PHARMACY DIRECTORY TTY NetworkHealthMedicare.com

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RX 2018 PHARMACY DIRECTORY For the most up-to-date directory listings, go to NetworkHealthMedicare.com. 800-378-5234 TTY 800-947-3529 NetworkHealthMedicare.com H5215_1166p1_081017 Accepted 09072017

Network PlatinumPlus Pharmacy (PPO) Network PlatinumPremier Pharmacy (PPO) NetworkCares (SNP PPO) Network PlatinumChoice (PPO) Network PlatinumSelect (PPO) Network Health Medicare Go (PPO) Network Health Medicare Anywhere (PPO) 2018 Pharmacy Directory This pharmacy directory was updated on 10-23-2018. For more recent information or other questions, please contact Network Health Medicare Advantage plans customer service at 800-316-3107 or, for TTY users, 800-899-2114, 24 hours a day/seven days a week, or visit NetworkHealthMedicare.com. Our network has changed more than usual for 2018. An updated Pharmacy Directory is located on our website at NetworkHealthMedicare.com. You may also call customer service for updated provider information. We strongly suggest that you review our current Pharmacy Directory to see if your pharmacy is still in our network. This language is available for free in other formats upon request by calling customer service at 800-378-5234 Monday through Friday 8 a.m. to 8 p.m. TTY users should call 800-947-3529. Network Health Medicare Advantage plans include MSA and PPO plans with a Medicare contract. NetworkCares is a PPO SNP plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in Network Health Medicare Advantage Plans depends on contract renewal. H5215_1166p1_081017 Accepted 09072017

TABLE OF CONTENTS Introduction...1...3 Mail Order Pharmacy...30 Home Infusion Pharmacies...31 Long-Term Care Pharmacies...34 Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies...37 Network Health 1570 Midway Place Menasha, WI 54952 Customer Service 800-316-3107 TTY 800-899-2114 24 hours a day/seven days a week NetworkHealthMedicare.com

Introduction This booklet provides a list of Network Health Medicare Advantage plans network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Network Health Medicare Advantage plans formulary. When this Pharmacy Directory refers to we, us, or our, it means Network Health Medicare Advantage plans. When it refers to plan or our plan, it means Network PlatinumPlus Pharmacy, Network PlatinumPremier Pharmacy, NetworkCares, Network PlatinumSelect, Network Health Medicare Go, Network Health Medicare Anywhere, and Network PlatinumChoice. 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 Network Health Medicare Advantage plan only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription, but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of October, 23, 2018. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all the pharmacies on this list, but your costs for some drugs may be less at pharmacies in this list that offer preferred cost-sharing. We have marked these pharmacies with (*) to distinguish them from other pharmacies in our network that offer standard cost-sharing. You can get prescription drugs shipped to your home through our network mail order delivery program which is called Express Scripts Mail Order. For more information, please contact us or see the mail order section of this pharmacy directory. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us. 1

This directory contains the different types of pharmacies in our network. These pharmacies are listed alphabetically by community. To locate a participating pharmacy, find the community nearest you and check the listing of participating pharmacies. Call customer service (phone numbers are located on the front and back covers of this directory) or visit our website at NetworkHealthMedicare.com for additional information. If you are hearing impaired and there is not a TTY number listed for a pharmacy in the Retail Pharmacy section of this directory you may dial the TRS Relay number 711 for assistance. * Preferred Pharmacy Legend # Extended Supply Pharmacy. This pharmacy can provide an extended day supply of medications (up to a 90-day supply). 2

Algoma Algoma Hometown Pharmacy# 801 Jefferson St Algoma, WI 54201 (920) 487-2887 Appleton Consumer Prescription Center#* 2310 W College Ave Appleton, WI 54914 (920) 739-9232 Copps Food Center Phcy#* 2700 N Ballard Rd Appleton, WI 54911 (920) 996-0121 Copps Food Center Phcy#* 511 W Calumet St Appleton, WI 54915 (920) 734-3882 1485 Oneida St Appleton, WI 54915 (920) 733-1194 1800 South Kensington Dr Appleton, WI 54915 (920) 749-9775 4301 W Wisconsin Ave Appleton, WI 54913 (920) 243-7877 700 W Wisconsin Ave Appleton, WI 54914 (920) 991-1190 HealthDirect IPS* 3701 E Evergreen Dr STE 1000 Appleton, WI 54913 (920) 739-5900 Meijer Pharmacy#* 3801 N Richmond Street Appleton, WI 54913 (920) 350-6210 Sam's Club#* 1000 N Westhill Blvd Appleton, WI 54914 (920) 733-7410 Shopko Express Pharmacy#* 2101 E Evergreen Dr Appleton, WI 54913 (920) 733-2305 Shopko Express Pharmacy#* W3208 Van Roy Rd Appleton, WI 54915 (920) 733-3846 1000 W Northland Ave Appleton, WI 54914 (920) 739-6871 ThedaCare Infusion Pharmacy* 1818 N Meade St Appleton, WI 54911 (920) 969-0919 Uvanta Pharmacy - Fox Valley 1050 S Grider St STE C Appleton, WI 54914 (920) 257-2411 3701 E Calumet St Appleton, WI 54915 (920) 996-0746 955 N Mutual Way Appleton, WI 54913 (920) 954-6400 1901 S Oneida St Appleton, WI 54915 (920) 739-7321 2803 N Meade St Appleton, WI 54911 (920) 830-6985 3

Appleton (continued) 3330 E Calumet St Appleton, WI 54915 (920) 733-3016 700 W College Ave Appleton, WI 54914 (920) 733-6599 729 W Northland Ave Appleton, WI 54914 (920) 954-8100 Ashwaubenon 2301 S Oneida St Ashwaubenon, WI 54304 (920) 490-0424 Beaver Dam BDCH Pharmacy# 705 S University Ave Beaver Dam, WI 53916 (920) 356-0040 Beaver Dam Hometown Pharmacy# 709 N Spring St Beaver Dam, WI 53916 (920) 356-1500 Hillside Unit Pharmacy# 707 S University Ave Beaver Dam, WI 53916 (920) 887-4038 822 Park Ave Beaver Dam, WI 53916 (920) 887-7461 120 Francis Ln Beaver Dam, WI 53916 (920) 885-5808 607 Park Ave Beaver Dam, WI 53916 (920) 356-0148 Bellevue Costco#* 2355 Costco Way Bellevue, WI 54311 (920) 469-5710 1979 Lime Kiln Rd Bellevue, WI 54311 (920) 288-0638 Berlin Field Pharmacy#* 135 W Huron St Berlin, WI 54923 (920) 361-1565 W861 County Road F Berlin, WI 54923 (920) 361-3433 Big Bend Jerome Drugs# W230S8715 Clark St Big Bend, WI 53103 (262) 662-5622 Brillion 1010 W Ryan St Brillion, WI 54110 (920) 756-2640 Brookfield Aurora Phcy Bluemound# 16985 W Bluemound Rd STE 100 Brookfield, WI 53005 (262) 782-8125 12725 W Bluemound Rd Brookfield, WI 53005 (262) 395-1626 17165 Bluemound Rd Brookfield, WI 53005 (262) 797-9074 HealthDirect IPS* 150 N Patrick Blvd STE 250 Brookfield, WI 53045 (262) 395-4658 4

Brookfield (continued) Metro Market Pharmacy#* 17630 W Bluemound Rd Brookfield, WI 53045 (262) 784-2490 12735 W Capitol Dr Brookfield, WI 53005 (262) 783-7302 15170 W Greenfield Ave Brookfield, WI 53005 (262) 782-2787 17295 W Capitol Dr Brookfield, WI 53045 (262) 373-1080 15650 W Greenfield Ave Brookfield, WI 53005 (262) 786-3692 15738 W Capitol Dr Brookfield, WI 53005 (262) 781-6926 2205 N Calhoun Rd STE 22 Brookfield, WI 53005 (262) 782-3120 Wheaton Franciscan Pharmacy#* 19333 W North Ave STE 390 Brookfield, WI 53045 (262) 780-4430 Brown Deer 9200 N Green Bay Rd Brown Deer, WI 53209 (414) 354-7213 6300 W Brown Deer Rd Brown Deer, WI 53223 (414) 410-2551 6020 W Brown Deer Rd Brown Deer, WI 53223 (414) 365-3608 Burlington 210 S Pine St Burlington, WI 53105 (262) 763-7177 250 McHenry St Burlington, WI 53105 (262) 767-6004 709 Spring Valley Rd STE 1200 Burlington, WI 53105 (262) 971-9550 1008 Milwaukee Ave Burlington, WI 53105 (262) 767-1446 The Pharmacy Station# 300 S Pine St Burlington, WI 53105 (262) 763-8877 1901 S Milwaukee Ave Burlington, WI 53105 (262) 767-1902 680 Milwaukee Ave Burlington, WI 53105 (262) 767-0697 Campbellsport The Village Apothecary#* 110 W Main St Campbellsport, WI 53010 (920) 533-4012 Cedar Grove 313 S Main St Cedar Grove, WI 53013 (920) 668-6286 Cedarburg W63N152 Washington Ave Cedarburg, WI 53012 (262) 377-5685 W62N190 Washington Ave Cedarburg, WI 53012 (262) 375-3039 5

