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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name ABERNATHY KING PHARMACY 920 AVE D 79311 806 298-2222 N TRINET ABILENE ALBERTSONS MARKET PHARMACY #679 4450 BUFFALO GAP RD 79606 325 695-4690 N UNITED PHARMACY TX ABILENE BARNES & WILLIAMS DRUG CENTER NO. 2 4601 S 14TH ST 79605 325 695-3784 N ACCESSHEALTH ABILENE BARNES AND WILLIAMS DRUG CENTER 701 HICKORY ST 79601 325 677-9191 N ACCESSHEALTH ABILENE BIG COUNTRY PHARMACY 3190 ANTILLEY RD SUITE B 79606 325 704-5222 N ELEVATE PROVIDER NETWORK ABILENE CASH SAVER COST PLUS PHARMACY 2160 PINE ST 796012436 325 673-4737 N LEADER DRUG STORES INC ABILENE CVS PHARMACY 1010 N WILLIS 79603 325 677-5291 N CVS PHARMACY INC ABILENE CVS PHARMACY 4580 BUFFALO GAP RD 79606 325 698-0651 N CVS PHARMACY INC ABILENE CVS PHARMACY 965 N JUDGE ELY BLVD 79601 325 677-0616 N CVS PHARMACY INC ABILENE DRUG EMPORIUM 2550 BARROW ST 796056235 325 698-0442 N EPIC PHARMACY NETWORK INC ABILENE HEB PHARMACY 1345 BARROW ST 79605 325 690-5011 N HEB GROCERY COMPANY LP ABILENE JAMES MCCOYS DRUG STORE 839 N JUDGE ELY 79601 325 677-2300 N ELEVATE PROVIDER NETWORK ABILENE JAMES MCCOYS DRUG STORE SOUTH 1725 ANTILLEY ROAD 79606 325 676-8900 N ELEVATE PROVIDER NETWORK ABILENE KMART PHARMACY7795 4565 S 1ST ST 796051427 325 690-9668 N K MART PHARMACY ABILENE NATIONAL CENTRAL PHARMACY 3402 S 14TH ST 796056414 325 695-0491 N GERIMED LTC NETWORK INC ABILENE SAMS PHARMACY 5550 S CLACK ST 796063708 325 793-2652 N WALMART STORES INC ABILENE UNITED PHARMACY 920 N WILLIS 79603 325 677-1362 N UNITED PHARMACY TX ABILENE UNITED PHARMACY 3301 S 14TH 79605 325 698-7801 N UNITED PHARMACY TX ABILENE WAL-MART PHARMACY 10-0535 4350 SOUTHWEST DR 79606 325 695-9250 N WALMART STORES INC ABILENE WAL-MART PHARMACY 10-0536 1650 STATE HWY 351 79601 325 677-2191 N WALMART STORES INC ADDISON AMERICARE INFUSION CENTERS, LLC 15800 DOOLEY RD STE 185 750014284 972 661-2273 N ELEVATE PROVIDER NETWORK ADDISON A-SCRIPT PHARMACY 17051 DALLAS PKWY # 110 750017109 214 643-6287 N ACCESSHEALTH PLUS ADDISON KROGER PHARMACY 3770 BELT LINE ROAD 75001 972 620-0349 N THE KROGER CO ADDISON TARGET PHARMACY 3730 BELT LINE RD 75001 214 414-0026 N TARGET PHARMACIES ADDISON TOTAL LIFE CARE RX PHARMACY, LLC 4280 KELLWAY CIR 750014200 407 404-7170 N THIRD PARTY STATION CP ALAMO CVS PHARMACY # 427 E DURANTA 78516 956 783-1204 N CVS PHARMACY INC ALAMO HEB PHARMACY 1211 E FRONTAGE RD 78516 956 702-7550 N HEB GROCERY COMPANY LP ALAMO WAL-MART PHARMACY 1421 W FRONTAGE ROAD 78516 956 782-2156 N WALMART STORES INC ALAMO HEIGHTS BROADWAY PHARMACY 6100 BROADWAY 78209 210 824-3322 N COMMUNITY INDEPENDENT PHARMACY NETW ALAMO HEIGHTS CVS PHARMACY # 4600 BROADWAY ST 782096214 210 824-1679 CVS PHARMACY INC ALBANY SANDERS DRUG STORE 104 S MAIN ST 76430 325 762-3979 LEADER DRUG STORES INC

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Page 1: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

ABERNATHY KING PHARMACY 920 AVE D 79311 806 298-2222 N TRINET

ABILENE ALBERTSONS MARKET PHARMACY #679 4450 BUFFALO GAP RD 79606 325 695-4690 N UNITED PHARMACY TX

ABILENE BARNES & WILLIAMS DRUG CENTER NO. 2 4601 S 14TH ST 79605 325 695-3784 N ACCESSHEALTH

ABILENE BARNES AND WILLIAMS DRUG CENTER 701 HICKORY ST 79601 325 677-9191 N ACCESSHEALTH

ABILENE BIG COUNTRY PHARMACY 3190 ANTILLEY RD SUITE B 79606 325 704-5222 N ELEVATE PROVIDER NETWORK

ABILENE CASH SAVER COST PLUS PHARMACY 2160 PINE ST 796012436 325 673-4737 N LEADER DRUG STORES INC

ABILENE CVS PHARMACY 1010 N WILLIS 79603 325 677-5291 N CVS PHARMACY INC

ABILENE CVS PHARMACY 4580 BUFFALO GAP RD 79606 325 698-0651 N CVS PHARMACY INC

ABILENE CVS PHARMACY 965 N JUDGE ELY BLVD 79601 325 677-0616 N CVS PHARMACY INC

ABILENE DRUG EMPORIUM 2550 BARROW ST 796056235 325 698-0442 N EPIC PHARMACY NETWORK INC

ABILENE HEB PHARMACY 1345 BARROW ST 79605 325 690-5011 N HEB GROCERY COMPANY LP

ABILENE JAMES MCCOYS DRUG STORE 839 N JUDGE ELY 79601 325 677-2300 N ELEVATE PROVIDER NETWORK

ABILENE JAMES MCCOYS DRUG STORE SOUTH 1725 ANTILLEY ROAD 79606 325 676-8900 N ELEVATE PROVIDER NETWORK

ABILENE KMART PHARMACY7795 4565 S 1ST ST 796051427 325 690-9668 N K MART PHARMACY

ABILENE NATIONAL CENTRAL PHARMACY 3402 S 14TH ST 796056414 325 695-0491 N GERIMED LTC NETWORK INC

ABILENE SAMS PHARMACY 5550 S CLACK ST 796063708 325 793-2652 N WALMART STORES INC

ABILENE UNITED PHARMACY 920 N WILLIS 79603 325 677-1362 N UNITED PHARMACY TX

ABILENE UNITED PHARMACY 3301 S 14TH 79605 325 698-7801 N UNITED PHARMACY TX

ABILENE WAL-MART PHARMACY 10-0535 4350 SOUTHWEST DR 79606 325 695-9250 N WALMART STORES INC

ABILENE WAL-MART PHARMACY 10-0536 1650 STATE HWY 351 79601 325 677-2191 N WALMART STORES INC

ADDISON AMERICARE INFUSION CENTERS, LLC 15800 DOOLEY RD STE 185 750014284 972 661-2273 N ELEVATE PROVIDER NETWORK

ADDISON A-SCRIPT PHARMACY 17051 DALLAS PKWY # 110 750017109 214 643-6287 N ACCESSHEALTH PLUS

ADDISON KROGER PHARMACY 3770 BELT LINE ROAD 75001 972 620-0349 N THE KROGER CO

ADDISON TARGET PHARMACY 3730 BELT LINE RD 75001 214 414-0026 N TARGET PHARMACIES

ADDISON TOTAL LIFE CARE RX PHARMACY, LLC 4280 KELLWAY CIR 750014200 407 404-7170 N THIRD PARTY STATION CP

ALAMO CVS PHARMACY # 427 E DURANTA 78516 956 783-1204 N CVS PHARMACY INC

ALAMO HEB PHARMACY 1211 E FRONTAGE RD 78516 956 702-7550 N HEB GROCERY COMPANY LP

ALAMO WAL-MART PHARMACY 1421 W FRONTAGE ROAD 78516 956 782-2156 N WALMART STORES INC

ALAMO HEIGHTS BROADWAY PHARMACY 6100 BROADWAY 78209 210 824-3322 N COMMUNITY INDEPENDENT PHARMACY NETW

ALAMO HEIGHTS CVS PHARMACY # 4600 BROADWAY ST 782096214 210 824-1679 CVS PHARMACY INC

ALBANY SANDERS DRUG STORE 104 S MAIN ST 76430 325 762-3979 LEADER DRUG STORES INC

Page 2: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ALEDO ALEDO MEDICINE STORE 621 N FM1187 76008 817 441-2702 N

ELEVATE PROVIDER NETWORK ALEDO BROOKSHIRES PHARMACY 5118 E I 20 SERVICE ROAD

SOUTH 76008 817 441-5982 N

BROOKSHIRE GROCERY COMPANY ALICE CVS PHARMACY 215 N TEXAS BLVD 78332 361 664-7300 N

CVS PHARMACY INC ALICE HEB PHARMACY 1115 E MAIN ST 78332 361 664-1344 N

HEB GROCERY COMPANY LP ALICE RUSHING GONZALEZ LEGEND DRUG 301 E MAIN 78332 361 664-4368 N

ACCESSHEALTH ALICE WAL-MART PHARMACY 10-0791 2701 E MAIN 78332 361 668-0504 N

WALMART STORES INC ALLEN ALLEN FAMILY DRUG 317 CENTRAL EXPY N 75013 972 390-9888 N

ELEVATE PROVIDER NETWORK ALLEN CENTRAL ALLEN PHARMACY 1105 N CENTRAL EXPRESSWAY

SUITE 2110 75013 469 675-3309 N COMMUNITY INDEPENDENT PHARMACY

NETW ALLEN CVS PHARMACY 1550 STACY RD 75002 972 390-7650 N

CVS PHARMACY INC ALLEN CVS PHARMACY 1210 N ALMA DR 75013 214 383-0174 N

CVS PHARMACY INC ALLEN CVS PHARMACY 1540 E MAIN ST 75002 214 383-9765 N

CVS PHARMACY INC ALLEN CVS PHARMACY 520 E MAIN ST 75002 972 727-3368 N

CVS PHARMACY INC ALLEN KROGER PHARMACY 1320 W MCDERMOTT DRIVE 75013 214 495-0204 N

THE KROGER CO ALLEN KROGER PHARMACY 1212 E BETHANY DR 75002 972 727-9395 N

THE KROGER CO ALLEN KROGER PHARMACY 1210 N GREENVILLE 75002 214 383-7102 N

THE KROGER CO ALLEN TARGET PHARMACY 907 W MCDERMOTT DRIVE 75013 972 396-0096 N

TARGET PHARMACIES ALLEN TARGET PHARMACY 150 E STACY RD, STE 2400 75002 469 342-2005 N

TARGET PHARMACIES ALLEN UNITED MARKET STREET PHARMACY #563 985 BETHANY DRIVE 75013 972 908-3840 N

UNITED PHARMACY TX ALLEN WAL-MART PHARMACY 1520 EXCHANGE PARKWAY 75002 214 547-8671 N

WALMART STORES INC ALLEN WAL-MART PHARMACY 730 W EXCHANGE PKWY 75013 972 649-0364 N

WALMART STORES INC ALPINE CITY DRUG STORE 202 E AVE E 79830 432 837-2252

ACCESSHEALTH PLUS ALPINE HIGHLAND DRUG 504 E AVE E 79830 432 837-3931 N

ELEVATE PROVIDER NETWORK ALTON CVS PHARMACY # 409 W MAIN AVE STE 1 78573 956 580-3539

CVS PHARMACY INC ALTON MISSION PLAZA PHARMACY 816 E MAIN 78573 956 583-0044 N

ELEVATE PROVIDER NETWORK ALTON RICHARDS PHARMACY 3509 E MAIN AVE 78573 956 584-7772 N

ACCESSHEALTH ALTON WELL-CARE PHARMACY & DME 8115 N LOS EBANOS 78573 956 271-1555 N

TPN ALVARADO CVS PHARMACY # 6941 E HIGHWAY 67 76009 817 790-3355 N

CVS PHARMACY INC ALVIN CVS PHARMACY 1600 S BYPASS 35 77511 281 331-1536 N

CVS PHARMACY INC ALVIN KROGER PHARMACY 3100 HWY 35 77511 281 388-3403 N

THE KROGER CO ALVIN MEDIC ONE PHARMACY 400 MEDIC LN STE C 77511 281 824-0222 N COMMUNITY INDEPENDENT PHARMACY

NETW ALVIN WAL-MART PHARMACY 10-0462 400 HIGHWAY 35 BYP S 775118718 281 585-3451 N

WALMART STORES INC ALVORD S&J ALVORD PHARMACY 115 E BYPASS 287 76225 940 427-2801 N

ELEVATE PROVIDER NETWORK

Page 3: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AMARILLO ADC PHARMACY 6700 W 9TH 791061701 806 358-0331 N

ACCESSHEALTH PLUS AMARILLO AMARILLO PHARMACEUTICAL CARE CTR 1400 S COULTER STE 1100 79106 806 414-9390 N

LEADER DRUG STORES INC AMARILLO AMARILLO PHARMACY 6010 S WESTERN ST STE 100 791103612 806 803-9401 N

ACCESSHEALTH PLUS AMARILLO AMIGOS PHARMACY 3300 I-40 E 79103 806 373-8722 N

UNITED PHARMACY TX AMARILLO AVONDALE PHARMACY HOME HEALTH 5135 PLAINS BLVD 791064515 806 352-2708 N

LEADER DRUG STORES INC AMARILLO CASH SAVER COST PLUS PHARMACY 2200 S BELL 79106 806 359-8528 N

LEADER DRUG STORES INC AMARILLO CATCHINGS PRESCRIPTIONS LTD 1900 S COULTER 791061793 806 355-2924 N

ACCESSHEALTH AMARILLO CVS PHARMACY 7301 HILLSIDE RD 79119 806 677-0542 N

CVS PHARMACY INC AMARILLO CVS PHARMACY 317 E AMARILLO BLVD 79107 806 374-0581 N

CVS PHARMACY INC AMARILLO CVS PHARMACY 2012 S WASHINGTON ST 79109 806 379-6191 N

CVS PHARMACY INC AMARILLO CVS PHARMACY 3340 S WESTERN ST 79109 806 358-3388 Y

CVS PHARMACY INC AMARILLO DRUG EMPORIUM 4210 SW 45TH AVE B 791095402 806 358-1800 N

EPIC PHARMACY NETWORK INC AMARILLO GRAND PHARMACY 3500 NE 24TH AVE 791076920 806 350-7455 N

ACCESSHEALTH PLUS AMARILLO IVSOLUTIONS OF AMARILLO 102 SW 3RD AVE 79101 806 355-5029 N

MAXOR NATIONAL PHCY SRVS LLC AMARILLO JO WYATT COMMUNITY HEALTH CENTER 1411 AMARILLO BLVD EAST 79107 806 351-7240 N

ELEVATE PROVIDER NETWORK AMARILLO KINGS COMPOUNDING PHARMACY 1600 COULTER DR 791061718 806 358-4576 N

TRINET AMARILLO MARKET STREET PHARMACY 2530 S GEORGIA 79109 806 468-9911 N

UNITED PHARMACY TX AMARILLO MARTIN TIPTON PHARMACY LLC 1501 S TYLER ST 791014237 806 373-2812 N

ACCESSHEALTH AMARILLO MAXOR NATIONAL PHCY SRVS LLC 320 S POLK ST STE 100 791011436 806 324-5400

AMARILLO MAXOR PHARMACY 216 S POLK 79101 806 324-5580 N

MAXOR NATIONAL PHCY SRVS LLC AMARILLO MEDICAL SQUARE PHARMACY 1215 S COULTER ST STE 101 791061761 806 350-7451 N

ACCESSHEALTH PLUS AMARILLO MEDI-PARK PHARMACY 1920 MEDI PARK DR 791062111 806 359-5496 N

ELEVATE PROVIDER NETWORK AMARILLO PRO MED LTC 704 N POLK 79107 806 379-6966 N

GERIMED LTC NETWORK INC AMARILLO SAM'S CLUB PHARMACY 10-7676 8952 WESTGATE PKWY WEST 791241782 806 513-6487 N

WALMART STORES INC AMARILLO SAMS PHARMACY 2201 ROSS OSAGE DRIVE 79103 806 374-0622 N

WALMART STORES INC AMARILLO SIGNA PHARMACY GROUP 1900 S COULTER ST 791061784 806 353-7712 Y

GERIMED LTC NETWORK INC AMARILLO SOUTHPARK PHARMACY 5901 S BELL ST 791096271 806 358-2428 N

LEADER DRUG STORES INC AMARILLO SOUTHPARK PHARMACY 3324 S GEORGIA ST 791093446 806 353-6530 N

LEADER DRUG STORES INC AMARILLO TARGET PHARMACY 8201 I40 W 79121 806 356-9270 N

TARGET PHARMACIES AMARILLO UNITED PHARMACY 5807 SW 45TH #100 79109 806 353-7201 N

UNITED PHARMACY TX AMARILLO UNITED PHARMACY 4701 S WASHINGTON 79110 806 373-3341 N

UNITED PHARMACY TX AMARILLO UNITED PHARMACY 1501 E AMARILLO BLVD 79107 806 373-7057 N

UNITED PHARMACY TX AMARILLO UNITED PHARMACY 3400 RIVER RD 79107 806 383-3345 N

UNITED PHARMACY TX

Page 4: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AMARILLO UNITED PHARMACY 5601 AMARILLO BLVD W 79106 806 352-6650 N

UNITED PHARMACY TX AMARILLO UNITED PHARMACY #530 3552 S SONCY RD 791196672 806 467-6815 N

UNITED PHARMACY TX AMARILLO VALMED PHARMACY SOLUTIONS 3 CARE CIR 79124 806 350-6337 N COMMUNITY INDEPENDENT PHARMACY

NETW AMARILLO WAL-MART PHARMACY 4215 CANYON DRIVE 79110 806 352-8627 N

WALMART STORES INC AMARILLO WAL-MART PHARMACY 3700 I 40 EAST 79103 806 373-2611 N

WALMART STORES INC AMARILLO WAL-MART PHARMACY 5730 W AMARILLO BLVD 79106 806 354-9591 N

WALMART STORES INC AMARILLO WAL-MART PHARMACY 10-0755 4610 S COULTER 79121 806 353-9554 N

WALMART STORES INC AMARILLO WALMART PHARMACY 10-4464 2711 SW 58TH AVE 791103151 806 513-6505 N

WALMART STORES INC AMARILLO WALMART PHARMACY 10-7349 7251 ARDEN RD 79109 806 513-6401 N

WALMART STORES INC AMARILLO WALMART PHARMACY 10-7362 2035 SE 34TH AVE 79118 806 513-6391 N

WALMART STORES INC ANAHUAC WILCOX LEGEND DRUG STORE 1208 MILLER ST 775140220 409 267-6141 N

THIRD PARTY STATION CP ANDREWS NEIGHBORHOOD PHARMACY 801 N MAIN ST STE F 79714 432 523-7000 N

ELEVATE PROVIDER NETWORK ANDREWS PRESCRIPTION SHOP 813 HOSPITAL DR 797143618 432 523-4861 N

ACCESSHEALTH ANGLETON ANGLETON HEALTH MART PHARMACY 1104 E MULBERRY ST STE E 775153952 979 848-8878 N

ACCESSHEALTH PLUS ANGLETON CVS PHARMACY 601 N LOOP 274 77515 979 849-8294 N

CVS PHARMACY INC ANGLETON KROGER PHARMACY 1804 N VELASCO 77515 979 849-5460 N

THE KROGER CO ANGLETON MEDICINE SHOPPE PHARMACY 2301 E MULBERRY 77515 979 849-9391 N

MEDICINE SHOPPE INTERNATIONAL INC ANGLETON WAL-MART PHARMACY 10-0527 1801 N VELASCO 77515 979 849-3028 N

WALMART STORES INC ANNA ANNA FAMILY PHARMACY 813 W WHITE ST STE 200 754092613 972 895-2450 N

ACCESSHEALTH PLUS ANNA BROOKSHIRE PHARMACY 1325 W WHITE ST 75409 972 924-4220 N

BROOKSHIRE GROCERY COMPANY ANNA CVS PHARMACY # 2740 W WHITE ST 75409 972 924-8686

CVS PHARMACY INC ANSON ANSON PLAZA PHARMACY 1150 W COURT PLAZA 79501 325 823-3203 N

ELEVATE PROVIDER NETWORK ANSON WALMART PHARMACY 10-2410 122 COMMERCIAL AVE 79501 325 823-2483 N

WALMART STORES INC ARANSAS PASS HEB PHARMACY 101 E GOODNIGHT 78336 361 758-9565 N

HEB GROCERY COMPANY LP ARANSAS PASS JERRYS PHARMACY 105 S AVE A 78336 361 758-1404 N

ACCESSHEALTH ARANSAS PASS WAL-MART PHARMACY 10-0458 2501 W WHEELER 78336 361 758-2867 N

WALMART STORES INC ARGYLE S&J ARGYLE PHARMACY 101 OLD TOWN BLVD SOUTH 76226 940 464-4500 N

ELEVATE PROVIDER NETWORK ARLINGTON A-CLASS PHARMACY 4907 S COLLINS ST STE 141 760181159 817 466-7420 N

ACCESSHEALTH PLUS ARLINGTON ARLINGTON CANCER CENTER PHARMACY 906 W RANDOL MILL RD 76012 817 543-4685

ELEVATE PROVIDER NETWORK ARLINGTON COSTCO PHARMACY 600 W ARBROOK BLVD 76014 817 417-1602 N

COSTCO PHARMACIES ARLINGTON CVS PHARMACY 1811 E ARKANSAS LN 760106602 817 860-0066 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 815 E ABRAMS ST 76010 817 804-0124 N

