2010 Pharmacy Directory

Transcription

1 2010 Pharmacy Directory Pennsylvania West Virginia UPMC Medicare Health Plans include: UPMC for Life Plans (HMO, PPO, PDP) UPMC for Life Specialty Plan (HMO) UPMC for Community Living (HMO)

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3 UPMC for Life Pharmacy Directory 2010 NOTE: Throughout this document, UPMC for Life refers to the following plans: UPMC for Life, UPMC for Life Specialty Plan, and UPMC for Community Living. This booklet provides a list of UPMC for Life s network pharmacies. This directory lists pharmacies in Pennsylvania and West Virginia. 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. A pharmacy s listing in the directory does not guarantee the pharmacy is currently in the network, open for business, or is at the same location. This directory is current as of September To get current information about UPMC for Life network pharmacies in your area, please visit our website at or call Member Services at the phone numbers listed below. UPMC for Life is a Medicare Advantage organization with a Medicare contract and is a Medicare-approved Part D sponsor. UPMC for Life Plans (HMO, PPO, or PDP) For individuals in our HMO and PPO plans with prescription drug coverage and PDP plans. Member Services Hours: Available seven days a week from 8:00 a.m. to 8:00 p.m.* Current Members call TTY/TDD users call Prospective Members call TTY/TDD users call UPMC for Life Specialty Plan (HMO) or UPMC for Community Living (HMO) For individuals who have Medicare (Parts A and B) and who have full Medical Assistance. Plans ONLY available in Pennsylvania. Member Services Hours: Available seven days a week from 8:00 a.m. to 8:00 p.m.* Current Members call TTY/TDD users call Prospective Members call TTY/TDD users call From March 2 through November 14, you may receive a messaging service on weekends and holidays. Please leave a message and your call will be returned the next business day. 1

4 Introduction This booklet provides a list of UPMC for Life s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review your Evidence of Coverage and UPMC for Life formulary. If you have additional questions, please call Member Services at the phone number listed on page 1 of this booklet. How do I find a UPMC for Life network pharmacy? We call the pharmacies in this directory our network pharmacies because we have made arrangements with them to provide prescription drugs to plan members. A network pharmacy is a pharmacy where members obtain prescription drug benefits provided by UPMC for Life. In general, your prescriptions are covered under UPMC for Life only if they are filled at a network pharmacy or through our mail-order pharmacy service. Once you go to one, you are not required to continue going to the same pharmacy to fill your prescription. You can go to any of our network pharmacies throughout the United States. We will fill prescriptions at non-network pharmacies under certain non-routine limited circumstances, such as an emergency, when you cannot reasonably use network pharmacies as described in your Evidence of Coverage. NOTE: UPMC for Life cannot pay for any prescriptions that are filled by pharmacies outside the United States, even for medical emergencies. In this booklet, you will find a list of all UPMC for Life network pharmacies, designated in alphabetical order by state and then counties within that state. There is also an alphabetical index in the back of the directory for your convenience. The UPMC for Life pharmacy network includes: Retail Chain pharmacies Retail pharmacies Mail-order pharmacies Specialty pharmacies Home Infusion pharmacies Long-term Care pharmacies How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show your UPMC for Life member ID card. If you do not have your ID card with you when you fill your prescription, you may have to pay the full cost of the prescription (rather than paying just your copayment). If this happens, you can ask us to reimburse you for our share of the cost by submitting a paper claim to us. To find out how to submit a paper claim, look in your Evidence of Coverage or call Member Services at the phone number listed on page 1 of this booklet. 2

5 NOTE: If you are a member of UPMC for Life Specialty Plan, you must show both your UPMC for Life Specialty Plan member ID card and your Medical Assistance ACCESS card. Showing both cards ensures that you will get the highest level of coverage. If you are eligible for Pennsylvania s State Pharmaceutical Assistance Program (e.g., PACE or PACENET), you must show your member ID card and your PACE or PACENET membership card when you get your prescription filled at network pharmacies. How do I fill a prescription through UPMC for Life s mail-order pharmacy service? You may use our network mail-order pharmacy service to fill prescriptions that you take on a regular basis for a chronic or long-term medical condition. When you order prescription drugs through our network mail-order pharmacy service, you may order up to a 90-day supply of the drug. Please make sure your physician writes the prescription for the amount you need to receive. You are not required to use our mail-order services to get an extended supply of maintenance medications. You can also get an extended supply at network pharmacies. However they may charge a higher price than our mail-order service. Please call Member Services or look for the indicator next to the pharmacy name in this directory to find out which retail pharmacies offer an extended supply. If you decide to fill your prescription drugs through mail-order you must use Express Scripts mail-order service. Prescription drugs (excluding specialty medications) that you get through any other mail-order service will not be covered. You may use UPMC for Life Express Scripts mail-order service for the following types of mailorder prescription drugs: Generic drugs Preferred Brand drugs Non-preferred Brand drugs NOTE: Specialty drug prescriptions may be mail-ordered from CuraScript. Specialty prescription drugs that you get through another mail-order pharmacy may not be covered. 3

6 To get order forms and information about filling your prescriptions by mail, you can contact Member Services at the phone number listed on page 1 of this booklet. On the Express Scripts mail-order form, fill out the following personal information section for each new prescription you send: member ID number your name date of birth drug allergies sex your address your phone number doctor s name doctor s phone number Include the new prescription slip, which must list the patient s full name, date of birth, and address, as well as the doctor s name and phone number. Generally, it takes the mail-order pharmacy 14 days to process your order and ship it to you. To avoid running out of your prescription, reorder your medication when you have at least a 14-day supply left. Your prescription drug order will be processed promptly and shipped to you along with forms and instructions for future orders. If you are mailing a refill prescription request, include your copayment in the mail-order envelope. You may pay by check, money order, debit card, or credit card. Do not send cash. You may also request refills over the telephone by contacting Express Scripts Mail-order Customer Service at , 24 hours a day, seven days a week. TTY/TDD users should call If ordering refills by phone, you must pay by credit card. If you have questions about the status of your prescription, you should also call Express Scripts Mail-order Customer Service at , 24 hours a day, seven days a week. TTY/TDD users should call They will provide you with information, including the expected delivery date and what to do if your drug shipment is delayed. For More Information For more detailed information about your UPMC for Life prescription drug coverage, review your Evidence of Coverage, UPMC for Life formulary, or call Member Services at the phone number listed on the page 1 of this booklet. Our website address is plan.com/medicare and our mailing address is UPMC for Life, Attn. Member Services, One Chatham Center, 112 Washington Place, Pittsburgh, PA

7 TABLE OF CONTENTS HOME INFUSION SERVICES...9 PENNSYLVANIA...10 ALLEGHENY, PA...10 BLAIR, PA...10 BUTLER, PA...10 CENTRE, PA...10 CHESTER, PA...10 CRAWFORD, PA...10 DAUPHIN, PA...10 DELAWARE, PA...10 ERIE, PA...10 LACKAWANNA, PA...10 LANCASTER, PA...10 LYCOMING, PA...10 MONTGOMERY, PA...10 MONTOUR, PA...11 NORTHAMPTON, PA...11 YORK, PA...11 WEST VIRGINIA...12 HARRISON, WV...12 KANAWHA, WV...12 MONONGALIA, WV...12 LONG TERM CARE PHARMACIES...13 PENNSYLVANIA...14 ALLEGHENY, PA...14 ARMSTRONG, PA...14 BEAVER, PA...14 BERKS, PA...14 BLAIR, PA...14 BUCKS, PA...14 BUTLER, PA...14 CAMBRIA, PA...14 CARBON, PA...14 CENTRE, PA...14 CHESTER, PA...15 CLEARFIELD, PA...15 COLUMBIA, PA...15 CRAWFORD, PA...15 CUMBERLAND, PA...15 DAUPHIN, PA...15 DELAWARE, PA...15 ERIE, PA...15 FAYETTE, PA...15 FRANKLIN, PA...15 FULTON, PA...15 INDIANA, PA...15 LACKAWANNA, PA...15 LANCASTER, PA...16 LAWRENCE, PA...16 LEHIGH, PA...16 LUZERNE, PA...16 LYCOMING, PA...16 MERCER, PA...16 MONROE, PA...16 MONTGOMERY, PA...16 MONTOUR, PA...17 NORTHUMBERLAND, PA...17 PERRY, PA...17 PHILADELPHIA, PA...17 SOMERSET, PA...17 VENANGO, PA...17 WARREN, PA...17 WASHINGTON, PA...17 WESTMORELAND, PA...17 YORK, PA