Cedarburg (continued) Ye Olde Phcy and Wellness Ctr# N54W6135 Mill St STE 300 Cedarburg, WI 53012 (262) 375-0010 Chilton 810 S Irish Rd Chilton, WI 53014 (920) 849-7330 245 W Calumet St Chilton, WI 53014 (920) 849-2818 Clintonville Erickson Pharmacy#* 8 S Main St STE B Clintonville, WI 54929 (715) 823-2222 291 S Main St Clintonville, WI 54929 (715) 823-2350 201 S Main St Clintonville, WI 54929 (715) 823-4238 Cudahy Aurora St Luke's S Shore# 5900 S Lake Dr Cudahy, WI 53110 (414) 489-4600 5740 S Packard Ave Cudahy, WI 53110 (414) 483-5667 Kmart Pharmacy#* 6077 S Packard Ave Cudahy, WI 53110 (414) 769-0510 5851 S Packard Ave Cudahy, WI 53110 (414) 744-6058 3201 E Layton Ave Cudahy, WI 53110 (414) 481-8220 6241 S Packard Ave Cudahy, WI 53110 (414) 762-9717 De Pere 1881 Chicago St De Pere, WI 54115 (920) 403-8050 800 Main Ave De Pere, WI 54115 (920) 336-6373 Shopko Express#* 3705 Monroe Rd De Pere, WI 54115 (920) 336-6096 230 N Wisconsin St De Pere, WI 54115 (920) 336-2323 1415 Lawrence Dr De Pere, WI 54115 (920) 336-7168 150 S Wisconsin Ave De Pere, WI 54115 (920) 278-3241 901 Main Ave De Pere, WI 54115 (920) 983-6153 Delafield 2553 Sun Valley Dr Delafield, WI 53018 (262) 646-3637 2863 Heritage Dr Delafield, WI 53018 (262) 646-3535 2901 Golf Rd Delafield, WI 53018 (262) 646-9095 6

Elm Grove 15350 W Bluemound Rd Elm Grove, WI 53122 (262) 789-6819 Elmwood Park 3915 Durand Ave Elmwood Park, WI 53405 (262) 554-0035 Fond du Lac Agnesian Pharmacy Plus#* 420 E Division St Fond du Lac, WI 54935 (920) 926-8585 Agnesian Pharmacy#* 145 N Main St Fond du Lac, WI 54935 (920) 926-4660 Agnesian Prescription Center#* 421 Camelot Dr Fond du Lac, WI 54935 (920) 926-5455 210 Wisc American Dr STE 240 Fond du Lac, WI 54937 (920) 907-7260 485 N Rolling Meadows Dr Fond du Lac, WI 54937 (920) 921-6759 55 W Pioneer Rd Fond du Lac, WI 54935 (920) 923-7780 760 W Johnson St Fond du Lac, WI 54935 (920) 929-7422 616 W Johnson St Fond du Lac, WI 54935 (920) 921-5490 377 N Rolling Meadows Dr Fond du Lac, WI 54935 (920) 921-9591 1060 E Johnson St Fond du Lac, WI 54935 (920) 266-4323 192 N Main St Fond du Lac, WI 54935 (920) 921-5264 20 W Pioneer Rd Fond du Lac, WI 54935 (920) 907-0556 Fox Point 8661 N Port Washington Rd Fox Point, WI 53217 (414) 540-6836 8615 N Pt Washington Rd Fox Point, WI 53217 (414) 352-0526 Franklin 9200 W Loomis Rd Franklin, WI 53132 (414) 529-9275 5220 W Rawson Ave Franklin, WI 53132 (414) 423-5257 7800 S Lovers Lane Rd Franklin, WI 53132 (414) 448-4001 7201 S 76th St Franklin, WI 53132 (414) 427-8692 Sam's Club#* 6705 S 27th St Franklin, WI 53132 (414) 304-1255 6701 S 27th St Franklin, WI 53132 (414) 761-9571 7130 S 76th St Franklin, WI 53132 (414) 425-0411 7

Franklin (continued) 9527 S 27th St Franklin, WI 53132 (414) 304-1239 9909 W Loomis Rd Franklin, WI 53132 (414) 427-7187 Germantown W 112 N 16200 Mequon Rd Germantown, WI 53022 (262) 253-0052 W190 N9855 Appleton Ave Germantown, WI 53022 (262) 255-5351 W156N11261 Pilgrim Rd Germantown, WI 53022 (262) 253-9720 Gillett HSHS Pharmacy#* 117 N McKenzie St Gillett, WI 54124 (920) 848-6323 Glendale 1735 W Silverspring Rd Glendale, WI 53209 (414) 247-8581 Providence Family Pharmacy# 2500 W Silver Spring Dr Glendale, WI 53209 (414) 885-0550 5400 N Port Washington Rd Glendale, WI 53217 (414) 967-0457 Grafton 975 Port Washington Rd STE 100 Grafton, WI 53024 (262) 329-1600 Costco#* 950 Port Washington Rd Grafton, WI 53024 (262) 204-1059 1250 Port Washington Rd Grafton, WI 53024 (262) 375-6738 Meijer Pharmacy#* 1600 Port Washington Rd Grafton, WI 53024 (262) 204-2810 301 Falls Rd Grafton, WI 53024 (262) 375-1628 1771 Wisconsin Ave Grafton, WI 53024 (262) 375-0016 1915 Wisconsin Ave Grafton, WI 53024 (262) 377-0352 Grand Chute Copps Food Center Phcy#* 2400 W Wisconsin Ave Grand Chute, WI 54914 (920) 831-0400 Costco#* 5401 W Integrity Way Grand Chute, WI 54913 (920) 363-7010 1305 N Casaloma Dr Grand Chute, WI 54913 (920) 730-8218 Green Bay 2253 W Mason St Green Bay, WI 54303 (920) 327-7220 8

Green Bay (continued) 2845 Green Brier Rd STE 110 Green Bay, WI 54311 (920) 288-3140 Aurora Visiting Nurse Assoc# 931 Discovery Ave Green Bay, WI 54311 (920) 288-5141 Bellin Health Pharmacy# 1630 Commanche Ave STE 102 Green Bay, WI 54313 (920) 430-4555 Bellin Health Remote Disp# 3263 Eaton Rd Green Bay, WI 54311 (920) 433-6790 Copps Food Center Phcy#* 1291 Lombardi Access Rd Green Bay, WI 54304 (920) 498-9783 Copps Food Center Phcy#* 1819 Main St Green Bay, WI 54302 (920) 469-3436 1001 Cormier Rd Green Bay, WI 54304 (920) 499-2608 1561 W Mason St Green Bay, WI 54303 (920) 497-5959 2050 Lime Kiln Rd Green Bay, WI 54311 (920) 406-9049 2222 S Webster Ave Green Bay, WI 54301 (920) 430-8089 2400 Velp Ave Green Bay, WI 54303 (920) 434-3954 930 Main St Green Bay, WI 54301 (920) 436-9382 Hemophilia Outreach Center# 2060 Bellevue St Green Bay, WI 54311 (920) 965-0606 Krider Pharmacy and Gifts#* 1119 W Mason St Green Bay, WI 54303 (920) 499-6225 Lineville Health Mart Pharmacy# 2673 Lineville Rd Green Bay, WI 54313 (920) 434-1444 Sam's Club#* 2470 W Mason St Green Bay, WI 54303 (920) 494-0536 Shopko Express#* 2585 Lineville Rd Green Bay, WI 54313 (920) 662-9450 216 S Military Ave Green Bay, WI 54303 (920) 499-0895 2320 Lineville Rd Green Bay, WI 54313 (920) 434-5846 2430 E Mason St Green Bay, WI 54302 (920) 468-6044 301 Bay Park Sq Green Bay, WI 54304 (920) 499-5889 Streu's Pharmacy* 528 N Monroe Ave Green Bay, WI 54301 (920) 437-0206 Streus Pharmacy#* 635 Main St Green Bay, WI 54301 (920) 437-0206 2292 Main St Green Bay, WI 54311 (920) 465-7737 9

