Missouri Medicare Select (HMO SNP) 2019 Pharmacy Directory

Transcription

1 2019 Part D Model Pharmacy Directory Missouri Medicare Select (HMO SNP) 2019 Pharmacy Directory This pharmacy directory was updated on 08/27/2018. For more recent information or other questions, please contact us, Missouri Medicare Select (HMO SNP) Member Services, at (844) or, for TTY users, 711, 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30, or visit MissouriMedicareSelect.com Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at MissouriMedicareSelect.com. You may also call Member Services for updated provider. May H4490_2019_PharmDirec_C

2 2019 Part D Model Pharmacy Directory Introduction This booklet provides a list of Missouri Medicare Select 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 Missouri Medicare Select (HMO SNP) s formulary. 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 Missouri Medicare Select 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 nonnetwork 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 08/27/2018. For the most current list, please contact us. Our contact information appears on the front and back cover pages. 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 Missouri Medicare Select. May H4490_2019_PharmDirec_C

3 Retail Pharmacies, including Chain Pharmacies MISSOURI Cass Belton CVS PHARMACY #05661 * 409 E N Ave Belton, MO (816) CVS PHARMACY #16868 * 1106 E North Ave Belton, MO (816) HY-VEE PHARMACY (1034) * 1307 E North Avenue Belton, MO (816) PRICE CHOPPER PHARMACY 359 * 109 North Cedar Street Belton, MO (816) WALGREENS #5277 * 1400 E North Ave Belton, MO (816) Drexel DREXEL 203 E Main St Drexel, MO (816) Harrisonville CVS PHARMACY #08563 * 300 S Commercial St Harrisonville, MO (816) GILLEN 2820 E Rock Haven Rd Ste 110 Harrisonville, MO (816) PRICE CHOPPER 520 S. Commercial Harrisonville, MO (816) WALGREENS #12778 * 505 S Commercial St Harrisonville, MO (816) * 1700 North 291 Highway Harrisonville, MO (816) Peculiar HOMETOWN PHARMACY - PECULIAR * 501 Schug Ave Peculiar, MO (816) Pleasant Hill PLEASANT HILL DRUG STORE * 1905 N State Route 7 Pleasant Hill, MO (816) PRICE CHOPPER 2101 N Hwy 7 Pleasant Hill, MO (816) Raymore CVS PHARMACY #08595 * 1215 W Foxwood Dr Raymore, MO (816) PRICE CHOPPER 900 West Foxwood Drive Raymore, MO (816) SAM'S PHARMACY * 141 N Dean Ave Raymore, MO (816) WALGREENS #11087 * 1214 W Foxwood Dr Raymore, MO (816) * 2015 West Foxwood Dr Raymore, MO (816) Jackson Blue Springs CVS PHARMACY #08570 * 1616 N 7th Hwy Blue Springs, MO (816) Page 1

4 CVS PHARMACY #08581 * 3201 South 7 Highway Blue Springs, MO (816) CVS PHARMACY #08950 * 1101 Nw Woods Chapel Rd Blue Springs, MO (816) CVS PHARMACY #17553 * 1040 Ne Coronado Blue Springs, MO (816) HY-VEE PHARMACY (1033) * 625 W 40 Hwy Blue Springs, MO (816) PRICE CHOPPER PHARMACY 104 * 1101 S 7 Highway Blue Springs, MO (816) WALGREENS #4225 * 1701 Nw Highway 7 Blue Springs, MO (816) WALGREENS #7789 * 3200 Sw State Route 7 Blue Springs, MO (816) * 600 Ne Coronado Drive Blue Springs, MO (816) * 1700 N 7 Hwy Blue Springs, MO (816) Grain Valley HILS 451 A Sw Eagles Pkwy Grain Valley, MO (816) PRICE CHOPPER PHARMACY #325 * 1191 Ne Mcquerry Rd Grain Valley, MO (816) Grandview ALBERS MEDICAL 7201 E. 147th Street Grandview, MO (816) CVS PHARMACY #08607 * S 71 Hwy Grandview, MO (816) PRICE CHOPPER PHARMACY #16 * S Us Highway 71 Grandview, MO (816) WALGREENS #1236 * S Us Highway 71 Grandview, MO (816) Independence AUBURN E. 23rd St Independence, MO (816) COSTCO E Valley View Pkwy Independence, MO (816) CVS PHARMACY #05652 * 1545 E 23rd St Independence, MO (816) CVS PHARMACY #05691 * E Us Hwy 24 Hwy Independence, MO (816) CVS PHARMACY #08430 * 3825 S Noland Rd Independence, MO (816) CVS PHARMACY #08564 * E Us Highway 24 Independence, MO (816) CVS PHARMACY #10241 * 1315 W 23rd St Independence, MO (816) CVS PHARMACY #16558 * E 39th St S Independence, MO (816) HY-VEE PHARMACY #1 (1260) * 1525 E 23rd Street Independence, MO (816) Page 2

5 HY-VEE PHARMACY #2 (1261) * 4545 South Noland Road Independence, MO (816) LOWE DRUG AT CENTERPOINT * E 39th Street Independence, MO (816) SAMS PHARMACY * 4100 Bolger Road Independence, MO (816) STADIUM 4811 S Arrowhead Dr Independence, MO (816) WALGREENS #4224 * 1536 E 23rd Street Independence, MO (816) WALGREENS #4236 * 2261 S Sterling Ave Independence, MO (816) WALGREENS #5247 * 3915 S Noland Rd Independence, MO (816) WALGREENS #5873 * E Us Hwy 24 Independence, MO (816) * 4000 South Bolger Dr Independence, MO (816) * 3411 S Noland Rd Independence, MO (816) Kansas City ALBERS MEDICAL 4400 Broadway Kansas City, MO (816) BURNS & MCDONNELL 9450 Ward Pkwy Kansas City, MO (816) COSTCO 241 East Linwood Blvd Kansas City, MO (816) CVS PHARMACY #05635 * Holmes Rd Kansas City, MO (816) CVS PHARMACY #05663 * 6244 Brookside Blvd Kansas City, MO (816) CVS PHARMACY #05678 * 7907 State Line Rd Kansas City, MO (816) CVS PHARMACY #05697 * 3902 Main St Kansas City, MO (816) CVS PHARMACY #05724 * State Line Rd Kansas City, MO (816) CVS PHARMACY #08553 * State Line Rd Kansas City, MO (816) CVS PHARMACY #08567 * 5011 Main St Kansas City, MO (816) CVS PHARMACY #08571 * 4750 Lees Summit Rd Kansas City, MO (816) CVS PHARMACY #08576 * 2435 E Independence Kansas City, MO (816) CVS PHARMACY #08578 * 6300 Prospect Ave Kansas City, MO (816) CVS PHARMACY #08583 * 4531 Troost Kansas City, MO (816) CVS PHARMACY #08590 * 315 W 75th Street Kansas City, MO (816) Page 3

6 CVS PHARMACY #08592 * 921 Main Kansas City, MO (816) CVS PHARMACY #08594 * 5901 Independence Kansas City, MO (816) CVS PHARMACY #08609 * 7003 Banister Rd Kansas City, MO (816) CVS PHARMACY #16770 * 8509 State Line Rd Kansas City, MO (816) CVS PHARMACY #16961 * 1201 W 136th St Kansas City, MO (816) DCI PHARMACY KANSAS CITY * 650 Carondelet Dr Kansas City, MO (816) MARSHS SUN FRESH 4001 Mill St Kansas City, MO (816) PRICE CHOPPER * 8430 Wornall Road Kansas City, MO (816) PRICE CHOPPER 1030 W 103rd St Kansas City, MO (816) SPALITTO'S 3801 Independence Ave Kansas City, MO (816) ST LUKES HOSPITAL 4320 Wornall Rd Ste 128 Kansas City, MO (816) ST. JOSEPH OUTPATIENT 1000 Carondelet Dr Kansas City, MO (816) SWOPE HEALTH SERVICES * 3801 Blue Pkwy Kansas City, MO (816) THE CHILDRENS MERCY HOSPITAL 2401 Gillham Rd Kansas City, MO (816) WALGREENS #4210 * 1100 E 63rd St Kansas City, MO (816) WALGREENS #4211 * 4630 Troost Ave Kansas City, MO (816) WALGREENS #4212 * 2501 E Linwood Kansas City, MO (816) WALGREENS #4222 * 5400 E Independence Kansas City, MO (816) WALGREENS #4235 * 7500 Wornall Rd Kansas City, MO (816) WALGREENS #5278 * 3845 Broadway Blvd Kansas City, MO (816) WALGREENS #10845 * 2301 Holmes Kansas City, MO (816) WALGREENS #15588 * 7900 Lees Summit Rd Kansas City, MO (816) WALGREENS #16073 * 6420 Prospect Ave Kansas City, MO (816) WALGREENS #16360 * 300 W 19th Ter Kansas City, MO (816) Blue Ridge Blvd Kansas City, MO (816) Page 4