8 TABLE OF CONTENTS WEST VIRGINIA...19 BROOKE, WV...19 CABELL, WV...19 GREENBRIER, WV...19 MERCER, WV...19 MONONGALIA, WV...19 OHIO, WV...19 PUTNAM, WV...19 MAIL-ORDER...21 RETAIL CHAIN PHARMACIES...23 RETAIL PHARMACIES...24 PENNSYLVANIA...25 ADAMS, PA...25 ALLEGHENY, PA...25 ARMSTRONG, PA...27 BEAVER, PA...28 BEDFORD, PA...28 BERKS, PA...29 BLAIR, PA...29 BRADFORD, PA...30 BUCKS, PA...30 BUTLER, PA...31 CAMBRIA, PA...31 CAMERON, PA...32 CARBON, PA...32 CENTRE, PA...32 CHESTER, PA...33 CLARION, PA...34 CLEARFIELD, PA...34 CLINTON, PA...34 COLUMBIA, PA...34 CRAWFORD, PA...34 CUMBERLAND, PA...35 DAUPHIN, PA...35 DELAWARE, PA...36 ELK, PA...37 ERIE, PA...37 FAYETTE, PA...38 FOREST, PA...39 FRANKLIN, PA...39 FULTON, PA...39 GREENE, PA...39 HUNTINGDON, PA...39 INDIANA, PA...39 JEFFERSON, PA...40 JUNIATA, PA...40 LACKAWANNA, PA...40 LANCASTER, PA...41 LAWRENCE, PA...42 LEBANON, PA...42 LEHIGH, PA...43 LUZERNE, PA...43 LYCOMING, PA...45 MCKEAN, PA...45 MERCER, PA...45 MIFFLIN, PA...45 MONROE, PA...46 MONTGOMERY, PA...46 MONTOUR, PA...47 NORTHAMPTON, PA...48 NORTHUMBERLAND, PA...48 PERRY, PA...48 PHILADELPHIA, PA...49 PIKE, PA...53 POTTER, PA...53 SCHUYLKILL, PA...54 SNYDER, PA...54 SOMERSET, PA

9 TABLE OF CONTENTS SULLIVAN, PA...55 SUSQUEHANNA, PA...55 TIOGA, PA...55 UNION, PA...55 VENANGO, PA...55 WARREN, PA...55 WASHINGTON, PA...56 WAYNE, PA...56 WESTMORELAND, PA...56 WYOMING, PA...58 YORK, PA...58 WEST VIRGINIA...59 BARBOUR, WV...59 BERKELEY, WV...59 BOONE, WV...59 BRAXTON, WV...59 BROOKE, WV...59 CABELL, WV...59 CALHOUN, WV...60 CLAY, WV...60 DODDRIDGE, WV...60 FAYETTE, WV...60 GILMER, WV...60 GRANT, WV...60 GREENBRIER, WV...60 HAMPSHIRE, WV...60 HANCOCK, WV...60 HARDY, WV...61 HARRISON, WV...61 JACKSON, WV...61 JEFFERSON, WV...61 KANAWHA, WV...61 LEWIS, WV...62 LINCOLN, WV...62 LOGAN, WV...62 MARION, WV...62 MARSHALL, WV...63 MASON, WV...63 MCDOWELL, WV...63 MERCER, WV...63 MINERAL, WV...63 MINGO, WV...63 MONONGALIA, WV...64 MONROE, WV...64 MORGAN, WV...64 NICHOLAS, WV...64 OHIO, WV...64 PENDLETON, WV...65 PLEASANTS, WV...65 POCAHONTAS, WV...65 PRESTON, WV...65 PRESTON, WV...65 PRESTON, WV...65 PUTNAM, WV...65 RALEIGH, WV...65 RANDOLPH, WV...65 RITCHIE, WV...65 ROANE, WV...65 SUMMERS, WV...65 TAYLOR, WV...66 TUCKER, WV...66 TYLER, WV...66 UPSHUR, WV...66 WAYNE, WV...66 WEBSTER, WV...66 WETZEL, WV...66 WIRT, WV...66 WOOD, WV

10 TABLE OF CONTENTS WYOMING, WV...66 SPECIALTY PHARMACIES...69 PENNSYLVANIA...70 ALLEGHENY, PA...70 BUCKS, PA...70 LACKAWANNA, PA...70 LUZERNE, PA...70 PHILADELPHIA, PA...70 FLORIDA...71 ORANGE, FL...71 ALPHABETICAL INDEX

11 Home Infusion Pharmacies UPMC for Life will cover home infusion therapy if: Your prescription drug is on UPMC for Life s formulary or a formulary exception has been granted for your prescription drug; UPMC for Life has approved your prescription drug for home infusion therapy; Your prescription is written by an authorized prescriber; Your prescription drug is not otherwise covered under your plan s medical benefits; and You get your infused drug from a UPMC for Life network pharmacy. Please call Member Services at the phone number listed on page 1 of this booklet to get more information. 9

12 ALLEGHENY, PA HOME INFUSION SERVICES - PENNSYLVANIA ALLEGHENY, PA ACCREDO THERAPEUTICS 3000 ERICSSON DR WARRENDALE, PA (724) CHARTWELL PENNSYLVANIA PHCY 215 BEECHAM DR PITTSBURGH, PA (412) CRITICAL CARE SYSTEMS 3243 OLD FRANKSTOWN RD PITTSBURGH, PA (724) HEARTLAND HOME HEALTH CARE 750 HOLIDAY DR PITTSBURGH, PA (866) INFUSION PARTNERS 610 ALPHA DR PITTSBURGH, PA (412) BLAIR, PA HOME HEALTH RESOURCE 1216 PLEASANT VALLEY BLVD ALTOONA, PA (814) BUTLER, PA CORAM ALTERNATE SITE SERVICES 220 EXECUTIVE DR STE #500 CRANBERRY TWNSHP, PA (724) CENTRE, PA CRITICAL CARE SYSTEMS 253 BENNER PIKE STE# D STATE COLLEGE, PA (814) CHESTER, PA CORAM ALTERNATE SITE SVCS 6 SPRING MILL DR MALVERN, PA (610) CORAMRX 4-REAR SPRING MILL DR MALVERN, PA (610) CRAWFORD, PA VANTAGE HOME INFUSION THERPY PERRY HWY MEADVILLE, PA (814) DAUPHIN, PA CRITICAL CARE SYSTEMS 6380 FLANK DR STE 600 HARRISBURG, PA (717) DELAWARE, PA APRIA HEALTHCARE 16 CREEK PKWY BOOTHWYN, PA (800) BURMANS APOTHECARY 3413 EDGMONT AVE BROOKHAVEN, PA (610) CRITICAL CARE SYSTEMS 3901 COLUMBIA AVE LINWOOD, PA (610) PENTECH HEALTH 4 CREEK PKWY BOOTHWYN, PA (610) ERIE, PA GREAT LAKES HOME HLTHCARE 1700 PEACH ST ERIE, PA (814) LACKAWANNA, PA I V SOLUTIONS 162 N MAIN ST OLD FORGE, PA (570) LANCASTER, PA APRIA HEALTHCARE 155 N DONNERVILLE RD #1 MOUNTVILLE, PA (800) HORIZON HEALTHCARE SERVICES 2106 HARRISBURG PIKE LANCASTER, PA (717) LYCOMING, PA SERVICES 2195 RT 442 HWY MUNCY, PA (570) MONTGOMERY, PA ABINGTON HOME INFUSION 2500 MARYLAND RD WILLOW GROVE, PA (215) AIR PRODUCTS HEALTHCARE PHCY 480 NORRISTOWN RD BLUE BELL, PA (866) BIOSCRIP INFUSION SERVICES 625 CLARK AVE KING OF PRUSSIA, PA (610)