Green Bay (continued) 2440 W Mason St Green Bay, WI 54303 (920) 499-2330 116 N Military Ave Green Bay, WI 54303 (920) 498-3247 1165 W Mason St Green Bay, WI 54303 (920) 498-3794 1401 E Mason St Green Bay, WI 54301 (920) 435-7679 1995 Main St Green Bay, WI 54302 (920) 465-6210 2204 University Ave Green Bay, WI 54302 (920) 469-5516 464 Cardinal Ln Green Bay, WI 54313 (920) 661-9355 Greendale 5301 S 76th St Greendale, WI 53129 (414) 978-9019 6210 W Loomis Rd Greendale, WI 53129 (414) 423-1485 Greenfield 4777 S 27th St Greenfield, WI 53221 (414) 282-0634 Greenfield Pharmacy# 5233 S 27th St Greenfield, WI 53221 (414) 727-1006 Hayat Pharmacy# 4931 S 27th St STE 400 Greenfield, WI 53221 (414) 817-6666 Meijer Pharmacy#* 5800 W Layton Ave Greenfield, WI 53220 (414) 304-2010 4279 S 76th St Greenfield, WI 53220 (414) 541-3836 10600 W Layton Ave Greenfield, WI 53228 (414) 529-4699 4296 S 76th St Greenfield, WI 53220 (414) 321-7602 4405 W Layton Ave Greenfield, WI 53220 (414) 281-5762 4688 S 108th St Greenfield, WI 53228 (414) 427-1328 Greenville Omnicare of Appleton* N926 Tower View Dr Greenville, WI 54942 (920) 954-8401 Hales Corners 5826 S 108th St Hales Corners, WI 53130 (414) 525-0763 5860 S 108th St Hales Corners, WI 53130 (414) 529-3222 Hartford 1640 E Sumner St Hartford, WI 53027 (262) 670-4210 1220 Thiel St Hartford, WI 53027 (262) 670-5803 10

Hartford (continued) 1400 E Sumner St Hartford, WI 53027 (262) 670-1137 Hartland Hartland Hometown Pharmacy# 109 E Capitol Dr Hartland, WI 53029 (262) 367-3141 423 Merton Ave Hartland, WI 53029 (262) 367-4751 Horicon Marshland Pharmacy# 700 Washington St Horicon, WI 53032 (920) 485-3400 Howard Meijer Pharmacy#* 2015 Shawano Ave Howard, WI 54303 (920) 496-8110 Hubertus 1303 Highway 175 Hubertus, WI 53033 (262) 628-3550 Iola Sweet Med Prescriptions Plus#* 155 N Main St Iola, WI 54945 (715) 445-3117 Jackson Genoa Healthcare# W209N17321 Industrial Dr Jackson, WI 53037 (262) 677-1401 N 168 W 21330 Main St Jackson, WI 53037 (262) 677-1702 Kaukauna 2412 Crooks Ave Kaukauna, WI 54130 (920) 759-7436 7540 22nd Ave Kenosha, WI 53143 (262) 605-3674 2207 80th St Kenosha, WI 53143 (262) 658-3731 3710 57th St Kenosha, WI 53144 (262) 652-1474 3726 N 22nd Ave Kenosha, WI 53140 (262) 654-6545 Good Value Pharmacy Larsen# 3535 30th Ave Kenosha, WI 53144 (262) 658-8124 Good Value Pharmacy LTC* 9916 75th St Kenosha, WI 53142 (262) 925-0201 Good Value Pharmacy MCW# 9916 75th St STE 103 Kenosha, WI 53142 (262) 925-0201 Howards Grove 620 S Wisconsin Dr Howards Grove, WI 53083 (920) 565-5425 Kenosha 10400 75th St Kenosha, WI 53142 (262) 948-7040 Good Value Pharmacy# 3207 80th St # 100 Kenosha, WI 53142 (262) 697-5744 11

Kenosha (continued) Kmart Pharmacy#* 4100 52nd St Kenosha, WI 53144 (262) 658-0902 Meijer Pharmacy#* 7701 Green Bay Rd Kenosha, WI 53142 (262) 612-1610 Modern Apothecary#* 4924 7th Ave Kenosha, WI 53140 (262) 997-9573 Pick 'n Save Pharmacy#* 2811 18th St Kenosha, WI 53140 (262) 551-0367 5710 75th St Kenosha, WI 53142 (262) 697-5424 Reliable Pharmacy of Wisconsin# 10105 74th St STE 102 Kenosha, WI 53142 (262) 565-6365 Sam's Club#* 3300 Brumback Blvd Kenosha, WI 53144 (262) 654-6854 3500 Brumback Blvd Kenosha, WI 53144 (262) 652-1458 1810 30th Ave Kenosha, WI 53144 (262) 551-8812 3805 80th St Kenosha, WI 53142 (262) 694-0750 3820 52nd St Kenosha, WI 53144 (262) 652-9665 7525 Sheridan Rd Kenosha, WI 53143 (262) 652-2396 7535 N Green Bay Rd Kenosha, WI 53142 (262) 697-8927 Kewaskum FHHP Kewaskum# 901 Fond du Lac Ave Kewaskum, WI 53040 (262) 477-1700 Kiel 1001 Service Rd Kiel, WI 53042 (920) 894-4370 1120 State Road 67 Kiel, WI 53042 (920) 894-3604 Kimberly 800 E Maes Ave Kimberly, WI 54136 (920) 788-9154 King Wisconsin Veterans Home Phcy* N2665 County Rd QQ King, WI 54946 (715) 258-5586 Kohler 795 Woodlake Rd Kohler, WI 53044 (920) 459-8768 5300 52nd St Kenosha, WI 53144 (262) 658-8137 Kewaunee 802 N Main St Kewaunee, WI 54216 (920) 388-2915 Lakewood Nicolet Pharmacy#* 15481 Commercial Rd Lakewood, WI 54138 (715) 276-3646 12

Little Chute Smith Pharmacy#* 1800 Freedom Rd STE D Little Chute, WI 54140 (920) 788-8888 219 W Main St Little Chute, WI 54140 (920) 687-6193 Lomira Aurora Pres Dispensing Center# 375 East Ave STE 1 Lomira, WI 53048 (920) 269-2080 Luxemburg Luxemburg Pharmacy#* 125 School Creek Trl Luxemburg, WI 54217 (920) 845-5832 701 E Reed Ave Manitowoc, WI 54220 (920) 682-3726 HFM Pharmacy#* 1650 S 41st St Manitowoc, WI 54220 (920) 320-4400 Manitowoc Pharmacies#* 919 S 8th St Manitowoc, WI 54220 (920) 684-6789 3415 Calumet Ave Manitowoc, WI 54220 (920) 684-0251 4115 Calumet Ave Manitowoc, WI 54220 (920) 684-5016 2702 Calumet Ave Manitowoc, WI 54220 (920) 683-8887 Menasha 1578 Appleton Rd Menasha, WI 54952 (920) 722-1895 305 Racine St Menasha, WI 54952 (920) 722-4759 Menomonee Falls N84 W16889 Menomonee Ave STE 1408 Menomonee Falls, WI 53051 (262) 251-8500 N93W14575 Whittaker Way Menomonee Falls, WI 53051 (262) 253-3000 Manitowoc 3509 Dewey St STE 100 Manitowoc, WI 54220 (920) 652-3030 Copps Food Center Phcy#* 3300 Calumet Ave Manitowoc, WI 54220 (920) 682-3051 Markesan Agnesian Pharmacy#* 49 S Bridge St Markesan, WI 53946 (920) 398-3261 Mayville 2050 Horicon St Mayville, WI 53050 (920) 387-0257 Careplus CVS Pharmacy# W165N5595 Creekwood Xing Menomonee Falls, WI 53051 (262) 703-3386 Costco#* 9235 Pershing Ave Menomonee Falls, WI 53051 (262) 946-6070 13

