 68701 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX NUCKOLLS MERRICK SUPERIOR CENTRAL CITY SUPERIOR PHARMACY...... (402) 879-4234 CORNER DRUG...... (308) 946-2205 348 N CENTRAL AVE • 68978 401 G ST • 68826 SAVE, 90, 90+SAVE, eRX 90, eRX MERRICK MEDICAL CENTER...... (308) 946-5981 1715 26TH STREET • 68826 90, 24HR, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 16

Nebraska Pharmacy Listing PLATTE

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. OTOE PIERCE NEBRASKA CITY OSMOND MOSER'S U SAVE PHARMACY...... (402) 873-3397 THE OSMOND PHARMACY...... (402) 748-3708 1821 S 11TH ST • 68410 322 STATE STREET • 322 STATE ST • 68765 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #12854...... (402) 873-1012 PIERCE 502 S 11TH ST • 68410 PIERCE PHARMACY...... (402) 329-4067 SAVE, 90, 90+SAVE, eRX 215 E. MAIN STREET, STE. B • 68767 WALMART PHARMACY 10-4209...... (402) 874-9093 SAVE, 90, 90+SAVE, eRX 2101 S. 11TH STREET • 68410 PLAINVIEW SAVE, 90, 90+SAVE, eRX PLAINVIEW FAMILY PHARMACY..... (402) 582-4202 SYRACUSE 103 S MAIN • 68769 SYRACUSE U-SAVE PHARMACY..... (402) 269-2001 SAVE, 90, 90+SAVE, eRX 1710 POPLAR • 68446 PLATTE SAVE, 90, 90+SAVE, eRX COLUMBUS PAWNEE BOB'S U-SAVE PHARMACY...... (402) 564-2883 PAWNEE CITY 2759 33RD AVE • 68601 PETES PHARMACY...... (402) 852-2321 SAVE, 90, 90+SAVE, eRX 643 G ST • 68420 CVS/PHARMACY # 10441...... (402) 564-5105 90, eRX 2307 23RD ST • 68601 PERKINS 90, eRX GRANT HY-VEE PHARMACY (1078)...... (402) 562-7668 GRANT PHARMACY...... (308) 352-4511 3010 23RD ST • 68601 218 CENTRAL AVE • 69140 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX SUPER SAVER PHARMACY #18...... (402) 563-3349 PHELPS 3318 23RD ST • 68601 HOLDREGE SAVE, 90, 90+SAVE, eRX TOOLEY DRUG AND HOMECARE.... (402) 564-7205 FULMER USAFE PHARMACY...... (308) 995-4401 2615 13TH ST • 68601 1317 HILL ST • 68949 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX TOOLEY'S CLINIC PHARMACY...... (402) 562-8627 HOLDREGE PHARMACY...... (308) 995-5414 4306 38TH ST • 68601 516 W 14TH ST • SUITE 500 • 68949 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #12115...... (402) 563-3588 2320 23RD AVE • 68601 SAVE, 90, 90+SAVE, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 17