13 HOME INFUSION SERVICES - PENNSYLVANIA MONTGOMERY, PA HOME SOLUTIONS 2 WALNUT GROVE DR HORSHAM, PA (215) OPTION CARE 120 W GERMANTOWN PIKE PLYMOUTH MEETING, PA (610) PENN HOME IT 625 CLARK AVE STE 657 KING OF PRUSSIA, PA (610) SNI HEALTHCARE TECHNOLOGIES 700 BUSINESS CENTER DR HORSHAM, PA (800) MONTOUR, PA VITALINE 109 WOODBINE LN DANVILLE, PA (570) NORTHAMPTON, PA OPTION CARE 3895 ADLER PL BETHLEHEM, PA (610) YORK, PA HOME SOLUTIONS 3415 CONCORD RD YORK, PA (717)

14 HARRISON, WV HOME INFUSION SERVICES - WEST VIRGINIA HARRISON, WV TOTAL HEALTH SERVICES 700 OAKMOUND RD CLARKSBURG, WV (304) KANAWHA, WV MOUNTAIN STATE VITAL CARE 1111A JEFFERSON RD SOUTH CHARLESTON, WV (304) MONONGALIA, WV CARE PARTNERS HOME THERAPIES 601 HARTMAN RUN RD MORGANTOWN, WV (304)

15 Long-Term Care Pharmacies Generally, residents of a long-term care facility (like a nursing home) may get their prescription drugs through the facility s long-term care pharmacy or another network long-term care pharmacy. If your long-term care pharmacy isn t listed, or for more information, please call Member Services at the number listed on page 1 of this booklet. 13

16 ALLEGHENY, PA LONG TERM CARE PHARMACIES - PENNSYLVANIA ALLEGHENY, PA CCRX OF WESTERN PA 1215 HULTON AVE OAKMONT, PA (724) GRANE SUPPLY 464 NIXON RD CHESWICK, PA (724) JOHNSONS PHARMACEUTICAL SVCS 600 OLD CLAIRTON RD PITTSBURGH, PA (412) MILLENNIUM SYSTEMS PERRY HWY STE 200 WEXFORD, PA (724) PDC 100 PASSAVANT WAY PITTSBURGH, PA (412) ST CLAIR SENIOR CARE NETWORK 1082 BOWER HILL RD PITTSBURGH, PA (412) ARMSTRONG, PA LEECHBURG LTC 111 2ND ST LEECHBURG, PA (724) MISSION SERVICES 201 N JEFFERSON ST KITTANNING, PA (724) BEAVER, PA EXPRESS MED PHARMACEUTICAL 3950 BRODHEAD RD STE 100 MONACA, PA (724) BERKS, PA LUTHERAN APOTHECARY 1 S HOME AVE TOPTON, PA (610) PHARMERICA 1011 BERKS RD LEESPORT, PA (610) WERNERSVILLE STATE HOSPITAL ROUTE 422 & SPORTSMAN RD WERNERSVILLE, PA (610) BLAIR, PA MOUNTAIN CITY HOME TH AVE ALTOONA, PA (814) BUCKS, PA BROCKIE PHARMATECH 275 N PINE ST #B LANGHORNE, PA (215) CONTRACT SERVICES 125 TITUS AVE WARRINGTON, PA (800) EASTON RD WARRINGTON, PA (215) PENNSWOOD VILLAGE 1382 NEWTOWN LANGHORNE RD NEWTOWN, PA (215) SHELLYS MEDICATION SERVICES 1504 GRUNDY'S LN UNIT #8 BRISTOL, PA (215) BUTLER, PA PROVIDENCE SERVICES 615 N PIKE RD CABOT, PA (724) QUALITY 164 MEDICAL CTR RD STE F CHICORA, PA (724) CAMBRIA, PA FOREST HILLS 550 LOCUST ST SAINT MICHAEL, PA (814) CARBON, PA NORTHEAST SERVICES 590 COAL ST LEHIGHTON, PA (610) CENTRE, PA CENTRE SERVICES 724 S ATHERTON ST STATE COLLEGE, PA (814)

17 LONG TERM CARE PHARMACIES - PENNSYLVANIA CHESTER, PA CHESTER, PA CAMILLA HALL 1145 KING RD IMMACULATA, PA (610) CLEARFIELD, PA GUARDIAN LTC 123 BRUBAKER RD BROCKWAY, PA (814) COLUMBIA, PA CARE FIRST SERVICES 1015 N VINE ST BERWICK, PA (570) CRAWFORD, PA CARE APOTHECARY PERRY HWY MEADVILLE, PA (800) NORTHWEST SOLUTIONS 740 N MAIN ST EXT MEADVILLE, PA (814) CUMBERLAND, PA PHARMERICA 1000 CLAREMONT RD CARLISLE, PA (717) DAUPHIN, PA PHARMERICA 491-A BLUE EAGLE AVE HARRISBURG, PA (717) DELAWARE, PA ELWYN SPECIALTY CARE 54 CONCHESTER RD GLEN MILLS, PA (610) MARTIN DRUGS 623 S CHESTER RD REAR SWARTHMORE, PA (610) MILLENNIUM SYSTEMS 340 MIDDLETOWN RD LIMA, PA (610) SOURCE ONE SVCS 485 BALTIMORE PIKE UNIT 202-B GLEN MILLS, PA (610) STELTEC 601 UPLAND AVE BROOKHAVEN, PA (888) ERIE, PA PHARMERICA 2337 W 50TH ST ERIE, PA (814) PLEASANT RIDGE MANOR 8300 W RIDGE RD GIRARD, PA (814) FAYETTE, PA LAUREL LTC 278 MCCLELLANDTOWN RD UNIONTOWN, PA (724) FRANKLIN, PA CONTINUING CARE RX 2075 SCOTLAND AVE CHAMBERSBURG, PA (717) FULTON, PA FULTON COUNTY MEDICAL CTR PHCY 214 PEACH ORCHARD RD MCCONNELLSBURG, PA (717) INDIANA, PA DIAMOND SERVICES 645 KOLTER DR INDIANA, PA (724) GENOA HEALTHCARE 793 OLD RTE 119 HWY N INDIANA, PA (724) LACKAWANNA, PA ALLIED SERVICES 201 SMALLACOMBE DR STE 1 SCRANTON, PA (570) CLARK SUMMIT HOSPITAL PHCY 1451 HILLSDALE DR CLARK SUMMIT, PA (570) FIGLIOMENI CARE 24 N CHURCH ST CARBONDALE, PA (570) NEIGHBORCARE SCRANTON 2400 STAFFORD AVE #800 SCRANTON, PA (570)