Menomonee Falls (continued) N83 W1550 Appleton Ave Menomonee Falls, WI 53051 (262) 253-5056 N95 WEST17707 Shady Ln Menomonee Falls, WI 53051 (262) 415-0005 Froedtert Health Menomonee#* W180 N8000 Town Hall Rd Menomonee Falls, WI 53051 (262) 532-3050 Isc Central Hospital Pharmacy* N86W12999 Nightingale Way Menomonee Falls, WI 53051 (262) 532-5124 N77W14435 Appleton Ave Menomonee Falls, WI 53051 (262) 255-8673 N95W18351 County Line Rd Menomonee Falls, WI 53151 (262) 253-4705 N56W15501 Silver Spring Dr Menomonee Falls, WI 53051 (262) 703-9781 N83W15701 Appleton Ave Menomonee Falls, WI 53051 (262) 251-3890 Mequon 10932 N Port Washington Rd STE 100 Mequon, WI 53092 (262) 241-5320 Columbia St Mary's Phcy#* 13133 N Port Washington Rd STE G01 Mequon, WI 53097 (262) 243-6700 Mequon Family Pharmacy# 1424 W Mequon Rd # B Mequon, WI 53092 (262) 581-0411 Metro Market Pharmacy#* 11558 N Port Washington Rd Mequon, WI 53092 (262) 241-7983 Skywalk Mequon# 1655 W Mequon Rd Mequon, WI 53092 (262) 432-7613 11270 N Port Washington Rd Mequon, WI 53092 (262) 241-5539 Milwaukee AMC Pharmacy#* 820 N Plankinton Ave Milwaukee, WI 53203 (414) 223-6820 ASLMC Pharmacy# 2801 W KK River Pkwy STE 125 Milwaukee, WI 53215 (414) 649-6738 ASLMC Pharmacy# 2900 W Oklahoma Ave STE 1001 Milwaukee, WI 53215 (414) 649-6930 ASMC Pharmacy# 1020 N 12th St Milwaukee, WI 53233 (414) 219-7963 ASMC Pharmacy# 945 N 12th St Milwaukee, WI 53233 (414) 219-3100 1220 Dewey Ave Milwaukee, WI 53213 (414) 454-6796 14

Milwaukee (continued) 1575 N Rivercenter Dr Milwaukee, WI 53212 (414) 224-1555 2424 S 90th St Milwaukee, WI 53227 (414) 546-9722 2906 S 20th St Milwaukee, WI 53215 (414) 385-7850 3003 W Good Hope Rd STE 1129 Milwaukee, WI 53209 (414) 540-9236 3355 W Forest Home Ave Milwaukee, WI 53215 (414) 385-0244 6901 W Edgerton Ave Milwaukee, WI 53220 (414) 421-8401 7878 N 76th St STE 101 Milwaukee, WI 53223 (414) 586-5665 Aurora Phcy 62 W Allis# 7220 W National Ave Milwaukee, WI 53214 (414) 771-1350 Center for Advanced Care Pharm#* 9200 W Wisconsin Ave Milwaukee, WI 53226 (414) 805-1295 CHW Employee Pharmacy Ctr# 999 N 92nd St Milwaukee, WI 53226 (414) 266-3306 Clinica Latina Pharmacy# 1238 S Cesar E Chavez Dr Milwaukee, WI 53204 (414) 737-9585 Community#* 826 N Plankinton Ave STE 100 Milwaukee, WI 53203 (414) 278-7828 1316 W Forest Home Ave Milwaukee, WI 53204 (414) 672-4554 1650 N Farwell Ave Milwaukee, WI 53202 (414) 277-5054 2607 N Downer Ave Milwaukee, WI 53211 (414) 906-0942 2950 S Chase Ave Milwaukee, WI 53207 (414) 483-1190 3030 W Villard Ave Milwaukee, WI 53209 (414) 536-3378 3860 S 27th St Milwaukee, WI 53221 (414) 282-7557 5929 W Libson Ave Milwaukee, WI 53210 (414) 442-9233 7550 W Perkins Pl Milwaukee, WI 53216 (414) 466-4875 Family Pharmacy# 3512 Oakland Ave Milwaukee, WI 53211 (414) 332-9300 Froedtert East Op Pharmacy#* 9200 W Wisconsin Ave STE 100E Milwaukee, WI 53226 (414) 805-6501 Froedtert Eye Institute Phcy#* 925 N 87th St Milwaukee, WI 53226 (414) 955-3360 Froedtert West Pharmacy#* 9200 W Wisconsin Ave STE 200W Milwaukee, WI 53226 (414) 805-5117 15

Milwaukee (continued) Genoa Healthcare# 229 E Wisconsin Ave STE 601 Milwaukee, WI 53202 (414) 244-9844 Genoa Healthcare* 10424 W Bluemound Rd STE B Milwaukee, WI 53226 (414) 244-9844 Hayat Pharmacy 10# 5308 W Burleigh St Milwaukee, WI 53210 (414) 837-5555 Hayat Pharmacy 7# 5312 W Villard Ave Milwaukee, WI 53218 (414) 858-1111 Hayat Pharmacy 9# 8434 W Silver Spring Dr Milwaukee, WI 53225 (414) 454-9798 Hayat Pharmacy# 1919 W North Ave Milwaukee, WI 53205 (414) 374-0000 Hayat Pharmacy# 3727 W Wisconsin Ave Milwaukee, WI 53208 (414) 931-0000 Hayat Pharmacy# 5434 W Capitol Dr Milwaukee, WI 53216 (414) 817-1111 Hayat Pharmacy# 5928 W Vilet St Milwaukee, WI 53208 (414) 454-0000 Hayat Pharmacy# 8500 W Capitol Dr Milwaukee, WI 53222 (414) 463-1111 HCHM Pharmacy# 210 W Capitol Dr Milwaukee, WI 53212 (414) 962-3750 Life Change Pharmacy# 1844 S 15th St Milwaukee, WI 53204 (414) 999-0999 Lifetree Pharmacy#* 8329-5 W Appleton Avenue Milwaukee, WI 53218 (414) 585-9991 Medpack Pharmacy# 7324 W Capitol Dr Milwaukee, WI 53216 (414) 436-7311 Meijer Pharmacy#* 11111 W Burleigh St Milwaukee, WI 53222 (414) 290-0910 Metro Market Pharmacy#* 1123 N Van Buren St Milwaukee, WI 53202 (414) 397-9219 Midtown Pharmacy# 7235 W Appleton Ave STE 101 Milwaukee, WI 53216 (414) 269-0341 Midtown Pharmacy# 7733 W Burleigh St Milwaukee, WI 53222 (414) 299-3828 My Key Pharmacy# 7114 W Capitol Dr Milwaukee, WI 53216 (414) 210-5005 Omnicare Pharmacy# 1134 W North Ave Milwaukee, WI 53205 (414) 727-3005 Pharmerica* 9041 W Heather Ave Milwaukee, WI 53224 (262) 347-0030 Phoenix Pharmacy* 1748 N Farwell Ave Milwaukee, WI 53202 (414) 225-4478 1100 E Garfield Ave Milwaukee, WI 53212 (414) 374-8769 2355 N 35th St Milwaukee, WI 53210 (414) 447-8117 250 W Holt Ave Milwaukee, WI 53207 (414) 769-8990 16

Milwaukee (continued) 3701 S 27th St Milwaukee, WI 53221 (414) 281-3622 7401 W Good Hope Rd Milwaukee, WI 53223 (414) 760-3273 Roeschen's Omnicare Pharmacy* 5185 S 9th St Milwaukee, WI 53221 (414) 486-3100 Sam's Club#* 8050 N 124th St Milwaukee, WI 53224 (414) 371-1580 Serv-U Pharmacy# 709 W Oklahoma Ave Milwaukee, WI 53215 (414) 481-8170 Seton Pharmacy#* 2323 N Lake Dr Milwaukee, WI 53211 (414) 291-1303 Tosa Pharmacy# 9235 W Capitol Dr Milwaukee, WI 53222 (414) 462-1700 10330 W Silver Spring Dr Milwaukee, WI 53225 (414) 355-1838 3355 S 27th St Milwaukee, WI 53215 (414) 383-1522 401 E Capital Dr Milwaukee, WI 53212 (414) 967-9360 7025 W Main St Milwaukee, WI 53214 (414) 203-0683 10725 W Greenfield Ave Milwaukee, WI 53214 (414) 258-8054 1400 E Brady St Milwaukee, WI 53202 (414) 272-2171 1433 W Burnham St Milwaukee, WI 53204 (414) 672-3017 1600 W Wisconsin Ave Milwaukee, WI 53233 (414) 344-1833 2222 W Capitol Dr Milwaukee, WI 53206 (414) 871-7738 2410 W Forest Home Ave Milwaukee, WI 53215 (414) 383-3414 2615 W National Ave Milwaukee, WI 53204 (414) 383-4021 2727 W North Ave Milwaukee, WI 53208 (414) 933-9150 275 W Wisconsin Ave STE 1108 Milwaukee, WI 53203 (414) 273-5426 2826 N M L King Dr Milwaukee, WI 53212 (414) 374-8536 2950 N Oakland Ave Milwaukee, WI 53211 (414) 332-1901 3109 S Kinnickinnic Ave Milwaukee, WI 53207 (414) 482-3515 3333 S 27th St Milwaukee, WI 53215 (414) 671-3660 3522 W Wisconsin Ave Milwaukee, WI 53208 (414) 342-4446 370 E Capitol Dr Milwaukee, WI 53212 (414) 964-9851 17