POLK Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. WALMART PHARMACY 10-0774...... (402) 563-4571 SALINE 818 EAST 23RD ST. • 68601 CRETE SAVE, 90, 90+SAVE, eRX KEN'S U-SAVE PHARMACY...... (402) 826-3784 POLK 1302 LINDEN AVE • 68333 OSCEOLA SAVE, 90, 90+SAVE, eRX TOOLEY'S OSCEOLA PHARMACY...(402) 747-8994 WALMART PHARMACY 10-4322...... (402) 826-1032 415 HAWKEYE STREET • 68651 1800 EAST 29TH STREET • 68333 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX STROMSBURG FRIEND YUNGDAHLS APOTHECARY INC..... (402) 764-2827 JOHNSON PHARMACY...... (402) 947-2341 309 COMMERCIAL ST • 68666 151 MAPLE ST • 68359 SAVE, 90, 90+SAVE, eRX 90, eRX RED WILLOW WILBER MCCOOK BARNAS DRUG INC...... (402) 821-2834 FARRELL'S PHARMACY...... (308) 345-1781 124 W 3RD ST • 68465 120 WEST B ST • 69001 90, eRX SAVE, 90, 90+SAVE SARPY U-SAVE PHARMACY AND MEDICAL BELLEVUE SUPPLY...... (308) 345-5670 BAKERS PHARMACY...... (402) 292-0331 902 N HWY 83 • 69001 801 GALVIN RD • 68005 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-0790...... (308) 345-7024 BAKERS PHARMACY...... (402) 292-3580 1902 WEST B • 69001 3614 TWIN CREEK DR • 68123 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX RICHARDSON CHI HEALTH PHARMACY - FALLS CITY BELLEVUE...... (402) 291-5076 KEX RX PHARMACY & HOME CARE(402) 245-2029 3308 SAMSON WAY • STE 106 • 68123 120 E 18TH ST • 68355 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX CVS PHARMACY # 03085...... (402) 292-2685 ROCK 1701 GALVIN RD S • 68005 BASSETT 90, 24HR, eRX CVS PHARMACY #16867...... (402) 291-6779 ROCK COUNTY PHARMACY...... (402) 684-2730 3808 TWIN CREEK DR • 68123 801 S STATE ST • 68714 90, eRX 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 18

Nebraska Pharmacy Listing SARPY

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. THE NEBRASKA MEDICAL CENTER BELLEVUE WALMART PHARMACY 10-3173...... (402) 513-4214 PHARMACY...... (402) 595-1156 9460 GILES RD • 68128 2510 BELLEVUE MEDICAL CENTER DR STE 100 • SAVE, 90, 90+SAVE, eRX 68123 LAVISTA 90, eRX CHI HEALTH PHARMACY - WALGREENS #03694...... (402) 291-8400 LAVISTA...... (402) 717-9510 1802 GALVIN RD S • 68005 8248 S. 96TH STREET • SUITE 101 • 68128 SAVE, 90, 90+SAVE, 24HR, eRX SAVE, 90, 90+SAVE, eRX WALGREENS #05540...... (402) 734-7592 AMBER PHARMACY...... (402) 896-5000 6905 S 36TH ST • 68147 10004 S 152ND ST • STE A • 68138 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-2847...... (402) 292-0463 HY-VEE PHARMACY SOLUTIONS.... (877) 794-9833 10504 SOUTH 15TH STREET • 68123 10004 S 152ND STREET • SUITE C • 68138 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-3154...... (402) 686-2043 REDLERS LTC PHARMACY LLC...... (402) 592-5244 2109 TOWNE CENTER DR • 68123 13831 CHALCO VALLEY PKWY STE 101 • 68138 SAVE, 90, 90+SAVE, eRX 90, eRX GRETNA PAPILLION COMMUNITY PHARMACY SERVICES CHI HEALTH PHARMACY - INC...... (402) 289-0431 MIDLANDS...... (402) 827-4200 21689 NORTHSTAR DR • 68028 11109 S 84TH ST • STE 1841 • 68046 90, eRX SAVE, 90, 90+SAVE, eRX U SAVE PHARMACY GRETNA...... (402) 332-5990 CVS PHARMACY #16148...... (402) 597-9499 611 N HIGHWAY 6 • 68028 718 N WASHINGTON ST • 68046 SAVE, 90, 90+SAVE, eRX 90, eRX WALMART PHARMACY 10-4600...... (402) 881-3687 HY VEE PHARMACY #1514...... (402) 597-5056 11350 WICKERSHAM BLVD • 68028 11650 S 73RD ST • 68046 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX LA VISTA KOHLL'S RX...... (402) 331-8639 COSTCO PHARMACY #1237...... (402) 378-7408 1413 S WASHINGTON ST STE 125 • 68046 12515 PORTSIDE PKWY • 68128 eRX SAVE, 90, 90+SAVE, eRX RXSOLUTIONS...... (402) 502-6511 CVS/PHARMACY # 2741...... (402) 339-1090 1225 GOLDEN GATE DR • 68046 6901 S 84TH ST • 68128 90 90, 24HR, eRX WALGREENS #11355...... (402) 408-1086 WALGREENS #04754...... (402) 592-7990 9512 S 71ST PLAZA • 68133 8380 HARRISON ST • 68128 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, 24HR, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 19