CVS PHARMACY INC

Page 5: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ARLINGTON CVS PHARMACY 5900 W PLEASANT RIDGE RD 76016 817 478-6041 Y

CVS PHARMACY INC ARLINGTON CVS PHARMACY 3801 SW GREEN OAKS BLVD 76017 817 572-2365 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 6151 MATLOCK RD 76018 817 465-6537 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 1901 SE GREEN OAKS BLVD 76018 817 557-0963 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 506 N FIELDER RD 76012 817 274-1696 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 1800 BROWN BLVD 76006 817 459-4066 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 3401 S COLLINS ST 760143244 817 472-5343 N

CVS PHARMACY INC ARLINGTON CVS PHARMACY 831 E PARK ROW DR 76010 817 861-5740 Y

CVS PHARMACY INC ARLINGTON CVS PHARMACY 900 W PIONEER PKWY 76013 817 277-4463 N

CVS PHARMACY INC ARLINGTON DFW WELLNESS PHARMACY 711 E LAMAR BLVD STE # 101 760113888 817 459-8400 N

ELEVATE PROVIDER NETWORK ARLINGTON EXPRESS CARE PHARMACY 905 MEDICAL CENTRE DRIVE 76012 817 861-2273 N

ACCESSHEALTH PLUS ARLINGTON GEESONS PHARMACY 5201 S COOPER ST 760175964 817 419-2688 N

ELEVATE PROVIDER NETWORK ARLINGTON HIGHPOINT PHARMACY 800 W ARBROOK 76015 817 466-3607 N

RECEPT HEALTHCARE SERVICES ARLINGTON IMIX RX PHARMACY 1102 ORCHARD DR 76012 817 617-3460 N

TRINET ARLINGTON KROGER PHARMACY 2350 SOUTHEAST GREEN OAKS

BL 76018 817 419-0312 N

THE KROGER CO ARLINGTON KROGER PHARMACY 5701 W PLEASANT RIDGE RD 76016 817 483-0354 N

THE KROGER CO ARLINGTON KROGER PHARMACY 301 S BOWEN 76013 817 277-0072 N

THE KROGER CO ARLINGTON KROGER PHARMACY 2580 E ARKANSAS LANE 76014 817 861-2779 N

THE KROGER CO ARLINGTON KROGER PHARMACY 5330 S COOPER 76017 817 472-9576 N

THE KROGER CO ARLINGTON KROGER PHARMACY 945 W LAMAR BLVD 76012 817 277-2144 N

THE KROGER CO ARLINGTON KROGER PHARMACY 2475 ASCENSION BLVD 76011 817 275-2901 N

THE KROGER CO ARLINGTON KROGER PHARMACY 2210 S FELDER 76013 817 277-3533 N

THE KROGER CO ARLINGTON KVN PHARMACY 4860 MATLOCK RD STE 120 76018 817 962-0417 N

ACCESSHEALTH PLUS ARLINGTON M & A PHARMACY 8200 MATLOCK ROAD STE 150 76002 682 222-7830 N

ACCESSHEALTH PLUS ARLINGTON MATLOCK PHARMACY 3360 MATLOCK RD STE # 100 760152907 817 557-3900 N

ELEVATE PROVIDER NETWORK ARLINGTON MEDEASE RX PHARMACY 4519 MATLOCK RD STE 135 760185664 817 855-1035 N

RECEPT HEALTHCARE SERVICES ARLINGTON MI DOCTOR ARLINGTON 941 E PARK ROW 76010 817 522-0221 N

ACCESSHEALTH PLUS ARLINGTON NEXGEN SPECIALTY PHARMACY 2233 AVE J STE 103 760065884 817 583-6611 N

TRINET ARLINGTON NORTH COLLINS PHARMACY 2301 N COLLINS ST SUITE 104 76011 817 795-8884 N

ELEVATE PROVIDER NETWORK ARLINGTON PHARMACIA HENRIQUE 4201 INTERWAY PLACE 76018 817 701-1930 N

ACCESSHEALTH PLUS ARLINGTON PHARMACY DEPOT 1119 W RANDOL MILL RD STE

104 760126509 682 323-5528 N

EPIC PHARMACY NETWORK INC ARLINGTON PHARMACY SOLUTIONS 1921 W PIONEER PARKWAY 76013 817 274-0050 N

THIRD PARTY STATION CP

Page 6: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ARLINGTON RANDOL MILL PHARMACY 1014 N FIELDER RD 76012 817 274-1883 N

ACCESSHEALTH PLUS ARLINGTON RAY'S TOWN NORTH PHARMACY 975 N COOPER ST 760115781 817 274-8221

TPN ARLINGTON SAVON PHARMACY 301 SW PLAZA SHOPPING CTR 76016 817 478-4238 N

ALBERTSONS LLC ARLINGTON SAVON PHARMACY 6220 US HIGHWAY 287 76017 817 478-1313 N

ALBERTSONS LLC ARLINGTON SAVON PHARMACY #4163 5950 S COOPER ST 76017 817 472-6458 N

ALBERTSONS LLC ARLINGTON TARGET PHARMACY 1600 W ARBROOK 76015 817 557-9560 N

TARGET PHARMACIES ARLINGTON TCHD ARKANSAS LANE PHARMACY 1050 W ARKANSAS LN STE 150 760136308 817 702-7603 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA ARLINGTON THE AGAPE PHARMACY 6109 S COOPER ST # 111 760015814 817 419-2822 COMMUNITY INDEPENDENT PHARMACY

NETW ARLINGTON TREASURE PHARMACY 2625 MATLOCK RD STE 102 760152527 817 617-3598 N

TPN ARLINGTON WAL-MART PHARMACY 2121 N COLLINS ST 76011 817 505-1389 N

WALMART STORES INC ARLINGTON WAL-MART PHARMACY 5401 PARK SPRINGS BLVD 76017 817 466-0677 N

WALMART STORES INC ARLINGTON WAL-MART PHARMACY 915 E RANDOL MILL ROAD 76011 817 274-1090 N

WALMART STORES INC ARLINGTON WAL-MART PHARMACY 4800 US 287 HIGHWAY 760172816 817 563-6232 N

WALMART STORES INC ARLINGTON WAL-MART PHARMACY 735 W SUBLETT ROAD 76017 817 557-8093 N

WALMART STORES INC ARLINGTON WAL-MART PHARMACY 4801 S COOPER ST 76017 817 465-2474 N

WALMART STORES INC ARLINGTON WEBB KOHLER PHARMACY AND HME

SUPPLY 2204 PARK SPRINGS BLVD 76013 817 861-4631 N

TRINET ASPERMONT ASPERMONT PHARMACY INC 616 S WASHINGTON 79502 940 989-2139 N

LEADER DRUG STORES INC ATASCOCITA TARGET PHARMACY 6931 FM 1960 RD E 773462705 281 318-2238 N

TARGET PHARMACIES ATHENS ANDERSON DRUG 419 S PALESTINE ST 757512571 903 675-5040 N

LEADER DRUG STORES INC ATHENS BROOKSHIRES PHARMACY 807 E TYLER ST 75751 903 675-4211 N

BROOKSHIRE GROCERY COMPANY ATHENS CVS PHARMACY 702 E TYLER 75751 903 675-7152 N

CVS PHARMACY INC ATHENS GIBSON PHARMACY 890 W CORSICANA ST 757512260 903 675-7069 N

ELEVATE PROVIDER NETWORK ATHENS WAL-MART PHARMACY 10-0412 1405 E TYLER 75751 903 677-2501 N

WALMART STORES INC ATLANTA CVS PHARMACY 101 LOOP 59 N 755512009 903 799-5024

CVS PHARMACY INC ATLANTA RED RIVER PHARMACY OF ATLANTA 102 E ALLDAY ST 755512305 903 799-7737 N

ACCESSHEALTH PLUS ATLANTA ROBINSON FAMILY PHARMACY 213 N PINECREST DR 755513130 903 796-1730 N

ELEVATE PROVIDER NETWORK ATLANTA WAL-MART PHARMACY 100226 201 US HWY 59 LOOP 75551 903 796-8231 N

WALMART STORES INC AUBREY AUBREY PHARMACY 701 S HIGHWAY 377 76227 940 440-0400 N

ACCESSHEALTH AUBREY SAVANNAH PHARMACY 26795 E HIGHWAY 762277853 940 366-8380 N

ACCESSHEALTH PLUS AUSTIN 38TH STREET PHARMACY INC 711 W 38TH 78705 512 458-3784 N COMMUNITY INDEPENDENT PHARMACY

NETW AUSTIN APOTHECARY SHOP 11645 ANGUS RD 787594004 512 345-1444 N

THIRD PARTY STATION CP AUSTIN AURO PHARMACY 7801 N LAMAR BLVD 78752 512 206-3150 N

TRINET

Page 7: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AUSTIN AUSTIN COMPOUNDING PHARMACY 3010 BEE CAVE RD 787465562 512 327-7455 N

THIRD PARTY STATION CP AUSTIN AVELLA OF AUSTIN 3016 GUADALUPE ST STE A 787052862 512 368-2962 N

ELEVATE PROVIDER NETWORK AUSTIN CHILDREN'S HEALTH EXPRESS 2900 MUELLER BLVD 78723 512 324-0149 N

ACCESSHEALTH PLUS AUSTIN COMMUNITYCARE CENTRAL PHARMACY 2901 MONTOPOLIS DR 787416411 512 978-9011 N

ACCESSHEALTH PLUS AUSTIN COSTCO PHARMACY 4301 W WILLIAM CANNON DR 78749 512 382-3020 N

COSTCO PHARMACIES AUSTIN COSTCO PHARMACY 10401 RESEARCH BLVD 78759 512 634-2252 N

COSTCO PHARMACIES AUSTIN CRESTVIEW PHARMACY 7100 WOODROW AVE 787571898 512 452-9535 N

THIRD PARTY STATION AUSTIN CVS PHARMACY 11300 N LAMAR BLVD 78753 512 835-6751 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 1701 E PARMER LN 78754 512 973-0843 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 3500 W SLAUGHTER LN 78749 512 292-6832 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 520 W SLAUGHTER LN 78748 512 280-1784 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 2900 W ANDERSON LN STE 10 78757 512 452-7693 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 2610 LAKE AUSTIN BLVD 78703 512 477-1261 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 2301 S CONGRESS AVE 78704 512 444-3671 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 1105 N IH 35 78702 512 476-2681 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 10550 W PARMER LN 787174873 512 310-3190 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 4405 E RIVERSIDE DR 78741 512 447-7272 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 5256 BURNETT RD STE B 78756 512 452-9471 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 3569 FAR W BLVD 78731 512 345-2570 Y

CVS PHARMACY INC AUSTIN CVS PHARMACY 1901 W WILLIAM CANNON DR

147 78745 512 443-3734 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 11725 N FM 620 78750 512 996-8660 Y

CVS PHARMACY INC AUSTIN CVS PHARMACY 2927 GUADALUPE ST 78705 512 474-2323 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 3201 BEE CAVES RD 132 78746 512 327-1843 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 4001 W WILLIAM CANNON

DRIVE 78749 512 891-0172 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 1701 BRIARCLIFF BLVD 78723 512 928-1705 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 5526 CONGRESS AVE 78745 512 462-3820 N

CVS PHARMACY INC AUSTIN CVS PHARMACY 500 CONGRESS AVE 78701 512 478-1091 N

CVS PHARMACY INC AUSTIN CVS PHARMACY # 13510 W HIGHWAY 290 787379399 512 288-0798

CVS PHARMACY INC AUSTIN CVS PHARMACY # 7300 N FM 620 787264514 512 249-9448

CVS PHARMACY INC AUSTIN CVS PHARMACY # 01430 2101 S LAMAR BLVD UNIT B 78704 512 383-8522

CVS PHARMACY INC AUSTIN EAST AUSTIN MEDICINE SHOP 2115 E MARTIN LUTHER KING JR

BLVD 787021341 512 643-0999 N

ACCESSHEALTH PLUS AUSTIN ECO PHARMACY OF SOUTH AUSTIN LLC 2555 WESTERN TRAILS BLVD 78745 512 519-9248 N

ACCESSHEALTH PLUS

Page 8: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AUSTIN FORTY ACRES PHARMACY 100 F W DEAN KEETON SSB 1 110 787121108 512 471-1824 N

ACCESSHEALTH PLUS AUSTIN GENORITE PHARMACY 4544 S LAMAR BLVD STE 730 787451500 512 351-9160 N

ACCESSHEALTH PLUS AUSTIN HEB PHARMACY 1801 E 51ST ST 78723 512 474-2662 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 12860 N HIGHWAY 183 78750 512 506-9250 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 2400 S CONGRESS 78704 512 442-1578 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 7010 HIGHWAY 71 W 78735 512 288-5713 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 7301 N FM 620 78726 512 336-7706 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 12407 N MOPAC EXWY 78758 512 339-6644 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 2508 E RIVERSIDE DRIVE 78741 512 448-3353 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 1000 E 41ST ST 78751 512 459-8308 Y

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 500 CANYON RIDGE DRIVE 78753 512 973-8753 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 6900 BRODIE LN 78745 512 891-8906 Y

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 14028 N US 183 78717 512 249-9886 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 9414 N LAMAR 78753 512 837-9580 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 11521 N FM 620 BLDG A 78750 512 249-0577 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 7025 VILLAGE CENTER DR 78731 512 502-8801 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 6001 W PARMER LANE 78727 512 249-8316 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 6607 IH 35 78744 512 441-3692 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 5808 BURNET ROAD 78756 512 454-6691 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 5800 W SLAUGHTER LANE 78749 512 301-9772 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 2701 E SEVENTH 78702 512 478-8086 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 10710 RESEARCH BLVD STE 200 78759 512 794-8227 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 2110 NEW SLAUGHTER LN 78748 512 282-0990 N

HEB GROCERY COMPANY LP AUSTIN HEB PHARMACY 7112 ED BLUESTEIN 78723 512 926-0586 N

HEB GROCERY COMPANY LP AUSTIN HEPCARE PHARMACY 2200 PARK BEND DR BLDG 1 #

300 787585387 512 381-1708 N

RECEPT HEALTHCARE SERVICES AUSTIN HILL COUNTRY APOTHECARY - RIVERPLACE 6611 RIVER PLACE BLVD STE 103 787301170 512 487-5759 N

TRINET AUSTIN LAKE HILLS PHARMACY 12005 BEE CAVE RD STE 1A 787386387 512 608-9355 N

ELEVATE PROVIDER NETWORK AUSTIN LAMAR FAMILY PHARMACY 8738 N LAMAR BLVD STE C 787535424 512 765-5831 N

ACCESSHEALTH PLUS AUSTIN LAMAR PLAZA DRUG STORE 1509 S LAMAR BLVD 78704 512 442-6777 N

ELEVATE PROVIDER NETWORK AUSTIN LIBERTY PHARMACY 8650 SPICE WOOD SPRINGS RD 78759 512 249-7500 N

TPN AUSTIN LONGHORN HEALTH SOLUTIONS 11310 W HIGHWAY 290 787372801 512 222-5544 N

ELEVATE PROVIDER NETWORK AUSTIN NAUS ENFIELD DRUG 1115 W LYNN ST 787033999 512 476-1221 N COMMUNITY INDEPENDENT PHARMACY

NETW

Page 9: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AUSTIN NORTHWEST HILLS AT DAVENPORT 3801 CAPITOL OF TX HWY N

D200 78746 512 329-8667 N

THIRD PARTY STATION CP AUSTIN PAIN SPECIALISTS OF AUSTIN PHARMACY 4100 DUVAL RD BLDG 3 # 201 787594275 512 485-7207 N

TPN AUSTIN PEOPLES PHARMACY 3801 B S LAMAR BLVD 78704 512 444-8866 N

ACCESSHEALTH PLUS AUSTIN PEOPLES PHARMACY 4201 WESTBANK DR 78746 512 327-8877 N

ACCESSHEALTH PLUS AUSTIN PEOPLES PHARMACY 13860 US HWY 183 N 78750 512 219-9499 N

ACCESSHEALTH PLUS AUSTIN PEOPLES PHARMACY 4018 N LAMAR BLVD 78756 512 459-9090 N

ACCESSHEALTH PLUS AUSTIN PHARMACY ALTERNATIVES 5810 TRADE CENTER DR 78744 512 383-9229 N

GERIMED LTC NETWORK INC AUSTIN RITE-AWAY PHARMACY #4 2410 E RIVERSIDE DR STE D4 787413053 512 827-2250 N

ACCESSHEALTH PLUS AUSTIN RITE-AWAY PHARMACY & MEDICAL

SUPPLY #3 730 W STASSNEY LN STE 160 787453133 512 827-2600 N

ACCESSHEALTH PLUS AUSTIN SAM'S CLUB PHARMACY 10-6188 10901 LAKELINE MALL DR 78717 512 872-8450 N

WALMART STORES INC AUSTIN SAMS PHARMACY 4970 HWY 290 WEST 78735 512 358-8734 N

WALMART STORES INC AUSTIN SAMS PHARMACY 9900 S INTERSTATE 35 787483885 512 582-4883 N

WALMART STORES INC AUSTIN SAMS PHARMACY 9700 N CAPITAL OF TX HWY 78759 512 349-9753 N

WALMART STORES INC AUSTIN SETON CENTRAL OUTPATIENT PHARMACY 601 E 15TH ST # L201A 787011930 512 324-7393 N

ACCESSHEALTH PLUS AUSTIN SOLUTIONS PHARMACY 8825 BEE CAVE RD STE A 787464720 512 920-3784 N

TPN AUSTIN SOUTH AUSTIN PHARMACY 4203A JAMES CASEY ST 787451108 512 383-9000 N

ACCESSHEALTH PLUS AUSTIN STONEGATE PHARMACY 2501 W WILLIAM CANNON

DRIVE 78745 512 707-2300 N

ELEVATE PROVIDER NETWORK AUSTIN STONEGATE PHARMACY AT THE VILLAGE 5625 EIGER RD STE 150 787358980 512 693-4222 N

ELEVATE PROVIDER NETWORK AUSTIN TARGET PHARMACY 5300 S MO PAC EXPY 78749 512 892-3753 N

TARGET PHARMACIES AUSTIN TARGET PHARMACY 9500 S I H 35 78748 512 687-0635 N

TARGET PHARMACIES AUSTIN TARGET PHARMACY 2300 W BEN WHITE 78704 512 443-2678 N

TARGET PHARMACIES AUSTIN TARGET PHARMACY 10900 LAKELINE MALL BLVD 78717 512 651-3377 N

TARGET PHARMACIES AUSTIN TARGET PHARMACY 10107 RESEARCH BLVD 787595803 512 687-1316 N

TARGET PHARMACIES AUSTIN TARRYTOWN PHARMACY 2727 EXPOSITION BLVD 78703 512 478-6419 N

ACCESSHEALTH AUSTIN THE AUSTIN DIAGNOSTIC CLINIC

PHARMACY 12221 N MO PAC EXPY STE 100 787582494 512 901-4797 N

TPN AUSTIN THE DAILY DOSE PHARMACY 4534 WESTGATE BLVD STE 111 78745 512 334-9697 N

TPN AUSTIN VICTORY MEDICAL CENTER PHARMACY 4303 VICTORY DR 787047507 512 279-0985 N

TPN AUSTIN VINA PHARMACY 11207 N LAMAR BLVD STE A 787533056 512 977-8844 N

ACCESSHEALTH PLUS AUSTIN WAL-MART PHARMACY 2525 W ANDERSON LN 787571180 512 345-8904 N

WALMART STORES INC AUSTIN WAL-MART PHARMACY 12900 N I 35 SVC RD SB 78753 512 837-9530 N

WALMART STORES INC AUSTIN WAL-MART PHARMACY 13201 FM 620 N 787291011 512 335-5275 N

WALMART STORES INC

Page 10: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network AUSTIN WAL-MART PHARMACY 5017 US HWY 290 WEST 78735 512 892-6175 N