7 WALGREENS, SPECIALTY PHARMACY #16072 * 3537 Broadway Blvd Bld Kansas City, MO (816) * E Us Highway 40 Kansas City, MO (816) WALMART PHARMACY * 1701 West 133rd Street Kansas City, MO (816) Lees Summit CVS PHARMACY #04088 * 3351 Sw 3rd St Lees Summit, MO (816) CVS PHARMACY #05719 * 621 Sw 3rd St Lees Summit, MO (816) CVS PHARMACY #08557 * 1900 Ne Langsford Rd Lees Summit, MO (816) CVS PHARMACY #08579 * 751 Ne Woods Chapel Road Lees Summit, MO (816) CVS PHARMACY #16731 * 1850 Nw Chipman Rd Lees Summit, MO (816) FLATLAND PHARMACY LLC * 202 Nw Oldham Parkway Lees Summit, MO (844) HY-VEE PHARMACY #1 (1380) * 301 Ne Rice Road Lees Summit, MO (816) HY-VEE PHARMACY #2 (1381) * 310 Sw Ward Road Lees Summit, MO (816) PRICE CHOPPER * 1600 Se Blue Parkway Lees Summit, MO (816) PRICE CHOPPER 251 Sw Greenwich Dr Lees Summit, MO (816) PRICE CHOPPER 937 Ne Woods Chapel Rd Lees Summit, MO (816) THE MEDICINE SHOPPE 1405 Ne Douglas St Lees Summit, MO (816) WALGREENS #2450 * 330 Sw Ward Rd Lees Summit, MO (816) WALGREENS #4182 * 1801 Se Langsford Rd Lees Summit, MO (816) Sw M 150 Hwy Lees Summit, MO (816) * 1000 Ne Sam Walton Lane Lees Summit, MO (816) * 3410 Sw Market St Lees Summit, MO (816) Oak Grove 400 S Broadway Oak Grove, MO (816) * 201 South Salem Street Oak Grove, MO (816) Raytown CVS PHARMACY #08566 * 5310 Blueridge Blvd Raytown, MO (816) CVS PHARMACY #08598 * 9005 East 350 Highway Raytown, MO (816) Page 5

8 HY-VEE PHARMACY (1542) * 9400 E. 350 Highway Raytown, MO (816) WALGREENS #5357 * 9300 E Gregory Blvd Raytown, MO (816) * E Hwy 350 Raytown, MO (816) Lafayette Higginsville MEDICINE SHOPPE 1573 * 810 W 35th St Higginsville, MO (660) * 1180 W 19th Sttreet Higginsville, MO (660) Lexington CVS PHARMACY #11312 * 1030 Main St Lexington, MO (660) MINUTEMAN 538 S Business Highway 13 Lexington, MO (660) Odessa CVS PHARMACY #11313 * 101 S 2nd St Odessa, MO (816) THE DRUG STORE * 408 N 4th St Odessa, MO (816) St. Charles Cottleville SCHNUCKS 6083 Mid Rivers Mall Dr Cottleville, MO (636) Dardenne Prairie CVS PHARMACY #17189 * 7955 Hwy N Dardenne Prairie, MO (636) SHOP N SAVE 7909 Hwy N Dardenne Prairie, MO (636) Lake Saint Louis THE MEDICINE SHOPPE * 149 Pond Fort Trlal Lake Saint Louis, MO (636) Lake St Louis SCHNUCKS 101 Civic Center Dr Lake St Louis, MO (636) * 6100 Ronald Reagan Drive Lake St Louis, MO (636) O Fallon CVS PHARMACY #06477 * 3002 Highway K O Fallon, MO (636) CVS PHARMACY #10134 * 801 Highway K O Fallon, MO (636) CVS PHARMACY #10546 * 1580 Bryan Rd O Fallon, MO (636) CVS PHARMACY #16592 * 2300 Highway K O Fallon, MO (636) DIERBERGS DEER CREEK CROSSING 2979 Highway K O Fallon, MO (636) POWERS HEALTHMART 7776 Winghaven Blvd O Fallon, MO (636) SCHNUCKS 8660 Veterans Memorial Parkway O Fallon, MO (636) SCHNUCKS 3029 Highway K O Fallon, MO (636) Page 6

9 2616 * 1307 Highway K O Fallon, MO (636) Ofallon SHOP N SAVE 1421 Mexican Loop Rd. East Ofallon, MO (636) WALGREENS #4090 * 2920 Highway K Ofallon, MO (636) WALGREENS #5552 * 920 N Main St Ofallon, MO (636) WALGREENS #5748 * 1490 Mexico Loop Rd E Ofallon, MO (636) WALGREENS #6286 * 9495 Mexico Rd Ofallon, MO (636) WALGREENS #6711 * 7422 Highway N Ofallon, MO (636) Hwy K Ofallon, MO (636) WHARF HEALTH MART 2175 W Terra Ln Ofallon, MO (636) Saint Charles CVS PHARMACY #10096 * st Capitol Dr Saint Charles, MO (636) CVS PHARMACY #16625 * 3881 Mexico Rd Saint Charles, MO (636) DIERBERGS BOGEY HILLS 2021 Zumbehl Rd Saint Charles, MO (636) SAMS PHARMACY * 2855 Veterans Memorial Parkway Saint Charles, MO (636) SSM ST. CHARLES CLINIC MEDICAL GROUP, INC- PHARMACY DEPT. * 711 Veterans Memorial Parkway Saint Charles, MO (636) Saint Peters CVS PHARMACY #06282 * 1749 Woodstone Dr Saint Peters, MO (636) CVS PHARMACY #10053 * 400 Mid Rivers Mall Dr Saint Peters, MO (636) CVS PHARMACY #10418 * 200 Jungermann Rd Saint Peters, MO (636) CVS PHARMACY #16420 * 6241 Mid Rivers Mall Dr Saint Peters, MO (636) DIERBERGS 79 CROSSING 217 Salt Lick Rd Saint Peters, MO (636) DIERBERGS 94 CROSSING 6211 Mid Rivers Mall Drive Saint Peters, MO (636) ST PETERS COMMUNITY 4885 Mexico Rd Saint Peters, MO (636) WALGREENS #6246 * 909 Jungerman Rd Saint Peters, MO (636) * 45 Sutters Mill Rd Saint Peters, MO (636) Page 7

10 5427 * 3031 Mid Rivers Mall Dr Saint Peters, MO (636) WASHINGTON UNIVERSITY CANCER CENTER PHARMACY - ST. PETERS * 150 Entrance Way Saint Peters, MO (636) St Charles SCHNUCKS 48 Plaza Ninety Four Dr St Charles, MO (636) SCHNUCKS 1950 Zumbehl Rd St Charles, MO (636) SCHNUCKS st Capitol Dr St Charles, MO (636) SHOP N SAVE 3740 Monticello Plaza Dr St Charles, MO (636) SHOP N SAVE 60 Harvester Square St Charles, MO (636) THE MEDICINE SHOPPE 488 South Fifth Street St Charles, MO (636) WALGREENS #2617 * 2329 W Clay St St Charles, MO (636) WALGREENS #3687 * 4492 Central School Rd St Charles, MO (636) WALGREENS #4970 * 2310 S Old Hwy 94 St Charles, MO (636) WALGREENS #6059 * 1003 Wolfrum Rd St Charles, MO (636) WALGREENS #6801 * 1780 Zumbehl St Charles, MO (636) Elm St St Charles, MO (636) S 5th Street St Charles, MO (636) * 2897 Veterans Memorial Pkwy St Charles, MO (636) St Louis 3497 Technology Dr Lake St Louis, MO (636) St Peters COSTCO 200 Costco Way St Peters, MO (636) EXCEL 505 Salt Lick Rd St Peters, MO (636) SCHNUCKS 577 Midrivers Mall Dr St Peters, MO (636) SHOP N SAVE 100 Jungermann Rd St Peters, MO (636) WALGREENS #2733 * 530 Mid Rivers Mall Drive St Peters, MO (636) WALGREENS #5974 * 1305 Jungerman Rd St Peters, MO (636) WALGREENS #6247 * 3801 Old Hwy 94 St Peters, MO (636) WALGREENS #10474 * 499 Salt Lick Rd St Peters, MO (636) Page 8