SAUNDERS Nebraska Pharmacy Listing

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. WALGREENS #11356...... (402) 408-0761 WALGREENS #07383...... (308) 635-3296 11343 S 96TH ST • 68046 205 W 27TH ST • 69361 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-1671...... (402) 597-8982 WALMART PHARMACY 10-0867...... (308) 632-3767 8525 S 71ST PLZ • 68133 3322 AVENUE I • 69361 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX SPRINGFIELD SEWARD SPRINGFIELD DRUG...... (402) 253-2000 MILFORD 205 MAIN ST • 68059 MILFORD PHARMACY...... (402) 761-2222 SAVE, 90, 90+SAVE, eRX 610 1ST ST • 68405 SAUNDERS 90, eRX ASHLAND SEWARD ASHLAND PHARMACY, MEDICINE SHOPPE MUERI DRUG...... (402) 643-3332 2058...... (402) 944-3303 544 SEWARD ST • 68434 1401 SILVER ST • 68003 SAVE, 90, 90+SAVE, eRX 90, eRX PAC N. SAVE DISCOUNT WAHOO PHARMACY...... (402) 643-2918 URBAN CLINIC PHARMACY INC...... (402) 443-1630 1519 W HWY 34 • STE 1 • 68434 1760 COUNTY RD J • 68066 90, eRX SAVE, 90, 90+SAVE, eRX SEWARD FAMILY PHARMACY...... (402) 646-4607 WAHOO PHARMACY AND GIFTS..... (402) 443-4167 250 N COLUMBIA AVE • 68434 526 N LINDEN ST • 68066 90, eRX SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-0885...... (402) 643-6611 SCOTTS BLUFF 1326 280TH ROAD • 68434 GERING SAVE, 90, 90+SAVE, eRX SHERIDAN GERING U-SAVE PHARMACY...... (308) 436-2181 1400 10TH STREET • 69341 GORDON SAVE, 90, 90+SAVE, eRX STOCKMEN'S DRUG...... (308) 282-1114 SCOTTSBLUFF 116 N MAIN ST • 69343 SAVE, 90, 90+SAVE, eRX COMMUNITY PHARMACY AT REGIONAL WEST...... (308) 630-1900 SHERMAN 3911 AVENUE B • STE M200 • 69361 LOUP CITY SAVE, 90, 90+SAVE, eRX GOOD LIFE PHARMACY...... (308) 745-1614 SAFEWAY PHARMACY #0556...... (308) 635-1444 727 O ST • 68853 601 BROADWAY • 69361 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX LOUP CITY RX SHOPPE...... (308) 745-2109 133 S 7TH ST • 68853 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 20