18 LACKAWANNA, PA LONG TERM CARE PHARMACIES - PENNSYLVANIA PRIMECARE SERVICES 310 ADAMS AVE SCRANTON, PA (570) LANCASTER, PA CONTINUING CARE RX 2124 TOWN SQUARE N MANHEIM, PA (717) DIAMOND SERVICES 900 E KING ST LANCASTER, PA (717) MASONIC HOMES 1 MASONIC DR ELIZABETHTOWN, PA (717) WILLIAMS APOTHECARE 3001 LITITZ PIKE LANCASTER, PA (717) WILLIAMS APOTHECARY 1001 E OREGON RD LITITZ, PA (717) HARRISBURG PIKE LANCASTER, PA (717) N LIME ST LANCASTER, PA (717) LAWRENCE, PA MEDICAL ARTS CENTER 1000 S MERCER ST STE 102 NEW CASTLE, PA (724) LEHIGH, PA ALLENTOWN STATE HOSPITAL 1600 HANOVER AVE ALLENTOWN, PA (610) HEARTLAND OF PA 7010 SNOWDRIFT RD ALLENTOWN, PA (800) PHOEBE SERVICES 6520 STONEGATE DR ALLENTOWN, PA (610) LUZERNE, PA APS SERVICES 225 OVERLOOK DR PITTSTON, PA (570) GENERAL COMMUNITY 562 WYOMING AVE KINGSTON, PA (570) KEYSTONE PROFESSIONAL PHCY 485 S RIVER ST WILKES BARRE, PA (570) PHARMERICA 153 STEWART RD WILKES BARRE, PA (570) LYCOMING, PA NEIGHBORCARE WILLIAMSPORT 1000 COMMERCE PARK DR WILLIAMSPORT, PA (570) MERCER, PA INSTITUTIONAL CARE 175 CANAL ST SHARPSVILLE, PA (724) PHCY MANAGEMENT GROUP OF PA 175 SNYDER RD HERMITAGE, PA (800) MONROE, PA SALERNO'S BOSSARDVILLE & BUS RTE 209 SCIOTA, PA (570) MONTGOMERY, PA CONTINUING CARE RX 2566 INDUSTRY RD NORRISTOWN, PA (610) CONTRACT SERVICES 1400 WAVERLY RD GLADWYNE, PA (610) CPS ABRAMSON CTR 1425 HORSHAM RD NORTH WALES, PA (215) INTEGRITY 489 SHOEMAKER RD KING OF PRUSSIA, PA (484) KING OF PRUSSIA PHCY SVCS 20 UNION HILL RD STE 100 WEST CONSHOHOCKEN, PA (610)

19 LONG TERM CARE PHARMACIES - PENNSYLVANIA MONTGOMERY, PA MILLENNIUM SYSTEMS 1500 INDUSTRY RD HATFIELD, PA (724) NEIGHBORCARE-KING OF PRUSSIA 600 ALLENDALE RD KING OF PRUSSIA, PA (610) NORRISTOWN STATE HOSPITAL 1001 STERIGERE ST NORRISTOWN, PA (610) PBC 815 MAPLEWOOD AVE HARLEYSVILLE, PA (215) PDC 2550 EISENHOWER AVE NORRISTOWN, PA (484) PHARMERICA 5100 CAMPUS DR PLYMOUTH MEETING, PA (610) SYNERGY SERVICES 2500 BLVD OF THE GENERALS NORRISTOWN, PA (610) WILLITS SERVICES S YORK RD HATBORO, PA (215) MONTOUR, PA DANVILLE STATE HOSPITAL 200 STATE HOSPITAL DR DANVILLE, PA (570) NORTHUMBERLAND, PA SYNERGY GRANDVIEW 173 POINT TOWNSHIP DR NORTHUMBERLAND, PA (570) PERRY, PA CONTINUING CARE RX 28 S 2ND ST NEWPORT, PA (717) PHILADELPHIA, PA EXCELLERX 530 WALNUT PHILADELPHIA, PA (215) FRIENDSHIP 3300 COTTMAN AVE 2ND FL PHILADELPHIA, PA (215) GERMANTOWN HOSP & MED CTR PHCY 1 PENN BLVD PHILADELPHIA, PA (215) SQA SERVICES 4700 WISSAHICKON AVE PHILADELPHIA, PA (215) SOMERSET, PA BOSWELL SERVICES 131 SCHOOLHOUSE RD JENNERSTOWN, PA (814) VENANGO, PA COMMUNITY DRUGS 123 N 13TH ST FRANKLIN, PA (814) WARREN, PA WARREN STATE HOSPITAL 33 MAIN DR WARREN, PA (814) WASHINGTON, PA CURTIS LTC 1100 W CHESTNUT ST WASHINGTON, PA (724) WESTMORELAND, PA DIAMOND HCS 445 MAIN ST MOUNT PLEASANT, PA (724) GARDA RX 320 RTE 22 #8 DELMONT, PA (724) PHARMERICA 900 GREENGATE PLAZA GREENSBURG, PA (724) RANIER'S 1107 LOWRY AVE JEANNETTE, PA (724) TORRANCE STATE HOSPITAL RENNER BUILDING TORRANCE, PA (724) YORK, PA BROCKIE PHARMATECH 100 HOMEWOOD WAY HANOVER, PA (717) PLEASANT ACRES RD YORK, PA (717)

20 YORK, PA LONG TERM CARE PHARMACIES - PENNSYLVANIA 209 N BEAVER ST YORK, PA (717)

21 LONG TERM CARE PHARMACIES - WEST VIRGINIA BROOKE, WV BROOKE, WV TRISTATE LTC 651 COLLIERS HWY WEIRTON, WV (304) CABELL, WV CONTINUUMCARE 78 PERRY WINKLE LN HUNTINGTON, WV (304) GREENBRIER, WV ENCORE 840 N JEFFERSON ST STE A LEWISBURG, WV (304) MERCER, WV CLINIC IV 100 NEW HOPE RD STE 8-A PRINCETON, WV (304) MONONGALIA, WV NEIGHBORCARE MORGANTOWN 1401 EARL CORE RD #A MORGANTOWN, WV (304) OHIO, WV WHEELING HOSPITAL 1 MEDICAL PARK RD WHEELING, WV (304) PUTNAM, WV HOME CARE ST AVE STE 200 NITRO, WV (304)

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23 UPMC for Life Network Pharmacies Mail-Order Pharmacy UPMC for Life s mail-order service provider is: Express Scripts Home Delivery Service P.O. Box 847 Bensalem, PA TTY/TTD For Specialty drugs, please refer to the Specialty Section starting on page Provider also contracted for 90 day supply 21

24 UPMC for Life Network Pharmacies Retail Chain Pharmacies UPMC for Life has listed the national chain pharmacies included in our pharmacy network. Please call the following toll-free phone number to locate the closest pharmacy, or call Member Services at the phone number listed on page 1 of this booklet for assistance in locating a chain pharmacy. 22

25 RETAIL CHAIN PHARMACIES COSTCO❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) CVS❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) DISCOUNT DRUG MART❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) FRUTH Toll Free: (866) TTY/TTD: 711 (TRS Relay Number) GENUARDI'S Toll Free: (877) TTY/TTD: (866) GIANT EAGLE❶ Toll Free: (800) TTY/TTD: (877) KMART Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) KOPP DRUG❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) KROGER Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) MARC'S Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) MEDICAP Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) MEDICINE SHOPPE Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) MEIJER Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) MR Z'S Toll Free: (888) TTY/TTD: 711 (TRS Relay Number) OMNICARE Toll Free: (888) TTY/TTD: 711 (TRS Relay Number) PATHMARK Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) RITE AID❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) SAM'S CLUB❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) SHOPRITE Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) SUPER FRESH❶ Toll Free: (866) TTY/TTD: 711 (TRS Relay Number) TARGET Toll Free: (800) x6 TTY/TTD: (800) WALGREENS❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) WAL-MART❶ Toll Free: (800) TTY/TTD: 711 (TRS Relay Number) WEGMANS Toll Free: (877) TTY/TTD: 711 (TRS Relay Number) WEIS Toll Free: (888) TTY/TTD: 711 (TRS Relay Number) ❶PROVIDER ALSO CONTRACTED FOR 90 - DAY SUPPLY 23