11 0648 * 1661 Jungerman Rd St Peters, MO (636) Wentzville CVS PHARMACY #10193 * 1550 Wentzville Pkwy Wentzville, MO (636) CVS PHARMACY #17410 * 1883 Wentzville Pkwy Wentzville, MO (636) DIERBERGS WENTZVILLE 1820 Wentzville Pkwy Wentzville, MO (636) LAKEFOREST 950 Corporate Pkwy Ste 104 Wentzville, MO (636) SAMS PHARMACY * 3055 Bear Creek Dr Wentzville, MO (636) SCHNUCKS 1960 Wentzville Parkway Wentzville, MO (636) SSM HEALTH ST. JOSEPH HOSPITAL - WENTZVILLE * 500 Medical Dr Wentzville, MO (636) WALGREENS #4584 * 1993 Wentzville Pkwy Wentzville, MO (636) WALGREENS #11311 * 1053 Meyer Rd Wentzville, MO (636) E Highway N Wentzville, MO (636) * 1971 Wentzville Pkwy Wentzville, MO (636) St. Louis Affton THE MEDICINE SHOPPE 7922 Mackenzie Rd Affton, MO (314) WALGREENS #7762 * 1 Grasso Plaza Affton, MO (314) Ballwin CVS PHARMACY #02341 * Clayton Rd Ballwin, MO (636) CVS PHARMACY #16006 * Manchester Rd Ballwin, MO (636) FITZPATRICK PHARMACY INC * Manchester Rd Ballwin, MO (636) MERCY PHARMACY CLAYTON-CLARKSON * Clayton Rd Ste 140 Ballwin, MO (636) SCHNUCKS Manchester Rd Ballwin, MO (636) SCHNUCKS 1393 Big Bend Sq Ballwin, MO (636) WALGREENS #10429 * Manchester Rd Ballwin, MO (636) Big Bend Rd Ballwin, MO (636) Black Jack WALGREENS #2741 * Old Halls Ferry Black Jack, MO (314) Brentwood CVS PHARMACY #16476 * 25 Brentwood Promenade Ct Brentwood, MO (314) Page 9

12 SCHNUCKS 8800 Manchester Rd Brentwood, MO (314) S Brentwood Blvd Brentwood, MO (314) Bridgeton CVS PHARMACY #10261 * Saint Charles Rock Rd Bridgeton, MO (314) PREMIER 3550 Mckelvey Rd Bridgeton, MO (314) SCHNUCKS St Charles Rock Rd Bridgeton, MO (314) SCHNUCKS Enterprise Way Bridgeton, MO (314) SSM HEALTH Depaul Drive Suite 105 Bridgeton, MO (314) WALGREENS #2501 * St Charles Rock Rd Bridgeton, MO (314) WALGREENS #6492 * St Charles Rock Rd Bridgeton, MO (314) * Saint Charles Rock Rd Bridgeton, MO (314) Chesterfield CVS PHARMACY #16692 * 40 Thf Blvd Chesterfield, MO (636) CVS PHARMACY #17069 * 1272 Town & Country Crossing Dr Chesterfield, MO (636) DIERBERGS MARKETPLACE 1730 Clarkson Road Chesterfield, MO (636) SAMS PHARMACY * 196 Thf Blvd Chesterfield, MO (636) SCHNUCKS 141 Hilltown Village Chesterfield, MO (636) SCHNUCKS 1060 Schnucks Woods Mill Plaza Chesterfield, MO (636) SCHNUCKS 2511 Kehrs Mill Rd Chesterfield, MO (636) ST LUKES 224 S Woods Mill Rd Chesterfield, MO (314) THE MEDICINE SHOPPE Seasons Shopping Ctr Ste B Chesterfield, MO (314) WALGREENS #4220 * Clayton Rd Chesterfield, MO (636) WALGREENS #7185 * 917 Chesterfield Pkwy East Chesterfield, MO (636) WALGREENS #7692 * 97 Long Rd Chesterfield, MO (636) * 100 Thf Blvd Chesterfield, MO (636) Clayton CVS PHARMACY #10325 * 8101 Clayton Rd Clayton, MO (314) MEDICAL ARTS CLAYTON 7710 Carondelet Avenue Clayton, MO (314) Country Club Hills Page 10

13 WALGREENS #11350 * 5790 Lucas And Hunt Rd Country Club Hills, MO (314) Crestwood SAMS PHARMACY * Big Bend Blvd Crestwood, MO (314) WALGREENS #9436 * 9807 Watson Rd Crestwood, MO (314) Creve Coeur COMMUNITY, A WALGREENS PHARMACY #16552 * 628 N New Ballas Rd Creve Coeur, MO (314) CVS PHARMACY #03087 * Olive Blvd Creve Coeur, MO (314) GOLIVEWELL Olive Blvd Ste 210 Creve Coeur, MO (844) OLIVE STREET PHARMACY LLC * Old Olive Street Rd Ste 103 Creve Coeur, MO (314) WALGREENS #10082 * Olive Blvd Creve Coeur, MO (314) Olive Street Creve Coeur, MO (314) Dellwood WALGREENS #11351 * W Florissant Ave. Dellwood, MO (314) Des Peres DIERBERGS DES PERES 1080 Lindemann Rd Des Peres, MO (314) WALGREENS #5120 * Manchester Rd Des Peres, MO (314) Desperes SCHNUCKS Manchester Rd Desperes, MO (314) Earth City FOUNDATION CARE LLC * 4010 Wedgeway Ct Earth City, MO (877) Ellisville CVS PHARMACY #05689 * Manchester Rd Ellisville, MO (636) SHOP N SAVE Manchester Rd Ellisville, MO (636) WALGREENS #4701 * Manchester Rd Ellisville, MO (636) WALGREENS #11744 * 1302 Clarkson Clayton Ctr Ellisville, MO (636) Eureka SCHNUCKS 245 East Fifth St Eureka, MO (636) WALGREENS #2227 * 250 E 4th St Eureka, MO (636) * 131 Erka Twn Cntr Dr Eureka, MO (636) Fenton CVS PHARMACY #16657 * 197 Gravois Bluffs Plaza Dr Fenton, MO (636) DIERBERGS FENTON CROSSING 450 Old Smizer Mill Road Fenton, MO (636) SHOP N SAVE 45 Gravoi Bluffs Plz Dr Fenton, MO (636) Page 11

14 WALGREENS #3652 * 1001 Bowles Ave Fenton, MO (636) Gravois Bluffs Blvd Fenton, MO (636) * 653 Gravois Bluffs Blvd Fenton, MO (636) Ferguson SAMS PHARMACY * W Florissant Ave Ferguson, MO (314) N Florissant Rd Ferguson, MO (314) Florissant CVS PHARMACY #06745 * 6999 Parker Rd Florissant, MO (314) CVS PHARMACY #10171 * 696 N Highway 67 St #698 Florissant, MO (314) CVS PHARMACY #10355 * 1550 S New Florissant Rd Florissant, MO (314) DIERBERGS FLORISSANT 222 North Highway 67 Florissant, MO (314) KMART PHARMACY4304 * 1 Flower Valley Shp Ctr Florissant, MO (314) SCHNUCKS 74 Grandview Plaza Ctr Florissant, MO (314) SCHNUCKS New Halls Ferry Rd Florissant, MO (314) SCHNUCKS 8200 N Lindbergh Florissant, MO (314) SCHNUCKS 1160 Shackelford Rd Florissant, MO (314) SHOP N SAVE 2183 Charbonier Rd Florissant, MO (314) SHOP N SAVE 196 Mayfair Plaza Shopping Center Florissant, MO (314) SHOP N SAVE 175 Flower Valley Shopping Center Florissant, MO (314) THE MEDICINE SHOPPE 2386 N Hwy 67 Florissant, MO (314) WALGREENS #1124 * 460 N Hwy 67 Florissant, MO (314) WALGREENS #2901 * 1705 Shackelford Florissant, MO (314) WALGREENS #2971 * 2a Grandview Plaza Florissant, MO (314) WALGREENS #4866 * New Halls Ferry Rd Florissant, MO (314) WALGREENS #4867 * 3160 N Hwy 67 Florissant, MO (314) WALGREENS #5749 * 500 Howdershell Rd Florissant, MO (314) Page 12