Nebraska Pharmacy Listing YORK

Retail Pharmacies, Including Chain Pharmacies

For TTY users, please dial 711. THAYER U-SAVE PHARMACY...... (402) 375-2922 HEBRON 216 E 7TH ST • 68787 SAVE, 90, 90+SAVE, eRX PRIEFERT PHARMACY...... (402) 768-6319 428 LINCOLN AVE • 68370 WEBSTER SAVE, 90, 90+SAVE, eRX BLUE HILL THURSTON RONS PHARMACY...... (402) 756-3811 PENDER 537 WEST GAGE ST • 68930 SAVE, 90, 90+SAVE, eRX THE APOTHECARY SHOP...... (402) 385-3350 958 WELLNESS WAY SUITE 2 • 68047 RED CLOUD 90, eRX VILLAGE PHARMACY...... (402) 746-3335 VALLEY 317 N WEBSTER ST • 68970 ORD 90, eRX YORK ANDERSON PHARMACY...... (308) 728-5922 1429 M ST • 68862 HENDERSON 90, eRX HENDERSON PHARMACY...... (402) 723-4475 GOOD LIFE PHARMACY...... (308) 728-3295 1060 N MAIN ST • 68371 125 S 16TH ST • 68862 SAVE, 90, 90+SAVE, eRX SAVE, 90, 90+SAVE, eRX YORK WASHINGTON CHARLIE'S U-SAVE PHARMACY...... (402) 362-4429 BLAIR 2029 N LINCOLN AVE • 68467 SAVE, 90, 90+SAVE, eRX HEALTH MART PHARMACY...... (402) 426-9066 238 S 8TH ST • 68008 WALGREENS #10892...... (402) 362-1280 SAVE, 90, 90+SAVE, eRX 533 S LINCOLN AVE • 68467 SAVE, 90, 90+SAVE, eRX WALGREENS #11957...... (402) 533-8444 1260 WASHINGTON ST • 68008 WALMART PHARMACY 10-0350...... (402) 362-2092 SAVE, 90, 90+SAVE, eRX 101 EAST DAVID DRIVE • 68467 SAVE, 90, 90+SAVE, eRX WALMART PHARMACY 10-4568...... (402) 533-8288 1882 HOLLY ST • 68008 SAVE, 90, 90+SAVE, eRX WAYNE WAYNE PROVIDENCE COMMUNITY PHARMACY...... (402) 375-8862 803 PROVIDENCE RD STE 101 • 68787 90, eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 21

Nebraska Pharmacy Listing

Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under our plan through the facility's long-term care pharmacy or another network pharmacy. For more information, please see your Member Handbook.

BOONE DAWES ALBION CHADRON WELLS DRUG...... (402) 395-2184 PETERSEN DRUG...... (308) 432-2400 113 S 4TH ST • 68620 302 MAIN ST • 69337 BOX BUTTE DAWSON HEMINGFORD OVERTON DAVE'S PHARMACY...... (308) 487-5212 OVERTON COMMUNITY 508 NIOBRARA AVE • 69348 PHARMACY...... (402) 289-0431 BUFFALO 509 C ST • 68863 KEARNEY DIXON PONCA ABC DRUG...... (308) 237-2178 2123 CENTRAL AVE • 68847 KELLER PHARMACY...... (402) 755-2216 CASS 101 W 3RD ST • 68770 LOUISVILLE DODGE FREMONT BLAKE'S PHARMACY...... (402) 234-3025 213 MAIN ST • 68037 GENOA HEALTHCARE, LLC...... (402) 289-8533 CEDAR 2740 N CLARKSON ST • SUITE P1 • 68025 LAUREL MILLER PHARMACY SPECIALTIES..(402) 721-1177 322 E. 22ND STREET • 68025 MAIN ST APOTHECARY...... (402) 256-3511 201 E 2ND ST • 68745 DOUGLAS CHEYENNE OMAHA SIDNEY DIABETES SUPPLY CENTER OF THE MIDLANDS...... (402) 399-8444 WESTERN DRUG...... (308) 254-2032 2910 S 84TH ST • 68124 806 ILLINIOS • 69162 CUMING DOUGLAS COUNTY HEALTH CENTER PHARMACY...... (402) 444-7403 WISNER 4102 WOOLWORTH • 68105 WISNER APOTHECARY...... (402) 529-3550 GENOA HEALTHCARE, LLC...... (402) 979-8011 1024 AVENUE E STE 100 • 68791 4001 LEAVENWORTH ST STE 150A • 68105 CUSTER GERIMED INC...... (402) 827-6080 BROKEN BOW 7915 N 30TH ST • 68112 FRONTIER FAMILY PHARMACY...... (308) 872-5231 KOHLL'S EXTENDED CARE...... (402) 895-7037 540 S 8TH AVE • 68822 12767 Q ST • 68137