WALMART STORES INC AUSTIN WAL-MART PHARMACY 8201 N FM 620 78726 512 249-9530 N

WALMART STORES INC AUSTIN WAL-MART PHARMACY 710 E BEN WHITE BLVD 78704 512 443-6588 N

WALMART STORES INC AUSTIN WAL-MART PHARMACY 1030 NORWOOD PARK BD 78753 512 339-2050 N

WALMART STORES INC AUSTIN WALMART PHARMACY 10-5317 9300 S INTERSTATE 35 STE B 78748 512 292-0346 N

WALMART STORES INC AUSTIN NORTH TARGET PHARMACY 8601 RESEARCH BLVD 78758 512 652-0483 N

TARGET PHARMACIES AZLE BROOKSHIRES PHARMACY 511 N STEWART ROAD 76020 817 444-0306 N

BROOKSHIRE GROCERY COMPANY AZLE CVS PHARMACY 460 NORTHWEST PKWY 76020 817 444-7099 N

CVS PHARMACY INC AZLE LAURA'S PHARMACY 605 NORTHWEST PKWY STE 150 760202915 817 406-4546 N

ACCESSHEALTH PLUS AZLE SAVON PHARMACY 480 NW PKWY 76020 817 270-1120 N

ALBERTSONS LLC AZLE WALMART PHARMACY 10-5359 721 BOYD RD 76020 817 270-5838 N

WALMART STORES INC BACLIFF SULLIVAN PHARMACY 1140 GRAND AVE 775182760 281 339-4577 N

ELEVATE PROVIDER NETWORK BALCH SPRINGS CVS PHARMACY 11820 ELAM RD 75180 972 286-3530 N

CVS PHARMACY INC BALCH SPRINGS KROGER PHARMACY 11925 ELAM RD 75180 972 557-2567 N

THE KROGER CO BALCH SPRINGS MINYARD PHARMACY 4202 PIONEER 75180 972 557-3535 N

ACCESSHEALTH PLUS BALCH SPRINGS WAL-MART PHARMACY 12300 LAKE JUNE RD 75180 972 286-0180 N

WALMART STORES INC BALCONES HGTS TARGET PHARMACY 4522 FREDRICKSBURG ROAD 78201 210 280-0001 N

TARGET PHARMACIES BALLINGER KEEL DRUG STORE 2001 HUTCHINGS AVE 76821 325 365-3505 N

THIRD PARTY STATION CP BALLINGER WAL-MART PHARMACY 2005 HUTCHINGS AVE 76821 325 365-5741 N

WALMART STORES INC BANDERA BANDERA DRUG, LLC 1100 MULBERRY ST 78003 830 796-3111 N

ACCESSHEALTH PLUS BANDERA CVS PHARMACY # 1202 MAIN ST 78003 830 460-7701 N

CVS PHARMACY INC BANGS RIPPETOE PHARMACY 205 E HALL ST 76823 325 752-6133 N

ACCESSHEALTH PLUS BARTONVILLE KROGER PHARMACY #572 3400 FM 407 E 762269707 940 294-8252 N

THE KROGER CO BASTROP CVS PHARMACY # 01037 1671 HIGHWAY 71 EAST 78602 512 308-0234

CVS PHARMACY INC BASTROP HEB PHARMACY 104 HASLER BLVD 78602 512 321-1033 N

HEB GROCERY COMPANY LP BASTROP LOCK DRUG STORE 103 HWY 71 WEST 786023216 512 321-2422 N

ACCESSHEALTH BASTROP WAL-MART PHARMACY 488 HWY 71 WEST 78602 512 321-1020 N

WALMART STORES INC BAY CITY CVS PHARMACY 2711 7TH ST 77414 979 245-1657 N

CVS PHARMACY INC BAY CITY HEB PHARMACY 2700 SEVENTH 77414 979 245-1991 N

HEB GROCERY COMPANY LP BAY CITY HIBBS PHARMACY 1415 AVE G 77414 979 245-5501 N

ELEVATE PROVIDER NETWORK BAY CITY MUECKE PRESCRIPTION SHOPPE 2808 7TH ST 774145306 979 244-1772 N

ELEVATE PROVIDER NETWORK BAY CITY WAL-MART PHARMACY 4600 7TH ST 77414 979 245-0095 N

WALMART STORES INC BAYTOWN BLUE RIBBON PHARMACY 1248 GARTH RD STE D 775202596 281 838-8025 N

TRINET

Page 11: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BAYTOWN CVS PHARMACY 1514 N ALEXANDER 77520 281 420-7510 N

CVS PHARMACY INC BAYTOWN CVS PHARMACY 3923 GARTH RD 77521 281 427-6156 Y

CVS PHARMACY INC BAYTOWN CVS PHARMACY 2001 GARTH RD 77520 281 422-0525 N

CVS PHARMACY INC BAYTOWN KROGER PHARMACY 4533 GARTH ROAD 77521 281 422-0105 N

THE KROGER CO BAYTOWN KROGER PHARMACY 1700 N ALEXANDER DR 77520 281 422-8034 N

THE KROGER CO BAYTOWN MD PHARMACY 11540 EAGLE DR 77523 281 576-0106 N

TRINET BAYTOWN SOUTHSIDE PHARMACY 10 2802 GARTH RD STE 101 775213924 832 831-8010 N

ACCESSHEALTH PLUS BAYTOWN TARGET PHARMACY 4510 GARTH RD 77521 281 422-5153 N

TARGET PHARMACIES BAYTOWN WAL-MART PHARMACY 10-0194 4900 GARTH ROAD 77520 281 421-3024 N

WALMART STORES INC BAYTOWN WALMART PHARMACY 10-2439 8700 N HWY 146 77523 281 918-3067 N

WALMART STORES INC BAYTOWN WELLNESS PHARMACY 3007 GARTH RD 775213946 281 428-4705 N

ELEVATE PROVIDER NETWORK BEAUMONT CHILDREN'S SPECIALTY PHARMACY 490 INTERSTATE 10 N STE 400 77702 409 838-5552 N

ELEVATE PROVIDER NETWORK BEAUMONT CORNER PHARMACY 3570 FANNETT RD 777051396 409 842-3222 N

THIRD PARTY STATION CP BEAUMONT CVS PHARMACY 6850 EASTEX FWY 77708 409 892-8511 N

CVS PHARMACY INC BEAUMONT CVS PHARMACY 2950 N DOWLEN RD 77706 409 861-3413 Y

CVS PHARMACY INC BEAUMONT CVS PHARMACY 3890 PHELAN BLVD 77707 409 832-8001 N

CVS PHARMACY INC BEAUMONT CVS PHARMACY 3595 COLLEGE ST 77701 409 835-1788 Y

CVS PHARMACY INC BEAUMONT GOLDEN TRIANGLE PHARMACY SERVICES 3515 FANNIN ST STE 105 77701 409 832-6100 N

THIRD PARTY STATION CP BEAUMONT HEB PHARMACY 3025 N DOWLEN 77706 409 860-4212 N

HEB GROCERY COMPANY LP BEAUMONT HEB PHARMACY 3590 COLLEGE ST 77701 409 813-8452 N

HEB GROCERY COMPANY LP BEAUMONT KING'S PHARMACY BEAUMONT 3610 N MAJOR DRIVE 77713 409 860-0040 N

ELEVATE PROVIDER NETWORK BEAUMONT KROGER PHARMACY 3965 DOWLEN 77706 409 899-8697 N

THE KROGER CO BEAUMONT KROGER PHARMACY 3845 PHELAN BLVD 77707 409 833-4437 N

THE KROGER CO BEAUMONT LOVOI AND SONS PHARMACIES 3480 FANNIN ST 777013804 409 833-7538 N COMMUNITY INDEPENDENT PHARMACY

NETW BEAUMONT MALLEY'S FAMILY PHARMACY 3110 CALDER ST 777021411 409 866-1429 N

TRINET BEAUMONT MARKET BASKET PHARMACY 3955 PHELAN BLVD 77707 409 833-1298 N

LEADER DRUG STORES INC BEAUMONT MARKET BASKET PHARMACY 655 E LAVACA 777053897 409 835-4558 N

LEADER DRUG STORES INC BEAUMONT MARKET BASKET PHARMACY 5960 HWY 105 77708 409 892-2282 N

LEADER DRUG STORES INC BEAUMONT MCMAKIN PHARMACY 4225 GLADYS 777063644 409 898-0717 N COMMUNITY INDEPENDENT PHARMACY

NETW BEAUMONT PECCIO PHARMACY PLUS 3035 COLLEGE ST 777014607 409 813-1717 N

TRINET BEAUMONT SAMS PHARMACY 1615 INTERSTATE 10 S 77701 409 840-9776 N

WALMART STORES INC BEAUMONT TARGET PHARMACY 5850 EASTEX FREEWAY 77708 409 898-1584 N

TARGET PHARMACIES

Page 12: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BEAUMONT WAL-MART PHARMACY 10-0651 4145 N DOWLEN ROAD 77706 409 899-3615 N

WALMART STORES INC BEDFORD CVS PHARMACY 601 N INDUSTRIAL BLVD 76021 817 283-0161 Y

CVS PHARMACY INC BEDFORD CVS PHARMACY 2900 CENTRAL DR 76021 817 571-7979 N

CVS PHARMACY INC BEDFORD CVS PHARMACY 237 PIPELINE RD 76022 817 282-2581 N

CVS PHARMACY INC BEDFORD GREEN CROSS PHARMACY 1305 AIRPORT FREEWAY #110 76021 817 354-7771 N

ELEVATE PROVIDER NETWORK BEDFORD KROGER PHARMACY 2109 HARWOOD RD 76021 817 685-9628 N

THE KROGER CO BEDFORD MINYARD PHARMACY #55 3300 HARWOOD 76021 817 540-3131 Y

ACCESSHEALTH PLUS BEDFORD NORTHEAST COMM CLINIC PHY 837 BROWN TRAIL 760227386 817 702-6457 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA BEDFORD SAVON PHARMACY 1300 AIRPORT FWY 76022 817 354-0991 N

ALBERTSONS LLC BEDFORD TRAIL CREEK PHARMACY 2700 TIBBETS DR 76022 817 684-9464 N

ELEVATE PROVIDER NETWORK BEDFORD WAL-MART PHARMACY 4101 HWY 121 76021 817 571-6222 N

WALMART STORES INC BEDFORD WAL-MART PHARMACY 2108 BEDFORD ROAD 76021 817 283-7529 N

WALMART STORES INC BEE CAVE CVS PHARMACY # 14057 BEE CAVE PKWY 78738 512 263-8750

CVS PHARMACY INC BEE CAVE HEB PHARMACY 12400 STATE HWY 71 WEST 78738 512 253-0561 N

HEB GROCERY COMPANY LP BEE CAVE TARGET PHARMACY 3702 RANCH ROAD 620 S 78738 512 651-0095 N

TARGET PHARMACIES BEEVILLE HEB PHARMACY 100 E HOUSTON ST 78102 361 358-3737 N

HEB GROCERY COMPANY LP BEEVILLE SCHULZ AND WROTEN PHARMACY 122 N WASHINGTON ST 78102 361 358-1150 N

ELEVATE PROVIDER NETWORK BEEVILLE TLC PHARMACY & MEDICAL EQUIPMENT 200 S HILLSIDE DR 781025349 361 362-9984 N

ELEVATE PROVIDER NETWORK BEEVILLE WAL-MART PHARMACY 10-0463 502 E FM 351 78102 361 362-0661 N

WALMART STORES INC BELLAIRE CVS PHARMACY 5430 BISSONNET ST 77401 713 218-2291 N

CVS PHARMACY INC BELLAIRE MEDLEY COMPOUNDING PHARMACY 5711 BISSONNET ST STE F 774014724 713 838-1500

TPN BELLAIRE PLATINUM RX 5420 W LOOP SOUTH 77401 713 667-6777 N

ELEVATE PROVIDER NETWORK BELLAIRE RECEPT PHARMACY 4747 BELLAIRE BLVD STE 135 761073356 832 426-1520 N

RECEPT HEALTHCARE SERVICES BELLAIRE WESTLANDS PHARMACY 5819 BISSONNET ST 774014719 713 664-1400 N

TRINET BELLMEAD HEB PHARMACY 801 N IH 35 76705 254 799-0219 N

HEB GROCERY COMPANY LP BELLMEAD WAL-MART PHARMACY 1521 I 35 EAST 76705 254 867-0211 N

WALMART STORES INC BELLS BELLS FAMILY DRUG 103 W BELLS BLVD 754140205 903 965-7383 N

ELEVATE PROVIDER NETWORK BELLVILLE WALTER'S PHARMACY, INC. 250 W PALM ST 77418 979 865-3696 N

ACCESSHEALTH BELTON BAYLOR SCOTT & WHITE PHARMACY #229 309 LAKE RD 76513 254 933-6000 N

LEADER DRUG STORES INC BELTON CVS PHARMACY # 2849 N MAIN ST 765131100 254 933-7553

CVS PHARMACY INC BELTON HEB PHARMACY 2509 N MAIN ST 76513 254 939-0843 N

HEB GROCERY COMPANY LP BELTON MEDICINE SHOPPE 502 E CENTRAL AVE 765133244 254 939-0831 N

MEDICINE SHOPPE INTERNATIONAL INC BELTON WAL-MART PHARMACY 2604 N MAIN ST 76513 254 939-7664 N

WALMART STORES INC

Page 13: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BENBROOK BENBROOK PHARMACY 410 MERCEDES ST 76126 817 249-9595 N

ELEVATE PROVIDER NETWORK BENBROOK CVS PHARMACY 8660 US HWY 377 S 76126 817 249-4040 Y

CVS PHARMACY INC BENBROOK WAL-MART PHARMACY 8840 BENBROOK BLVD 761263440 682 233-6827 N

WALMART STORES INC BEVERLY HILLS CVS PHARMACY 1513 S VALLEY MILLS DR 767111683 254 756-1876 Y

CVS PHARMACY INC BIG LAKE NEIGHBORHOOD PHARMACY 116 N MAIN AVE 769325211 325 716-1800 N

ELEVATE PROVIDER NETWORK BIG SPRING LEONARDS PRESCRIPTION PHARMACY 701 SCURRY ST 79720 432 263-7344 N COMMUNITY INDEPENDENT PHARMACY

NETW BIG SPRING PROFESSIONAL PHARMACY 1000 S MAIN ST 797202998 432 267-2546 N COMMUNITY INDEPENDENT PHARMACY

NETW BIG SPRING WAL-MART PHARMACY 10-0513 201 W MARCY 79720 432 267-1585 N

WALMART STORES INC BIG SPRING WESTOVER PHARMACY 710 W MARCY DR 79720 432 267-1611 N COMMUNITY INDEPENDENT PHARMACY

NETW BIG SPRINGS HEB PHARMACY 2000 S GREGG 79720 432 263-3020 N

HEB GROCERY COMPANY LP BLANCO STRICKLAND DRUGS 316 PECAN ST 78606 830 833-4815 N

BOERNE ANNIES APOTHECARY 31007 IH 10 WEST 78006 830 981-4774 N

THIRD PARTY STATION CP BOERNE BOERNE DRUG COMPANY 725 N MAIN ST STE 2 780061623 830 331-8183 N

TRINET BOERNE HEB PHARMACY 420 W BANDERA 78006 830 816-9769 N

HEB GROCERY COMPANY LP BOERNE ROCK PHARMACY 1201 S MAIN ST 780067218 830 357-5052 N

ACCESSHEALTH BOERNE TALON PHARMACY OF BOERNE 1430 S MAIN ST STE 105 780063334 830 816-5910 N

TRINET BOERNE WAL-MART PHARMACY 1381 S MAIN ST 78006 830 816-3587 N

WALMART STORES INC BONHAM BONHAM FAMILY DRUG 100 E SAM RAYBURN DRIVE 75418 903 583-7325 N

ELEVATE PROVIDER NETWORK BONHAM BROOKSHIRES PHARMACY 2228 ISLAND BAYOU RD 75418 903 583-2887 N

BROOKSHIRE GROCERY COMPANY BONHAM FANNIN PHARMACY 2108 N CENTER ST 754182627 903 583-8017 N

ELEVATE PROVIDER NETWORK BONHAM WAL-MART PHARMACY 10-0158 2021 N HIGHWAY 121 754182340 903 583-5564 N

WALMART STORES INC BORGER CVS PHARMACY # 230 N CEDAR ST 790074026 806 273-1433

CVS PHARMACY INC BORGER HOLMES PHARMACY 600 S MAIN ST 790074808 806 274-5334 N

THIRD PARTY STATION CP BORGER UNITED PHARMACY 1414 W WILSON 79007 806 273-6427 N

UNITED PHARMACY TX BORGER WAL-MART PHARMACY 1501 ROOSEVELT ST 79007 806 274-7243 N

WALMART STORES INC BOWIE CVS PHARMACY 1419 HWY 59 N 76230 940 872-6117 N

CVS PHARMACY INC BOWIE RICKS PHARMACY 503 E LONDON 76230 940 872-1140 N

THIRD PARTY STATION CP BOWIE WAL-MART PHARMACY 10-0271 1341 HIGHWAY 287 N 762307531 940 872-3003 N

WALMART STORES INC BOYD BOYD MEDICINE STORE 417 W ROCK ISLAND AVE 760233103 940 433-8056 N

ELEVATE PROVIDER NETWORK BRADY CITY DRUG OF BRADY INC 704 W 17TH ST 76825 325 597-2325 N

ACCESSHEALTH BRADY WAL-MART PHARMACY 2207 S BRIDGE ST 76825 325 597-4457 N

WALMART STORES INC BRECKENRIDGE CVS PHARMACY 1501 W WALKER ST 76424 254 559-3341 N

CVS PHARMACY INC

Page 14: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BRECKENRIDGE LARSON'S PHARMACY 2802 W WALKER ST 764244000 254 559-4080 N

LEADER DRUG STORES INC BRENHAM CVS PHARMACY 2500 S DAY ST 77833 979 836-9367 N

CVS PHARMACY INC BRENHAM HEB PHARMACY 2508 S DAY ST 77833 979 277-0906 N

HEB GROCERY COMPANY LP BRENHAM MEDICAL ARTS DRUG COMPANY 207 E ACADEMY ST 77833 979 836-3687 N

THIRD PARTY STATION CP BRENHAM NORMAN'S PHARMACY 2105 S DAY ST 77833 979 836-5264 N

ELEVATE PROVIDER NETWORK BRENHAM WALDIES PHARMACY 203 E ACADEMY ST 77833 979 836-5684 N

THIRD PARTY STATION CP BRENHAM WAL-MART PHARMACY 10-0321 203 HIGHWAY 290 W 778336801 979 830-1023 N

WALMART STORES INC BRIDGE CITY BRIDGE CITY FAMILY PHARMACY 1910 TEXAS AVE 776112834 409 735-5555 N

TRINET BRIDGE CITY CVS PHARMACY # 00851 485 TEXAS AVE 776114221 409 697-3211

CVS PHARMACY INC BRIDGE CITY WAL-MART PHARMACY 10-0283 795 TX AVE 77611 409 735-2469 N

WALMART STORES INC BRIDGEPORT BROOKSHIRE PHARMACY 1203 US HIGHWAY 380 764262087 940 683-1510 N

BROOKSHIRE GROCERY COMPANY BRIDGEPORT GAIL'S PHARMACY 810 WW RAY CIRCLE 76426 940 683-4011 N

ELEVATE PROVIDER NETWORK BRIDGEPORT VALU-RITE PHARMACY 709 WOODROW WILSON RAY

CIRCLE 76426 940 683-2950 N

ELEVATE PROVIDER NETWORK BROWNFIELD CLINIC PHARMACY 901 TAHOKA RD 793163817 806 637-7049 N

ACCESSHEALTH BROWNFIELD LIFECARE PHARMACY 706 E FELT ST 793163440 806 636-8000 N

EPIC PHARMACY NETWORK INC BROWNFIELD NELSON PHARMACY 805 TAHOKA RD 793163699 806 637-3533 N

THIRD PARTY STATION CP BROWNFIELD UNITED PHARMACY 1401 TAHOKA HWY 79316 806 637-7597 N

UNITED PHARMACY TX BROWNSVILLE ARTS PHARMACY 3354 INTERNATIONAL BLVD 78521 956 544-2959 N

ELEVATE PROVIDER NETWORK BROWNSVILLE AUTREY PHARMACY 1 1205 CENTRAL BLVD 78520 956 548-0801

LEADER DRUG STORES INC BROWNSVILLE AUTREY PHARMACY 2 1365 E RUBEN TORRES SR BLVD 785210964 956 542-5100

LEADER DRUG STORES INC BROWNSVILLE AUTREY PHARMACY 3 800 E ALTON GLOOR BLVD UNIT

B 78526 956 230-3200 N

LEADER DRUG STORES INC BROWNSVILLE COMPLETE RX PHARMACY 1885 E PRICE 78521 956 554-3532 N

ACCESSHEALTH PLUS BROWNSVILLE CVS PHARMACY 4531 PADRE ISLAND HWY 785214209 956 542-1733

CVS PHARMACY INC BROWNSVILLE CVS PHARMACY 1484 RUBEN TORRES BLVD 785211537 956 541-0167

CVS PHARMACY INC BROWNSVILLE CVS PHARMACY 790 ALTON GLOOR BLVD 78526 956 544-0213

CVS PHARMACY INC BROWNSVILLE CVS PHARMACY # 1454 CENTRAL BLVD 78520 956 541-4102

CVS PHARMACY INC BROWNSVILLE CVS PHARMACY # 08398 7395 PADRE ISLAND HWY 785213467 956 838-1264

CVS PHARMACY INC BROWNSVILLE ESCOBEDOS PHARMACY 4430 E 14TH ST 78520 956 986-0707 N

THIRD PARTY STATION BROWNSVILLE HEB PHARMACY 1628 CENTRAL BLVD 78520 956 542-0934 N

HEB GROCERY COMPANY LP BROWNSVILLE HEB PHARMACY 2950 SOUTHMOST RD 78521 956 541-8602 N

HEB GROCERY COMPANY LP BROWNSVILLE HEB PHARMACY 2155 PAREDES LINE RD 78526 956 574-9707 N

HEB GROCERY COMPANY LP BROWNSVILLE HEB PHARMACY 2250 BOCA CHICA BLVD 78520 956 541-0384 N

HEB GROCERY COMPANY LP

Page 15: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BROWNSVILLE KMART PHARMACY9329 2440 PABLO KISEL BLVD 785264095 956 546-3407 N