15 5927 * 3390 N Highway 67 Florissant, MO (314) Hazelwood WALGREENS 1633 * 7398 N Lindbergh Blvd Hazelwood, MO (314) Jennings 9285 Halls Ferry Road Jennings, MO (314) Kirkwood CVS PHARMACY #10334 * Manchester Rd Kirkwood, MO (314) CVS PHARMACY #16624 * 1042 S Kirkwood Rd Kirkwood, MO (314) SCHNUCKS Manchester Rd Kirkwood, MO (314) SHOP N SAVE Manchester Rd Kirkwood, MO (314) WALGREENS #4392 * 441 N Kirkwood Kirkwood, MO (314) * 1202 S Kirkwood Rd Kirkwood, MO (314) Manchester COSTCO 301 Highlands Boulevard Dr Manchester, MO (636) DIERBERGS LAFAYETTE 421 Lafayette Ctr Manchester, MO (636) DIRECTRX 140 Enchanted Pkwy Ste 100 Manchester, MO (636) WALGREENS #5003 * Manchester Rd Manchester, MO (636) Manchester Rd Manchester, MO (636) * 201 Highlands Boulevard Dr Manchester, MO (636) Maplewood CVS PHARMACY #04403 * 7470 Manchester Rd Maplewood, MO (314) SAMS PHARMACY * 2100 Maplewood Commons Dr Maplewood, MO (314) * 1900 Maplewood Commons Drive Maplewood, MO (314) Maryland Heights SCHNUCKS 2030 Dorsett Rd Maryland Heights, MO (314) WALGREENS #9481 * Dorsett Rd Maryland Heights, MO (314) Moline Acres SHOP N SAVE 9521 Lewis And Clark Blvd Moline Acres, MO (314) Olivette CVS PHARMACY #05670 * 9141 Olive Blvd Olivette, MO (314) WALGREENS #6350 * 9395 Olive Blvd Olivette, MO (314) Overland Page 13

16 THE MEDICINE SHOPPE 2514 Woodson Rd Overland, MO (314) Lackland Overland, MO (314) Richmond Heights 6733 Clayton Rd Richmond Heights, MO (314) Rock Hill WALGREENS #9771 * 9801 Manchester Rd Rock Hill, MO (314) Saint Ann WALGREENS #15941 * St Charles Rock Rd Saint Ann, MO (314) Saint Louis AVELLA OF ST LOUIS * 450 N New Ballas Rd Ste 256 Saint Louis, MO (314) BEVERLY HILLS 7150 Natural Bridge Rd Saint Louis, MO (314) BHS PHARMACY, LLC * 763 S New Ballas Rd Saint Louis, MO (314) BJC EMPLOYEE 3844 S Lindbergh Blvd Ste 150 Saint Louis, MO (314) CARDINAL CARE 2319 Weldon Pkwy Saint Louis, MO (800) CLAYTON HEALTH SERVICES PHARMACY WEST * 1035 Bellevue Ave Saint Louis, MO (314) CVS PHARMACY #05643 * 7334 S Lindbergh Blvd Saint Louis, MO (314) CVS PHARMACY #10097 * 8915 Saint Charles Rock Rd Saint Louis, MO (314) CVS PHARMACY #10135 * 9433 Manchester Rd Saint Louis, MO (314) CVS PHARMACY #16839 * 4250 Rusty Rd Saint Louis, MO (314) DIERBERGS BRENTWOOD POINTE 8450 Eager Rd Saint Louis, MO (314) DIERBERGS HERITAGE PLACE Olive Street Road Saint Louis, MO (314) DIERBERGS LEMAY PLAZA 2516 Lemay Ferry Rd Saint Louis, MO (314) DIERBERGS MACKENZIE POINTE 7233 Watson Rd Saint Louis, MO (314) DIERBERGS SOUTHROADS Tesson Ferry Road Saint Louis, MO (314) DIERBERGS TELEGRAPH PLAZA 5640 Telegraph Road Saint Louis, MO (314) DIERBERGS WARSON WOODS 9901 Manchester Rd Saint Louis, MO (314) DIERBERGS WEST OAK Olive Street Road Saint Louis, MO (314) Page 14

17 GOLDSMITH MEDICENTER 777 S New Ballas Rd Saint Louis, MO (314) KRUMMENACHER Olive Blvd Saint Louis, MO (314) MERCY PHARMACY MEDICAL TOWER A/B * 621 S New Ballas Rd Ste 20a Saint Louis, MO (314) MERCY PHARMACY OLIVE- MASON * Olive Blvd Ste 150 Saint Louis, MO (314) MERCY PHARMACY ST. LOUIS LOBBY * 615 S New Ballas Rd Saint Louis, MO (314) MERCY PHARMACY TESSON FERRY AT I-270 * Old Tesson Rd Ste 100 Saint Louis, MO (314) NEELS 8 Crestwood Executive Ctr Saint Louis, MO (314) QUADRANGLE PHARMACY, LLC * 6643 Shepley Drive Saint Louis, MO (314) READYMED Tesson Ferry Rd Saint Louis, MO (314) SAMS PHARMACY * Manchester Road Saint Louis, MO (314) SAMS PHARMACY * 4512 Lemay Ferry Road Saint Louis, MO (314) SCHNUCKS 8650 Big Bend Saint Louis, MO (314) SCHNUCKS 1520 S Brentwood Blvd Saint Louis, MO (314) ST. ANTHONY'S PLAZA RETAIL Southfork Rd Ste 110 Saint Louis, MO (314) VAN'S DELIVERY 3229 Lemay Ferry Rd Saint Louis, MO (314) WALGREENS #11836 * Page Ave Saint Louis, MO (314) WALGREENS #15265 * 8390 Delmar Blvd Saint Louis, MO (314) Brown Rd Saint Louis, MO (314) Carondelet Ave Ste 301 Saint Louis, MO (314) * W Florissant Ave Saint Louis, MO (314) WASHINGTON UNIVERSITY CANCER CENTER PHARMACY-SOUTH COUNTY * 5225 Midamerica Plaza Saint Louis, MO (314) WASHINGTON UNIVERSITY CANCER CENTER PHARMACY - WEST COUNTY * 10 Barnes West Dr Bldg 2 # 100 Saint Louis, MO (314) Sappington Page 15

18 THE MEDICINE SHOPPE Gravois Rd Sappington, MO (314) Shrewsbury 3061 * 7437 Watson Rd Shrewsbury, MO (314) St Ann SHOP N SAVE St Charles Rock Rd St Ann, MO (314) St John SHOP N SAVE 9070 St Charles Rock Rd St John, MO (314) St Louis COSTCO 4200 Rusty Road St Louis, MO (314) FAMILY CARE 3023 N Ballas Road St Louis, MO (314) FAMILY CARE PHARMACY AT CHRISTIAN HOSPITAL * Dunn Rd St Louis, MO (314) LADUE PHARMACY LLC * 9832 Clayton Rd St Louis, MO (314) REHOBOTH 9944 W Florissant Ave St Louis, MO (314) SCHNUCKS 8037 W Florissant Ave St Louis, MO (314) SCHNUCKS 8867 Ladue Rd St Louis, MO (314) SCHNUCKS 5519 Oakville Shopping Ctr St Louis, MO (314) SCHNUCKS Gravois St Louis, MO (314) SCHNUCKS 6600 Clayton Rd St Louis, MO (314) SCHNUCKS 9540 Watson Rd St Louis, MO (314) SCHNUCKS Olive Blvd St Louis, MO (314) SCHNUCKS 5434 Southfield Center St Louis, MO (314) SCHNUCKS 49 N Florissant Rd St Louis, MO (314) SCHNUCKS 1589 Sierra Vista Shopping Ctr St Louis, MO (314) SCHNUCKS 6920 Olive Blvd St Louis, MO (314) SCHNUCKS Olive Blvd St Louis, MO (314) SCHNUCKS 4333 Butler Hill Rd St Louis, MO (314) SCHNUCKS Clayton Rd St Louis, MO (314) SHOP N SAVE Old Halls Ferry Rd St Louis, MO (314) SHOP N SAVE 1032 Lemay Ferry Rd St Louis, MO (314) Page 16

19 ST ANTHONYS MEDICAL CENTER Kennerly Road St Louis, MO (314) THE MEDICINE SHOPPE 4441 Brown Rd St Louis, MO (314) WALGREENS #854 * 5764 S Lindbergh St Louis, MO (314) WALGREENS #4345 * 2700 Telegraph Rd St Louis, MO (314) WALGREENS #4467 * 1205 Sulphur Spring Rd St Louis, MO (636) WALGREENS #4824 * Lusher Rd St Louis, MO (314) WALGREENS #4833 * 651 Lemay Ferry Rd St Louis, MO (314) WALGREENS #5047 * 2202 Chambers Rd St Louis, MO (314) WALGREENS #5228 * 4400 Lemay Ferry Rd St Louis, MO (314) WALGREENS #5285 * 5050 Lemay Ferry Rd St Louis, MO (314) WALGREENS #5513 * Gravois Rd St Louis, MO (314) WALGREENS #5667 * 6071 Telegraph Rd St Louis, MO (314) WALGREENS #9714 * 9978 Kennerly Road St Louis, MO (314) Natural Bridge Rd St Louis, MO (314) * 3270 Telegraph Road St Louis, MO (314) St Louis County WALGREENS #5363 * 5414 Telegraph Road St Louis County, MO (314) Stlouis SCHNUCKS 9074 Overland Plaza Stlouis, MO (314) Town And Country CHILDREN'S HOSPITAL SPECIALTY CARE CENTER N Outer 40 Rd Town And Country, MO (314) University City MILLBROOK 7010 Pershing Ave University City, MO (314) WALGREENS #4671 * 7501 Olive St University City, MO (314) Valley Park THE MEDICINE SHOPPE 16 Stonegate Center Valley Park, MO (636) Webster Groves COLONIAL VILLAGE 7945 Big Bend Blvd Webster Groves, MO (314) CVS PHARMACY #02363 * 8021 Watson Rd Webster Groves, MO (314) Page 17