Milwaukee (continued) 3701 S Howell Ave Milwaukee, WI 53207 (414) 482-1470 4730 S 27th St Milwaukee, WI 53221 (414) 817-0647 4808 N Hopkins St Milwaukee, WI 53209 (414) 462-4310 5115 W Capitol Dr Milwaukee, WI 53216 (414) 444-0506 5201 N 91st St Milwaukee, WI 53225 (414) 527-2044 6030 W Oklahoma Ave Milwaukee, WI 53219 (414) 327-1010 620 W Oklahoma Ave Milwaukee, WI 53215 (414) 744-1135 6292 S 27th St Milwaukee, WI 53221 (414) 761-0994 6442 N 76th St Milwaukee, WI 53223 (414) 353-5620 6707 W Hampton Ave Milwaukee, WI 53218 (414) 536-1179 7171 N Teutonia Ave Milwaukee, WI 53209 (414) 351-2538 7600 W Capitol Dr Milwaukee, WI 53222 (414) 464-4601 9040 W Good Hope Rd Milwaukee, WI 53224 (414) 358-1526 9100 W Beloit Rd Milwaukee, WI 53227 (414) 328-1228 Wcs Pharmacy# 3734 W Wisconsin Ave Milwaukee, WI 53208 (414) 343-3543 Wheaton Franciscan Pharmacy#* 2500 W Layton Ave STE 150 Milwaukee, WI 53221 (414) 281-7500 Wheaton Franciscan Pharmacy#* 3237 S 16th St RM 121 Milwaukee, WI 53215 (414) 647-5300 Wheaton Franciscan Pharmacy#* 5000 W Chambers St Room #1801 Milwaukee, WI 53210 (414) 447-2585 Whole Health Pharmacy# 932 S 60th St RM 223 Milwaukee, WI 53214 (414) 476-8602 Montello Bentley Pharmacies#* 25 Montello St Montello, WI 53949 (608) 297-2474 Mount Pleasant 2820 S Green Bay Rd Mount Pleasant, WI 53406 (262) 554-1116 3049 S Oakes Rd Mount Pleasant, WI 53177 (262) 598-8528 5625 Washington Ave Mount Pleasant, WI 53406 (262) 886-2729 18

Mount Pleasant (continued) 6125 Durand Ave Mount Pleasant, WI 53406 (262) 554-6116 Wheaton Franciscan Pharmacy#* 3807 Spring St Mount Pleasant, WI 53405 (262) 687-8430 Wheaton Franciscan Pharmacy#* 3811 Spring St Mount Pleasant, WI 53405 (262) 687-1600 Mukwonago Miller Pharmacy# 801 N Rochester St Mukwonago, WI 53149 (262) 363-4001 1010 N Rochester St Mukwonago, WI 53149 (262) 363-1680 250 E Wolf Run Mukwonago, WI 53149 (262) 363-8366 212 N Rochester St Mukwonago, WI 53149 (262) 363-5235 Muskego Jerome Drugs# S75W17301 Janesville Rd Muskego, WI 53150 (262) 679-1800 W159S6530 Moorland Rd Muskego, WI 53150 (414) 209-0324 S70W15775 Janesville Rd Muskego, WI 53150 (414) 422-1359 S79 W 18885 Janesville Rd Muskego, WI 53150 (262) 679-5894 Neenah Affinity Home Care Plus* 2074 American Dr STE A Neenah, WI 54956 (800) 648-8055 901 S Green Bay Rd Neenah, WI 54956 (920) 729-1448 Morton Drug CO* 201 E Bell St Neenah, WI 54956 (920) 727-3853 Neenah Hometown Pharmacy#* 1415 S Commercial St Neenah, WI 54956 (920) 729-4910 828 Fox Point Plz Neenah, WI 54956 (920) 722-1348 699 Green Bay Rd Neenah, WI 54956 (920) 751-0270 1155 Winneconne Ave Neenah, WI 54956 (920) 722-1185 1191 W Towne Dr Neenah, WI 54956 (920) 725-3152 500 S Commercial St Neenah, WI 54956 (920) 729-1311 New Berlin 14555 W National Ave STE 100 New Berlin, WI 53151 (262) 827-9062 Coram* 5345 S Moorland Rd STE 101 New Berlin, WI 53151 (262) 207-1590 Costco#* 15300 W Grange Ave New Berlin, WI 53151 (262) 599-7040 19

New Berlin (continued) 4798 S Moorland Rd New Berlin, WI 53151 (262) 207-0021 15445 W National Ave New Berlin, WI 53151 (262) 938-0133 Skywalk Pharmacy New Berlin# 4855 S Moorland Rd New Berlin, WI 53151 (262) 432-7613 Thrifty White Pharmacy# 2720 S 163rd St New Berlin, WI 53151 (262) 780-1910 15205 W Greenfield Ave New Berlin, WI 53151 (262) 796-2734 3855 S Moorland Rd New Berlin, WI 53151 (262) 784-4992 New London Jernegans Pharmacy#* 1301 Mill St New London, WI 54961 (920) 982-7670 Jernegans Pharmacy* 1301 Mill St New London, WI 54961 (920) 982-7670 1717 N Shawano St New London, WI 54961 (920) 982-7906 981 N Shawano St New London, WI 54961 (920) 982-5189 Oak Creek 200 E Ryan Rd STE 101 Oak Creek, WI 53154 (414) 570-3580 8989 S Howell Ave Oak Creek, WI 53154 (414) 216-0002 Meijer Pharmacy#* 171 W Town Square Way Oak Creek, WI 53154 (414) 501-1710 2320 W Ryan Rd Oak Creek, WI 53154 (414) 761-1692 6462 S 27th St Oak Creek, WI 53154 (414) 761-1550 8770 S Howell Ave Oak Creek, WI 53154 (414) 762-6770 9449 S Howell Ave Oak Creek, WI 53154 (414) 764-8980 Oconomowoc 1284 Summit Ave STE 100 Oconomowoc, WI 53066 (262) 569-8204 Kmart Pharmacy#* 1450 Summit Ave Oconomowoc, WI 53066 (262) 567-9254 1300 Pabst Farms Cir Oconomowoc, WI 53066 (262) 200-7000 36903 E Wisconsin Ave Oconomowoc, WI 53066 (262) 567-7938 Prescription Center Pharmacy# 888 Thackeray Trl Oconomowoc, WI 53066 (262) 567-7267 Prohealth Phcy Oconomowoc# 791 Summit Ave Oconomowoc, WI 53066 (262) 569-0284 20

Oconomowoc (continued) Tobin Drug Oconomowoc# 1260A Brown St Oconomowoc, WI 53066 (262) 567-6651 1021 Summit Ave Oconomowoc, WI 53066 (262) 567-9173 Oconto Benzer Pharmacy# 1008 Main St Oconto, WI 54153 (920) 834-4455 126 Charles St Oconto, WI 54153 (920) 834-9800 Oconto Falls HSHS Pharmacy#* 855 S Main St Oconto Falls, WI 54154 (920) 846-8059 Oconto Falls Pharmacy HM#* 323 E Highland Dr Oconto Falls, WI 54154 (920) 848-3721 Omro Omro Pharmacy#* 328 E Main St Omro, WI 54963 (920) 685-5041 Oneida Oneida Comm Health Center Phcy* 525 Airport Dr Oneida, WI 54155 (920) 869-4826 Oshkosh 414 Doctors Ct STE 100 Oshkosh, WI 54901 (920) 303-5006 855 N Westhaven Dr Oshkosh, WI 54904 (920) 303-8830 1736 W 9th Ave Oshkosh, WI 54902 (920) 235-6664 1900 S Koeller St Oshkosh, WI 54902 (920) 233-4287 LHO Pharmacy# 225 N Eagle St Oshkosh, WI 54902 (920) 966-1345 Murdock Hometown Phcy#* 1828 Jackson St Oshkosh, WI 54901 (920) 231-3300 1940 S Koeller St Oshkosh, WI 54902 (920) 236-9494 Sawyer Street Hometown Phcy#* 321 N Sawyer St Oshkosh, WI 54902 (920) 426-0763 Schultz Pharmacy#* 220 N Main St Oshkosh, WI 54901 (920) 233-2151 1300 Koeller Rd Oshkosh, WI 54901 (920) 426-5770 351 S Washburn St Oshkosh, WI 54904 (920) 231-2219 1100 Emmers Ln Oshkosh, WI 54904 (920) 237-4753 315 W Murdock Ave Oshkosh, WI 54901 (920) 231-8664 950 S Koeller St Oshkosh, WI 54902 (920) 303-1712 21