K MART PHARMACY BROWNSVILLE LAS PALMAS PHARMACY 864 CENTRAL BLVD STE 1200 785207501 956 542-7400 N

ACCESSHEALTH PLUS BROWNSVILLE LOS EBANOS PHARMACY LLC 1134 LOS EBANOS BLVD 785208730 956 542-8542 N

TRINET BROWNSVILLE OCEAN PLAZA PHARMACY 1740 BOCA CHICA BLVD STE 400 785208146 956 504-1290 N

ELEVATE PROVIDER NETWORK BROWNSVILLE PETES PHARMACY II 5235 SOUTHMOST RD 78521 956 504-9555 N

THIRD PARTY STATION CP BROWNSVILLE SAMS PHARMACY 3570 W ALTON GLOOR B 78520 956 350-9938 N

WALMART STORES INC BROWNSVILLE TARGET PHARMACY 301 E MORRISON RD 78526 956 698-6121 N

TARGET PHARMACIES BROWNSVILLE THE FRIENDLY PHARMACY 3302 BOCA CHICA BLVD 78526 956 544-1200 N

ACCESSHEALTH PLUS BROWNSVILLE THE NEIGHBORHOOD PHARMACY 95 E PRICE RD BLDG F 785213531 956 550-8908 N

ACCESSHEALTH PLUS BROWNSVILLE THE PHARMACY AT UPTOWN 100 UPTOWN AVE # 110-B 785207559 956 544-0237 N

ACCESSHEALTH PLUS BROWNSVILLE TRINITY DME 680 PAREDES LINE RD 78521 956 554-3560 N

THIRD PARTY STATION BROWNSVILLE TRINITY RX2 5850 FM 802 78526 956 621-0678 N

THIRD PARTY STATION CP BROWNSVILLE UNITED CARE PHARMACY 1755 W PRICE RD 78521 956 546-0444 N

ACCESSHEALTH PLUS BROWNSVILLE WAL-MART PHARMACY 2721 BOCA CHICA BLVD 78521 956 544-7516 N

WALMART STORES INC BROWNSVILLE WAL-MART PHARMACY 7480 PADRE ISLAND BLVD 78521 956 832-0392 N

WALMART STORES INC BROWNSVILLE WAL-MART PHARMACY 10-0456 3500 W ALTON GLOOR BLVD 78520 956 350-3455 N

WALMART STORES INC BROWNSVILLE WALMART PHARMACY 10-4112 2205 RUBEN TORRES BLVD 785267439 956 509-2078 N

WALMART STORES INC BROWNWOOD CVS PHARMACY 100 E COMMERCE ST 76801 325 646-8588 N

CVS PHARMACY INC BROWNWOOD CVS PHARMACY 1319 AUSTIN AVE 76801 325 643-1516 N

CVS PHARMACY INC BROWNWOOD DOCS DRUGSTORE 3800 HWY 377 S 76801 325 643-3800 N

ACCESSHEALTH PLUS BROWNWOOD JACOBS FAMILY PHARMACY 2701 AUSTIN AVE 768015834 325 646-1100 N

ELEVATE PROVIDER NETWORK BROWNWOOD LIVE OAK PHARMACY 3707 AUSTIN AVE 768016626 325 643-2648 N

ACCESSHEALTH PLUS BROWNWOOD UNITED PHARMACY #554 300 E COMMERCE ST 768011824 325 510-3400 N

UNITED PHARMACY TX BROWNWOOD WAL-MART PHARMACY 10-0813 401 W COMMERCE 76801 325 643-2029 N

WALMART STORES INC BRYAN BRYAN MEDICINE CHEST 2300 DE LEE ST 77802 979 776-6800 N

ELEVATE PROVIDER NETWORK BRYAN CVS PHARMACY 3000 S TEXAS AVE 77802 979 822-7344 N

CVS PHARMACY INC BRYAN HEB PHARMACY 1609 N TEXAS AVE 77803 979 778-2074 N

HEB GROCERY COMPANY LP BRYAN HEB PHARMACY 725 E VILLA MARIA 77802 979 822-1850 N

HEB GROCERY COMPANY LP BRYAN KROGER PHARMACY 2303 BOONVILLE RD 778082232 979 774-8377 N

THE KROGER CO BRYAN TARGET PHARMACY 3061 WILDFLOWER DR 778023060 979 774-1481 N

TARGET PHARMACIES BRYAN VILLAGE FOODS 1760 BRIARCREST DR 77802 979 846-8199 N

ELEVATE PROVIDER NETWORK BRYAN WAL-MART PHARMACY 1901 S TEXAS AVE 77802 979 599-5562 N

WALMART STORES INC BRYAN WAL-MART PHARMACY 10-0322 2200 BRIARCREST DRVE 77802 979 776-0375 N

WALMART STORES INC

Page 16: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network BRYAN WALMART PHARMACY 10-4183 643 N HARVEY MITCHELL

PARKWAY 77807 979 599-9208

WALMART STORES INC BUCKINGHAM KROGER PHARMACY 536 CENTENNIAL BLVD 75081 972 437-2478 N

THE KROGER CO BUDA BUDA DRUG STORE 203 RAILROAD ST 78610 512 312-2111 N COMMUNITY INDEPENDENT PHARMACY

NETW BUDA CVS PHARMACY # 220 N FM 1626 786103071 401 765-1500

CVS PHARMACY INC BUDA HEB PHARMACY 15300 S IH 35 78610 512 312-0907 N

HEB GROCERY COMPANY LP BUDA WAL-MART PHARMACY 690 OLD SAN ANTONIO ROAD 78610 512 312-2256 N

WALMART STORES INC BULLARD BROOKSHIRES PHARMACY 213 N US HWY 69 75757 903 894-9648 N

BROOKSHIRE GROCERY COMPANY BUNA KARR PHARMACY INC 351 TEXAS STATE HWY 62 776126473 409 994-3535 N

TRINET BURKBURNETT UNITED PHARMACY 311 S AVE D 76354 940 569-3319 N

UNITED PHARMACY TX BURLESON BEST VALUE WEST PHARMACY 124 W RENFRO 76028 817 295-6128 N

ELEVATE PROVIDER NETWORK BURLESON CVS PHARMACY 100 SW WILSHIRE BLVD 76028 817 295-1125 Y

CVS PHARMACY INC BURLESON CVS PHARMACY # 05465 1421 SW WILSHIRE BLVD 76028 817 295-8659

CVS PHARMACY INC BURLESON DANDY DRUG 5450 E FM 1187 76028 817 483-3784 N

ELEVATE PROVIDER NETWORK BURLESON HEB PHARMACY 165 NW JOHN JONES DR 76028 817 447-3213 N

HEB GROCERY COMPANY LP BURLESON KROGER PHARMACY #591 1631 SW WILSHIRE BLVD 760286305 817 258-5952 N

THE KROGER CO BURLESON RONS APOTHECARY SHOP 117 W RENFRO ST 760284298 817 295-2273 N

ELEVATE PROVIDER NETWORK BURLESON SAMS PHARMACY 600 N BURLESON BLVD 760282901 817 568-9652 N

WALMART STORES INC BURLESON SAVON PHARMACY 833 NE ALSBURY BLVD 76028 817 447-8060 N

ALBERTSONS LLC BURLESON TARGET PHARMACY 200 NW JOHN JONES DR 76028 817 302-0059 N

TARGET PHARMACIES BURLESON WAL-MART PHARMACY 10-0220 951 SW WILSHIRE BLVD 76028 817 447-2307 N

WALMART STORES INC BURLESON WALMART PHARMACY 10-3653 965 NW JOHN JONES DR 760285288 817 840-4609 N

WALMART STORES INC BURNET HEB PHARMACY 105 S BOUNDARY 78611 512 715-0701 N

HEB GROCERY COMPANY LP BURNET LAKE AREA PHARMACY 608 BUCHANAN DR 78611 512 756-8550 N

ACCESSHEALTH CALDWELL WAL-MART PHARMACY 10-0567 475 STATE HIGHWAY 36 N 77836 979 567-0234 N

WALMART STORES INC CAMERON BAYLOR SCOTT & WHITE PHARMACY #275 101-A LAFFERTY 765203683 254 605-1150 N

LEADER DRUG STORES INC CAMERON CVS PHARMACY 1605 W 4TH ST 12 76520 254 697-6583 N

CVS PHARMACY INC CANTON BROOKSHIRE PHARMACY 880 E STATE HIGHWAY 243 75103 903 567-2403 N

BROOKSHIRE GROCERY COMPANY CANTON CVS PHARMACY 1215 S TRADES DAY BLVD 75103 903 567-6516 N

CVS PHARMACY INC CANTON PEACE PHARMACY 300 S BUFFALO ST 75103 903 567-4129 N

ELEVATE PROVIDER NETWORK CANTON WAL-MART PHARMACY 10-0827 603 HWY 243 EAST 75103 903 567-6578 N

WALMART STORES INC CANYON MEDI DRIVE PHARMACY 507 23RD ST 790154043 806 655-1024 N

ACCESSHEALTH CANYON UNITED PHARMACY 201 N 23RD ST 790152500 806 655-5757 N

UNITED PHARMACY TX

Page 17: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CANYON WAL-MART PHARMACY 10-0793 1701 N 23RD ST 79015 806 655-2581 N

WALMART STORES INC CANYON LAKE CVS PHARMACY # 8049 FM 2673 781336429 830 899-9700

CVS PHARMACY INC CANYON LAKE MOUNTAIN VALLEY PHARMACY 1395 SATTLER RD 78132 830 964-3615 N

ELEVATE PROVIDER NETWORK CARRIZO SPRINGS HEB PHARMACY 2030 N 1ST ST 78834 830 876-9109 N

HEB GROCERY COMPANY LP CARRIZO SPRINGS WAL-MART PHARMACY 2214 N 1ST ST 788342036 830 876-3506 N

WALMART STORES INC CARROLLTON AMERICAN SPECIALTY PHARMACY 2138 N JOSEY LN STE 100 750063035 972 232-7458 N

TPN CARROLLTON BAYLOR SCOTT & WHITE PHARMACY #104 4323 N JOSEY LN STE 102 750104630 972 512-1581 N

LEADER DRUG STORES INC CARROLLTON CVS PHARMACY 1009 W ROSEMEADE PARKWAY 75007 972 492-3070 N

CVS PHARMACY INC CARROLLTON CVS PHARMACY 2142 N JOSEY LN 75006 972 446-1915 N

CVS PHARMACY INC CARROLLTON CVS PHARMACY 3065 N JOSEY LN STE 64 75007 972 492-0425 Y

CVS PHARMACY INC CARROLLTON CVS PHARMACY 4100 STATE HWY 121 750101118 972 939-7062 N

CVS PHARMACY INC CARROLLTON CVS PHARMACY # 08440 4205 N JOSEY LN 750104601 972 492-1706

CVS PHARMACY INC CARROLLTON EXPRESS CARE PHARMACY 3648 OLD DENTON RD STE 104 750077977 214 800-5526 N

ELEVATE PROVIDER NETWORK CARROLLTON GENERX DISCOUNT PHARMACY 1235 S JOSEY LN 750067665 972 417-8895 N

ELEVATE PROVIDER NETWORK CARROLLTON KROGER PHARMACY 4038 DENTON ROAD 75007 972 512-3366 N

THE KROGER CO CARROLLTON PEOPLEFIRST PHARMACY 2501 HEBRON PARKWAY 75010 972 300-4130 N

ELEVATE PROVIDER NETWORK CARROLLTON RITE CARE PHARMACY 1205 N JOSEY LN STE B 750066145 214 483-3000 N COMMUNITY INDEPENDENT PHARMACY

NETW CARROLLTON SAVON PHARMACY 2150 N JOSEY LN 75006 972 446-8231 N

ALBERTSONS LLC CARROLLTON SMILE PHARMACY 2625 OLD DENTON RD STE 586 75007 972 446-9191 N

ELEVATE PROVIDER NETWORK CARROLLTON TRINITY PHARMACY 1925 E ROSEMEADE PKY 750072499 972 492-4411 N

ACCESSHEALTH PLUS CARROLLTON WAL-MART PHARMACY 1213 E TRINITY MILLS ROAD 75006 972 245-2323 N

WALMART STORES INC CARROLLTON WAL-MART PHARMACY 4025 OLD DENTON RD 750071023 469 557-7719 N

WALMART STORES INC CARROLLTON WAL-MART PHARMACY 10-2625 1025 W TRINITY MILLS RD 750061375 800 273-3455 N

WALMART STORES INC CARTHAGE CVS PHARMACY 801 W PANOLS ST 75633 903 693-2611 N

CVS PHARMACY INC CARTHAGE WAL-MART PHARMACY 10-0523 4609 NW LOOP 436 75633 903 693-6502 N

WALMART STORES INC CASTLE HILLS CVS PHARMACY 6915 W AVE 78213 210 341-1487 N

CVS PHARMACY INC CASTROVILLE QRC HEALTHMART PHARMACY 408 US HIGHWAY 90 W STE B 78009 830 931-2116 N

ACCESSHEALTH CEDAR HILL CVS PHARMACY 385 E BELT LINE RD 75104 972 299-5347 N

CVS PHARMACY INC CEDAR HILL KROGER PHARMACY 235 E FM 1382 75104 972 291-0224 N

THE KROGER CO CEDAR HILL MORNING STAR PHARMACY 329 N HIGHWAY 67 STE 150 751042187 972 291-2525 N

ACCESSHEALTH PLUS CEDAR HILL RITE CARE PHARMACY II 716 N HIGHWAY 67 751042141 972 291-0100 N COMMUNITY INDEPENDENT PHARMACY

NETW CEDAR HILL SAVON PHARMACY 427 E FM 1382 75104 972 291-0241 N

ALBERTSONS LLC

Page 18: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CEDAR HILL TARGET PHARMACY 739 N HIGHWAY 67 75104 972 291-6813 N

TARGET PHARMACIES CEDAR HILL WAL-MART PHARMACY 621 UPTOWN BLVD 75104 469 272-7380 N

WALMART STORES INC CEDAR HILL WALMART PHARMACY 10-3204 820 E BELT LINE RD 751042215 479 204-8550 N

WALMART STORES INC CEDAR PARK COSTCO PHARMACY #1152 4601 183A TOLL ROAD BUIDLING

A 78613 512 690-9083 N

COSTCO PHARMACIES CEDAR PARK CPRX PHARMACY 351 CYPRESS CREEK RD 786134544 512 382-7393 N

TPN CEDAR PARK CVS PHARMACY 851 S BELL BLVD 78613 512 219-9232 N

CVS PHARMACY INC CEDAR PARK CVS PHARMACY 1950 BAGDAD RD 78613 512 528-1193 N

CVS PHARMACY INC CEDAR PARK HEB PHARMACY 170 E WHITESTONE 78613 512 259-5755 N

HEB GROCERY COMPANY LP CEDAR PARK HEB PHARMACY 2800 E WHITESTONE 78613 512 528-0150 N

HEB GROCERY COMPANY LP CEDAR PARK SPECIALTY COMPOUNDING 211 S BELL BLVD 786132909 512 219-0724 N

ACCESSHEALTH PLUS CEDAR PARK TARGET PHARMACY 1101 C BAR RANCH TRAIL 78613 512 456-2934 N

TARGET PHARMACIES CEDAR PARK WAL-MART PHARMACY 201 WALTON WAY 78613 512 528-8794 N

WALMART STORES INC CEDAR PARK WALMART PHARMACY 10-4163 2801 E WHITESTONE BLVD 786137273 512 690-9345 N

WALMART STORES INC CELINA BROOKSHIRES PHARMACY 675 SUNSET BLVD 75009 972 382-3989 N

BROOKSHIRE GROCERY COMPANY CELINA CELINA DRUG 701 N PRESTON RD 750090358 972 382-2832 N

ELEVATE PROVIDER NETWORK CELINA CVS PHARMACY # 310 S PRESTON RD 75009 972 382-8668

CVS PHARMACY INC CENTER CVS PHARMACY 640 HURST ST 75935 936 598-6254 N

CVS PHARMACY INC CENTER WAL-MART PHARMACY 10-0364 810 HURST ST 75935 936 598-2921 N

WALMART STORES INC CENTERVILLE CAROLS PHARMACY 316 S COMMERCE 758330535 903 536-7326 N

THIRD PARTY STATION CHANDLER BROOKSHIRES PHARMACY 703 HWY 31 EAST 75758 903 849-4090 N

BROOKSHIRE GROCERY COMPANY CHANDLER CHANDLER DRUG, LLC 201 HWY 31 E 75758 903 849-6442 N

LEADER DRUG STORES INC CHANNELVIEW CHANNELVIEW PHARMACY 441 SHELDON RD 77530 281 457-0523 N COMMUNITY INDEPENDENT PHARMACY

NETW CHANNELVIEW CVS PHARMACY 814 SHELDON RD 77530 281 452-7184 N

CVS PHARMACY INC CHILDRESS CHILDRESS OUTPOST PHARMACY 805 HIGHWAY 83 NORTH 79201 940 937-9030 N

ELEVATE PROVIDER NETWORK CHILDRESS UNITED PHARMACY 2105 AVE F NW 79201 940 937-8242 N

UNITED PHARMACY TX CHILDRESS WAL-MART PHARMACY 2801 AVE F 79201 940 937-6168 N

WALMART STORES INC CHINA CHINA FAMILY PHARMACY 207 E RAILROAD 77613 409 752-3450 N

TRINET CIBOLO CVS PHARMACY # 200 CIBOLO VALLEY DRIVE 78108 210 566-1585

CVS PHARMACY INC CIBOLO TRIANGLE PHARMACY SOLUTIONS LLC 791 FM 1103 STE 121 781080000 210 659-9588 N COMMUNITY INDEPENDENT PHARMACY

NETW CIBOLO WALMART PHARMACY 10-4115 602 CIBOLO VALLEY DR 781083801 479 204-8550 N

WALMART STORES INC CISCO BROOKSHIRES PHARMACY 1010 AVE E 76437 254 442-2251 N

BROOKSHIRE GROCERY COMPANY CLARENDON CLARENDON OUTPOST 619 W 2ND ST 79226 806 874-5202 N

ELEVATE PROVIDER NETWORK

Page 19: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CLARKSVILLE MEDICINE CHEST 1909 W BROADWAY ST 75426 903 427-2050 N