20 WALGREENS #7680 * 8571 Watson Rd Webster Groves, MO (314) Wildwood DIERBERGS TOWN CENTER 2460 Taylor Rd Wildwood, MO (636) SCHNUCKS Manchester Wildwood, MO (636) WALGREENS #6155 * 100 Plaza Drive Wildwood, MO (636) Home Infusion Pharmacies ALABAMA Mobile Mobile HPC LLC * 63 S Royal St Mobile, AL (800) ARIZONA Maricopa Scottsdale DIPLOMAT SPECIALTY INFUSION GROUP 9045 E Pima Center Pkwy Scottsdale, AZ (480) CALIFORNIA Los Angeles Santa Fe Springs CRESCENT HEALTHCARE INC Telegraph Rd Santa Fe Springs, CA (562) Riverside Temecula NUFACTOR Winchester Rd Temecula, CA (800) San Diego Carlsbad DIPLOMAT SPECIALTY INFUSION GROUP 1819 Aston St Ste 102 Carlsbad, CA (760) COLORADO Denver Denver US BIOSERVICES 501 W 44th Ave Unit A Denver, CO (800) FLORIDA Broward Pompano Beach PATIENT CARE AMERICA 3890 Park Central Blvd N. Pompano Beach, FL (866) Orange Orlando ACARIAHEALTH PHARMACY, INC Lee Vista Blvd Ste 200 Orlando, FL (407) GEORGIA Muscogee Columbus ACARIAHEALTH PHARMACY, INC Sandy Pkwy Columbus, GA (706) ILLINOIS Cook Chicago KABAFUSION IL 5517 N Cumberland Ave Chicago, IL (800) PHARMASCRIPT INC N. Broadway Avenue Chicago, IL (773) Mt Prospect CORAM CVS/SPECIALTY INFUSION SERVICES 1471 Bus Center Dr Mt Prospect, IL (847) Orland Park AMERICAN SERVICE AND PRODUCT th St Orland Park, IL (708) Dupage Lombard Page 18

21 OPTION CARE 2050 S Finley Rd Ste 20 Lombard, IL (630) Henry Kewanee PREFERRED 150 W South St Kewanee, IL (309) St. Clair Belleville IV CARE 65 S 65th St Belleville, IL (618) IOWA Polk Urbandale DIPLOMAT SPECIALTY INFUSION GROUP & Aurora Ave. Urbandale, IA (515) OPTION CARE Aurora Ave Urbandale, IA (515) Scott Davenport CORAM CVS/SPECIALTY INFUSION SERVICES 5327 Carey Ave, Suite A Davenport, IA (563) KANSAS Johnson Lenexa ACARIAHEALTH PHARMACY, INC W 84th Terrace Lenexa, KS (800) CORAM CVS/SPECIALTY INFUSION SERVICES 8013 Flint St Lenexa, KS (913) SOLEO HEALTH Rene Lenexa, KS (913) US BIOSERVICES 8028 Reeder Rd. Lenexa, KS (800) Overland Park HERITAGE BIOLOGICS, INC Metcalf Ln Ste 200 Overland Park, KS (866) OPTION CARE 8940 Nieman Rd Overland Park, KS (913) KENTUCKY Jefferson Louisville OPTION CARE Bluegrass Pkwy Ste 400 Louisville, KY (502) Mccracken Paducah OPTION CARE 3487 Park Ave Paducah, KY (270) LOUISIANA Jefferson Metairie FAST ACCESS SPECIALTY THERAPEUTICS 3131 N I 10 Service Rd E Ste 202 Metairie, LA (877) Ouachita Monroe RELIANT HEALTHCARE * 1004 N 19th St Monroe, LA (877) MASSACHUSETTS Middlesex Wilmington ACARIAHEALTH PHARMACY, INC. 260 E Fordham Rd. Wilmington, MA (800) MICHIGAN Kalamazoo Kalamazoo OPTIMED SPECIALTY PHARMACY 6480 Technology Kalamazoo, MI (877) Oakland Troy Page 19

22 HOMESCRIPTS 500 Kirts Blvd Ste 300 Troy, MI (248) MINNESOTA Dakota Mendota Heights CORAM CVS/SPECIALTY INFUSION SERVICES 2345 Waters Dr Mendota Heights, MN (651) MISSOURI Boone Columbia OPTION CARE 1410 Heriford Road Columbia, MO (573) Cape Girardeau Cape Girardeau HOME PARENTERAL SERVICES OF SEMO 286 Christine St Cape Girardeau, MO (573) Greene Springfield HOME PARENTERAL SERVICES 2240 W Sunset St Ste 104 Springfield, MO (417) Jackson Kansas City SAINT LUKE'S ADVANCED CARE PHARMACY Elm Ave Kansas City, MO (816) Lees Summit HERITAGE BIOLOGICS, INC. 255 Nw Victoria Dr Lees Summit, MO (855) Miller Eldon ELDON DRUG COMPANY * 101 S Maple Street Eldon, MO (573) St. Louis Chesterfield BIOSCRIP INFUSION SERVICES 528 Trade Center Blvd Chesterfield, MO (636) Fenton OPTION CARE 535 Axminister Dr Fenton, MO (314) Saint Louis CORAM CVS/SPECIALTY INFUSION SERVICES 8248 Lackland Rd Ste 101 Saint Louis, MO (314) NEBRASKA Douglas Omaha AFFINITY BIOTECH, INC N 203rd St Omaha, NE (402) CORAM CVS/SPECIALTY INFUSION SERVICES Mill Valley Rd Omaha, NE (402) OPTION CARE John Galt Blvd Omaha, NE (402) NEW JERSEY Middlesex Edison KABAFUSION NJ 160 Raritan Center Pkwy Edison, NJ (800) Monmouth Howell PARKWAY PHARMACY LP 3502 Us Highway 9 Howell, NJ (866) Passaic Totowa BIOLOGICTX LLC 40d Commerce Way Totowa, NJ (877) Wayne BASIC HOME INFUSION 1401 Valley Road Wayne, NJ (888) NEW YORK Page 20

23 Westchester Hawthorne ACARIAHEALTH PHARMACY #12 5 Skyline Dr Ste 240 Hawthorne, NY (800) SOLEO HEALTH 4 Skyline Drive Hawthorne, NY (800) NORTH CAROLINA Forsyth Kernersville NUFACTOR 1601 Old Greensboro Rd Kernersville, NC (844) Wake Raleigh DIPLOMAT SPECIALTY INFUSION GROUP 140 Northway Court Raleigh, NC (888) OHIO Hamilton Cincinnati DIPLOMAT SPECIALTY INFUSION GROUP 7167 E Kemper Rd Cincinnati, OH (513) PENNSYLVANIA Delaware Boothwyn PENTEC HEALTH, INC 4 Creek Parkway Boothwyn, PA (800) US BIOSERVICES 109 Chelsea Parkway Boothwyn, PA (800) Garnet Valley ELWYN SPECIALTY CARE 3070 Mccann Farm Dr Ste 101 Garnet Valley, PA (610) Sharon Hill HOMETECH ADVANCED THERAPIES, INC. * 505 Elmwood Ave Sharon Hill, PA (484) TENNESSEE Shelby Memphis HEMOPHILIA PREFERRED CARE OF MEMPHIS * 6423 Shelby View Dr Ste 104 Memphis, TN (901) TEXAS Collin Frisco US BIOSERVICES 3200 Internet Blvd Frisco, TX (888) Dallas Dallas PARAGON INFUSION CARE, INC Preston Road Dallas, TX (972) Irving OPTION CARE 6611 N Belt Line Rd Ste 100 Irving, TX (972) Y MEDICAL ASSOCIATES, INC N Mac Arthur Blvd Irving, TX (972) Richardson KROGER SPECIALTY INFUSION TX 1748 N Greenville Ave Richardson, TX (855) Denton Lewisville PHARMACY SPECIALISTS 697 S Stemmons Fwy Lewisville, TX (972) Harris Houston ACARIAHEALTH PHARMACY # W Sam Houston Pkwy N # 130 Houston, TX (800) Page 21