Pewaukee Plover Princeton Costco#* 443 Pewaukee Rd Pewaukee, WI 53072 (262) 956-6701 Meijer Pharmacy#* N51W24953 Lisbon Rd Pewaukee, WI 53072 (262) 932-2510 2160 Silvernail Rd Pewaukee, WI 53072 (262) 547-6343 411 Pewaukee Rd Pewaukee, WI 53072 (262) 695-2878 1441 Capitol Dr Pewaukee, WI 53072 (262) 695-3088 Pleasant Prairie Costco#* 7707 94th Ave Pleasant Prairie, WI 53158 (262) 597-1037 9777 76th St Pleasant Prairie, WI 53158 (262) 842-1171 7520 118th Ave Pleasant Prairie, WI 53158 (262) 857-9484 Copps Food Center Phcy#* 1850 Plover Rd Plover, WI 54467 (715) 344-0066 1800 Plover Rd Plover, WI 54467 (715) 342-9368 250 Crossroads Dr Plover, WI 54467 (715) 345-7870 Plymouth 2635 Eastern Ave Plymouth, WI 53073 (920) 893-1442 428 Walton Dr Plymouth, WI 53073 (920) 892-2656 2455 Eastern Ave Plymouth, WI 53073 (920) 893-5895 Port Washington Shopko Express#* 1011 N Wisconsin St Port Washington, WI 53074 (262) 284-3436 Bentley Pharmacies#* 528 W Water St Princeton, WI 54968 (920) 295-6271 Pulaski Healthmart Pulaski Pharmacy#* 121 N Saint Augustine St Pulaski, WI 54162 (920) 822-3011 Racine 8348 Washington Ave Racine, WI 53406 (262) 884-4030 1122 West Blvd Racine, WI 53405 (262) 637-5603 Genoa Healthcare 1717 Taylor Ave STE P1 Racine, WI 53403 (262) 672-6183 Good Value Pharmacy Racine# 5220 Washington Ave # 101 Racine, WI 53406 (262) 632-6561 Kmart Pharmacy#* 5141 Douglas Ave Racine, WI 53402 (262) 639-8947 22

Racine (continued) Lakeview LTC Pharmacy* 517 Wisconsin Ave Racine, WI 53403 (262) 632-8215 Lakeview Pharmacy of Racine# 516 Monument Sq Racine, WI 53403 (262) 632-0520 4801 Washington Ave Racine, WI 53406 (262) 637-8444 1920 Douglas Ave Racine, WI 53402 (262) 633-4948 3825 Durand Ave Racine, WI 53405 (262) 554-8686 819 N Memorial Dr Racine, WI 53404 (262) 637-4900 Wheaton Francsican Pharmacy#* 1244 Wisconsin Ave Racine, WI 53403 (262) 687-2150 Ripon Kmart Pharmacy#* 1200 W Fond du Lac St Ripon, WI 54971 (920) 748-1203 Ripon Drug#* 328 Watson St Ripon, WI 54971 (920) 748-5174 1203 W Fond du Lac St Ripon, WI 54971 (920) 748-6005 Salem 25401 75th St Salem, WI 53168 (262) 843-1550 Saukville 825 E Green Bay Ave Saukville, WI 53080 (262) 284-9881 829 E Green Bay Ave Saukville, WI 53080 (262) 268-9091 Seymour 1010 S Mainline Dr Seymour, WI 54165 (920) 833-0430 4810 Washington Ave Racine, WI 53406 (262) 635-0181 4901 Spring St Racine, WI 53406 (262) 886-9643 5005 Douglas Ave Racine, WI 53402 (262) 639-9241 Saint Francis 2000 E Layton Ave Saint Francis, WI 53235 (414) 483-3800 4698 S Whitnall Ave Saint Francis, WI 53235 (414) 769-0660 Shawano Dreier Health Mart Pharmacy#* 117 S Main St Shawano, WI 54166 (715) 526-2011 100 Cty Rd B Shawano, WI 54166 (715) 526-3456 1244 E Green Bay St Shawano, WI 54166 (715) 524-5983 23

Shawano (continued) 401 E Green Bay St Shawano, WI 54166 (715) 524-5600 Sheboygan 2414 Kohler Memorial Dr Sheboygan, WI 53081 (920) 459-2630 509 Superior Ave Sheboygan, WI 53081 (920) 459-2637 1108 N 14th St Sheboygan, WI 53081 (920) 452-0079 Glander Prescription Plus#* 3529 Superior Ave Sheboygan, WI 53081 (920) 459-2755 Glander Prescriptions Plus# 3529 Superior Ave Sheboygan, WI 53081 (920) 459-2755 1317 N 25th St Sheboygan, WI 53081 (920) 457-5839 Sheboygan Health Mart Pharmacy#* 577 S Taylor Dr Sheboygan, WI 53081 (920) 459-7467 518 S Taylor Dr Sheboygan, WI 53081 (920) 458-0040 3711 S Taylor Dr Sheboygan, WI 53081 (920) 459-8601 4433 Vanguard Dr Sheboygan, WI 53081 (920) 459-9470 1029 N 14th St Sheboygan, WI 53081 (920) 458-7707 2702 Calumet Dr Sheboygan, WI 53083 (920) 457-5656 3320 S Business Dr Sheboygan, WI 53081 (920) 452-5858 Sheboygan Falls 4085 State Highway 28 Sheboygan Falls, WI 53085 (920) 451-8448 Shorewood Metro Market Pharmacy#* 4075 N Oakland Ave Shorewood, WI 53211 (414) 962-3744 Thompson's Serv-U Pharmacy# 1421 E Capitol Dr Shorewood, WI 53211 (414) 962-9665 4035 N Oakland Ave Shorewood, WI 53211 (414) 961-2001 Slinger 1061 E Commerce Blvd STE 100 Slinger, WI 53086 (262) 644-5246 South Milwaukee 2414 10th Ave South Milwaukee, WI 53172 (414) 762-2610 222 N Chicago Ave South Milwaukee, WI 53172 (414) 501-1122 24

South Milwaukee (continued) 2985 S Chicago Ave South Milwaukee, WI 53172 (414) 762-9653 Stevens Point Copps Food Center Phcy#* 1500 Pinecrest Ave Stevens Point, WI 54481 (715) 345-7175 1200 Main St Stevens Point, WI 54481 (715) 344-1230 Trigs County Market Pharmacy# 1600 Academy Ave Stevens Point, WI 54481 (715) 341-6102 10 Park Ridge Dr Stevens Point, WI 54481 (715) 344-7368 3301 Church St Stevens Point, WI 54481 (715) 345-2843 900 Illinois Ave Stevens Point, WI 54481 (715) 344-6834 Summit 36500 Aurora Dr STE 100 Summit, WI 53066 (262) 434-7700 Sussex Pick 'n Save Pharmacy#* N65W24838 Main St Sussex, WI 53089 (262) 946-6363 N66W25201 Cth VV Sussex, WI 53089 (262) 820-2611 N65 W25055 Main St Sussex, WI 53089 (262) 820-0750 Thiensville 278 N Main St Thiensville, WI 53092 (262) 242-3451 Welltopia# 136 N Main St Thiensville, WI 53092 (414) 204-4025 Twin Lakes 700 N Lake Avenue STE 101 Twin Lakes, WI 53181 (262) 877-8777 Two Rivers 2219 Garfield St STE 100 Two Rivers, WI 54241 (920) 794-8029 5300 Memorial Dr Two Rivers, WI 54241 (920) 793-7380 Medicine Shoppe Pharmacy#* 1500 Washington St Two Rivers, WI 54241 (920) 794-1225 2206 Washington St Two Rivers, WI 54241 (920) 793-8352 Union Grove 4310 67th Dr Union Grove, WI 53182 (262) 878-1171 Wales 405 N Wales Rd Wales, WI 53183 (262) 968-9570 320 W Summit Ave Wales, WI 53183 (262) 968-6900 25

