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Retail Pharmacy Network A well-balanced pharmacy network offers you convenient access and competitive discounts for brand and generic medications. Our national retail pharmacy network includes more than 64,000 chain and independent retail pharmacies, so you’re sure to find one close to home or work. Using Your ID Card When you fill a prescription through a participating pharmacy, show the pharmacy your ID card so they can submit a claim for coverage by your pharmacy benefit plan. When you pick up your prescription, the pharmacy then collects your applicable member contribution as defined by your plan. If you do not present your ID card or you fill a prescription at a non-participating pharmacy, you pay the full retail price for your medication. If the prescription is eligible for coverage under your pharmacy benefit plan, you may submit a claim to request reimbursement (forms are available at www.optumrx.com or by calling customer service). When you submit a claim using the reimbursement form, OptumRx first determines if your plan covers the medication. If it is covered, the amount you receive is based on contracted pharmacy rates less your plan’s out-of-pocket member contribution. All prescription claims are subject to your pharmacy benefit plan’s rules and restrictions. Retail Pharmacy Network Finding a Network Pharmacy You can choose from three easy ways to find participating pharmacies near you: 1. Review the partial list included on the following pages. 2. Go to our website and use the LOCATE A PHARMACY tool. 3. Contact customer service using the number on the back of your benefit plan member ID card. A Brown & Cole Stores Dominicks A & P Pharmacy Bruno’s Drug Castle ABCO Desert Markets Buehler Foods Drug Emporium AccessHealth Member Pharmacies C Drug Town Acme Pharmacy Cash Wise Pharmacy Drug World Pharmacy Ahold USA Care Pharmacies Duane Reade AHS — St. John Pharmacy Carrs Pharmacy E Albertsons Centex Pharmacies Eagle Food Centers Pharmacy Allina Community Pharmacy Chronimed Eagle Pharmacy Allscripts City Center Drug Eckerd Drugs Ambulatory Pharmaceutical Svcs City Market (Kroger) Econo Foods American Drug Stores CJM Em Dee Drug Anchor Pharmacy Cleveland Clinic Foundation Enloe Drugs Appalachian Regional Health Clinic Pharmacy Administration Epic Pharmacy Network Assoc Wholesalers Groc Ntwk Clinic Pharmacy of Marshfield Erlanger Pharmacy Astrup Drug Coborn’s Pharmacy Eureka Drug Stores Aurora Pharmacy Community Distributors F B Community Pharmacy Fagen Pharmacy B & R Stores Continuing Care Rx Family Pharmacare Center Bakers Pharmacy Controlex Enterprises Fairview Pharmacy Services Balls Four B Costco Family Fare Bartell Drugs Covenant Regional Services Family Pharmacy Bashas’ United Drug Cub Pharmacy Familycare Network Bel Air Pharmacy CVS/Pharmacy Familymeds Bell Pharmacy D Farm Fresh Pharmacies Big A Drug Stores D & W Food Centers Felpausch Pharmacy Big Bear/Harts Stores Dahl’s Foods Fleming Companies Biggs Pharmacy Dean Pharmacy Administration Food Circus Super Markets Bi-Lo Department of Veterans Food City Pharmacy Bi-Mart