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 22

Nebraska Pharmacy Listing

NEBRASKA LTC PHARMACY...... (402) 328-0231 HALL 284 N 115TH ST • 68154 GRAND ISLAND NEIGHBORHOOD LTC PHARMACY..(402) 983-9600 MIDWEST LTC PHARMACY...... (308) 398-0538 5115 S 111TH ST • 68137 3003 FRONTAGE ROAD • STE 2 • 68803 PARAGON PARTNERS...... (833) 307-0400 JEFFERSON 10043 SCOTT CIR STE 105 • 68122 FAIRBURY PHARMERICA...... (888) 895-7133 GLOBE REXALL DRUG...... (402) 729-2620 6528 S 118TH ST • 68137 424 E ST • 68352 QUANTUM MED PHARMACY...... (402) 339-4036 JEFFERSON COMMUNITY HEALTH 3744 S 132ND ST • 68144 CENTER...... (402) 729-6881 DUNDY 2200 NORTH H ST • 68352 BENKELMAN KEARNEY BENKELMAN PHARMACY...... (308) 423-2759 MINDEN 509 S CHIEF • 69021 L. T PEDLEY DRUG...... (308) 832-2815 FURNAS 419 N COLORADO • 68959 CAMBRIDGE LANCASTER MARKS PHARMACY CAMBRIDGE... (308) 697-3400 LINCOLN 624 PATTERSON ST • 69022 GENOA HEALTHCARE, LLC...... (402) 817-0165 GAGE 2301 O ST • 68510 ADAMS GENOA HEALTHCARE, LLC...... (402) 858-7229 LAKE CREST PHARMACY...... (402) 988-7145 3100 N 14TH STREET, SUITE P • 68521 620 MAIN STREET • STE B • 68301 MADONNA REHABILITATION BEATRICE HOSPITAL...... (402) 413-3575 5401 SOUTH ST • 68506 NEBRASKA LONG TERM CARE LLC...... (402) 223-4779 NEBRASKA LTC PHARMACY...... (402) 328-0231 910 COURT ST • STE D • 68310 3901 NORMAL BLVD STE 203 • 68506 GARFIELD NEIGHBORHOOD LTC PHARMACY..(402) 488-1184 BURWELL 1265 S COTNER BLVD STE 30 • 68510 BURWELL PHARMACY...... (308) 346-4747 RELYCARE LTC LINCOLN...... (402) 466-6083 137 GRAND AVE • 68823 1219 NORTH COTNER BLVD • 68505 RELYCARE PHARMACY LINCOLN... (402) 466-7283 1221 N COTNER BLVD STE 1 • 68505