ELEVATE PROVIDER NETWORK CLEAR LAKE SHORES TARGET PHARMACY 255 MARINE BAY DRIVE 77565 281 538-7957 N

TARGET PHARMACIES CLEBURNE BEST VALUE ROYCES PHARMACY 502 N MAIN 760333806 817 645-2445 N

ELEVATE PROVIDER NETWORK CLEBURNE CLEBURNE DRUG 501 N RIDGEWAY 76033 817 645-2415 N

ELEVATE PROVIDER NETWORK CLEBURNE CVS PHARMACY 614 W HENDERSON ST 760334848 817 645-2419 N

CVS PHARMACY INC CLEBURNE HEB PHARMACY 600 W HENDERSON 76033 817 641-4036 N

HEB GROCERY COMPANY LP CLEBURNE KROGER PHARMACY 1617 W HENDERSON ST 760334122 817 641-0700 N

THE KROGER CO CLEBURNE SAVON PHARMACY 210 W KATHERINE P RAINES 76033 817 641-6030 N

ALBERTSONS LLC CLEBURNE WAL-MART PHARMACY 10-0228 1616 W HENDERSON 76031 817 558-9994 N

WALMART STORES INC CLEVELAND CLEVELAND PHARMACY 111 S WILIIAM BARNETT AVE 77327 281 593-3800 N

ACCESSHEALTH PLUS CLEVELAND CVS PHARMACY 108 N WASHINGTON AVE 77327 281 592-5279 N

CVS PHARMACY INC CLEVELAND WAL-MART PHARMACY 10-0249 831 HWY 59 SOUTH 77327 281 592-2636 N

WALMART STORES INC CLIFTON ALBRECHTS PHARMACY 506 W 5TH ST 766340273 254 675-8398 N

ACCESSHEALTH PLUS CLIFTON BROOKSHIRES PHARMACY 900 FM 3220 76634 254 675-3007 N

BROOKSHIRE GROCERY COMPANY CLIFTON PILL BOX DRIVE IN PHARMACY INC 210 POSEY AVE 76634 254 675-8659 N

THIRD PARTY STATION CP CLUTE KROGER PHARMACY 101 DIXIE DR 77531 979 265-2519 N

THE KROGER CO CLYDE LAWRENCE BROS. PHARMACY 505 S ACCESS RD 79510 325 893-4297 N

LEADER DRUG STORES INC COLEMAN THE OWL DRUG STORE 312 COMMERCIAL AVE 76834 325 625-9448 N

THIRD PARTY STATION COLEMAN TYSON PHARMACY 215 W PECAN ST 768344147 325 625-4136 N

ACCESSHEALTH PLUS COLLEGE STATION CVS PHARMACY 2411 TEXAS AVE S 77840 979 693-8085 Y

CVS PHARMACY INC COLLEGE STATION CVS PHARMACY 1800 ROCK PRAIRIE RD 77845 979 696-1075 N

CVS PHARMACY INC COLLEGE STATION CVS PHARMACY # 717 UNIVERSITY DR 778401477 979 721-9125

CVS PHARMACY INC COLLEGE STATION HEB PHARMACY 949 WILLIAM D FITCH PKWY 77845 979 690-4690 N

HEB GROCERY COMPANY LP COLLEGE STATION HEB PHARMACY 1900 TEXAS AVE 77840 979 693-1238 N

HEB GROCERY COMPANY LP COLLEGE STATION KROGER PHARMACY 2412 TEXAS AVE 77840 979 693-9976 N

THE KROGER CO COLLEGE STATION KROGER PHARMACY 3535 LONGMIRE DR 77845 979 485-8813 N

THE KROGER CO COLLEGE STATION SAMS PHARMACY 1405 EARL RUDDER FREEWAY 77845 979 696-0128 N

WALMART STORES INC COLLEGE STATION SCOTT & WHITE PHARMACY #276 1296 ARRINGTON RD 77845 979 361-6301 N

LEADER DRUG STORES INC COLLEGE STATION SCOTT & WHITE PHARMACY #277 1110 EARL RUDDER FREEWAY S 77840 979 691-3900 N

LEADER DRUG STORES INC COLLEGE STATION TARGET PHARMACY 2100 TEXAS AVE S 77840 979 696-4368 N

TARGET PHARMACIES COLLEGE STATION WAL-MART PHARMACY 1815 BROTHERS BLVD 77845 979 693-3841 N

WALMART STORES INC COLLEYVILLE DYM PHARMACY 5017 HERITAGE AVE STE CON1 760345994 817 571-9100 N

TRINET COLLEYVILLE SAVON PHARMACY #0070 4000 GLADE RD 76034 817 354-0109 N

ALBERTSONS LLC

Page 20: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network COLLEYVILLE UNITED MARKETSTREET PHARMACY 5605 COLLEYVILLE BLVD 76034 817 577-5030 N

UNITED PHARMACY TX COLLEYVILLE VILLAGE LANE APOTHECARY 60 VILLAGE LN 760342928 817 717-2000 N

ELEVATE PROVIDER NETWORK COLLEYVILLE WAL-MART PHARMACY 4904 COLLEYVILLE BLVD 760343938 817 770-8339 N

WALMART STORES INC COLORADO CITY CORNER DRUG 1001 HICKORY 79512 325 728-8030 N

ACCESSHEALTH PLUS COLORADO CITY MEDICINE PLACE 2250 CHESTNUT ST 79512 325 728-3489 N

ELEVATE PROVIDER NETWORK COLUMBUS WAL-MART PHARMACY 10-0503 2103 MILAM ST 78934 979 732-8319 N

WALMART STORES INC COMANCHE BROOKSHIRES PHARMACY 404 W CENTRAL 76442 325 356-5276 N

BROOKSHIRE GROCERY COMPANY COMANCHE COMANCHE COUNTY MEDIAL CENTER

PHARMACY 10201 HIGHWAY 16 NORTH 76442 254 879-4961 N

ACCESSHEALTH PLUS COMANCHE COMANCHE PHARMACY 1001 N AUSTIN 764421701 325 356-2585 N

ELEVATE PROVIDER NETWORK COMFORT THE DRUG SHOP 404 HIGHWAY 27 78013 830 995-3300 N

ELEVATE PROVIDER NETWORK COMMERCE BROOKSHIRES PHARMACY 1603 CULVER ST 75428 903 886-2867 N

BROOKSHIRE GROCERY COMPANY COMMERCE CVS PHARMACY # 2710 HIGHWAY 24 75428 903 886-0718

CVS PHARMACY INC COMMERCE TOTALCARE PHARMACY 1607 LIVE OAK ST 75428 903 886-8888 N COMMUNITY INDEPENDENT PHARMACY

NETW COMMERCE WAL-MART PHARMACY 10-0240 2701 HWY 50 75428 903 886-7732 N

WALMART STORES INC CONROE 3D&S SUPREME PHARMACY 203 E DAVIS ST 773013159 936 494-3781 N

TRINET CONROE COLLEGE PARK PHARMACY 3115 COLLEGE PARK DR 77384 936 321-4011 N

THIRD PARTY STATION CONROE COSTCO PHARMACY #1189 8185 SH 242 77385 936 703-2305 N

COSTCO PHARMACIES CONROE CVS PHARMACY 2110 N FRAZIER 773011203 936 760-3101 N

CVS PHARMACY INC CONROE CVS PHARMACY 910 W DAVIS ST 77301 936 539-1849 N

CVS PHARMACY INC CONROE CVS PHARMACY # 9884 HIGHWAY 242 77385 936 273-5444

CVS PHARMACY INC CONROE GHPMA PHARMACY 3251 I-45 N STE 190 77304 936 788-7700 N

TRINET CONROE HEB PHARMACY 2108 N FRAZIER 77301 936 756-1435 N

HEB GROCERY COMPANY LP CONROE HEB PHARMACY 3875 W DAVIS ST 773041837 936 760-6810 N

HEB GROCERY COMPANY LP CONROE KROGER PHARMACY 3830 W DAVIS ST 77304 936 756-7233 N

THE KROGER CO CONROE KROGER PHARMACY 2222 I 45 N 77301 936 441-7379 N

THE KROGER CO CONROE KROGER PHARMACY 220 S LOOP 336 77304 936 756-5574 N

THE KROGER CO CONROE MEDICAP PHARMACY 2105 W DAVIS ST STE A 77304 936 494-4002 N

MEDICAP PHARMACIES INC CONROE RICHIE'S SPECIALTY PHARMACY 12820 HIGHWAY 105 W 773041574 936 588-6337 N

ELEVATE PROVIDER NETWORK CONROE ROBERDS PHARMACY LP 503 MEDICAL CENTER BLVD STE

130 77304 936 756-4254 N

THIRD PARTY STATION CP CONROE SAMS PHARMACY 2000 WESTVIEW BLVD 77304 936 539-9429 N

WALMART STORES INC CONROE VILLAGE PHARMACY 404 RIVER POINTE 77304 936 756-7456 N

ACCESSHEALTH CONROE WAL-MART PHARMACY 10-0400 1407 LOOP 336 WEST 77304 936 760-2112 N

WALMART STORES INC

Page 21: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CONVERSE CVS PHARMACY # 8027 KITTY HAWK RD 78109 210 566-3615

CVS PHARMACY INC CONVERSE WAL-MART PHARMACY 8315 FM 78 78109 210 666-6507 N

WALMART STORES INC COOPER MILLERS PHARMACY 102 E DALLAS AVE 754322043 903 395-2161 N

ACCESSHEALTH PLUS COPPELL CVS PHARMACY 290 N DENTON TAP RD 75019 972 745-6566 N

CVS PHARMACY INC COPPELL CVS PHARMACY 1000 E SANDY LAKE RD 75019 972 304-1061 N

CVS PHARMACY INC COPPELL DAVITA RX 1234 LAKESHORE DR 75019 972 538-8100 N

ELEVATE PROVIDER NETWORK COPPELL FIFTY50 PHARMACY 440 WRANGLER DR 750197606 972 243-2727 N

ELEVATE PROVIDER NETWORK COPPELL KROGER PHARMACY 950 E SANDY LAKE RD 75019 972 304-0823 N

THE KROGER CO COPPELL PHARMACY PLUS #7 580 S DENTON TAP RD 75019 972 462-9400 N

ELEVATE PROVIDER NETWORK COPPELL UNITED MARKET STREET PHARMACY 700 N DENTON TAP ROAD 75019 469 322-6815 N

UNITED PHARMACY TX COPPERAS COVE CVS PHARMACY # 1407 E HIGHWAY 190 765222341 254 542-0099

CVS PHARMACY INC COPPERAS COVE HEB PHARMACY 2990 E HWY 190 76522 254 547-9755 N

HEB GROCERY COMPANY LP COPPERAS COVE MEDICAL ARTS PHARMACY 806 E AVE D 765222231 254 547-4146 N COMMUNITY INDEPENDENT PHARMACY

NETW COPPERAS COVE WAL-MART PHARMACY 10-0381 2720 E HWY 190 76522 254 542-7697 N

WALMART STORES INC CORINTH SAVON PHARMACY 4351 FM 2181 76210 940 321-4361 N

ALBERTSONS LLC CORPUS CHRISTI AMERICAN SPECIALTY PHARMACY 1521 S STAPLES ST STE 605 784043166 361 221-4778

TPN CORPUS CHRISTI CORPUS CHRISTI PAIN MEDICINE P A 3825 S PADRE ISLAND DR 784152913 361 225-0089 N

EMEDRX SOLUTIONS CORPUS CHRISTI CVS PHARMACY 4102 AYERS ST 78415 361 855-6261 N

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 2102 AIRLINE RD 78414 361 993-6661 Y

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 6601 EVERHART RD STE E 78413 361 857-5691 N

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 4101 IH 69 ACCESS RD 78410 361 241-9381 N

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 4801 S ALAMEDA ST 78412 361 992-5729 N

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 14525 S PADRE ISLAND DR 78418 361 939-8178 N

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY 4166 S STAPLES ST 78411 361 854-5318 Y

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY # 7442 S STAPLES ST 78413 361 991-0289 Y

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY # 7798 S PADRE ISLAND DR 78412 361 986-0000

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY # 3205 S ALAMEDA ST 784042507 361 814-8305

CVS PHARMACY INC CORPUS CHRISTI CVS PHARMACY # 1240 S PORT AVE 784052308 361 882-2586 N

CVS PHARMACY INC CORPUS CHRISTI DELEON PHARMACY 613 ELIZABETH ST 78404 361 882-3636 N

ELEVATE PROVIDER NETWORK CORPUS CHRISTI HAMLIN PHARMACY AND FOUNTAIN 3801 S STAPLES ST 784112391 361 853-7303 N

ELEVATE PROVIDER NETWORK CORPUS CHRISTI HEB PHARMACY 5801 WEBER RD 78413 361 854-8441 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 3133 S ALAMEDA 78404 361 852-1696 N

HEB GROCERY COMPANY LP

Page 22: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CORPUS CHRISTI HEB PHARMACY 3033 S PORT ST 78405 361 883-0875 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 4444 KOSTORYZ RD 78415 361 855-6121 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 11158 LEOPARD ST 78410 361 241-0378 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 1145 WALDRON 78418 361 939-5555 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 5313 SARATOGA 78413 361 993-1351 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 4320 S ALAMEDA 78412 361 993-8515 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 3500 LEOPARD ST 78408 361 883-7196 N

HEB GROCERY COMPANY LP CORPUS CHRISTI HEB PHARMACY 5425 S PADRE ISLAND DR 78411 361 992-6996 N

HEB GROCERY COMPANY LP CORPUS CHRISTI KELLY'S PHARMACY 520 EVERHART 78411 361 334-4500 N

THIRD PARTY STATION CP CORPUS CHRISTI NICHOLS SOUTHSIDE PHARMACY 3141 GOLLIHAR RD 784155099 361 852-8288 N

TRINET CORPUS CHRISTI RC PHARMACY 5633 S STAPLES ST 784114646 361 334-3493 N

ACCESSHEALTH PLUS CORPUS CHRISTI RECEPT PHARMACY 3301 S ALAMEDA ST STE 100B 784111882 361 853-9269 N

RECEPT HEALTHCARE SERVICES CORPUS CHRISTI SAMS PHARMACY 4833 S PADRE ISLAND DR 784114201 361 855-7995 N

WALMART STORES INC CORPUS CHRISTI SUNRISE PHARMACY INC 2601 HOSPITAL BLVD 107 78405 361 887-9226 N

ACCESSHEALTH PLUS CORPUS CHRISTI TARGET PHARMACY 5425 S PADRE ISLAND DR STE D 78411 361 980-8979 N

TARGET PHARMACIES CORPUS CHRISTI WAL-MART PHARMACY 4109 S STAPLES ST 78411 361 994-9015 N

WALMART STORES INC CORPUS CHRISTI WAL-MART PHARMACY 10-0464 3829 US HWY 77 78410 361 387-4920 N

WALMART STORES INC CORPUS CHRISTI WAL-MART PHARMACY 10-0470 1821 S PADRE ISLAND DR 784161352 361 854-5804 N

WALMART STORES INC CORPUS CHRISTI WAL-MART PHARMACY 10-0490 1250 FLOUR BLUFF DR 78418 361 937-2626 N

WALMART STORES INC CORPUS CHRISTI WALMART PHARMACY 10-5898 6101 SARATOGA RD 78412 361 445-3307 N

WALMART STORES INC CORSICANA BROOKSHIRES PHARMACY 800A N MAIN 75110 903 874-1111 N

BROOKSHIRE GROCERY COMPANY CORSICANA CVS PHARMACY 601 W 7TH AVE 75110 903 874-6597 N

CVS PHARMACY INC CORSICANA HEB PHARMACY 201 S 15TH ST 75110 903 874-6546 N

HEB GROCERY COMPANY LP CORSICANA HOMETOWN PHARMACY 2800 HWY 22 WEST 75110 903 872-3784 N

ELEVATE PROVIDER NETWORK CORSICANA SUPER 1 PHARMACY 100 N 15TH 75110 903 874-2152 N

BROOKSHIRE GROCERY COMPANY CORSICANA WAL-MART PHARMACY 10-0565 3801 W HWY 31 75110 903 874-8239 N

WALMART STORES INC COTULLA GADDIS PHARMACY 302 N MAIN ST 780142198 830 879-2323 N

ELEVATE PROVIDER NETWORK CRANDALL CRANDALL PHARMACY 1317 HWY 175 STE 1000 75114 972 427-6442 N

ELEVATE PROVIDER NETWORK CROCKETT DAVY CROCKETT DRUG INC 107 S 4TH ST 758352050 936 544-2275 N

LEADER DRUG STORES INC CROCKETT WAL-MART PHARMACY 10-0236 1225 E LOOP 304 75835 936 544-5661 N

WALMART STORES INC CROSBY CVS PHARMACY 14630 FM 2100 77532 281 328-4854 N

CVS PHARMACY INC CROSBY WAL-MART PHARMACY 10-0522 14215 FM 2100 77532 281 328-3529 N

WALMART STORES INC CROSBYTON REGIONAL PHARMACY 622 W MAIN ST 793220379 806 675-2001 N

ACCESSHEALTH PLUS

Page 23: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CROSS PLAINS LARSON'S PHARMACY 109 NE 2ND ST 764432401 254 725-7130 N

LEADER DRUG STORES INC CROSS ROADS CVS PHARMACY # 11101 US 380 76227 940 365-5762

CVS PHARMACY INC CROSS ROADS WALMART PHARMACY 10-5707 11700 US HIGHWAY 380 76227 940 488-7011 N

WALMART STORES INC CROWLEY CVS PHARMACY 825 S CROWLEY RD 76036 817 297-2281 N

CVS PHARMACY INC CROWLEY KROGER PHARMACY 1004 S CROWLEY RD 76036 817 297-0006 N

THE KROGER CO CROWLEY WAL-MART PHARMACY 1221 FM 1187 E 760364370 682 233-7841 N

WALMART STORES INC CUERO HEB PHARMACY #712 909 E BROADWAY ST 779542126 361 275-8934 N

HEB GROCERY COMPANY LP CUERO REUSS PHARMACY 515 N ESPLANADE ST 779543603 361 275-3411

ACCESSHEALTH PLUS CUERO WAL-MART PHARMACY 10-0385 1202 E BROADWAY 77954 361 275-9260 N

WALMART STORES INC CYPRESS A PLUS PHARMACY 8190 BARKER CYPRESS RD STE

800 774332280 281 858-5353 N

THIRD PARTY STATION CP CYPRESS BC PHARMACY INC. 14030 TELGE RD STE E 774296201 832 334-5695 N

TRINET CYPRESS BGC PHARMACY LLC 12101 GRANT RD 77429 281 257-4299

TRINET CYPRESS CVS PHARMACY 16155 SPRING CYPRESS RD 77429 281 256-3070 N

CVS PHARMACY INC CYPRESS CVS PHARMACY 13757 CYPRESS N HOUSTON RD 77429 281 890-3467 N

CVS PHARMACY INC CYPRESS CVS PHARMACY 26265 NORTHWEST FREEWAY 77429 281 758-0092 N

CVS PHARMACY INC CYPRESS CVS PHARMACY 8960 BARKER CYPRESS RD 77433 281 656-3520 N

CVS PHARMACY INC CYPRESS CVS PHARMACY 12550 LOUETTA RD 77429 281 257-7792 N

CVS PHARMACY INC CYPRESS CVS PHARMACY 7010 FRY RD 77433 281 345-1119 N

CVS PHARMACY INC CYPRESS CVS PHARMACY # 10515 FRY RD 77433 401 765-1500

CVS PHARMACY INC CYPRESS CY SPRINGS PHARMACY 7630 FRY RD STE 500 774333376 832 427-6694 N

TRINET CYPRESS CYPRESS PHARMACY 17330 SPRING CYPRESS ROAD 77429 281 213-3490 N

ACCESSHEALTH PLUS CYPRESS HEB PHARMACY 14100 SPRING CYPRESS RD 77429 281 320-3700 N

HEB GROCERY COMPANY LP CYPRESS HEB PHARMACY 24224 NORTHWEST FREEWAY 77429 281 758-1155 N

HEB GROCERY COMPANY LP CYPRESS HEB PHARMACY 28550 HIGHWAY 290 77433 281 256-6490 N

HEB GROCERY COMPANY LP CYPRESS HEB PHARMACY #709 9722 FRY RD 774334847 281 373-2102 N

HEB GROCERY COMPANY LP CYPRESS KROGER PHARMACY 13135 LOUETTA ROAD 77429 281 379-7756 N

THE KROGER CO CYPRESS KROGER PHARMACY 17455 SPRING CYPRESS 77429 281 304-0971 N

THE KROGER CO CYPRESS KROGER PHARMACY 18030 FM529 77433 281 550-6942 N

THE KROGER CO CYPRESS KROGER PHARMACY #115 9703 BARKER CYPRESS RD 774331214 281 746-3645 N

THE KROGER CO CYPRESS KROGER PHARMACY #179 20355 CYPRESSWOOD DR 774336477 713 507-6276 N

THE KROGER CO CYPRESS MEDI PRO INTERNATIONAL PHARMACY 13203 FRY RD STE 400 774333690 281 277-0111 N

ELEVATE PROVIDER NETWORK CYPRESS NORTH CYPRESS VILLAGE PHARMACY 21212 NORTHWEST FWY STE 101 774295884 832 912-6210 N

ELEVATE PROVIDER NETWORK

Page 24: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network CYPRESS RX ONE PHARMACY 9740 BARKER CYPRESS ROAD 774331974 281 656-2000 N COMMUNITY INDEPENDENT PHARMACY