Affairs Pharmacies Fred Meyer (Kroger) BJ’s Pharmacy Dierbergs Family Markets Fred’s Brooks Pharmacy Dillon’s Pharmacy (Kroger) Fruth Brookshire Brothers Discount Drug Mart Frys Food And Drug (Kroger) Brookshire Grocery Discount Emporium Furrs Supermarkets Doc’s Drugs Ltd G Kessel Pharmacy Mr Discount Drugs G & A Medical Personnel Keystone - Medicine Chest Mr Z’s Pharmacy Gabler’s Drug King Kullen Pharmacy N Gavin Herbert King Soopers Pharmacy (Kroger) Nash Finch Gentiva Health Svcs (Quantum) Kings Pharmacy Navarro Discount Pharmacy Genuardi’s (Safeway) Kinney Drugs NCS Healthcare Gerimed Pharmacy Klingensmith’s Drug Stores Neighborcare Pharmacy Giant Eagle Pharmacy Knight Drugs New Oakland Pharmacy Giant Food Stores Kohll’s Pharmacy & Homecare Nob Hill Pharmacy Giant Of Maryland Kopp Drug Nortex Drug Distributors Glass Gardens Kreisler Drug Northwest Health Ventures Golub Kroger Pharmacy Nova Factor Good Neighbor Pharmacy Provider Network K-VA-T Food Stores O Greco Enterprises L Oakwood Healthcare Gristedes Leader Drug Stores OK Health Care Authority-Tpl Group Health Associates Lewis Drug Omnicare Inc. H Lewis Family Drug Oncology Pharmacy Services H E B Pharmacy Longs Drug Store OptionCare Haggen Food & Pharmacy Louis & Clark Drugstores Osco Drug Hannaford Bros Lowe’s Marketplace Pharmacy P Happy Harry’s Discount Drug M P & C Food Markets Harmons Pharmacy M.K. Stores Pamida Harps Food Stores Major Value Member Pharmacies Park Nicollet Pharmacy Harris Teeter Pharmacy MAL Enterprises Pathmark Stores Hartig Drug Marc Glassman Patient’s Pharmacy Health Mart Market Basket Pavilions Pharmacy Healthpartners Pharmacy Marsh Drugs Payless Drugs Heartland Pharmacy Maxor Pharmacy Perlmart/Shoprite Henry Ford Med Ctr Pharmacy Maxi Drug Inc. Pediatric Services Of America HIP Pharmacy Service of NY Mays Drug Stores Penn Traffic Hi-School Pharmacy Mcauley Pharmacy Peoples Pharmacy Homeland Stores McKesson Pharma-Card Hy-Vee Food Stores Med-Fast Pharmacy Pharmacare I Medic Drug Pharmacy Associates IHC Health Services Medicap Pharmacy Pharmacy Express Services Ingles Markets Medicine Center Pharmacy Plus J Medicine Shoppe Pharmacy Providers Of OK Mediserv Jewel-OSCO Pharmapoint Pharmacy Network Med-Rx Drug Jordan Drug Pharmerica Drug Systems Med-X Drug K Pinnacle Pharmacy Meijer Pharmacy Planned Parenthood Greater NNJ K Mart Pharmacy Metro Group #64 Price Chopper Pharmacy Kelsey Seybold Pharmacy Minyard Food Stores Price Cutter Pharmacy Kerr Drug Stores Morton Drug Primemed Pharmacy Services Priority Health Care Pharmacy Shaws Supermarkets U Procare Pharmacy Shelby Shore Drugs Ukrops Super Markets Professional Pharmacy Services Shelly’s Pharmacy UMC Dept Of Pharmacy Services Providence Pharmacy Shop n Save Pharmacy Union Prescription Center Publix Super Markets Shopko Pharmacy United Pharmacy Q Shoppers Pharmacy United Supermarkets QFC (Kroger) Shoprite Pharmacy Unity Retail Pharmacy Quick Chek Pharmacy Dept Smiths Food & Drug Centers (Kroger) Univ Of Utah Health Network R Smittys Pharmacy University Of Wisconsin Snyder Drug Emporium Rainbow Food Group USA/Super D Drug Snyder’s Drug Store Raley’s