24 SPECIALTY THERAPEUTIC CARE 1311 W Sam Houston Pkwy N Ste 150 Houston, TX (866) Lubbock Lubbock IV SOLUTIONS OF LUBBOCK rd Street Lubbock, TX (806) Tarrant Ft Worth AMERICAN OUTCOMES MGMT LP 6310 Southwest Blvd Ste 204 Ft Worth, TX (800) Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Missouri Medicare Select through the facility s long-term care pharmacy or another network long-term care pharmacy. ARIZONA Maricopa Phoenix PHARMERICA 8826 N 23rd Ave Ste C-2 Phoenix, AZ (602) ARKANSAS Clark Arkadelphia ALLCARE PHARMACY 521 Main St Arkadelphia, AR (877) Fulton Mammoth Spring PALACE DRUG * 270 Main St Mammoth Spring, AR (870) Washington Springdale PREMIER PHARMACY CARE LLC 834 E Henri De Tonti Blvd Springdale, AR (479) ILLINOIS Cook Hillside UNITED RX, LLC 150 Fencl Lane Hillside, IL (708) Niles CARE ONE PHARMACY SERVICES LLC 7550 N Oak Park Ave Niles, IL (847) La Salle La Salle PHARMBLUE ILLINOIS LLC * 2960 Chartres St Ste 100 La Salle, IL (724) Williamson Marion HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC. # Aviation Dr Marion, IL (618) INDIANA Marion Indianapolis PHARMERICA 6330 E 75th St Indianapolis, IN (317) IOWA Lee Fort Madison RASHID LTC PHARMACY/JRX PHARMACY SERVICES 2402 Avenue L Fort Madison, IA (319) KANSAS Douglas Lawrence QUALICARE INC 2336 Ridge Court Lawrence, KS (785) Johnson Lenexa ALIXARX - KS HUB Renner Blvd Lenexa, KS (877) Page 22

25 UVANTA PHARMACY - KANSAS CITY Renner Blvd Lenexa, KS (913) Miami Paola AUBURN LTC 1011 Baptiste Dr Paola, KS (913) Shawnee Topeka SENIOR RX CARE OF KANSAS LLC 121 Se 6th Ave Topeka, KS (877) KENTUCKY Graves Mayfield DUNCAN SPECIALTY PHARMACY 317 W. Broadway Mayfield, KY (270) MICHIGAN Kalamazoo Kalamazoo OPTIMED SPECIALTY PHARMACY 6480 Technology Kalamazoo, MI (877) MISSOURI Adair Kirksville KIRKSVILLE 1611 S Baltimore St Kirksville, MO (660) MED DEPOT 800 W Jefferson St Kirksville, MO (660) RIDER DRUG INC * 1207 S Baltimore Kirksville, MO (660) Andrew Savannah COUNTRYSIDE PHARMACY * 402 E Price Savannah, MO (816) Atchison Rock Port STONER DRUG * 315 S Main St Rock Port, MO (660) Tarkio ROGERS 411 Main St Tarkio, MO (660) Audrain Mexico A AND B PRESCRIPTION SHOP INC * 201 E Monroe St Mexico, MO (573) JACKSON STREET DRUG, A MEDICINE SHOPPE PHARMACY #1111 * 200 E Jackson St Mexico, MO (573) PARKWAY 340 Kelley Pkwy Mexico, MO (573) Barry Cassville SATER 705 Main St Cassville, MO (417) WHITLEY 101 W 8th St Cassville, MO (417) Bates Adrian ADRIAN KREISLER DRUG * 21 E Main St Adrian, MO (816) Benton Cole Camp COLE CAMP 106 S Maple St Cole Camp, MO (660) Warsaw J AND D TRUECARE 1330 Commercial St Warsaw, MO (660) Page 23

26 Boone Ashland KILGORE'S MEDICAL 109 B Eastside Dr Ashland, MO (573) Columbia FLOWS 1506 E Broadway Columbia, MO (573) KILGORE'S MEDICAL 700 N Providence Rd Columbia, MO (573) KILGORE'S MEDICAL 1608 Chapel Hill Rd Columbia, MO (573) OMNICARE OF COLUMBIA 4509 I 70 Drive Se Columbia, MO (573) Buchanan Saint Joseph GENOA HEALTHCARE, LLC 724 N 22nd St Saint Joseph, MO (816) STEVENSON FAMILY 6201 King Hill Ave Saint Joseph, MO (816) St Joseph ROGERS 2524 Frederick Ave St Joseph, MO (816) Butler Poplar Bluff EASTSIDE 400 E Pine Poplar Bluff, MO (573) KEY DRUGS * 910 N Westwood Poplar Bluff, MO (573) Caldwell Hamilton NORTHWEST PHARMACY SERVICES * 103 E. Cross Street Hamilton, MO (816) Callaway Fulton FULTON STATE HOSPITAL 600 E 5th St Fulton, MO (573) SAULTS DRUG STORE INC * 505 Court Street Fulton, MO (573) Camden Camdenton AUBURN PHARMACY #280 * 113 E Us Hwy 54 Camdenton, MO (573) Lake Ozark LAKE REGIONAL PHARMACY - LO * 1870-C Bagnell Dam Blvd Lake Ozark, MO (573) Osage Beach LAKE REGIONAL PHARMACY - OBMP * 1057-B Medical Park Dr Osage Beach, MO (573) Cape Girardeau Cape Girardeau BROADWAY 710 Broadway Cape Girardeau, MO (573) GENOA HEALTHCARE, LLC 402 S Silver Springs Rd Ste 101a Cape Girardeau, MO (573) JOHN'S RX 2003 Independence St Cape Girardeau, MO (573) MEDICENTER 465 S Mount Auburn Rd Ste 101 Cape Girardeau, MO (573) MISSOURI MED, LLC 121 S Broadview St Cape Girardeau, MO (573) Page 24

27 SOUTHEAST 1723 Broadway Ste 110 Cape Girardeau, MO (573) Jackson HORST 2705 E Jackson Blvd Jackson, MO (573) MEDICENTER 200 W Washington Jackson, MO (573) Carroll Carrollton HOMETOWN PHARMACY CARROLLTON LTC 1409 N Jefferson St Carrollton, MO (660) Carter Van Buren VAN BUREN DRUG * 406 Main St Van Buren, MO (573) Cass Harrisonville GILLEN 2820 E Rock Haven Rd Ste 110 Harrisonville, MO (816) Cedar El Dorado Springs EVANS DRUGS * 209 E Us Hwy 54 El Dorado Springs, MO (417) Stockton ZUMWALT 19 Public Square Stockton, MO (417) Clark Kahoka CLARK COUNTY PHARMACY INC * 250 S Johnson Street Kahoka, MO (660) Clay Excelsior Springs JACK MONROE PHARMACY * 1236 N Jesse James Rd Excelsior Springs, MO (816) KEX RX PHARMACY & HOME CARE * 1500 Kearney Rd Excelsior Springs, MO (816) RED CROSS LTC PHARMACY 1000 N Jesse James Rd Excelsior Springs, MO (816) Kansas City GENOA HEALTHCARE, LLC 3100 Ne 83rd St Kansas City, MO (816) Clinton Cameron THE DRUG STORE * 610 N Walnut Cameron, MO (816) Cole Jefferson City ROBERTS DRUG STORE * 3501 W Truman Blvd Ste H Jefferson City, MO (573) WHALEYS PRO CARE SERVICES 630 B East High Street Jefferson City, MO (573) Cooper Boonville MEDICAL ARTS PHARMACY * 800 Main St Boonville, MO (660) Crawford Cuba THE TOWNE 200 N Franklin Cuba, MO (573) Dade Greenfield GREENFIELD 105 N Grand Greenfield, MO (417) Dallas Buffalo Page 25