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 23

Nebraska Pharmacy Listing

THE PHARMACY...... (402) 466-7283 OTOE 1221 N COTNER BLVD • STE 1 • 68505 SYRACUSE LINCOLN SYRACUSE U-SAVE LTC NORTH PLATTE PHARMACY...... (402) 269-2001 1710 POPLAR • 68446 U-SAVE PHARMACY...... (308) 532-0310 211 W. LEOTA • 69101 SYRACUSE U-SAVE PHARMACY..... (402) 269-2001 1710 POPLAR • 68446 WESTFIELD PHARMACY...... (308) 532-5539 1845 WEST A ST • 69101 PHELPS MADISON HOLDREGE NORFOLK HOLDREGE PHARMACY...... (308) 995-5414 516 W 14TH ST • SUITE 500 • 68949 NORTHEAST NEBRASKA LTC...... (402) 371-0172 120 N 27TH ST STE 200A • 68701 PIERCE MERRICK PLAINVIEW CENTRAL CITY PLAINVIEW FAMILY PHARMACY..... (402) 582-4202 103 S MAIN ST • 68769 CORNER DRUG...... (308) 946-2205 401 G ST • 68826 PLATTE TRAV'S U-SAVE PHARMACY...... (308) 946-3859 COLUMBUS 1414 16TH ST • 68826 BOB'S U-SAVE PHARMACY...... (402) 564-2883 MORRILL 2759 33RD AVE • 68601 BRIDGEPORT GENOA HEALTHCARE, LLC...... (402) 835-0413 4321 41ST AVE, STE 1 • 68601 NEIN PHARMACY...... (308) 262-1070 1012 MAIN ST • 69336 TOOLEY DRUG AND HOMECARE.... (402) 564-7205 2615 13TH ST • 68601 SONNYS PHARMACY...... (308) 262-0580 310 N MAIN • 69336 TOOLEY DRUG AND HOMECARE.... (402) 564-7205 NANCE 2615 13TH ST • 68601 GENOA TOOLEY'S CLINIC PHARMACY...... (402) 562-8627 4306 38TH ST • 68601 GENOA COMMUNITY PHARMACY... (402) 993-2400 508 WILLARD AVE. • 68640 TOOLEY'S CLINIC PHARMACY...... (402) 562-8627 4306 38TH ST • 68601

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 24

Nebraska Pharmacy Listing

POLK REDLERS LTC PHARMACY LLC...... (402) 592-5244 OSCEOLA 13831 CHALCO VALLEY PKWY STE 101 • 68138 LTC TOOLEYS OSCEOLA SAUNDERS PHARMACY...... (402) 747-8994 ASHLAND 415 HAWKEYE ST • 68651 ASHLAND PHARMACY, MEDICINE SHOPPE STROMSBURG 2058...... (402) 944-3303 YUNGDAHLS APOTHECARY INC..... (402) 764-2827 1401 SILVER ST • 68003 309 COMMERCIAL ST • 68666 WAHOO RED WILLOW SAUNDERS MEDICAL CENTER LTC MCCOOK PHARMACY...... (402) 443-4191 1760 COUNTY ROAD J • 68066 U-SAVE PHARMACY AND MEDICAL SUPPLY...... (308) 345-5670 WAHOO PHARMACY AND GIFTS..... (402) 443-4167 902 N HWY 83 • 69001 526 N LINDEN ST • 68066 ROCK SCOTTS BLUFF BASSETT GERING ROCK COUNTY PHARMACY...... (402) 684-2730 GERING U-SAVE PHARMACY...... (308) 436-2181 801 S STATE ST • 68714 1400 10TH STREET • 69341 SALINE SEWARD WILBER SEWARD BARNAS DRUG INC...... (402) 821-2834 MUERI DRUG...... (402) 643-3332 124 W 3RD ST • 68465 544 SEWARD ST • 68434 SARPY PAC N. SAVE DISCOUNT BELLEVUE PHARMACY...... (402) 643-2918 1519 W HWY 34 • STE 1 • 68434 RELYCARE LTC BELLEVUE...... (402) 991-7283 2227 THURSTON CIR • 68005 SEWARD FAMILY PHARMACY...... (402) 646-4607 250 N COLUMBIA AVE • 68434 GRETNA SHERMAN COMMUNITY PHARMACY SERVICES LOUP CITY INC...... (402) 289-0431 21689 NORTHSTAR DR • 68028 LOUP CITY RX SHOPPE...... (308) 745-2109 LA VISTA 133 S 7TH ST • 68853 OMNICARE PHARMACY OF NEBRASKA LLC...... (402) 896-3636 8402 S. 117TH STREET • SUITES 300 400 • 68128