Pharmacy V St Louis Connectcare Ralphs (Kroger) Value Center Standard Drug Randalls Vg’s Pharmacy Statscript Pharmacy Reasor’s Village Supermarkets Steele’s Pharmacy Ridley’s Food And Drug Vollmer Pharmacy Stop & Shop Pharmacy Rinderer’s Drug Stores Von’s Pharmacy Strategic Health Alliance/Caremax Rite Aid W Sun Factors Ritzman Pharmacy W P Malone Sun Fresh Pharmacy Rogers Pharmacy Walgreens Super D Ronci Family Discount Drugs Inc Wal-Mart Pharmacy Super One Pharmacy Ronetco Wayne Drug Super Rx Pharmacy Rosauers Supermarkets Weber & Judd Supermarket Inv/ Harvest Foods Rxd Pharmacy Wegmans Food Market Supervalu Pharmacy S Weis Pharmacy T Safeway (Genuardi’s) Welcome Pharmacy Target Pharmacy Sam’s Club Pharmacy Wender & Roberts Thriftway Pharmacy Associates Save Mart Pharmacy Westbury Pharmacy Thrifty-White Drug Sav-Mor Drug Stores Wilkinson Pharmacy Tidyman’s Pharmacy Sav-On Drugs Winn-Dixie Stores Tiffany-Davis Drug Schnucks Markets Woods Pharmacy Tom Thumb Scolari’s Food & Drug Y Tom’s Mad Pricer Discount Scots Lo-Cost Pharmacy Yoke’s Pharmacy TOPS Markets Seaway Food Town TriNet Pharmacy (Truecare) Z Sedano’s Pharmacy Twin Knolls Pharmacy Zallie Supermarkets Sedell’s Pharmacy www.optumrx.com 2300 Main Street, Irvine, CA 92614 OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. We are an OptumTM company — a leading provider of integrated health services. Learn more at www.optum.com. All OptumTM trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. ORX0779_120720 ©2012 OptumRx, Inc..
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    Appendix Radio Radio Callsign Service Licensee State Callsign Service Licensee State KA26590 IG MDOI INC TX KA96512 IG PM REALTY GROUP TX KA2774 PW OXFORD, VILLAGE OF MI KAA245 IG YELLOW & CITY CAB CO KS KA3917 IG SCRANTON TIMES PA KAD598 PW RED OAK VETERINARY CLINIC IA KA40009 IG GADSDEN, CITY OF AL KAE933 IG FOODSERVICE MANAGEMENT GROUPFL INC KA40058 IG HOUMANN, JIM:HOUMANN, CHETND KAG551 PW COOK, RICHARD L MO KA42246 IG HOUSTON FLEA MARKET INC TX KAH411 IG MIKE HOPKINS DIST CO INC TX KA42563 IG MUIRFIELD VILLAGE GOLF CLUBOH KAH535 PW CEDAR RAPIDS, CITY OF IA KA4305 IG CITY OF LOS ANGELES DEPARTMENTCA OF KAJ418WATER & POWERIG KOPSA, LEO E IA KA43600 IG SHAPLEY, CHARLES P MO KAM394 IG CROOKSTON IMPLEMENT CO INCMN KA48204 PW PRESQUE ISLE, COUNTY OF MI KAM826 IG AIRGAS SOUTHWEST INC TX KA52811 IG R & R INDUSTRIES INC MA KAM951 IG TERRA INTERNATIONAL INC IA KA53323 IG ELK RIDGE LOG INC WA KAM983 IG RAY KREBSBACH & SONS IA KA53447 PW PIERCE, TOWNSHIP OF OH KAN247 IG BROCE CONSTRUCTION CO INCKS KA53918 IG B M I INC MI KAN892 PW HIAWATHA, CITY OF KS KA61058 IG THISTLE, RONALD F MA KAO274 IG MALINE, THOMAS G NE KA62473 PW KENTUCKY, COMMONWEALTH OFKY DBA KYKAP406 EMERGENCY MANAGEMENTIG DYNEGY IT INC TX KA64283 IG SAINT MARY MEDICAL CENTERWA KAP554 IG AWARE OPERATING SERVICES TXINC KA64769 IG SOUTHERN WAREHOUSING & DISTRIBUTIONFL KAQ533 LTD PW CALIFORNIA, STATE OF CA KA65089 IG DUN & BRADSTREET NJ KAQ708 PW PENNSYLVANIA, COMMONWEALTHPA OF KA65696 IG PARSONS INFRASTRUCTURE &CA TECHNOLOGYKAR785 GROUP PW PIMA, COUNTY OF AZ KA66353 IG BALTIMORE MARINE