28 CORNER DRUG STORE * 308 W Dallas St Buffalo, MO (417) NYBERG PHARMACY 2461 * 315 S Ash Buffalo, MO (417) Dekalb Maysville RANDOLPH DRUG STORE * 301 South Polk Street Maysville, MO (816) Dunklin Kennett HARRIS 1224 First Street Kennett, MO (573) Franklin Gerald MEDLEY 733 W Springfield Rd Gerald, MO (573) New Haven PRATTS 100 Dwayne Vonbehren Dr New Haven, MO (573) Saint Clair SINKS 1435 N. Main St Saint Clair, MO (636) ST CLAIR (REXALL) HEALTH MART PHARMACY * 855 N Commercial Ave Saint Clair, MO (636) St Clair THE MEDICINE SHOPPE 920 H St Clair Plaza Dr St Clair, MO (636) Sullivan SINKS 153 E Springfield Rd Sullivan, MO (573) Union GENOA HEALTHCARE, LLC 1780 Old Highway 50 East Union, MO (636) HEARTLAND DISCOUNT 707 Hwy 50 W Union, MO (636) Gasconade Hermann BERLENER 119 Bavarian Hills Blvd Hermann, MO (573) Owensville MEDLEY 601 E Hwy 28 Owensville, MO (573) Gentry Stanberry FAMILY HEALTH LTC PHARMACY 102 W 1st St Ste 100 Stanberry, MO (660) FAMILY HEALTH 102 W 1st St Stanberry, MO (660) Greene Ash Grove ASH GROVE PHARMACY INC * 490 N Medical Drive Ash Grove, MO (417) Brookline INFINIUM PHARMACY - REPUBLIC 6129 W Us Highway 60 Brookline, MO (417) Springfield ALPS LONG TERM CARE PHARMACY 2828 N National Ave Springfield, MO (417) ALPS PHARMACY #2 * 2828 N National Ave Ste A Springfield, MO (417) Page 26

29 ALPS 2650 W Kearney Springfield, MO (417) GUARDIAN PHARMACY OF MISSOURI 2103 E Rockhurst St Ste 108 Springfield, MO (417) OMNICARE OF SPRINGFIELD 1947 W Sunset Ste 200 Springfield, MO (417) Henry Clinton SUMMERS 605 Pawnee St Clinton, MO (660) Windsor MERRYFIELD 200 W Benton St Windsor, MO (660) Holt Mound City ROGERS 607 State Street Mound City, MO (660) Howard Fayette SAM'S HEALTH MART PHARMACY # North Church Street Fayette, MO (660) SAM'S HEALTH MART 300 N Church St Fayette, MO (660) Glasgow HENDERSONS DRUG STORE * 523 1st St Glasgow, MO (660) Howell West Plains BURTON CREEK PHARMACY 805 N Kentucky Ave Ste 2 West Plains, MO (417) Jackson Grain Valley HILS 451 A Sw Eagles Pkwy Grain Valley, MO (816) Independence GENOA HEALTHCARE, LLC E 23rd St S Rm D404 Independence, MO (816) STERLING PHARMACY E Us Highway 40 Independence, MO (816) Kansas City OMNICARE OF KANSAS CITY Hickman Mills Dr Kansas City, MO (816) ROCKHILL LTC PHARMACY 4240 Southwest Trfy Kansas City, MO (816) Lees Summit GENOA HEALTHCARE, LLC 901 Ne Independence Avenue Lees Summit, MO (816) GENOA HEALTHCARE, LLC 1535 Ne Rice Rd Ste A Lees Summit, MO (816) SYMBRIA RX SERVICES, LLC 348 Nw Capital Dr Lees Summit, MO (630) THE MEDICINE SHOPPE 1405 Ne Douglas St Lees Summit, MO (816) Jasper Carl Junction BRUNER DRUGS * 102 S Main Carl Junction, MO (417) Carthage Page 27

30 WILKINSON 2017 S Garrison Ave Carthage, MO (417) Joplin THE MEDICINE SHOPPE 2131 E 32nd St Ste 3 Joplin, MO (417) Webb City BRUNER'S PHARMACY 101 W Daugherty St Webb City, MO (417) BRUNER'S 101 W Daugherty St Webb City, MO (417) STONE'S CORNER 6059 N Main Street Rd Webb City, MO (417) Jefferson Cedar Hill CEDAR HILL DRUG * 7032 State Route Bb Cedar Hill, MO (636) Desoto THE MEDICINE SHOPPE 100 North Main St Desoto, MO (636) Hillsboro HILLSBORO DRUG * Hwy 21 Hillsboro, MO (636) Johnson Holden AUBURN PHARMACY #265 * 1200 E 10th St Holden, MO (816) Knox Edina KNOX COUNTY PHARMACY LLC * 105 E Reid St Suite C Edina, MO (660) Laclede Lebanon JOES 489 S Jefferson Ave Lebanon, MO (417) Lafayette Concordia BRITTS CENTRAL DRUG STORE 728 Main St Concordia, MO (660) Higginsville MEDICINE SHOPPE 1573 * 810 W 35th St Higginsville, MO (660) Odessa THE DRUG STORE * 408 N 4th St Odessa, MO (816) Lawrence Aurora AURORA PROFESSIONAL 124 S Madison Aurora, MO (417) Marionville MARIONVILLE 201 S Us Hwy 60 Marionville, MO (417) Mount Vernon LANDRUM DRUG * 1319-E S Landrum Mount Vernon, MO (417) MT VERNON HOMETOWN * 606 E Mount Vernon Blvd Mount Vernon, MO (417) Lincoln Elsberry ELSBERRY PHARMACY, MEDICINE SHOPPE 2028 * 106 A Broadway Elsberry, MO (573) Troy BECKWITH 107 N Lincoln Dr Troy, MO (636) Linn Page 28

31 Brookfield GREEN HILLS 712 S Main St Brookfield, MO (660) Livingston Chillicothe CHILLICOTHE FAMILY 504 S Washington St Chillicothe, MO (660) HLTC PHARMACY 519 Locust St Chillicothe, MO (660) HOMETOWN PHARMACY - CHILLICOTHE * 601 Locust St Chillicothe, MO (660) Macon La Plata LA PLATA July Road La Plata, MO (660) Macon MILLER REXALL DRUG * 115 Vine Street Macon, MO (660) Madison Fredericktown PARKLAND HEALTH MART PHARMACY 1025 Hwy 72 Bypass Fredericktown, MO (573) PARKLAND HEALTH MART 1025 Highway 72 Bypass Fredericktown, MO (573) Maries Belle SINKS 206 D South Alvarado Belle, MO (573) Vienna SINKS 606 E Hwy 63 Vienna, MO (573) Marion Hannibal GOSNEY LONG TERM CARE 2902 Saint Marys Ave Hannibal, MO (573) Miller Eldon ELDON DRUG COMPANY * 101 S Maple Street Eldon, MO (573) Moniteau California BOND 703 W Buchanan California, MO (573) Tipton SSM HEALTH 875 Hwy 5 South Tipton, MO (660) Monroe Paris PARIS 223 North Main Street Paris, MO (660) Montgomery Montgomery City THE MEDICINE SHOPPE 635 S Sturgeon St Montgomery City, MO (573) Morgan Laurie LAKE REGIONAL PHARMACY - LAURIE * 156 -D Missouri Blvd Laurie, MO (573) LAURIE FAMILY PHARMACY * 154 South Main Laurie, MO (573) Versailles Page 29

32 CLINIC 901 Kidwell Dr Versailles, MO (573) VERSAILLES 700 West Clay Road Versailles, MO (573) New Madrid Portageville BUTLER DRUG STORE INC * 222 E Main St Portageville, MO (573) Sikeston GENOA HEALTHCARE, LLC 760 Plantation Blvd Sikeston, MO (573) Newton Joplin QUICKMEDS 3201 Mcclelland Blvd Joplin, MO (417) Neosho MITCHELL'S DOWNTOWN DRUG STORE * 115 E Hickory St Neosho, MO (417) MITCHELL'S DRUG STORES ON THE BOULEVAARD 719 S Neosho Blvd Neosho, MO (417) MITCHELL'S UPTOWN DRUG STORE * 1504 N Business 49 Neosho, MO (417) Seneca PRATER'S 1711 Cherokee Avenue Seneca, MO (417) Nodaway Maryville ROGERS 125 E South Ave Maryville, MO (660) Pemiscot Caruthersville HAYDEN 1200 Ward Ave Caruthersville, MO (573) PRESCRIPTION DRUG STORE * 410 Ward Ave Caruthersville, MO (573) Hayti THE PRESCRIPTION DRUG STORE * 308 E Main St Hayti, MO (573) Perry Perryville PRESCRIPTIONS PLUS LONGTERM CARE PHARMACY 212 Hospital Ln Ste 103 Perryville, MO (573) Pettis Sedalia MEDICAL CENTER 1700 S Ingram Ave Sedalia, MO (660) SWORDS' FAMILY 300 S Ohio Ave Sedalia, MO (660) Phelps Rolla SINKS 1375 B East 10th Street Rolla, MO (573) SINKS PHARMACY SOUTH * 1024 South Bishop Rolla, MO (573) Saint James FOREST CITY 125 N Jefferson St Saint James, MO (573) Pike Bowling Green Page 30