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 25

Nebraska Pharmacy Listing

THAYER HEBRON TCHS PHARMACY...... (402) 768-4315 120 PARK AVE • 68370 THURSTON PENDER THE APOTHECARY SHOP...... (402) 385-3350 958 WELLNESS WAY SUITE 2 • 68047 VALLEY ORD ANDERSON PHARMACY...... (308) 728-5922 1429 M ST • 68862 GOOD LIFE LONG TERM CARE...... (308) 728-3295 125 S 16TH ST STE A • 68862 WAYNE WAYNE U-SAVE PHARMACY...... (402) 375-2922 216 E 7TH ST • 68787 YORK HENDERSON HENDERSON PHARMACY...... (402) 723-4475 1060 N MAIN ST • 68371

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 26 Nebraska Pharmacy Listing

Home Infusion Pharmacies

For TTY users, please dial 711. For more information, please see your Evidence of Coverage.

ADAMS SARPY HASTINGS LA VISTA REDLINE SPECIALTY PHARMACY...(402) 462-2929 OPTUM INFUSION SERVICES 302, 2415 OSBORNE DRIVE EAST, STE 100 • 68901 LLC...... (402) 331-5086 DOUGLAS 8720 SOUTH 114TH STREET • SUITE 106 • 68128 OMAHA ACCREDO HEALTH GROUP INC...... (402) 597-2330 19060 Q ST • STE 101 • 68135 ARJ INFUSION SERVICES...... (866) 451-8804 3730 S 149TH ST STE 102 • 68144 CHI HEALTH AT HOME - HME...... (402) 898-8470 5428 F ST • 68117 CORAM CVS/SPECIALTY INFUSION SERVICES...... (402) 330-5482 11111 MILL VALLEY RD • 68154 OPTION CARE...... (402) 331-0980 10924 JOHN GALT BLVD • 68137 VNA HOME INFUSION THERAPY CO...... (402) 930-4206 12565 W CENTER RD STE 100 • 68144 HALL GRAND ISLAND GREATER NEBRASKA HOME INFUSION, INC...... (308) 398-4663 2604 SAINT PATRICK AVE STE # 2 • 68803 LANCASTER LINCOLN OPTION CARE...... (402) 423-1333 4401 S 70TH ST • STE 2 • 68516 PLATTE COLUMBUS TOOLEY'S CLINIC PHARMACY...... (402) 562-8627 4306 38TH ST • 68601

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 27

Nebraska Pharmacy Listing

Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through our plan's pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). For more information, please see your Member Handbook.

DOUGLAS OMAHA FRED LEROY HEALTH AND WELLNESS CENTER...... (402) 738-3190 2602 J ST • 68107 eRX MADISON NORFOLK PONCA HILLS HEALTH AND WELLNESS CENTER PHARMACY...... (402) 371-0313 1800 SYRACUSE AVE • 68701 eRX THURSTON MACY CARL T CURTIS HEALTH EDUC. CENTER...... (402) 837-5381 100 INDIAN HILLS DR • 68039 eRX

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 28

Nebraska Pharmacy Listing

Specialty Pharmacies

The pharmacy listed below delivers specialty medications to your door. There are other pharmacies in the previous section of this document in our network that may also be able to provide specialty medications. AllianceRx Walgreens Prime (877) 627-6337 TTY: 711 Hours of operation: 7 a.m. to 7 p.m. Central Time, Monday through Friday, and 8 a.m. to 8 p.m. Eastern Time, Monday through Friday. www.alliancerxwp.com THE NEBRASKA MED CENTER CLINIC PHCY 989200 Nebraska Medical Center Omaha, NE 68198 (402) 559-5215

SAVE = Preferred cost sharing 24HR = Open 24 hours 90 = 90-day supply eRX = Electronic prescribing 90+SAVE = 90-day supply with preferred cost sharing 29

Blue Cross Blue Shield Nebraska Medicare Advantage (MA) Individual and Group 2021

2021 Pharmacy Directory

This pharmacy directory was updated on 09/2020. For more recent information or other questions, please contact Blue Cross and Blue Shield of Nebraska Customer Service at:

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