Waterford 818 Forest Ln STE 101 Waterford, WI 53185 (262) 514-8050 Lakeview Specialty Hosp Rehab* 1701 Sharp Rd Waterford, WI 53185 (262) 534-8597 The Pharmacy Station# 601 N Milwaukee St Waterford, WI 53185 (262) 534-9222 900 E Main St Waterford, WI 53185 (262) 514-4290 Waukesha W231 N1440 Corporate Ct STE 101 Waukesha, WI 53186 (262) 896-6040 1130 W Sunset Dr Waukesha, WI 53189 (262) 446-5169 1250 W Sunset Dr Waukesha, WI 53189 (262) 832-1273 2135 Silvernail Rd Waukesha, WI 53188 (262) 513-9221 2401 Kossow Rd Waukesha, WI 53186 (262) 784-8417 Genoa Healthcare 1501 Airport Rd STE 1072 Waukesha, WI 53188 (262) 347-4201 Genoa Healthcare# 514 Riverview Ave RM 328 Waukesha, WI 53188 (262) 955-8811 Medical Center Pharmacy# 1111 Delafield St STE 109 Waukesha, WI 53188 (262) 544-5303 Meijer Pharmacy#* 801 E Sunset Dr Waukesha, WI 53189 (262) 899-6010 Moreland Plaza Pharmacy Combo* 827 W Moreland Blvd Waukesha, WI 53188 (262) 542-4488 Moreland Plaza Pharmacy# 827 W Moreland Blvd Waukesha, WI 53188 (262) 542-4488 1220 W Sunset Dr Waukesha, WI 53189 (262) 446-6924 220 E Sunset Dr Waukesha, WI 53189 (262) 574-0405 Prohealth Care Pharmacy# N16W24131 Riverwood Dr Waukesha, WI 53188 (262) 696-0919 Prohealth Pharmacy Waukesha# 725 American Ave Waukesha, WI 53188 (262) 928-2279 Sam's Club#* 600 N Springdale Rd Waukesha, WI 53186 (262) 798-1580 Valucare Pharmacy# 501 S Grand Ave Waukesha, WI 53186 (262) 544-6622 200 S West Ave Waukesha, WI 53186 (262) 521-9204 21325 E Moreland Blvd Waukesha, WI 53186 (262) 798-0223 221 E Sunset Dr Waukesha, WI 53189 (262) 542-3981 26

Waukesha (continued) 230 Madison St Waukesha, WI 53188 (262) 542-9935 2700 N Grandview Blvd Waukesha, WI 53188 (262) 542-2003 601 Meadowbrook Rd Waukesha, WI 53188 (262) 549-2356 Waupaca Kmart Pharmacy#* 830 W Fulton St Waupaca, WI 54981 (715) 258-4285 800 Riverside Dr Waupaca, WI 54981 (715) 256-1115 825 W Fulton St Waupaca, WI 54981 (715) 258-9000 Stratton Drug Store#* 107 N Main St Waupaca, WI 54981 (715) 258-7057 925 W Fulton St Waupaca, WI 54981 (715) 258-9228 Waupaca Hometown Pharmacy#* 115 N Western Ave Unit 8 Waupaca, WI 54981 (715) 256-0400 Waupun Agnesian Pharmacy#* 904 W Main St Waupun, WI 53963 (920) 324-3010 999 E Main St Waupun, WI 53963 (920) 324-4696 Wautoma 900 E Division St Wautoma, WI 54982 (920) 787-6940 N2585 Plaza Rd Wautoma, WI 54982 (920) 787-2090 N2934 Highway 22 Wautoma, WI 54982 (920) 787-5757 Wauwatosa Assisted Living Pharmacy Svc# 1441 N Mayfair Rd STE 202 Wauwatosa, WI 53226 (414) 433-1700 3900 N 124th St Wauwatosa, WI 53222 (414) 847-1101 7520 W Blue Mound Rd Wauwatosa, WI 53213 (414) 771-9146 Froedtert Health Plank Road#* 1155 N Mayfair Rd Wauwatosa, WI 53226 (414) 955-3990 Froedtert Hosp Cancer Ctr Phcy#* 9200 W Wisconsin Ave STE 200C Wauwatosa, WI 53226 (414) 805-0977 Option Care* 1435 N 113th St Wauwatosa, WI 53226 (888) 256-7234 1717 N Mayfair Rd Wauwatosa, WI 53226 (414) 778-1884 6950 W State St Wauwatosa, WI 53213 (414) 475-1932 Skywalk Pharmacy# 9000 W Wisconsin Ave STE 211 Wauwatosa, WI 53226 (414) 266-1893 27

Wauwatosa (continued) Swan Serv-U Pharmacy# 9130 W North Ave Wauwatosa, WI 53226 (414) 258-9550 10800 W Capitol Dr Wauwatosa, WI 53222 (414) 466-1221 2275 N Mayfair Rd Wauwatosa, WI 53226 (414) 774-4821 2656 N Wauwatosa Ave Wauwatosa, WI 53213 (414) 453-9630 6600 W State St Wauwatosa, WI 53213 (414) 476-5585 Wheaton Franciscan Pharmacy#* 201 N Mayfair Rd Wauwatosa, WI 53226 (414) 259-7440 West Allis Aurora at Home# 11333 W National Ave West Allis, WI 53227 (414) 328-4503 2600 S 108th St West Allis, WI 53227 (414) 545-0385 7522 W Oklahoma Ave West Allis, WI 53219 (414) 321-8236 9220 W Greenfield West Allis, WI 53214 (414) 456-9119 Evergreen Pharmacy# 10101 W Greenfield Ave West Allis, WI 53214 (414) 533-6600 2625 S 108th St West Allis, WI 53227 (414) 328-4051 6760 W National Ave West Allis, WI 53214 (414) 476-5111 Prescriptions Plus* 10233 W Greenfield Ave West Allis, WI 53214 (414) 727-5750 Skywalk Pharmacy West Allis# 6737 W Washington St STE 1100 West Allis, WI 53214 (414) 337-3333 2677 S 108th St West Allis, WI 53227 (414) 545-1440 6101 W Greenfield Ave West Allis, WI 53214 (414) 258-1652 8333 W Greenfield Ave West Allis, WI 53214 (414) 443-9414 West Bend 205 Valley Ave West Bend, WI 53095 (262) 338-2311 Cedar Lake Campus Pharmacy# 5595 County Road Z West Bend, WI 53095 (262) 306-2140 Froedtert Health Hometown Phcy# 1709 S 18th Ave West Bend, WI 53095 (262) 338-6444 Froedtert Health St Joseph's#* 3200 Pleasant Valley Rd STE 1A West Bend, WI 53095 (262) 836-5411 Genoa Healthcare 333 W Washington St STE 2100 West Bend, WI 53095 (262) 346-1144 28

West Bend (continued) Meijer Pharmacy#* 2180 S Main St West Bend, WI 53095 (262) 334-8510 1629 S Main St West Bend, WI 53095 (262) 335-2292 2518 W Washington St West Bend, WI 53095 (262) 334-4033 1710 S Main St West Bend, WI 53095 (262) 338-0222 1515 W Paradise Dr West Bend, WI 53095 (262) 334-8134 1720 W Washington St West Bend, WI 53095 (262) 438-1120 1921 S Main St West Bend, WI 53095 (262) 338-1156 West Milwaukee 1501 Miller Pkwy West Milwaukee, WI 53214 (414) 203-0107 Pick 'n Save Pharmacy#* 2201 Miller Pkwy West Milwaukee, WI 53219 (414) 384-2474 4140 W Greenfield Ave West Milwaukee, WI 53215 (414) 978-2007 Westfield Bentley Pharmacies#* 206 S Main St Westfield, WI 53964 (608) 296-2877 Whitefish Bay 240 E Hampton Rd Whitefish Bay, WI 53217 (414) 962-7071 Dan Fitzgerald Pharmacy# 424 E Silver Spring Dr Whitefish Bay, WI 53217 (414) 332-8380 Winneconne 946 E Main St Winneconne, WI 54986 (920) 582-4414 Wittenberg Gwidt Pharmacy#* 203 E Westgor Ave Wittenberg, WI 54499 (715) 253-2164 Gwidt Pharmacy#* 203 E Westgor Ave STE 1 Wittenberg, WI 54499 (715) 253-2164 Wrightstown Bellin Health Remote Disp#* 555 Quality Ct Wrightstown, WI 54180 (920) 532-0700 Altscripts Specialty Pharmacy# 1636 Miller Park Way West Milwaukee, WI 53214 (414) 385-9500 29