NETW CYPRESS TARGET PHARMACY 25901 HIGHWAY 290 77429 281 256-8102 N

TARGET PHARMACIES CYPRESS WAL-MART PHARMACY 26270 NORTHWEST FREEWAY 77429 281 304-9664 N

WALMART STORES INC CYPRESS WAL-MART PHARMACY 13742 N ELDRIDGE PKWY 77429 281 655-8758 N

WALMART STORES INC CYPRESS WALMART PHARMACY 10-4465 11425 BARKER CYPRESS RD 77433 832 349-7189 N

WALMART STORES INC CYPRESS WALMART PHARMACY 10-7357 8208 BARKER CYPRESS RD 774331211 281 500-7991 N

WALMART STORES INC DAINGERFIELD BROOKSHIRES PHARMACY 609 LINDA DRIVE 75638 903 645-4552 N

BROOKSHIRE GROCERY COMPANY DALHART UNITED PHARMACY 1601 TENNESSEE 79022 806 249-4772 N

UNITED PHARMACY TX DALLAS ACORN PHARMACY 5315 ROSS AVE 75206 214 887-0744 N

ELEVATE PROVIDER NETWORK DALLAS AHF PHARMACY 3920 CEDAR SPRINGS RD 75219 214 599-7020 N

LEADER DRUG STORES INC DALLAS AMERICA MEDS DIRECT RX 5728 LYNDON B JOHNSON FWY 752406323 866 321-1732 N

ACCESSHEALTH PLUS DALLAS AMERICAN CUSTOM COMPOUNDING

PHARMACY 2607 WALNUT HILL LN STE 220 752297615 214 366-0022 N

TRINET DALLAS AMERICAN SPECIALTY PHARMACY 7125 MARVIN D LOVE FWY STE

105 75237 469 779-2044

TPN DALLAS APEX PHARMA 5710 LYNDON B JOHNSON FWY 752406324 469 425-9587 N

ACCESSHEALTH PLUS DALLAS AVITA DRUGS 219 SUNSET AVE STE 118-A 752084599 214 943-5187 N

ACCESSHEALTH PLUS DALLAS BAYLOR SCOTT & WHITE PHARMACY #101 3600 GASTON AVE STE 109 #

LB12 75246 214 820-3451 N

LEADER DRUG STORES INC DALLAS BROOKHAVEN APOTHECARY & SURGICAL

SHOP 4373 S HAMPTON RD STE 1 752321058 972 620-2121 N

ACCESSHEALTH PLUS DALLAS BUCKNER NEIGHBORHOOD PHARMACY 3535 N BUCKNER BLVD 75228 214 321-3000 N

ELEVATE PROVIDER NETWORK DALLAS CARECENTER PHARMACY LLC 208 S AKARD ST 75202 214 741-4912

CVS PHARMACY INC DALLAS CVS PHARMACY 7102 CAMPBELL RD 75248 972 931-7045 N

CVS PHARMACY INC DALLAS CVS PHARMACY 17410 MARSH LN 75287 972 306-4931 N

CVS PHARMACY INC DALLAS CVS PHARMACY 10455 N CENTRAL EXPY 75231 214 369-3872 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 5429 ROSS AVE 75206 214 823-9995 N

CVS PHARMACY INC DALLAS CVS PHARMACY 6004 SAMUELL BLVD 75228 214 388-0411 N

CVS PHARMACY INC DALLAS CVS PHARMACY 5659 LEMMON AVE 75209 214 252-0121 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 14041 NOEL RD 75240 972 387-4006 N

CVS PHARMACY INC DALLAS CVS PHARMACY 13033 COIT RD 75240 972 392-9634 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 4610 FRANKFORD RD 75287 972 732-6197 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 8024 WALNUT HILL LANE 75231 214 368-3050 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 4207 LEMMON AVE 75219 214 528-0328 N

CVS PHARMACY INC DALLAS CVS PHARMACY 10014 GARLAND RD 75218 214 320-8690 N

CVS PHARMACY INC

Page 25: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DALLAS CVS PHARMACY 1235 S BUCKNER BLVD 75217 214 391-2151 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 8335 WESTCHESTER DRIVE STE

140 75225 214 361-7110 N

CVS PHARMACY INC DALLAS CVS PHARMACY 4202 ROSS AVE 75204 214 584-2480 N

CVS PHARMACY INC DALLAS CVS PHARMACY 5111 GREENVILLE AVE STE 140 75206 214 691-0861 N

CVS PHARMACY INC DALLAS CVS PHARMACY 2427 W JEFFERSON BLVD 75211 214 943-2883 N

CVS PHARMACY INC DALLAS CVS PHARMACY 6709 PRESTON RD 75205 214 521-4085 N

CVS PHARMACY INC DALLAS CVS PHARMACY 7203 SKILLMANS ST 75231 214 349-4400 N

CVS PHARMACY INC DALLAS CVS PHARMACY 11661 PRESTON RD STE 218 75230 214 363-1571 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 10003 MARSH LN 75229 214 358-4865 N

CVS PHARMACY INC DALLAS CVS PHARMACY 1411 MAIN ST 75202 214 749-4092 N

CVS PHARMACY INC DALLAS CVS PHARMACY 10306 FERGUSON RD 75228 214 328-4391 N

CVS PHARMACY INC DALLAS CVS PHARMACY 2323 W ILLINOIS AVE 75224 214 331-5466 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 3798 FOREST LN 75244 214 357-4667 N

CVS PHARMACY INC DALLAS CVS PHARMACY 6120 E MOCKINGBIRD LN 75214 214 887-6955 Y

CVS PHARMACY INC DALLAS CVS PHARMACY 5370 W LOVERS LN STE 310 75209 214 358-0263 N

CVS PHARMACY INC DALLAS CVS PHARMACY 6832 SNIDER PLZ 75205 214 363-1524 N

CVS PHARMACY INC DALLAS CVS PHARMACY 3012 MOCKINGBIRD LN 75205 214 363-5525 N

CVS PHARMACY INC DALLAS CVS PHARMACY 10666 E NORTHWEST HWY 75238 214 349-2530 N

CVS PHARMACY INC DALLAS CVS PHARMACY # 15105 PRESTON RD 752484832 972 763-1527 Y

CVS PHARMACY INC DALLAS CVS PHARMACY # 9390 FOREST LN 75243 214 341-3600 N

CVS PHARMACY INC DALLAS CVS PHARMACY # 6420 GASTON AVE 752144022 469 334-0758

CVS PHARMACY INC DALLAS CVS PHARMACY # 8555 FERGUSON RD 75228 214 320-0892 N

CVS PHARMACY INC DALLAS CVS PHARMACY # 4930 MAPLE AVE 752358211 214 520-4840

CVS PHARMACY INC DALLAS CVS PHARMACY # 5050 S LANCASTER RD 75216 214 375-8924

CVS PHARMACY INC DALLAS CVS PHARMACY # 2350 N FITZHUGH AVE 75206 214 515-5574

CVS PHARMACY INC DALLAS CVS PHARMACY # 3133 E LEMMON AVE 752041411 214 599-2108

CVS PHARMACY INC DALLAS CVS PHARMACY # 00296 2420 W WHEATLAND RD 752373609 972 780-1325

CVS PHARMACY INC DALLAS CVS PHARMACY # 07149 2899 FOREST LN 752347501 972 241-0175

CVS PHARMACY INC DALLAS CYPRESS POINT RX 2225 VATICAN 752244719 817 375-2036 N

RECEPT HEALTHCARE SERVICES DALLAS DALLAS HEALTHCARE PHARMACY 4131 S BUCKNER 75227 214 388-5334 N

ELEVATE PROVIDER NETWORK DALLAS DOCTORS SPECIALTY PHARMACY 9101 N CENTRAL EXPY STE 565 752315927 214 363-3700 N

TPN DALLAS DOUGHERTYS PHARMACY 5959 ROYAL LN STE 515 75230 214 373-5300 N

LEADER DRUG STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DALLAS DOUGHERTY'S PHARMACY FOREST PARK

DALLAS 11970 N CENTRAL EXPY STE 100 752433714 469 248-1000 N

LEADER DRUG STORES INC DALLAS ELAM ROAD PHARMACY 9209 ELAM ROAD 75217 214 391-6363 N

ELEVATE PROVIDER NETWORK DALLAS FAMILY CARE PHARMACY 9991 MARSH LN 752201709 214 357-3303 N

THIRD PARTY STATION DALLAS FAMILY PHARMACY #3 5101 ROSS AVE STE 100 752067762 972 833-7779 N

TRINET DALLAS FIRST CHOICE PHARMACY 6029 BELT LINE RD STE 110 752547871 214 888-6976 N

AMERICAN PHARMACY NETWORK SOLUTIONS DALLAS FOREST DRUG STORE LLC 9550 FOREST LN STE 606 752436176 469 729-2769 N

THIRD PARTY STATION CP DALLAS FORNEY PHARMACY 13601 PRESTON RD STE 720E 752404920 972 552-2666 N

EPIC PHARMACY NETWORK INC DALLAS GASTON PHARMACY 712 N WASHINGTON AVE 75246 214 434-1964 N

EPIC PHARMACY NETWORK INC DALLAS GENPHARM PHARMACY 3920 W WHEATLAND RD 752373401 972 572-9006 N

ACCESSHEALTH PLUS DALLAS GLOBE PHARMACY 2223 SINGLETON BLVD 752123783 972 290-0862 N

ELEVATE PROVIDER NETWORK DALLAS GROVE MEDICAL CENTER PHARMACY 1143 S BUCKNER BLVD 752174398 214 391-2414 N

TRINET DALLAS GUARDIAN PHARMACY SERVICES 7920 ELMBROOK DR STE 108 752474933 214 521-2133 N

THIRD PARTY STATION DALLAS HAMPTON ALLIED PHARMACY INC 3030 LBJ FREEWAY #880 75234 214 330-7700 N

THIRD PARTY STATION CP DALLAS KK'S PHARMACY #51 2480 W ILLINOIS AVE 752331106 214 337-7770 N

ELEVATE PROVIDER NETWORK DALLAS KROGER PHARMACY 9140 FOREST LANE 75243 214 221-0978 N

THE KROGER CO DALLAS KROGER PHARMACY 3939 FRANKFORD RD 75287 972 662-1011 N

THE KROGER CO DALLAS KROGER PHARMACY 752 WYNNEWOOD VILLAGE 75224 214 942-3191 N

THE KROGER CO DALLAS KROGER PHARMACY 4142 CEDAR SPRINGS 75219 214 599-9861 N

THE KROGER CO DALLAS KROGER PHARMACY 5665 E MOCKINGBIRD LANE 75206 214 826-2967 N

THE KROGER CO DALLAS KROGER PHARMACY 4241 CAPITAL AVE 75204 972 338-3101 N

THE KROGER CO DALLAS KROGER PHARMACY 4901 MAPLE AVE 752358210 972 725-1270 N

THE KROGER CO DALLAS KROGER PHARMACY #511 10677E NORTHWEST HWY 752384812 214 553-0997 N

THE KROGER CO DALLAS KROGER PHARMACY #689 17194 PRESTON RD 752481221 972 931-9371 N

THE KROGER CO DALLAS LOT PHARMA 5710 LBJ FREEWAY 75240 214 888-8100 N

TRINET DALLAS M & M PHARMACY 8150 BROOKRIVER DR STE 107 752474068 469 547-2419 N

ELEVATE PROVIDER NETWORK DALLAS MAPLEWOOD PHARMACY 2515 INWOOD RD STE 107 752357400 214 366-0178 N COMMUNITY INDEPENDENT PHARMACY

NETW DALLAS MD KIDS PEDIATRICS PHARMACY 3201 W SANER AVE 752331430 214 331-0567 N

ACCESSHEALTH PLUS DALLAS MEDCORE PHARMACY 2600 N STEMMONS FWY 75207 469 333-8660 N

ACCESSHEALTH PLUS DALLAS MEDFONT PHARMACY 4041 W WHEATLAND RD STE 204 752374061 972 709-2190 N

ACCESSHEALTH PLUS DALLAS MEDPHARMA PHARMACY 2600 N STEMMONS FWY 75207 469 331-8290 N

ACCESSHEALTH PLUS DALLAS MERIDIAN PHARMACY GROUP 2815 S HAMPTON RD 75224 214 333-1600 N

ELEVATE PROVIDER NETWORK DALLAS MI DOCTOR ABRAMS 6751 ABRAMS RD #108 752310210 214 466-6381 N

ACCESSHEALTH PLUS

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DALLAS MI DOCTOR PHARMACY 655 W ILLINOIS AVE, BLDG 900 75224 214 845-4000 N

ACCESSHEALTH PLUS DALLAS MI DOCTOR PHARMACY- SPRING VALLEY 8112 SPRING VALLEY RD 752403829 214 884-1705 N

ACCESSHEALTH PLUS DALLAS MI DOCTOR PHARMACY-WEBB CHAPEL 9753 WEBB CHAPEL RD 752203578 214 622-6048 N

ACCESSHEALTH PLUS DALLAS MI DOCTOR WESTMORELAND 3247 DAWES DR 752115760 214 330-7767 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY 3230 MARTIN LUTHER KING 75210 214 421-1067 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY 10121 E LAKE JUNE ROAD 75217 972 289-9083 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY 2130 E LEDBETTER DR 75216 214 374-3559 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY 1201 W CAMP WISDOM 75232 214 376-2709 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #32 6464 E MOCKINGBIRD LN 752142406 214 827-4230 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #34 4349 W NW HWY 75220 214 357-8195 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #40 7007 ARAPAHO RD 75248 972 387-8977 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #41 3630 FOREST LN 75229 214 351-0007 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #68 3524 MCKINNEY AVE 75204 214 528-0516 N

ACCESSHEALTH PLUS DALLAS MINYARD PHARMACY #97 10203 E NW HWY 75238 214 221-5007 N

ACCESSHEALTH PLUS DALLAS NEW ERA PHARMACY 9709 BRUTON ROAD 75217 214 942-7300 N

ACCESSHEALTH PLUS DALLAS NORTH TEXAS INFUSION AND SPECIALTY

PHARMACY, LLC 3409 WORTH ST STE 725 752462043 214 276-5616 N

ELEVATE PROVIDER NETWORK DALLAS OAK CLIFF PHARMACY 3436 S POLK ST 75224 214 371-2815 N

ELEVATE PROVIDER NETWORK DALLAS OUTPATIENT PHARMACY AT THE CANCER

CENTER 3410 WORTH ST 75246 214 820-8400 N

LEADER DRUG STORES INC DALLAS PALMER PHARMACY PLUS 2731 W NORTHWEST HWY 75220 214 765-9238 N

ELEVATE PROVIDER NETWORK DALLAS PANACEA RX PHARMACY 1050 N WESTMORELAND RD STE

314 752112444 214 339-2352 N

ELEVATE PROVIDER NETWORK DALLAS PARAGON HEMOPHILIA SOLUTIONS, LLC 17111 PRESTON RD 752481234 972 588-1072 N

ELEVATE PROVIDER NETWORK DALLAS PINNACLE PHARMACY 5710 LBJ FREEWAY 75240 877 212-8628 N

TRINET DALLAS PLAZA MEDICAL PHARMACY 700 N PEARL ST STE N208 752017430 214 855-0606 N

ACCESSHEALTH PLUS DALLAS PRESBYTERIAN VILLAGE NORTH 8600 SKYLINE DR 75243 214 355-9082 N

LEADER DRUG STORES INC DALLAS PRESTON ROAD APOTHECARY INC 9301 N CENTRAL PKWY 75231 214 361-6172 N

ACCESSHEALTH DALLAS PRESTON ROAD PHARMACY 6901 PRESTON RD 75205 214 521-9991 N

ACCESSHEALTH DALLAS PRESTON VILLAGE PHARMACY 12606 GREENVILLE AVE #175 75243 972 866-0017 N

THIRD PARTY STATION CP DALLAS PRIDE PHARMACY - CARLISLE 4015 LEMMON AVE, SUITE 4001 75219 214 954-7389 N COMMUNITY INDEPENDENT PHARMACY

NETW DALLAS PROVIDENCE FAMILY PHARMACY 8877 HARRY HINES BLVD SUITE

300B 75235 214 353-7202 N COMMUNITY INDEPENDENT PHARMACY

NETW DALLAS RAVENS PHARMACY 820 N ZANG BLVD 75208 214 946-1700 N

EPIC PHARMACY NETWORK INC DALLAS RITE CARE PHARMACY 7560 GREENVILLE AVE 75231 214 421-2210 N

TPN

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DALLAS RITE CARE PHARMACY IV 3453 ST FRANCIS AVE 75228 214 324-5100 N

TPN DALLAS RITE CARE PHARMACY V 7108 ENVOY CT 752475102 214 483-5700 N

TPN DALLAS ROC PHARMA 5710 LBJ FREEWAY 75240 214 888-8090 N

TRINET DALLAS RX SQUARE PHARMACY 4305 W WHEATLAND RD STE 110 752373314 214 238-3619 N

THIRD PARTY STATION DALLAS SAFEMED PHARMACY 6300 SAMUAL BLVD 75228 972 412-7373 N

TPN DALLAS SALUD PHARMACY #1 2225 W LEDBETTER DR 752244713 972 283-0730 N

ELEVATE PROVIDER NETWORK DALLAS SALUD PHARMACY #2 611 W JEFFERSON BLVD 75208 214 946-3886 N

ELEVATE PROVIDER NETWORK DALLAS SAMS PHARMACY 4062 LBJ FREEWAY 75244 972 759-6492 N

WALMART STORES INC DALLAS SAMS PHARMACY 12000 MCCREE ROAD 75238 214 461-8777 N

WALMART STORES INC DALLAS SAMS PHARMACY 9461 WEBB CHAPEL RD 75220 214 530-5451 N

WALMART STORES INC DALLAS SAMS PHARMACY 5555 S BUCKNER BLVD 75228 214 321-9574 N

WALMART STORES INC DALLAS SAMS PHARMACY 2900 W WHEATLAND ROAD 75237 972 283-1059 N

WALMART STORES INC DALLAS SAMS PHARMACY 10-6372 6185 RETAIL RD 752317807 214 382-2525 N

WALMART STORES INC DALLAS SAVON PHARMACY 320 CASA LINDA PLZ 75218 214 319-8221 N

ALBERTSONS LLC DALLAS SAVON PHARMACY #4105 4625 FRANKFORD RD 75287 972 732-6863 N

ALBERTSONS LLC DALLAS SILVA PHARMACY INC. 939 W JEFFERSON BLVD #

STE101 752085006 214 484-4130 N

TPN DALLAS SMA PHARMACY 2603 OAK LAWN AVE STE 102 752194059 214 948-1848 N COMMUNITY INDEPENDENT PHARMACY

NETW DALLAS SMA PHARMACY 8067 W VIRGINIA DR 752373767 214 635-3435 N COMMUNITY INDEPENDENT PHARMACY

NETW DALLAS SOUTHWEST PAIN GROUP 8230 WALNUT HILL LN STE 320 752314481 214 265-9991 N

EMEDRX SOLUTIONS DALLAS TARGET PHARMACY 39739 LBJ FWY 75237 469 341-3921 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 13131 MONTFORT DRIVE 75240 972 490-3951 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 6419 SKILLMAN ST 75231 214 343-7418 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 2417 N HASKELL AVE 75204 214 370-5558 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 9440 MARSH LN 75220 214 902-9017 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 16731 COIT ROAD 75248 214 775-0207 N