26 Retail Pharmacies 1 Provider also contracted for 90 day supply 24

27 RETAIL PHARMACIES - PENNSYLVANIA ADAMS, PA ADAMS, PA ADAMS-CUMBERLAND 3463 BIGLERVILLE RD BIGLERVILLE, PA (570) CHOICE APOTHECARY 105 4TH ST EAST BERLIN, PA (717) CHOICE CRITICAL CARE 10 S 6TH ST MCSHERRYSTOWN, PA (717) CHOICE FAMILY 8 S 6TH ST MCSHERRYSTOWN, PA (717) EAST BERLIN 335 W KING ST EAST BERLIN, PA (717) GIANT 44 NATURAL SPRINGS RD GETTYSBURG, PA (717) KENNIE'S 520 W KING ST LITTLESTOWN, PA (717) LASLOW'S 6 SPRINGS AVE GETTYSBURG, PA (717) SHURFINE 30 PRIMROSE LN EAST BERLIN, PA (717) WELLSPAN 300 W KING ST LITTLESTOWN, PA (717) BIGLERVILLE RD BIGLERVILLE, PA (717) B FAIRFIELD RD FAIRFIELD, PA (717) WOGANS DRUG STORE 410 N QUEEN ST LITTLESTOWN, PA (717) ALLEGHENY, PA ADZEMA 8105 PERRY HIGHWAY PITTSBURGH, PA (412) ALERT SERVICES❶ 800 BURSCA DR STE 805 BRIDGEVILLE, PA (412) AMSLER 818 E WARRINGTON AVE PITTSBURGH, PA (412) ASTI'S SOUTH HILLS 250 MT LEBANON BLVD PITTSBURGH, PA (412) AYRES DRUG STORE❶ 3000 WALNUT ST MCKEESPORT, PA (412) BILL'S 313 UNITY CENTER RD PITTSBURGH, PA (412) BLACKBURN'S PHYSICIANS PHCY 301 CORBET ST TARENTUM, PA (724) BLOOMFIELD DRUG STORE 4727 LIBERTY AVE PITTSBURGH, PA (412) CENTRAL 108 SIMPSON HOWELL RD ELIZABETH, PA (412) CENTURY SQUARE 2381 MOUNTAINVIEW RD WEST MIFFLIN, PA (412) COMMUNITY DRUG❶ 517 GREENFIELD AVE PITTSBURGH, PA (412) COMPLETE RX SERVICES 250 MOUNT LEBANON BLVD PITTSBURGH, PA (412) COORDINATED CARE NETWK PHCY❶ 300 PENN CENTER BLVD PITTSBURGH, PA (412) CVS PROCARE❶ 600 PENN CENTER BLVD PITTSBURGH, PA (800) EAST LIBERTY FAMILY HLTH CTR 7171 CHURCHLAND ST PITTSBURGH, PA (412) ELIZABETH ND AVE PITTSBURGH, PA (412) FALK TH AVE RM 211 PITTSBURGH, PA (412) ❶Provider also contracted for 90 - Day Supply 25

28 ALLEGHENY, PA FORBES 3501 FORBES AVE PITTSBURGH, PA (412) FRANCK'S AVALON COMMUNITY PHCY 550 CALIFORNIA AVE AVALON, PA (412) FRANCKS EPS 325 S BIRMINGHAM AVE AVALON, PA (412) GALLAGHER 426 W GRANT AVE DUQUESNE, PA (412) HEALTH KIDS RX❶ PERRY HWY WEXFORD, PA (724) HEIGHTS PRESCRIPTION 1633 UNION AVE NATRONA HEIGHTS, PA (724) HERITAGE VALLEY 720 BLACKBURN RD 3RD FL SEWICKLEY, PA (412) HIEBER'S TH AVE PITTSBURGH, PA (412) HILLMAN CENTER 5115 CENTRE AVE RM AG301 PITTSBURGH, PA (412) HOMETOWN 2103 NOBLESTOWN RD PITTSBURGH, PA (412) GOLDEN MILE HWY PITTSBURGH, PA (724) E 8TH AVE HOMESTEAD, PA (412) KANE REGIONAL CTR GLEN HAZEL 955 RIVERMONT DR PITTSBURGH, PA (412) KESSLING 2929 LIBERTY WAY MCKEESPORT, PA (412) LEBANON SHOPS 300 MT LEBANON BLVD PITTSBURGH, PA (412) LINCOLN 232 NORTH AVE AT LINCOLN PITTSBURGH, PA (412) LIVINGSTON 550 MILLER AVE CLAIRTON, PA (412) MANNS DRUG STORE❶ 1101 LINCOLN WAY MCKEESPORT, PA (412) MASONIC VILLAGE 1000 MASONIC DR SEWICKLEY, PA (412) MATILDA THEISS CLINIC❶ 373 BURROWS ST PITTSBURGH, PA (412) MCKEESPORT PRESCRIPTION CTR❶ 2301 VERSAILLES AVE MCKEESPORT, PA (412) RETAIL PHARMACIES - PENNSYLVANIA MED FAST 3125 BANKSVILLE RD PITTSBURGH, PA (412) MCKNIGHT RD PITTSBURGH, PA (412) BEAVER GRADE RD CORAOPOLIS, PA (412) MED PHARM 2506 WILDWOOD RD WILDWOOD, PA (412) MED-FAST 1886 HOMEVILLE RD WEST MIFFLIN, PA (412) WILLIAM PENN HWY PITTSBURGH, PA (412) LIBRARY RD BETHEL PARK, PA (412) WILLIAM FLYNN HWY GIBSONIA, PA (724) BUTLER ST PITTSBURGH, PA (412) MEDICINE STOP 215 ALLEGHENY AVE OAKMONT, PA (412) MOUNT ROYAL BLVD PITTSBURGH, PA (412) MELWOOD DRUG❶ 4631 CENTRE AVE PITTSBURGH, PA (412) MERCY HEALTH CENTER 1515 LOCUST ST PITTSBURGH, PA (412) ❶Provider also contracted for 90 - Day Supply 26