33 BOWLING GREEN 8 N Court St Bowling Green, MO (573) COUNTY MARKET PHARMACY 397 * 1106 Business Highway 61 S Bowling Green, MO (573) Louisiana FAMILY DRUG * 301 Georgia St Louisiana, MO (573) Polk Bolivar CMH SENIOR PHARMACY 1125 B North Butterfield Road Bolivar, MO (417) Pulaski Richland YORK & CO. 609 W Washington Ave Richland, MO (573) Waynesville SINKS 1000 Gw Ln Ste 105 Waynesville, MO (573) Randolph Moberly HILS 907 N Morley St Moberly, MO (660) SAM'S HEALTH MART PHARMACY # East 24 Highway Moberly, MO (660) SAM'S HEALTH MART 530 East 24 Highway Moberly, MO (660) SAM'S HEALTH MART 300 N Morley St Moberly, MO (660) Ray Richmond C & C DISCOUNT 508 Johnny Walker Lane Richmond, MO (816) Ripley Doniphan HOMETOWN 110 Leroux Street Doniphan, MO (573) Saline Marshall RED CROSS LTC PHARMACY 157 S Jefferson Marshall, MO (660) Scott Sikeston STERLING HEALTH CARE SERVICES 808 Hunter Ave Sikeston, MO (573) St. Charles Saint Charles GENOA HEALTHCARE, LLC 102 Compass Point Dr Ste A Saint Charles, MO (636) Saint Peters GENOA HEALTHCARE, LLC 255 Spencer Rd Ste 202 Saint Peters, MO (636) Wentzville GENOA HEALTHCARE, LLC 1032 Crosswinds Ct Wentzville, MO (636) St. Clair Appleton City KREISLER COUNTRY PHARMACY INC 121 West 4th Street Appleton City, MO (660) Osceola EVANS DRUGS * 675 3rd St Osceola, MO (417) St. Francois Bonne Terre Page 31

34 OZARK LTC RX LLC 9 Bonneville Plz Bonne Terre, MO (573) Farmington HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC. # Airpark Drive Farmington, MO (800) MEDICAP 800 Valley Creek Drive Farmington, MO (573) OMNICARE OF FARMINGTON 312 E Karsch Blvd Farmington, MO (573) St. Louis Chesterfield CORUM HEALTH SERVICES INC N Outer 40 Rd Chesterfield, MO (636) SENIOR SCRIPTS 739 Goddard Ave Chesterfield, MO (636) ST LUKES 224 S Woods Mill Rd Chesterfield, MO (314) THE MEDICINE SHOPPE Seasons Shopping Ctr Ste B Chesterfield, MO (314) Fenton INFINIUM PHARMACY 1617 Manufacturers Dr Fenton, MO (314) NETWORK HEALTHCARE MISSOURI 1329 Horan Dr Fenton, MO (888) Florissant OMNICARE OF ST LOUIS 345 Dunn Rd Florissant, MO (314) THE MEDICINE SHOPPE 2386 N Hwy 67 Florissant, MO (314) Ladue GENOA HEALTHCARE, LLC 9890 Clayton Rd Ste 125 Ladue, MO (314) Maryland Heights MED ASSIST PHARMACY Adie Rd Maryland Heights, MO (314) Saint Louis EVERSPRING 1884 Lackland Hill Parkway Saint Louis, MO (314) LONG TERM CARE RX INC 1a Document Dr Saint Louis, MO (314) NEELS 8 Crestwood Executive Ctr Saint Louis, MO (314) PHARMERICA 105 Arc Dr Saint Louis, MO (314) TARA PHARMACY SE LLC Lilburn Park Rd Saint Louis, MO (314) VAN'S DELIVERY 3229 Lemay Ferry Rd Saint Louis, MO (314) Sappington THE MEDICINE SHOPPE Gravois Rd Sappington, MO (314) St Louis HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES INC # Westport Center Dr St Louis, MO (314) Page 32

35 THE MEDICINE SHOPPE 4441 Brown Rd St Louis, MO (314) UNITED SCRIPTS LTC LLC 1861 Craig Park Court St Louis, MO (314) Valley Park THE MEDICINE SHOPPE 16 Stonegate Center Valley Park, MO (636) Webster Groves COLONIAL VILLAGE 7945 Big Bend Blvd Webster Groves, MO (314) St. Louis City Saint Louis WEST PINE 4401 W Pine Blvd Saint Louis, MO (314) WINKELMANN SONS DRUG CO 3300 Meramec St Saint Louis, MO (314) St Louis MEDICINE SHOPPE * 3137 South Grand Blvd St Louis, MO (314) THE MEDICINE SHOPPE 4900 Delmar Blvd St Louis, MO (314) Stoddard Advance ADVANCE 110 S Oak Advance, MO (573) Dexter KEY DRUGS AT DEXTER * 1007 W Business Us Highway 60 Dexter, MO (573) Texas Cabool CABOOL DRUG AND DIME * 518 Main Cabool, MO (417) Licking RINNE 100 Deer Lick Licking, MO (573) Vernon Nevada AUBURN LTC NEVADA # S Washington St Nevada, MO (417) COMMUNITY 900 S Adams St Nevada, MO (417) Warren Warrenton GENOA HEALTHCARE, LLC Brune Parkway Warrenton, MO (636) Washington Potosi PHOENIX HOME CARE PHARMACY 410 E High St Potosi, MO (573) Webster Marshfield MARSHFIELD CLINIC 483 Pomme De Terre Dr Marshfield, MO (417) Worth Grant City SHERRI'S PHARMACY SERVICES * 108 S Main St Grant City, MO (660) Wright Mountain Grove MOUNTAIN GROVE 106 N Union St Mountain Grove, MO (417) NORTH TOWNE FAMILY 1600 N Main Mountain Grove, MO (417) Page 33

36 NEBRASKA Sarpy Gretna COMMUNITY PHARMACY SERVICES Northstar Dr Gretna, NE (402) NEW JERSEY Morris Long Valley LTC SCRIPTS 62 E Mill Rd Ste B1 Long Valley, NJ (908) NEW YORK Kings Brooklyn MEDPACK 5923 Strickland Ave Brooklyn, NY (347) OHIO Cuyahoga Valley View EXACT CARE PHARMACY 8333 Rockside Rd Valley View, OH (216) PENNSYLVANIA Butler Warrendale PHARMBLUE LLC * 40 Pennwood Pl Ste 300 Warrendale, PA (724) Delaware Garnet Valley ELWYN SPECIALTY CARE 3070 Mccann Farm Dr Ste 101 Garnet Valley, PA (610) Westmoreland North Huntingdon ACCUSERV PHARMACY 8731 State Route 30 Ste 1 North Huntingdon, PA (866) TENNESSEE Putnam Cookeville PEGASUS EXPRESS PHARMACY 621 E 15th St Cookeville, TN (931) VIRGINIA Richmond City Richmond WESTWOOD PHARMACY CLINICAL SERVICES 5823 Patterson Ave Richmond, VA (804) Specialty Pharmacy ARIZONA Maricopa Phoenix LUMICERA HEALTH SERVICES, LLC 5350 E High St Ste 200 Phoenix, AZ (855) WISCONSIN Dane Madison LUMICERA HEALTH SERVICES 2601 W Beltline Hwy Ste 302 Madison, WI (855) Page 34

37 Discrimination is Against the Law Missouri Medicare Select complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Missouri Medicare Select does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Missouri Medicare Select: 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 our Compliance Officer. If you believe that Missouri Medicare Select 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: Compliance Officer, Missouri Medicare Select, P.O. Box 5849 Glen Allen, VA 23058, phone , TTY 711, fax , compliance@missourimedicareselect.com. You can file a grievance in person or by mail, fax, or . If you need help filing a grievance our Compliance Officer 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 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 , (TDD) Complaint forms are available at

38 English: ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call TTY: 711. Multi-Language Interpreter Services Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al TTY: 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 (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 TTY: 711. Serbo-Croatian: OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: 711). German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: TTY: 711 Arabic: برقم اتصل.بالمجان لك تتوافر اللغویة المساعدة خدمات فا ن اللغة اذكر تتحدث كنت إذا :ملحوظة (والبكم الصم ھاتف رقم: ). Korean: 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 TTY: 711 번으로전화해주십시오. Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните телетайп: 711. French: ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le (ATS : 711). Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa TTY: 711. Pennsylvania Dutch: Wann du Deitsch schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call TTY: 711. Persian (Farsi): فراھم امش برای رایگان بصورت زبانی تسھیلات کنید یم وگتفگ فارسی زبان ھب اگر :ھجوت می باشد. با (711 (TTY: تماس بگیرید. Cushite: XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa TTY: 711. Portuguese: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para TTY: 711. Amharic: ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ TTY: 711 H4490_2019MLIMO_C