TARGET PHARMACIES DALLAS TARGET PHARMACY 212 MEDALLION SHP CTR 75214 214 360-4203 N

TARGET PHARMACIES DALLAS TEXAS HEALTH PRESCRIPTION SHOP 8210 WALNUT HILL LN 75231 214 345-7759 N

LEADER DRUG STORES INC DALLAS TEXAS HEALTH PRESCRIPTION SHOP 8200 WALNUT HILL LANE 75231 214 345-2595 N

LEADER DRUG STORES INC DALLAS TEXAS RX PHARMACY II 11613 N CENTRAL EXPWY 75243 214 361-9228 N

ELEVATE PROVIDER NETWORK DALLAS THE APOTHECARY SHOP 6303 FOREST PARK RD 75235 214 357-8889 N

ACCESSHEALTH PLUS DALLAS THE FARMACY 18484 PRESTON RD, STE 112 75252 469 814-0919 N

THIRD PARTY STATION CP DALLAS TRINITY FAMILY PHARMACY 11445 GARLAND RD STE # 110 752182506 214 774-9261 N

COMMUNITY INDEPENDENT PHARMACY

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network

NETW

DALLAS WALMART PHARMACY 13739 N CENTRAL EXPRESSWAY 752431003 972 656-2821 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 12789 MIDWAY ROAD 75244 972 488-8982 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 2275 GUS THOMASSON ROAD 75228 214 660-9729 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 7401 SAMUELL BLVD 75228 214 319-0857 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 18121 MARSH LANE 75287 972 862-6360 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 2305 N CENTRAL EXPRESSWAY 75204 214 953-0165 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 2827 S BUCKNER BLVD 75227 214 388-5703 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 15220 MONTFORT DRIVE 75248 972 233-8764 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 3155 W WHEATLAND ROAD 75237 972 709-1500 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 1521 N COCKRELL HILL ROAD 75211 214 337-8092 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 9301 FOREST LN 75243 972 437-6858 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 2218 GREENVILLE AVE 752067122 972 581-0430 N WALMART STORES INC

DALLAS WALMART PHARMACY 10-2105 4122 LBJ FRWY 75244 972 239-4297 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 10-3014 200 SHORT ST 75232 972 232-6407 N WALMART STORES INC

DALLAS WALMART PHARMACY 10-5810 7075 W WHEATLAND RD 752491067 469 608-6223 N WALMART STORES INC

DALLAS WALMART PHARMACY 10-5823 6185 RETAIL RD 75231 972 656-2215 N WALMART STORES INC

DALLAS WAL-MART PHARMACY 10-5889 9410 WEBB CHAPEL RD 75220 972 629-0029 N WALMART STORES INC

DALLAS WALMART PHARMACY 10-8930 15757 COIT RD 752484467 972 235-0619 N WALMART STORES INC

DALLAS WHITE ROCK PHARMACY 9037 GARLAND RD 752183919 214 660-1603 N ELEVATE PROVIDER NETWORK

DALLAS W-TEE PHARMACY 2409 ALCO AVE 75211 214 467-9009 N TPN

DE KALB WALMART PHARMACY 10-4343 12522 FM 1840 75559 903 667-7919 N WALMART STORES INC

DE LEON DE LEON PHARMACY 309 S TEXAS 76444 254 893-2666 N ACCESSHEALTH PLUS

DECATUR BEST VALUE RENSHAW DRUG 800 A MEDICAL CENTER DR 76234 940 627-5343 N ELEVATE PROVIDER NETWORK

DECATUR CVS PHARMACY # 805 W BUSINESS HWY 380 76234 940 626-4889 CVS PHARMACY INC

DECATUR S&J MEDICAL CENTER PHARMACY 1101 EAGLE DR 76234 940 627-5400 LEADER DRUG STORES INC

DECATUR WAL-MART PHARMACY 10-0421 800 S US HWY 81 287 76234 940 627-3038 N WALMART STORES INC

DEER PARK CVS PHARMACY 3505 CENTER ST 77536 281 476-3463 Y CVS PHARMACY INC

DEER PARK HEB PHARMACY #715 4701 E BLVD 77536 210 938-2715 N HEB GROCERY COMPANY LP

DEKALB DEKALB PHARMACY 120 W FRONT ST 75559 903 667-0880 N TRINET

DEL RIO CVS PHARMACY # 409 VETERANS BLVD 78840 830 775-8538 N CVS PHARMACY INC

DEL RIO HEB PHARMACY 200 VETERANS BLVD 78840 830 774-4579 N HEB GROCERY COMPANY LP

DEL RIO WAL-MART PHARMACY 10-0447 2410 DODSON ST 78840 830 775-4000 N WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DENISON CENTRX PHARMACY AT TEXOMA 5012 S US HIGHWAY 75 STE 140 750204599 903 327-8808

ELEVATE PROVIDER NETWORK DENISON CVS PHARMACY 2910 FM 120 W 75020 903 464-9502 N

CVS PHARMACY INC DENISON KROGER PHARMACY 815 W CRAWFORD 75020 903 465-1991 N

THE KROGER CO DENISON MED CHOICE PHARMACY 2300 W MORTON ST 75020 903 463-6979 N

ACCESSHEALTH PLUS DENISON MEDICINE SHOPPE PHARMACY 2810 W MORTON ST STE 102 75020 903 463-3985 N

MEDICINE SHOPPE INTERNATIONAL INC DENISON PARKS DRUG 1926 W MORTON 75020 903 465-0048 N

ELEVATE PROVIDER NETWORK DENISON SAVON PHARMACY 200 W CRAWFORD 75020 903 465-6182 N

ALBERTSONS LLC DENISON WAL-MART PHARMACY 10-0147 401 N US HWY 75 75020 903 465-8035 N

WALMART STORES INC DENTON ADDIS PHARMACY 3305 S MAYHILL ROAD 76208 940 382-0079 N

ELEVATE PROVIDER NETWORK DENTON AMERICAN SPECIALTY PHARMACY 2436 S INTERSTATE 35 E STE 360 762054900 469 362-7700

TPN DENTON BROOKSHIRES PHARMACY 719 I 35 E SOUTH 76205 940 243-9401 N

BROOKSHIRE GROCERY COMPANY DENTON COMMUNITY PHARMACY 4400 TEASLEY LN STE 100 76210 940 382-1618 N

ELEVATE PROVIDER NETWORK DENTON CVS PHARMACY 3200 TEASLEY LANE 76210 940 382-1810 N

CVS PHARMACY INC DENTON CVS PHARMACY # 116 UNIVERSITY DR 76201 940 387-9549 Y

CVS PHARMACY INC DENTON CVS PHARMACY # 1510 W HICKORY ST 762013895 940 483-8187

CVS PHARMACY INC DENTON DENTON PRESCRIPTION SHOP 2501 W OAK ST STE 100 76201 940 382-6758 N

ACCESSHEALTH DENTON DRUG EMPORIUM 824 W UNIVERSITY DR 762011846 940 387-1290 N

EPIC PHARMACY NETWORK INC DENTON KROGER PHARMACY 500 W UNIVERSITY 76201 940 383-3512 N

THE KROGER CO DENTON KROGER PHARMACY 1592 S LOOP 288 762054730 940 566-5252 N

THE KROGER CO DENTON KROGER PHARMACY 5021 TEASLEY LANE 76210 940 380-4111 N

THE KROGER CO DENTON PREMIUM FAMILY PHARMACY 1512 TEASLEY LANE SUITE A 76205 940 442-6767 N

THIRD PARTY STATION CP DENTON S & J SCRIPTURE STREET PHARMACY 1612 SCRIPTURE ST 762013809 940 484-0100 N

ELEVATE PROVIDER NETWORK DENTON SAMS PHARMACY 2850 W UNIVERSITY DR 762011601 940 898-8780 N

WALMART STORES INC DENTON SAVON PHARMACY 2321 W UNIVERSITY DR 76201 940 383-1696 N

ALBERTSONS LLC DENTON TARGET PHARMACY 1801 S LOOP 288 76205 940 220-2123 N

TARGET PHARMACIES DENTON WAL-MART PHARMACY 2750 W UNIVERSITY DR 762011628 940 566-3842 N

WALMART STORES INC DENTON WAL-MART PHARMACY 10-0467 1515 S LOOP 288 76208 940 891-2900 N

WALMART STORES INC DENTON WALMART PHARMACY 10-4104 3930 TEASLY LN 762108420 940 783-4151 N

WALMART STORES INC DENVER CITY LIBERTY DRUGS 403 MUSTANG DRIVE 793234749 806 592-2765 N

EPIC PHARMACY NETWORK INC DESOTO ADAMS PHARMACY 309 N HAMPTON RD 751154915 972 223-0444 N COMMUNITY INDEPENDENT PHARMACY

NETW DESOTO CVS PHARMACY 1305 W BELTLINE RD 75115 972 223-0222 N

CVS PHARMACY INC DESOTO GREENCARE PHARMACY 941 YORK DR STE 201 75115 972 780-5999 N COMMUNITY INDEPENDENT PHARMACY

NETW

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network DESOTO HEALTHFIRST PHARMACY 424 E PLEASANT RUN RD 751153936 469 297-5022 N

THIRD PARTY STATION CP DESOTO KROGER PHARMACY 1001 N BECKLEY STE 500 75115 972 224-3225 N

THE KROGER CO DESOTO SAVON PHARMACY #4166 1300 W BELTLINE RD 75115 972 223-3134 N

ALBERTSONS LLC DESOTO SMA PHARMACY 1110 E PLEASANT RUN RD 75115 972 274-0256 N

TPN CP DESOTO WAL-MART PHARMACY 951 W BELT LINE ROAD 75115 972 223-1930 N

WALMART STORES INC DESOTO WALMART PHARMACY 10-7232 108 W PARKERVILLE RD 751158074 469 643-5017 N

WALMART STORES INC DEVINE CONOLY DRUG HEALTHMART 200 S TEEL 78016 830 663-2224 N

ACCESSHEALTH DEVINE WALMART PHARMACY 10-4103 175 IH 35 N 78016 830 663-5964 N

WALMART STORES INC DIANA WALMART PHARMACY 10-4316 1787 US HIGHWAY 259 S 756403503 903 663-3359 N

WALMART STORES INC DICKINSON CVS PHARMACY 100 FM 517 EAST 77539 281 337-1544 N

CVS PHARMACY INC DICKINSON KROGER PHARMACY 3410 GULF FREEWAY 77539 281 337-7751 N

THE KROGER CO DICKINSON SANTA FE PHARMACY 2251 FM 646 RD 155 A 77539 832 340-7230 N COMMUNITY INDEPENDENT PHARMACY

NETW DICKINSON TARGET PHARMACY 1801 GULF FREEWAY 775393207 281 534-5421 N

TARGET PHARMACIES DILLEY DILLEY DRUG STORE 106 N MAIN 78017 830 965-1666 N

ELEVATE PROVIDER NETWORK DIMMITT DIMMITT PHARMACY 201 NW 2ND ST 79027 806 647-3151 N

THIRD PARTY STATION CP DONNA CVS PHARMACY # 618 N MAIN ST 78537 956 464-2611

CVS PHARMACY INC DONNA O K PHARMACY INC 122 S MAIN ST 78537 956 464-2200 N

ACCESSHEALTH PLUS DONNA WALMART PHARMACY 10-2763 900 N SALINAS BLVD 78537 956 461-2953 N

WALMART STORES INC DRIPPING SPRINGS DRIPPING SPRINGS PHARMACY 100 COMMONS RD STE 1 786200001 512 858-7935 N

ELEVATE PROVIDER NETWORK DRIPPING SPRINGS HEB PHARMACY 598 E HWY 290 78620 512 858-0141 N

HEB GROCERY COMPANY LP DUBLIN BEST VALUE DUBLIN PHARMACY 604 N PATRICK ST 76446 254 445-3679 N

ELEVATE PROVIDER NETWORK DUMAS CVS PHARMACY # 100 N DUMAS AVE 790292432 806 935-2387

CVS PHARMACY INC DUMAS ROGERS PHARMACY 1021 E 1ST ST 79029 806 935-7494 N

ACCESSHEALTH DUMAS WAL-MART PHARMACY 10/0812 2003 S DUMAS AVE 79029 806 935-9228 N

WALMART STORES INC DUNCANVILLE BEN FRANKLIN APOTHECARY 302 N MAIN ST 751163651 972 298-4936 N

ACCESSHEALTH PLUS DUNCANVILLE COSTCO PHARMACY 250 W HIGHWAY 97 75137 469 221-8120 N

COSTCO PHARMACIES DUNCANVILLE CVS PHARMACY 603 S CEDAR RIDGE DR 75137 972 296-3891 N

CVS PHARMACY INC DUNCANVILLE CVS PHARMACY 615 S COCKRELL HILL RD 75137 972 298-0539 Y

CVS PHARMACY INC DUNCANVILLE KROGER PHARMACY 200 W CAMP WISDOM RD 75116 972 298-6255 N

THE KROGER CO DUNCANVILLE PRUDENTIAL PHARMACY 777 E WHEATLAND ROAD 75116 972 709-4500 N

ELEVATE PROVIDER NETWORK EAGLE PASS FRIENDLY PHARMACY 2176 E GARRISON ST 78852 830 752-6088 N

ELEVATE PROVIDER NETWORK EAGLE PASS HEB PHARMACY 2135 E MAIN 78852 830 773-0420 N

HEB GROCERY COMPANY LP

Page 32: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network EAGLE PASS WAL-MART PHARMACY 10-0461 496 S BIBB ST 78852 830 773-9001 N

WALMART STORES INC EARLY DOCS DRUGSTORE OF EARLY 1210 C C WOODSON RD 76802 325 646-2500 N

ACCESSHEALTH PLUS EAST BERNARD SAVON DRUGS 123 LEVERIDGE 77435 979 335-4810 N

ACCESSHEALTH PLUS EASTLAND LOVE OAK PHARMACY 805 W MAIN ST 764482536 254 629-1791

ELEVATE PROVIDER NETWORK EASTLAND WAL-MART PHARMACY 10-0561 1410 E MAIN ST 76448 254 629-3347 N

WALMART STORES INC EDEN CCH PHARMACY 614 EAKER ST SUITE 100 76837 325 869-8760 N

ACCESSHEALTH PLUS EDGEWOOD EDGEWOOD LEGEND DRUG 115 N HOUSTON 751170659 903 896-1473 N

ACCESSHEALTH PLUS EDGEWOOD WALMART PHARMACY 10-2363 504 W PINE ST 751172944 903 896-7053 N

WALMART STORES INC EDINBURG CANTU'S PHARMACY 504 S CLOSNER 785394697 956 383-1239 N

LEADER DRUG STORES INC EDINBURG CONQUEST PLAZA PHARMACY 316 CONQUEST 78539 956 287-2882 N

ACCESSHEALTH PLUS EDINBURG CVS PHARMACY 2121 W TRENTON ROAD 78539 956 664-1755

CVS PHARMACY INC EDINBURG CVS PHARMACY # 103 W MONTE CRISTO RD 785416589 956 383-4945

CVS PHARMACY INC EDINBURG CVS PHARMACY # 2820 W UNIVERSITY DR 785392823 956 292-0456

CVS PHARMACY INC EDINBURG GARZA PHARMACY 1200 S TENTH ST 785395516 956 383-5314 N

TRINET EDINBURG GPS PHARMACY 3521 W FREDDY GONZALEZ DR

STE A 785398391 956 287-4242 N

TRINET EDINBURG HEB PHARMACY 1212 S CLOSNER 78539 956 380-6219 N

HEB GROCERY COMPANY LP EDINBURG HEB PHARMACY 2700 W FREDDY GONZALEZ 78539 956 383-4165 N

HEB GROCERY COMPANY LP EDINBURG JACKSON PARK PHARMACY 668 S JACKSON RD 785392356 956 292-0404 N COMMUNITY INDEPENDENT PHARMACY

NETW EDINBURG JUNIOR'S PHARMACY 1313 S CLOSNER AVE 78539 956 383-4441 N

ACCESSHEALTH EDINBURG LINDBERG PHARMACY 5203 S MCCOLL RD 78539 956 687-6204 N

ELEVATE PROVIDER NETWORK EDINBURG OCHOA'S PHARMACY CENTRAL 1002 S 10TH AVE 78539 956 381-0967 N

ELEVATE PROVIDER NETWORK EDINBURG OCHOA'S PHARMACY SOUTH 301 CONQUEST BLVD 78539 956 318-5159 N

ELEVATE PROVIDER NETWORK EDINBURG RICHARDS PHARMACY 4630 S CLOSNER BLVD 78539 956 289-1880 N

ACCESSHEALTH EDINBURG SAENZ MEDICAL PHARMACY AT

RENAISSANCE INC 2821 MICHAEL ANGELO 78539 956 618-4500 N

ACCESSHEALTH PLUS EDINBURG UNIVERSITY PHARMACY 615 E UNIVERSITY DR 78539 956 387-0911

ACCESSHEALTH PLUS EDINBURG WAL-MART PHARMACY 4101 S MCCOLL ROAD 78539 956 618-5816 N

WALMART STORES INC EDINBURG WAL-MART PHARMACY 1724 W UNIVERSITY DRIVE 78539 956 381-1891 N

WALMART STORES INC EDINBURG WALMART PHARMACY 10-5809 2812 S EXPRESSWAY 281 78542 956 252-2050 N

WALMART STORES INC EDNA ROGERS PHARMACY #6 1013 S WELLS ST 779574098 361 782-3313

ELEVATE PROVIDER NETWORK EDNA WAL-MART PHARMACY 10-0474 1002 N WELLS 77957 361 782-3571 N

WALMART STORES INC EL CAMPO EL CAMPO PROFESSIONAL PHARMACY 1264 N MECHANIC ST 774370109 979 543-2761 N

ELEVATE PROVIDER NETWORK EL CAMPO HEB PHARMACY 306 N MECHANIC 77437 979 578-8609 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network EL CAMPO WAL-MART PHARMACY 10-0344 3413 W LOOP 77437 979 543-6280 N

WALMART STORES INC EL PASO ALAMEDA THRIFTY PHARMACY 4900 ALAMEDA AVE 799052802 915 772-5331 N

ACCESSHEALTH EL PASO AMERICAN SPECIALTY PHARMACY 1015 N ZARAGOZA RD 799071822 915 860-7225 N

TPN EL PASO BANK PHARMACY 4000 MONTANA AVE 799034510 915 562-4000 N

TRINET EL PASO CENTRO SAN VICENTE 8061 ALAMEDA AVE, SUITE B 79915 915 859-7545 N

EL PASO COSTCO PHARMACY 6101 GATEWAY W BLVD 79925 915 774-5202 N

COSTCO PHARMACIES EL PASO CVS PHARMACY # 201 N MESA ST 799011305 915 533-3709

CVS PHARMACY INC EL PASO CVS PHARMACY # 3401 JOE BATTLE BLVD 799382791 915 849-8567

CVS PHARMACY INC EL PASO CVS PHARMACY # 1212 MCRAE BLVD 799257502 915 594-4621

CVS PHARMACY INC EL PASO CVS PHARMACY # 745 N ZARAGOZA RD 799074751 915 859-2600 N

CVS PHARMACY INC EL PASO CVS PHARMACY # 2525 N MESA ST 799023110 915 533-8301

CVS PHARMACY INC EL PASO EL PASO PAIN CENTER PHARMACY 3215 GATEWAY BLVD W 799034225 915 500-6078 N

ELEVATE PROVIDER NETWORK EL PASO GRACE PHARMACY 11140 LA QUINTA PL STE 101 79936 915 593-0603 N

ACCESSHEALTH EL PASO GUARDIAN ANGEL PHARMACY 1537 ZARAGOSA 79936 915 850-0713 N

ELEVATE PROVIDER NETWORK EL PASO KMART PHARMACY3491 6375 MONTANA AVE 799252044 915 772-1402 N

K MART PHARMACY EL PASO KMART PHARMACY3919 11330 MONTWOOD DR 799364383 915 855-4967 N

K MART PHARMACY EL PASO KMART PHARMACY4201 1120 MCRAE BLVD 799257624 915 593-1296 N

K MART PHARMACY EL PASO KMART PHARMACY4205 9484 DYER ST 799246411 915 757-2531 N

K MART PHARMACY EL PASO KMART PHARMACY7347 411 N ZARAGOZA RD 799074745 915 872-9802 N

K MART PHARMACY EL PASO KMART PHARMACY9325 655 SUNLAND PARK DR 799125168 915 584-9448 N

K MART PHARMACY EL PASO MCCRORY'S PHARMACY 6151 DEW DR 79912 915 581-9655

LEADER DRUG STORES INC EL PASO MED TIME PHARMACY 641 N RESLER 79912 915 584-6337 N

ACCESSHEALTH PLUS EL PASO MEDICINE SHOPPE 3310 FORT BLVD 79930 915 564-5451 N

MEDICINE SHOPPE INTERNATIONAL INC EL PASO MEDICINE SHOPPE PHARMACY 2002 GRANT STEA 79930 915 544-6605 N

MEDICINE SHOPPE INTERNATIONAL INC EL PASO PHARMACY CENTER EAST 3100 LEE TREVINO DR 79936 915 595-1177 N

RECEPT HEALTHCARE SERVICES EL PASO PRIMEMED PHARMACY 7812 GATEWAY BLVD E 79915 915 595-1300 N

ELEVATE PROVIDER NETWORK EL PASO RECEPT PHARMACY 10412 VISTA DEL SOL 79410 915 533-0167 N

RECEPT HEALTHCARE SERVICES EL PASO SAM'S CLUB PHARMACY 10-6246 9498 GATEWAY BLVD N 799246808 915 730-6092 N

WALMART STORES INC EL PASO SAMS PHARMACY 7970 N MESA 79932 915 587-0626 N

WALMART STORES INC EL PASO SAMS PHARMACY 11360 PELLICANO DRIVE 79936 915 591-4090 N

WALMART STORES INC EL PASO SAMS PHARMACY 7001 GATEWAY BLVD WEST 79925 915 775-0960 N

WALMART STORES INC EL PASO SAVON PHARMACY 10765 KENWORTHY 79924 915 821-3031 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 3100 MESA ST 79902 915 351-1183 N