29 RETAIL PHARMACIES - PENNSYLVANIA ALLEGHENY, PA METRO FAMILY PRACTICE❶ 901-B WEST ST PITTSBURGH, PA (412) O'BRIEN'S 3400 S PARK RD BETHEL PARK, PA (412) PALMER DRUG STORE MAIN ST RUSSELLTON, PA (724) PENN TAFT 1815 PENNSYLVANIA AVE WEST MIFFLIN, PA (412) PHIL'S 426 BROADWAY PITCAIRN, PA (412) PITT STUDENT HEALTH PHCY❶ TH AVE PITTSBURGH, PA (412) PLEASANT HILLS APOTHECARY❶ 25 GILL HALL RD JEFFERSON HILLS, PA (412) PORTER'S PRESCRIPTION 935 BEAVER GRADE RD CORAOPOLIS, PA (412) POTOMAC 2860 BROADWAY AVE PITTSBURGH, PA (412) PRESCRIPTION CENTER PLUS 2850 BROWNSVILLE RD SOUTH PARK, PA (412) PRIMARY CARE HEALTH SERVICES❶ 7227 HAMILTON AVE PITTSBURGH, PA (412) PRIMARY CARE SERVICES❶ 2027 LEBANON CHURCH RD WEST MIFFLIN, PA (412) MOSSIDE BLVD STE 210 MONROEVILLE, PA (412) QOL MEDS❶ 4900 PERRY HWY PITTSBURGH, PA (412) RX PARTNERS LTC❶ 500 OLD POND RD STE 406 BRIDGEVILLE, PA (412) SCHILLER'S 811 S AIKEN AVE PITTSBURGH, PA (412) SHERMANS 3417 MAIN ST MUNHALL, PA (412) SHOP 'N SAVE FOOD AND DRUG❶ 3239 WASHINGTON PIKE BRIDGEVILLE, PA (412) SHOP 'N SAVE 799 CASTLE SHANNON BLVD PITTSBURGH, PA (412) SPARTAN 2941 BROWNSVILLE RD PITTSBURGH, PA (412) MCMURRAY RD BETHEL PARK, PA (412) KINGS SCHOOL RD BETHEL PARK, PA (412) ST CLAIR HOSPITAL O/P PHCY❶ 1000 BOWER HILL RD PITTSBURGH, PA (412) STANTON-NEGLEY DRUG❶ 804 N NEGLEY AVE PITTSBURGH, PA (412) STUTZ 2134 E CARSON ST PITTSBURGH, PA (412) TOWNE DRUGS 227 COMMERCIAL AVE ASPINWALL, PA (412) TROY 1612 LOWRIE ST PITTSBURGH, PA (412) WALTMIRE 1435 SPRING GARDEN AVE PITTSBURGH, PA (412) WESTBROOK PHCY AND SURG SUPPLY 1910 COCHRAN RD PITTSBURGH, PA (412) WILSON'S 4101 PENN AVE PITTSBURGH, PA (412) ARMSTRONG, PA BRACKENS 7 WATER ST EAST BRADY, PA (724) ❶Provider also contracted for 90 - Day Supply 27

30 ARMSTRONG, PA KLINGENSMITH'S DRUG❶ 153 MARKET ST LEECHBURG, PA (724) MARKET ST KITTANNING, PA (724) TH ST FREEPORT, PA (724) FIRST AVE KITTANNING, PA (724) FORD ST FORD CITY, PA (724) THIRD ST NU MINE, PA (724) US RT 422 HWY W SHELOCTA, PA (724) LEECHBURG 165 MARKET ST LEECHBURG, PA (724) NEW BETHLEHEM 332 BROAD ST NEW BETHLEHEM, PA (814) WYBLE'S 200 WARREN AVE APOLLO, PA (724) BEAVER, PA A & G SERVICES❶ 2665 BRODHEAD RD STE B ALIQUIPPA, PA (724) BEAVER FALLS CORNER DRUG TH AVE BEAVER FALLS, PA (724) BEAVER HEALTH MART 457 3RD ST BEAVER, PA (724) BRIGHTON 525 5TH AVE NEW BRIGHTON, PA (724) COLLEGE HILL TH AVE BEAVER FALLS, PA (724) EXPRESS MED 3950 BRODHEAD RD MONACA, PA (724) HERITAGE VALLEY 1000 DUTCHRIDGE RD BEAVER, PA (724) HOFFMAN'S DRUG STORE❶ 536 FRANKLIN AVE ALIQUIPPA, PA (724) HOMETOWN APOTHECARY DRUGS❶ 807 3RD AVE NEW BRIGHTON, PA (724) MED FAST 1647 STATE ST W BADEN, PA (724) SHEFFIELD RD ALIQUIPPA, PA (724) SHEFFIELD RD STE 1B ALIQUIPPA, PA (800) RETAIL PHARMACIES - PENNSYLVANIA 3589 N BRODHEAD RD MONACA, PA (724) MED-FAST 4935 TUSCARAWAS RD BEAVER, PA (724) THE MEDICINE STOP TH AVE BEAVER FALLS, PA (724) BEDFORD, PA CHESTNUT RIDGE 2262 QUAKER VALLEY RD FISHERTOWN, PA (814) EVERETT 108 E MAIN ST EVERETT, PA (814) FISHER'S 106 E PITT ST BEDFORD, PA (814) ICKES DRUG STORE 122 S JULIANNA ST BEDFORD, PA (814) LETRENT'S 135 W PITT ST BEDFORD, PA (814) LOWERS 33 E MAIN ST EVERETT, PA (814) MCCAHAN'S 813-A LOWER MAIN ST SAXTON, PA (814) ❶Provider also contracted for 90 - Day Supply 28

31 RETAIL PHARMACIES - PENNSYLVANIA BEDFORD, PA POTOMAC VALLEY WASHINGTON AT CENTRE STS HYNDMAN, PA (814) SAXTON STATION 509 MAIN ST STE 102 SAXTON, PA (814) WHYSONG'S 4186 CORTLAND DR NEW PARIS, PA (814) BERKS, PA ADAMS & BRIGHT DRUG❶ 306 STATE ST HAMBURG, PA (610) BAUSES SUPER DRUG STORE❶ 42 E PHILADELPHIA AVE BOYERTOWN, PA (610) BERKS HEMATOLOGY ONCOLOGY❶ S 6TH AVE & SPRUCE ST WEST READING, PA (610) BIRDSBORO 330 W MAIN ST BIRDSBORO, PA (610) BLANDON 104 ANNA AVE BLANDON, PA (610) ESTERBROOK 301 S 7TH AVE WEST READING, PA (610) GIANT 2104 VAN REED RD WEST LAWN, PA (610) SHILLINGTON RD READING, PA (610) PERKIOMAN AVE READING, PA (610) N 5TH ST HWY TEMPLE, PA (610) E LANCASTER AVE SHILLINGTON, PA (610) KING'S 552 STATE ST HAMBURG, PA (610) KING'S PLAZA OLEY, PA (610) PENN 900 PENN ST READING, PA (610) REDNER'S 5471 POTTSVILLE PIKE LEESPORT, PA (610) RONCO'S 3311 PENN AVE WEST LAWN, PA (610) SHURFINE 4724 PENN AVE SINKING SPRING, PA (610) THE COMMUNITY 145 N 6TH ST READING, PA (610) WEST READING DRUG STORE❶ 538 PENN AVE WEST READING, PA (610) BLAIR, PA BROAD AVENUE 2329 BROAD AVE ALTOONA, PA (814) COMMUNITY 1256 PENNSYLVANIA AVE TYRONE, PA (814) DICKS TH ST ALTOONA, PA (814) DICK'S 318 E. FIRST ST WILLIAMSBURG, PA (814) RT 220 CLAYSBURG, PA (814) DUNCANSVILLE RD AVE DUNCANSVILLE, PA (814) GREENWOOD DRUGS❶ 1667 BELLEMEADE DR ALTOONA, PA (814) MARTIN'S 2032 E PLEASANT VALLEY BLVD ALTOONA, PA (814) GLIMCHER DR DUNCANSVILLE, PA (814) ❶Provider also contracted for 90 - Day Supply 29