Mail Order Pharmacy You can get prescription drugs shipped to your home through our network mail order delivery program which is called Express Scripts Home Delivery. Mail Order Pharmacy If you have used mail order services with your current plan before, or if you opt in now, our pharmacy will automatically fill and ship new prescriptions received directly from your doctors or other prescribers. You may opt out of automatic deliveries of new prescriptions at any time by contacting us. If you never had mail order delivery and/or decide to stop automatic fills of new prescriptions, we will contact you each time we get a new prescription from a provider, to see if you want the medication filled and shipped at that time. This will give you an opportunity to make sure that the correct drug (including strength, amount, and form) will be delivered, and, if necessary, allow you to cancel or delay the order before you are billed and it is shipped. For refills of your mail order prescriptions, please contact us 21 days before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. Typically, you should expect to receive your prescription drugs within 14 days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at 800-316-3107. TTY (hearing impaired) should call 800-899-2114. Express Scripts Mail Order# (800)316-3107 TTY (800) 899-2114 30

Home Infusion Pharmacies Network Health Medicare Advantage plans will cover Part D drugs used for home infusion therapy if: Your prescription drug is on Network Health Medicare Advantage Plans' formulary or you have a formulary exception; Network Health Medicare Advantage Plans has approved your prescription drug for home infusion therapy; and Your prescription is written by an authorized prescriber. Accurate Rx Pharmacy (HI) 103 Corporate Lake Dr STE B Columbia, MO 65203 (573) 256-4279 Advanced Infusion Solutions (HI) 623 Highland Colony Pkwy STE 100 Ridgeland, MS 39157 (601) 988-1700 Affinity Home Care Plus (HI) 2074 American Dr STE A Neenah, WI 54956 (800) 648-8055 American Homecare Federation (HI) 31 Moody Rd Enfield, CT 06082 (800) 243-4621 American Outcomes Management (HI) 6310 Southwest Blvd STE 204 Fort Worth, TX 76109 (800) 556-4246 ARJ Infusion Services (HI) 7930 Marshall Dr Lenexa, KS 66214 (866) 451-8804 Aurora at Home (HI) 11333 W National Ave West Allis, WI 53227 (414) 328-4503 Aurora Visiting Nurse Assoc (HI) 931 Discovery Ave Green Bay, WI 54311 (920) 288-5141 Axelacare (HI) 9204 Berger Rd STE A Columbia, MD 21046 (800) 715-6650 Basic Home Infusion (HI) 1401 Valley Rd FL 4 Wayne, NJ 07470 (201) 475-0500 Bioscrip Infusion Services (HI) 102 the American Rd Morris Plains, NJ 07950 (800) 552-3462 Briovarx Infusion Services 305 (HI) 15529 College Blvd Lenexa, KS 66219 (913) 747-3700 Chartwell Midwest Wisconsin (HI) 2241 Pinehurst Dr Middleton, WI 53562 (608) 831-8555 Coram (HI) 5345 S Moorland Rd STE 101 New Berlin, WI 53151 (262) 207-1590 Crescent Healthcare (HI) 11980 Telegraph Rd STE 102 Santa Fe Springs, CA 90670 (877) 872-4844 Critical Care Systems (HI) 11372 Aurora Ave Urbandale, IA 50322 (515) 276-1660 Home Infusion Pharmacies 31

Home Infusion Pharmacies Home Infusion Pharmacies Elwyn Specialty Care (HI) 3070 Mccann Farm Dr STE 101 Garnet Valley, PA 19060 (610) 545-6040 Focus Rx Pharmacy Services (HI) 2805 Veterans Hwy STE 19 Ronkonkoma, NY 11779 (888) 464-8987 Forum Extended Care Svc (HI) 4201 W Victoria St Chicago, IL 60646 (847) 673-8727 Heritage Biologics (HI) 255 NW Victoria Dr Lees Summit, MO 64086 (816) 875-5101 Hometech Advanced Therapies (HI) 505 Elmwood Ave Sharon Hill, PA 19079 (855) 494-3121 Isc Central Hospital Pharmacy (HI) N86W12999 Nightingale Way Menomonee Falls, WI 53051 (262) 532-5124 Kroger Specialty Infusion Ca (HI) 19110 Van Ness Ave Torrance, CA 90501 (866) 202-9552 Matrix Health (HI) 40D Commerce Way Totowa, NJ 07512 (877) 567-8087 Mayo Clinic Phcy - Luther (HI) 1400 Bellinger St Eau Claire, WI 54703 (715) 838-6000 Medpro Rx (HI) 140 Northway Ct Raleigh, NC 27615 (888) 571-3100 Ministry Home Care Plus (HI) 1927 N Central Ave STE B Marshfield, WI 54449 (800) 648-8055 Nufactor (HI) 1601 Old Greensboro Rd Kernersville, NC 27284 (844) 871-4773 Nufactor (HI) 44900 Winchester Rd Temecula, CA 92590 (800) 323-6832 Omnicare Pharmacy (HI) 2313 S Mount Prospect Rd Des Plaines, IL 60018 (847) 635-3000 Option Care (HI) 1435 N 113th St Wauwatosa, WI 53226 (888) 256-7234 Paragon Infusion Care (HI) 17111 Preston Rd STE 160B Dallas, TX 75248 (972) 588-1000 Pentec Health (HI) 4 Creek Pkwy Upper Chichester, PA 19061 (800) 223-4376 Pri-Med Infusion Services (HI) 5517 N Cumberland Ave STE 915 Chicago, IL 60656 (800) 831-7740 Rochester Home Infusion (HI) 221 1st Ave SW STE 105R Rochester, MN 55902 (507) 316-0001 Roeschen's Omnicare Pharmacy (HI) 5185 S 9th St Milwaukee, WI 53221 (414) 486-3100 Soleo Health (HI) 655 W Grand Ave STE 240 Elmhurst, IL 60126 (630) 478-8240 Specialty Therapeutic Care (HI) 1311 W Sam Houston Pkwy N STE 150 Houston, TX 77043 (800) 511-5144 Superior Pharmacy Solutions (HI) 2050 E Algonquin Rd STE 606 Schaumburg, IL 60173 (847) 469-2400 32

Home Infusion Pharmacies ThedaCare Infusion Pharmacy (HI) 1818 N Meade St Appleton, WI 54911 (920) 969-0919 Unitypoint at Home (HI) 11333 Aurora Ave Urbandale, IA 50322 (515) 557-3120 US Bioservices (HI) 501 W 44th Ave Unit A Denver, CO 80216 (800) 809-0647 Walgreens Infusion Services (HI) 1000 S Benton Dr STE 405 Sauk Rapids, MN 56379 (800) 939-5666 Walgreens-Optioncare (HI) 2750 Arthur St Roseville, MN 55113 (877) 360-9272 Walgreens-Optioncare Chicago (HI) 1360 N Wood Dale Rd STE R Wood Dale, IL 60191 (800) 551-9355 Walgreens-Optioncare Columbia (HI) 1410 Heriford Rd Columbia, MO 65202 (800) 456-0417 Home Infusion Pharmacies 33

Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Network Health Medicare Advantage Plans through the facility's long-term care pharmacy or another network long-term care pharmacy. Appleton Green Bay Kenosha HealthDirect IPS (LTC) 3701 E Evergreen Dr STE 1000 Appleton,WI 54913 (920) 739-5900 Krider Pharmacy and Gifts (LTC) 1119 W Mason St Green Bay,WI 54303 (920) 499-6225 Good Value Pharmacy LTC (LTC) 9916 75th St Kenosha,WI 53142 (262) 925-0201 Long-Term Care Pharmacies Uvanta Pharmacy - Fox Valley (LTC) 1050 S Grider St STE C Appleton,WI 54914 (920) 257-2411 Beaver Dam Hillside Unit Pharmacy (LTC) 707 S University Ave Beaver Dam,WI 53916 (920) 887-4038 Brookfield HealthDirect IPS (LTC) 150 N Patrick Blvd STE 250 Brookfield,WI 53045 (262) 395-4658 Streu's Pharmacy (LTC) 528 N Monroe Ave Green Bay,WI 54301 (920) 437-0206 Greenville Omnicare of Appleton (LTC) N926 Tower View Dr Greenville,WI 54942 (920) 954-8401 Jackson Genoa Healthcare (LTC) W209N17321 Industrial Dr Jackson,WI 53037 (262) 677-1401 King Wisconsin Veterans Home Phcy (LTC) N2665 County Rd QQ King,WI 54946 (715) 258-5586 Little Chute Smith Pharmacy (LTC) 1800 Freedom Rd STE D Little Chute,WI 54140 (920) 788-8888 Milwaukee Family Pharmacy (LTC) 3512 Oakland Ave Milwaukee,WI 53211 (414) 332-9300 34