32 BLAIR, PA RETAIL PHARMACIES - PENNSYLVANIA 431 E 25TH AVE ALTOONA, PA (814) THOMPSON TH ST ALTOONA, PA (814) BLAIR ST HOLLIDAYSBURG, PA (874) E CHESTNUT AVE ALTOONA, PA (814) TIPTON US RTE 220 TIPTON, PA (814) BRADFORD, PA BROWN'S 47 SULLIVAN ST CANTON, PA (570) CANTON ST TROY, PA (570) CANTON 7 TROY ST CANTON, PA (570) CLINIC 7 COLONIAL DR TOWANDA, PA (570) ONE GUTHRIE SQUARE STE EC101 SAYRE, PA (570) COOKES 101 E MAIN ST TROY, PA (570) MILLER'S 137 MAIN ST WYALUSING, PA (570) PLAZA STATE RTE 6 WYALUSING, PA (570) BUCKS, PA ACME 550 W TRENTON AVE MORRISVILLE, PA (215) BENSALEM STREET RD BENSALEM, PA (215) BUCKS COUNTY 7501 NEW FALLS RD LEVITTOWN, PA (215) BURNS 82 N PENNSYLVANIA AVE MORRISVILLE, PA (215) FAMILY 4005 VETERANS HWY LEVITTOWN, PA (215) GARY'S RX SHOPPE❶ 33 E ST RD FEASTERVILLE, PA (215) GIANT 1153 N 5TH ST PERKASIE, PA (215) STREET RD BENSALEM, PA (215) NEW FALLS RD LEVITTOWN, PA (215) S OXFORD VALLEY RD FAIRLESS HILLS, PA (215) E LOGAN SQUARE NEW HOPE, PA (215) D WEST ST RD WARMINSTER, PA (215) RT 113 SOUDERTON, PA (215) S WEST END BLVD QUAKERTOWN, PA (215) HARRIS 511 E ST CENTER DOYLESTOWN, PA (215) HERITAGE 1091 GENERAL KNOX RD WASHINGTON XING, PA (215) HORSHAM SQUARE ANN'S CHOICE WAY WARMINSTER, PA (215) LANDIS 2685 COUNTY LINE RD TELFORD, PA (215) LANGHORNE 172 N PINE ST LANGHORNE, PA (215) LIFESTREAM 847 EASTON RD WARRINGTON, PA (215) LIFESTREAM RX 847 EASTON RD STE 2775 WARRINGTON, PA (215) ❶Provider also contracted for 90 - Day Supply 30

33 RETAIL PHARMACIES - PENNSYLVANIA BUCKS, PA MAT'S 701 BRISTOL PIKE CROYDON, PA (215) MAX-WELL SERVICES❶ 375 W STREET RD WARMINSTER, PA (215) MEDICAL PLAZA 240 MIDDLETOWN BLVD STE 105 LANGHORNE, PA (215) MILL STREET 416 MILL ST BRISTOL, PA (215) NESHAMINY 5417 NESHAMINY BLVD BENSALEM, PA (215) NOVACARE 711 BUSTLETON PIKE FEASTERVILLE, PA (215) NU-WAY 1627 HAINES RD LEVITTOWN, PA (215) OXFORD VALLEY 1265 WOODBOURNE RD LEVITTOWN, PA (215) PARKWOOD STREET ROAD 3532 ST RD BENSALEM, PA (215) SELLERSVILLE 218 SOUTH MAIN ST SELLERSVILLE, PA (215) VILLAGE SHIRES 1464 BUCK RD HOLLAND, PA (215) WHITMAN 4950 OLD YORK RD HOLICONG, PA (215) WINDSOR 1506 HAINES RD LEVITTOWN, PA (215) YORKE 5524 NEW FALLS RD LEVITTOWN, PA (215) BUTLER, PA BENBROOK 100 TECHNOLOGY DR STE 1 BUTLER, PA (724) CHICORA DRUG 100 W SLIPPERY ROCK ST CHICORA, PA (724) COLONIAL 708 EKASTOWN RD SARVER, PA (724) EVANS CITY PHCY & GIFT SHOPPE 201 E MAIN ST EVANS CITY, PA (724) INSTITUTE HILL 937 E JEFFERSON ST BUTLER, PA (724) MED FAST RTE 19 STE 23 CRANBERRY TWP, PA (724) PETROLEUM VALLEY MEDICAL CNTR❶ 296 CHURCH ST PETROLIA, PA (724) QUALITY 164 MEDICAL CTR STE E CHICORA, PA (724) RX BLUE STAR SOLUTIONS❶ 107 GEORGE RD EVANS CITY, PA (412) SAXONBURG DRUG 115 PITTSBURG ST SAXONBURG, PA (724) THE HOMETOWN 3 NORTHGATE PLZ UNIT 2 HARMONY, PA (724) CAMBRIA, PA BILO MARKET & 1910 MINNOW DR JOHNSTOWN, PA (814) CORNER DRUG STORE 150 FAIRFIELD AVE JOHNSTOWN, PA (814) CVMH 1086 FRANKLIN ST JOHNSTOWN, PA (814) EAST HILLS FAMILY 1111 SCALP AVE JOHNSTOWN, PA (814) ❶Provider also contracted for 90 - Day Supply 31

34 CAMBRIA, PA FOREST HILLS 552 LOCUST ST SAINT MICHAEL, PA (814) FOWLER'S 317 BEAVER ST HASTINGS, PA (814) JACKSONS 2423 BELTS AVE NORTHERN CAMBRIA, PA (814) JAMES DRUG STORE❶ 601 2ND ST CRESSON, PA (814) JOHNSTOWN 339 WALNUT ST STE 100 JOHNSTOWN, PA (814) MAINLINE ND ST CRESSON, PA (814) MAIN ST PORTAGE, PA (814) MARTELLA'S 1079 FRANKLIN ST JOHNSTOWN, PA (814) ONOCOLOGY 1020 FRANKLIN ST JOHNSTOWN, PA (814) PARK HILL DRUG STORE❶ 1940 WILLIAM PENN AVE JOHNSTOWN, PA (814) PATTON 402 PATTON PLAZA PATTON, PA (814) SHARBAUGH'S DRUG STORE❶ 2073 PLANK RD CARROLLTOWN, PA (814) TIBBOTT'S 1104 W HIGH ST EBENSBURG, PA (814) VINCO 2809 WILLIAM PENN AVE JOHNSTOWN, PA (814) WATTERS BROS DRUG STORE 4105 CRAWFORD AVE NORTHERN CAMBRIA, PA (814) WESTMONT DRUG STORE 1741 GOUCHER ST JOHNSTOWN, PA (814) CAMERON, PA EMPORIUM 105 E 4TH ST EMPORIUM, PA (814) CARBON, PA CARRIGAN'S COUNTRY RT 903 & OLD STAGE RD ALBRIGHTSVILLE, PA (570) COMMUNITY 30 RIVER ST JIM THORPE, PA (570) FIRST NATIONAL 143 N 1ST ST LEHIGHTON, PA (610) RETAIL PHARMACIES - PENNSYLVANIA LEHIGHTON 281 N 12TH ST STE C LEHIGHTON, PA (610) MAUCH CHUNK 1204 NORTH ST JIM THORPE, PA (570) SHIPMAN'S 326 DELAWARE AVE PALMERTON, PA (610) WEATHERLY AREA COMMUNITY PHCY. 202 CARBON ST WEATHERLY, PA (570) CENTRE, PA CARESITE 200 SCENERY DR STATE COLLEGE, PA (814) GREENTECH DR STATE COLLEGE, PA (814) GIANT E COLLEGE AVE STATE COLLEGE, PA (814) W CLINTON AVE STATE COLLEGE, PA (814) GRATTAN'S 230 N FRONT ST PHILIPSBURG, PA (814) MCLANAHAN DRUG OF CENTRE HALL 2827 EARLYSTOWN RD, RT 45 CENTRE HALL, PA (814) ❶Provider also contracted for 90 - Day Supply 32

35 RETAIL PHARMACIES - PENNSYLVANIA CENTRE, PA MOSHANNON VALLEY 208 MEDICAL CENTER DR PHILIPSBURG, PA (814) E SYCAMORE RD SNOW SHOE, PA (814) PARRISH APOTHECARY SHOP 114 N ALLEGHENY ST BELLEFONTE, PA (814) PENNS VALLEY 4576 PENNS VALLEY RD SPRING MILLS, PA (814) PLUMB'S DRUG STORE 105 N ALLEGHENY ST BELLEFONTE, PA (814) THE BOALSBURG APOTHECARY 3901 S ATHERTON ST STATE COLLEGE, PA (814) CHESTER, PA BRANDYWINE 2503 CONESTOGA AVE HONEY BROOK, PA (610) BRANDYWINE VALLEY FMLY PRAC❶ 20 MCMASTER BLVD STE 1 KEMBLESVILLE, PA (610) CHESPENN HEALTH SERVICES❶ 744 E LINCOLN HWY COATESVILLE, PA (877) DOUG'S FAMILY 101 DARBY SQUARE ELVERSON, PA (610) EXTON 1 MARCHWOOD RD EXTON, PA (610) GATEWAY 165 NUTT RD PHOENIXVILLE, PA (610) GIANT 1393 DILWORTHTOWN CROSSING WEST CHESTER, PA (610) E SWEDESFORD RD EXTON, PA (610) LINCOLN HWY THORNDALE, PA (610) SCARLET RD STE 220 KENNETT SQUARE, PA (610) DOWNINGTOWN PIKE WEST CHESTER, PA (610) NUTT RD PHOENIXVILLE, PA (610) W BALTIMORE PIKE WEST GROVE, PA (610) RTE 100 & TEMPLE RD POTSTOWN, PA (610) HONEY BROOK 35 VILLAGE SQUARE HONEY BROOK, PA (610) INFUSIONCARE NEW KENT DR WEST CHESTER, PA (610) KENDAL CROSSLANDS COMM PHCY❶ 1660 E STREET RD KENNETT SQUARE, PA (610) KOHLERMAN 101 W KING ST MALVERN, PA (610) LONGENECKER 108 W 1ST AVE PARKESBURG, PA (610) PAOLI APOTHECARY 255 W LANCASTER AVE STE 107 PAOLI, PA (610) PAOLI 82 E LANCASTER AVE PAOLI, PA (610) QUICK STOP 3506 E LINCOLN HWY THORNDALE, PA (610) SOUTHERN CHESTER COUNTY PHCY❶ 1011 W BALTIMORE PIKE WEST GROVE, PA (610) TOWN CENTER 606 WHARTON BLVD EXTON, PA (610) ❶Provider also contracted for 90 - Day Supply 33

36 CLARION, PA RETAIL PHARMACIES - PENNSYLVANIA CLARION, PA CLARION DEVELOPMENT 507 S PAINT BLVD SHIPPENVILLE, PA (814) HEALTH COMPLEX 24 DOCTORS LANE STE 100 CLARION, PA (814) KLINGENSMITH'S DRUG❶ 650 MAIN ST RIMERSBURG, PA (814) MAIN ST CLARION, PA (814) MED FAST RTE 68 CLARION, PA (814) PRIMARY HEALTH NETWORK❶ 419 KELLY'S WAY EAST BRADY, PA (724) TOMS RIVERSIDE 8868 RTE 338 KNOX, PA (814) CLEARFIELD, PA BILO MARKET & 100 N MAIN ST DU BOIS, PA (814) CITY DRUGS OF CURWENSVILLE 360 THOMPSON ST CURWENSVILLE, PA (814) CLEARFIELD 307 E MARKET ST CLEARFIELD, PA (814) DUBOIS DRUG AND WELLNESS 700 S BRADY ST DU BOIS, PA (814) LEYO'S NO MAIN ST COALPORT, PA (814) MARTIN'S 22 HOOVER AVE STE 130 DU BOIS, PA (814) MOSHANNON VALLEY 1071 N FRONT ST PHILIPSBURG, PA (814) SHANKEL'S 241 W LONG AVE DU BOIS, PA (814) WOODWARD 565 SPRING ST HOUTZDALE, PA (814) CLINTON, PA KELLER & MUNRO DRUG 127 E CHURCH ST LOCK HAVEN, PA (570) RAIBLE'S 260 MAIN ST MILL HALL, PA (570) SCOT'S LO-COST 6 MILLBROOK PLAZA MILL HALL, PA (570) COLUMBIA, PA GIANT 1000 SCOTT TOWN CTR BLOOMSBURG, PA (570) BRIAR CREEK PLAZA BERWICK, PA (570) PLUS 1 RX 6850 LOWS RD BLOOMSBURG, PA (570) CRAWFORD, PA CAMBRIDGE SPRINGS 227 S MAIN ST CAMBRIDGE SPRINGS, PA (814) E K THOMPSON & SON❶ 105 S FRANKLIN ST TITUSVILLE, PA (814) JACK'S 285 CHESTNUT ST MEADVILLE, PA (814) MILL RUN COMMUNITY 404 NORTH ST MEADVILLE, PA (814) NORTHWEST SOLUTIONS 740 N MAIN ST EXT MEADVILLE, PA (814) QUALITY MARKET 144 W CENTER ST MEADVILLE, PA (814) ❶Provider also contracted for 90 - Day Supply 34

37 RETAIL PHARMACIES - PENNSYLVANIA CUMBERLAND, PA CUMBERLAND, PA ALERT 940 OAK OVAL MECHANICSBURG, PA (717) ALERT SERVICES❶ 219 N BALTIMORE AVE MT HOLLY SPRINGS, PA (717) ANDREWS & PATEL ASSOCIATES❶ 3912 TRINDLE RD CAMPHILL, PA (717) BIG SPRING 91 S HIGH ST NEWVILLE, PA (717) CUMBERLAND APOTHECARY❶ 3300 MARKET ST CAMP HILL, PA (717) GIANT 255 CUMBERLAND PKWY MECHANICSBURG, PA (717) S SPRING GARDEN ST CARLISLE, PA (717) E PENN DR ENOLA, PA (717) TRINDLE RD CAMP HILL, PA (717) BALTIMORE RD SHIPPENSBURG, PA (717) SIMPSON FERRY RD MECHANICSBURG, PA (717) CARLISLE PIKE STE 100 MECHANICSBURG, PA (717) GOOD DAY 2025 TECHNOLOGY PKWY STE G04 MECHANICSBURG, PA (717) HOLLY 31 N BALTIMORE AVE MT HOLLY SPRINGS, PA (717) PROFESSIONAL 890 POPLAR CHURCH RD CAMP HILL, PA (717) QUALITY CARE 1 SPRINT DR CARLISLE, PA (717) ROBERT T. HENRY 54 E KING ST SHIPPENSBURG, PA (717) SHURFINE 1706 SPRING RD CARLISLE, PA (717) WALNUT BOTTOM RD CARLISLE, PA (717) SMARTMED 233 E HIGH ST CARLISLE, PA (717) DAUPHIN, PA ANDREWS & PATEL ASSOCIATION❶ 4518 UNION DEPOSIT RD HARRISBURG, PA (717) DAUPHIN PROFESSIONAL 722 ALLEGHENY ST DAUPHIN, PA (717) EAST SHORE 2723 AGATE ST HARRISBURG, PA (717) GIANT 1250 COCOA AVE HERSHEY, PA (717) KLINE VILLAGE HARRISBURG, PA (717) HERSEY RD HUMMELSTOWN, PA (717) UNION DEPOSIT RD HARRISBURG, PA (717) E+G282 MAIN ST MIDDLETOWN, PA (717) JONESTOWN RD HARRISBURG, PA (717) HARRISBURG 2645 N 3RD ST STE#80 HARRISBURG, PA (717) HERSHEY 731 CHERRY DR HERSHEY, PA (717) MIDDLETOWN 436 E MAIN ST MIDDLETOWN, PA (717) MILLERSBURG 242 MARKET ST MILLERSBURG, PA (717) ❶Provider also contracted for 90 - Day Supply 35