ALBERTSONS LLC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network EL PASO SAVON PHARMACY 2200 YARBROUGH DR 79925 915 591-5637 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 11320 MONTWOOD DR 79936 915 855-9772 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 7022 N MESA ST 79912 915 584-9481 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 5200 MONTANA AVE 79903 915 778-0680 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 9111 DYER ST 79924 915 751-8808 N

ALBERTSONS LLC EL PASO SAVON PHARMACY 5630 N DESERT BLVD 79912 915 845-1422 N

ALBERTSONS LLC EL PASO SURECARE SPECIALTY PHARMACY, LLC 720 ARIZONA AVE 799024402 915 532-2400 N

TRINET EL PASO TARGET PHARMACY 801 SUNLAND PARK DR 79912 915 255-4744 N

TARGET PHARMACIES EL PASO TARGET PHARMACY 1874 JOE BATTLE BVLD 79936 915 849-5011 N

TARGET PHARMACIES EL PASO TARGET PHARMACY 1901 GEORGE DIETER DR 799363855 915 255-4758 N

TARGET PHARMACIES EL PASO THE FAMILY PHARMACY 3660 JOE BATTLE BLVD STE 10 79938 915 857-5510 N

ACCESSHEALTH PLUS EL PASO THE PHARMACY CENTER 1720 MURCHISON 799022921 915 313-9870 N

RECEPT HEALTHCARE SERVICES EL PASO TIGUA PHARMACY 8269 N LOOP DR 79907 915 590-2800 N

ELEVATE PROVIDER NETWORK EL PASO U AND T PHARMACY 1390 GEORGE DIETER DRIVE 79936 915 590-9300 N

ACCESSHEALTH PLUS EL PASO UNIVERSITY MEDICAL CENTER EAST

PHARMACY 1485 GEORGE DIETER DR STE 107

799367650 915 521-7087 N ELEVATE PROVIDER NETWORK

EL PASO UNIVERSITY MEDICAL CENTER NORTHEAST PHARMACY

9839 KENWORTHY ST 79924 915 231-2310 N ELEVATE PROVIDER NETWORK

EL PASO UNIVERSITY MEDICAL CENTER OF EL PASO PHARMACY

4815 ALAMEDA AVE 799052794 915 521-7705 N ELEVATE PROVIDER NETWORK

EL PASO UNIVERSITY MEDICAL CENTER YSLETA PHARMACY

300 S ZARAGOZA ROAD BUILDING B

79907 915 790-5722 N ELEVATE PROVIDER NETWORK

EL PASO VIP PHARMACY 1891 N LEE TREVINO STE 200 799364132 915 629-2020 N ELEVATE PROVIDER NETWORK

EL PASO WALMART PHARMACY 101 E REDD RD 799321981 915 206-6140 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 8115 N LOOP 79907 915 629-0903 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 9441 ALAMEDA AVE 79907 915 858-1071 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 3000 SAUL KLEINFELD DRIVE 79936 915 849-7804 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 12236 MONTANA AVE 79936 915 921-6879 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 1551 N ZARAGOZA RD 79936 915 855-2745 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 7555 N MESA 79912 915 833-4332 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 7101 GATEWAY BLVD 79925 915 779-6768 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 951 N RESLER 79912 915 875-0196 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 10-0500 4530 WOODROW BEAN 799244408 915 757-2538 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 10-0512 10727 GATEWAY BLVD WEST 79935 915 593-3164 N WALMART STORES INC

EL PASO WAL-MART PHARMACY 10-2612 1850 N ZARAGOZA RD 79936 915 855-6597 N WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network EL PASO WALMART PHARMACY 10-5947 5631 DYER ST 799046204 915 245-3517 N

WALMART STORES INC EL PASO WALMART PHARMACY 105962 4716 HONDO PASS DR 799041421 915 245-3580 N

WALMART STORES INC EL PASO WALMART PHARMACY 10-6587 10840 MARTIN LUTHE KING

BLVD 79934 915 730-6195 N

WALMART STORES INC EL PASO WALMART PHARMACY 10-6813 3590 N ZARAGOZA RD 79938 915 342-9867 N

WALMART STORES INC ELECTRA GOLDSMITHS DRUG 111 W CLEVELAND 763602603 940 495-2335 N

ACCESSHEALTH PLUS ELGIN CVS PHARMACY # 1300 W HWY 290 786212018 512 285-5552 N

CVS PHARMACY INC ELGIN ELGIN MEDICINE SHOP 15 N MAIN ST 786212657 512 285-6308 N

ACCESSHEALTH PLUS ELGIN HEB PHARMACY 1080 W HWY 290 78621 512 285-4719 N

HEB GROCERY COMPANY LP ELGIN WAL-MART PHARMACY 10-3170 1320 W HWY 290 78621 512 285-3649 N

WALMART STORES INC ELKHART ELKHART PHARMACY 306 S US HWY 287 75839 903 764-2355 N

THIRD PARTY STATION CP ELSA CVS PHARMACY # 103 W EDINBURG AVE 78543 956 262-6292

CVS PHARMACY INC ELSA ELSA PHARMACY SERVICES 205 W EDINBURG DR 78543 956 262-6400 N

ACCESSHEALTH ELSA HEB PHARMACY 512 E EDINBURG AVE 78543 956 262-9719 N

HEB GROCERY COMPANY LP ELSA WALMART PHARMACY 10-5808 411 S BROADWAY ST 78543 956 262-9450 N

WALMART STORES INC EMORY BROOKSHIRES PHARMACY 959 E US HWY 69 75440 903 473-4523 N

BROOKSHIRE GROCERY COMPANY ENNIS BROOKSHIRE PHARMACY #88 2300 W ENNIS AVE 75119 972 875-4607 N

BROOKSHIRE GROCERY COMPANY ENNIS CVS PHARMACY 605 W ENNIS AVE 75119 972 875-4821 N

CVS PHARMACY INC ENNIS ENNIS PHARMACY 800 E ENNIS AVE STE A 751194168 972 346-1234 N

EPIC PHARMACY NETWORK INC ENNIS HEB PHARMACY 101 S CLAY 75119 972 875-8313 N

HEB GROCERY COMPANY LP ENNIS HOMETOWN DRUG 718 W LAMPASAS 751194552 972 875-6798 N

ELEVATE PROVIDER NETWORK ENNIS QUALITY CARE PHARMACY &

COMPOUNDING 601 S CLAY ST STE 108 751195771 972 875-5200 N

ELEVATE PROVIDER NETWORK ENNIS WAL-MART PHARMACY 10-0286 700 E ENNIS AVE 75119 972 875-9636 N

WALMART STORES INC EULESS KROGER PHARMACY 1060 N MAIN ST 76039 817 283-1152 N

THE KROGER CO EULESS SAVON PHARMACY #0106 1155 N MAIN ST 76039 817 354-2427 N

ALBERTSONS LLC EULESS SUPER VALUE PHARMACY 720 N INDUSTRIAL BLVD 760397495 817 283-5308 N

ELEVATE PROVIDER NETWORK EULESS TARGET PHARMACY 1401 W GLADE ROAD 76039 817 399-8486 N

TARGET PHARMACIES EULESS UNITED SPECIALTY PHARMACY 425 WESTPARK WAY STE 2 760403751 888 470-0573 N COMMUNITY INDEPENDENT PHARMACY

NETW EULESS WESTPARK DISCOUNT PHARMACY 350 WESTPARK WAY STE 300 760403965 817 545-6600 N

THIRD PARTY STATION CP FABENS THE MEDICINE SHOPPE 1420 FABENS RD STE B 79838 915 764-2739 N

MEDICINE SHOPPE INTERNATIONAL INC FABENS UNIVERSITY MEDICAL CENTER FABENS

PHARMACY 101 POTASIO ST 798383940 915 521-2271 N

ELEVATE PROVIDER NETWORK FAIR OAKS RANCH CVS PHARMACY # 9089 FAIR OAKS PKWY 780154646 210 698-9538

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FAIRFIELD HOMETOWN PHARMACY 201 E COMMERCE 75840 903 389-2541 N

ELEVATE PROVIDER NETWORK FALFURRIAS HEB PHARMACY #200 800 S SAINT MARYS ST 783555025 361 325-2910 N

HEB GROCERY COMPANY LP FALFURRIAS WAL-MART PHARMACY 2535 S US HIGHWAY 281 783555253 361 325-2411 N

WALMART STORES INC FARMERS BRANCH AMERICAN SPECIALTY PHARMACY 10 MEDICAL PKWY STE 105 752347838 214 432-4422 N

TPN FARMERS BRANCH RSVP PHARMACY #7, LLC 4343 SIGMA RD STE 400 752444449 855 313-7049

TRINET FARMERS BRANCH SYWELL PHARMACY 12895 JOSEY LN STE 111 752348300 972 993-7370 N

ACCESSHEALTH PLUS FARMERS BRANCH WAL-MART PHARMACY 13100 JOSEY LN 752346351 972 656-2287 N

WALMART STORES INC FARMERSVILLE BROOKSHIRE PHARMACY 1705 W AUDIE MURPHY PKWY 75442 972 782-8601 N

BROOKSHIRE GROCERY COMPANY FARMERSVILLE DYER DRUG STORE 133 MCKINNEY ST 75442 972 782-6262 N

ELEVATE PROVIDER NETWORK FLATONIA MAIN STREET PHARMACY 109 E N MAIN ST 78941 361 865-3554 N

THIRD PARTY STATION CP FLINT BROOKSHIRES PHARMACY 20100 HWY 155 SOUTH 75762 903 825-7418 N

BROOKSHIRE GROCERY COMPANY FLORESVILLE CVS PHARMACY # 104 B TURNER LN 78114 830 393-3111

CVS PHARMACY INC FLORESVILLE HEB PHARMACY 925 10TH ST 78114 830 393-8098 N

HEB GROCERY COMPANY LP FLORESVILLE WAL-MART PHARMACY 10-0465 305 10TH ST 78114 830 393-3119 N

WALMART STORES INC FLOWER MOUND CVS PHARMACY 1100 FLOWER MOUND RD 75028 972 874-8421 N

CVS PHARMACY INC FLOWER MOUND CVS PHARMACY 2220 CROSS TIMBERS RD 75028 972 874-1040 Y

CVS PHARMACY INC FLOWER MOUND FLOWER MOUND PHY AND HERBAL ALTS 1001 CROSSTIMBERS RD 75028 972 355-4614 N

ACCESSHEALTH PLUS FLOWER MOUND KK'S PHARMACY #151 2201 LONG PRAIRIE RD STE # 101 750224832 972 539-1777 N

ELEVATE PROVIDER NETWORK FLOWER MOUND KROGER PHARMACY 1101 FLOWER MOUND RD 75028 469 671-5877 N

THE KROGER CO FLOWER MOUND KROGER PHARMACY 2709 CROSS TIMBERS RD 75028 972 355-1086 N

THE KROGER CO FLOWER MOUND LONG PRAIRIE PHARMACY 4921 LONG PRAIRIE RD STE 105 75028 972 410-3773 N

ELEVATE PROVIDER NETWORK FLOWER MOUND TARGET PHARMACY 5959 LONG PRAIRIE ROAD 75028 972 874-6709 N

TARGET PHARMACIES FLOWER MOUND WAL-MART PHARMACY 2800 FLOWER MOUND RD 750224819 972 538-0444 N

WALMART STORES INC FLOYDADA PAYNE FAMILY PHARMACY 200 S MAIN ST 792352726 806 983-5111 N

LEADER DRUG STORES INC FOREST HILL CVS PHARMACY 3350 FOREST HILL CIR 76140 817 568-9566 Y

CVS PHARMACY INC FOREST HILL SUPER 1 PHARMACY 6750 FOREST HILL DRIVE 76140 817 568-9623 N

BROOKSHIRE GROCERY COMPANY FOREST HILL U S PHARMACY INC 6619 FOREST HILL DR 76140 817 478-9191 N COMMUNITY INDEPENDENT PHARMACY

NETW FORNEY BROOKSHIRES PHARMACY 427 PINSON ROAD 75126 972 552-9573 N

BROOKSHIRE GROCERY COMPANY FORNEY CVS PHARMACY 775 E US HIGHWAY 80 75126 972 552-1634 N

CVS PHARMACY INC FORNEY KROGER PHARMACY #579 500 MARKETPLACE BLVD 751266740 972 564-8490 N

THE KROGER CO FORNEY WAL-MART PHARMACY 802 E HIGHWAY 80 75126 972 564-9160 N

WALMART STORES INC FORT STOCKTON STOCKTON PHARMACY 237 W 21ST ST STE E 797352531 432 336-2200 N

THIRD PARTY STATION CP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FORT WORTH AHF PHARMACY 400 N BEACH ST STE 102 761117010 817 831-1814 N

LEADER DRUG STORES INC FORT WORTH ALBERTSONS PHARMACY #0232 3563 ALTON RD 761092834 817 923-3502 N

ALBERTSONS LLC FORT WORTH BEACH STREET PHARMACY 7630 N BEACH ST 76137 817 427-8774 N

ELEVATE PROVIDER NETWORK FORT WORTH CAREPLUS CVS PHARMACY 426 S HENDERSON ST 76104 817 336-7281 N

PROCARE PHARMACY LLC FORT WORTH COOK CHILDREN'S PHARMACY #1 801 7TH AVE STE 1700 76104 682 885-6913 N COMMUNITY INDEPENDENT PHARMACY

NETW FORT WORTH COSTCO PHARMACY #1173 8900 TEHAMA RIDGE PKWY 761772004 817 806-9843 N

COSTCO PHARMACIES FORT WORTH COURTYARD PHARMACY 1250 8TH AVE 76104 817 923-6688 N

LEADER DRUG STORES INC FORT WORTH CVS PHARMACY 6000 BRYANT IRVIN RD 76132 817 292-8000 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 6431 MCCART AVE 76133 817 263-8070 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 5012 TRL LAKE DR 76133 817 292-1700 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 3401 ALTA MERE DR 76116 817 763-5155 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 2603 W BERRY ST 76109 817 923-8259 Y

CVS PHARMACY INC FORT WORTH CVS PHARMACY 8560 S HULEN ST 76123 817 292-0048 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 4400 BASSWOOD BLVD 76137 817 605-1218 N

CVS PHARMACY INC FORT WORTH CVS PHARMACY 9620 WHITE SETTLEMENT RD 76108 817 246-2411 Y

CVS PHARMACY INC FORT WORTH CVS PHARMACY # 8601 BOAT CLUB RD 761793604 817 236-0186

CVS PHARMACY INC FORT WORTH CVS PHARMACY # 7220 BLUE MOUND RD 761314802 401 765-1500

CVS PHARMACY INC FORT WORTH FORT WORTH PHARMACY 7833 OAKMONT BLVD 76132 817 361-9960 N

ELEVATE PROVIDER NETWORK FORT WORTH GLENVIEW PROFESSIONAL PHARMACY 7640 GLENVIEW DR STE A 761808330 817 284-1489 N COMMUNITY INDEPENDENT PHARMACY

NETW FORT WORTH HALLMARK PHARMACY 1316 SYCAMORE SCHOOL RD 76134 817 293-2441 N

ELEVATE PROVIDER NETWORK FORT WORTH HALLS PHARMACY #2 8808 CAMP BOWIE W BLVD 76116 817 244-3300 N

EPIC PHARMACY NETWORK INC FORT WORTH HULEN PHARMACY 6249 GRANBURY RD 761333401 817 361-7777 N

ELEVATE PROVIDER NETWORK FORT WORTH JAMORX PHARMACY INC 650 ST LOUIS AVE 76104 817 810-9278 N

TPN FORT WORTH KROGER PHARMACY 3300 TEXAS SAGE TRAIL 76177 817 750-2041 N

THE KROGER CO FORT WORTH KROGER PHARMACY #034562 12600 N BEACH ST 762444200 817 562-3901 N

THE KROGER CO FORT WORTH KROGER PHARMACY #439 9114 CAMP BOWIE W BLVD 761166023 817 560-4233 N

THE KROGER CO FORT WORTH KROGER PHARMACY #520 3120 S UNIVERSITY 761095614 713 507-6256 N

THE KROGER CO FORT WORTH KROGER PHARMACY #532 5241 N TARRANT PKWY 762446292 713 507-6276

THE KROGER CO FORT WORTH KROGER PHARMACY #536 6650N BEACH ST 761371801 817 788-1757 N

THE KROGER CO FORT WORTH LEGACY PHARMACY 1307 8TH AVE 76104 817 924-3200 N

TPN FORT WORTH MCCART PHARMACY 4237 MCCART AVE 761151020 817 924-7200 N

ELEVATE PROVIDER NETWORK FORT WORTH MEADOWBROOK PHARMACY 6624 MEADOWBROOK DR 761125241 817 451-6900 N

ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FORT WORTH MIRA VISTA PHARMACY LLC 5701 BRYANT IRVIN RD STE 104 761324026 817 292-3800 N

TPN FORT WORTH NEW CARE PHARMACY, INC. 900 JEROME ST 76104 817 924-7000 N

ELEVATE PROVIDER NETWORK FORT WORTH PARK PLACE PHARMACY 1601 PARK PLACE AVE 761101303 817 924-9292 N

TRINET FORT WORTH PERRONERX, LLC 3923 HWY 377 SOUTH 76116 817 731-5899 Y

ELEVATE PROVIDER NETWORK FORT WORTH R3 PHARMACY 5324 WEDGMONT CIR N 761331946 817 263-5700 N

ACCESSHEALTH PLUS FORT WORTH RECEPT HEALTHCARE SERVICES 5500 E LOOP 820 S STE 102 761196550 817 572-0009

FORT WORTH RECEPT PHARMACY 800 8TH AVE 761042606 817 335-5712 N

RECEPT HEALTHCARE SERVICES FORT WORTH RECEPT PHARMACY #15 7148 TRAIL LAKE DR STE A 761231969 817 572-0009 N

RECEPT HEALTHCARE SERVICES FORT WORTH RXPRESS PHARMACY 1000 W WEATHERFORD ST STE

200 761021854 817 877-9981 N

TRINET FORT WORTH SAFEMED PHARMACY #2 4245 E BERRY ST 761055002 469 666-3600 N COMMUNITY INDEPENDENT PHARMACY

NETW FORT WORTH SAMS PHARMACY 4400 BRYANT IRVIN ROAD 76132 817 989-1931 N

WALMART STORES INC FORT WORTH SAMS PHARMACY 8351 ANDERSON BLVD 76120 817 459-4984 N

WALMART STORES INC FORT WORTH SARATOGA PHARMACY 12650 N BEACH ST STE 112 762444243 817 431-9700 N

ELEVATE PROVIDER NETWORK FORT WORTH SAVON PHARMACY 9300 CLIFFORD ST 76108 817 246-4909 N

ALBERTSONS LLC FORT WORTH SAVON PHARMACY 7400 OAKMONT BLVD 76132 817 423-9569 N

ALBERTSONS LLC FORT WORTH SAVON PHARMACY 10800 N BEACH ST 76248 817 431-8985 N

ALBERTSONS LLC FORT WORTH SAVON PHARMACY 850 E LOOP 820 76112 817 451-1637 N

ALBERTSONS LLC FORT WORTH TARGET PHARMACY 5700 OVERTON RIDGE BLVD 76132 817 423-1661 N

TARGET PHARMACIES FORT WORTH TARGET PHARMACY 8917 TEHAMA RIDGE PKWY 761772005 612 555-5555

TARGET PHARMACIES FORT WORTH TARGET PHARMACY 751 ALTA MERE DR 761161526 817 566-0566 N

TARGET PHARMACIES FORT WORTH TARGET PHARMACY 301 CARROLL ST 76107 817 302-0291 N

TARGET PHARMACIES FORT WORTH TARRANT COUNTY INFECTIOUS DISEASE

ASSOCIATES, PA 1125 COLLEGE AVE 761044514 817 336-1460 N

EMEDRX SOLUTIONS FORT WORTH WAL-MART PHARMACY 6756 W VICKERY BLVD 76116 817 732-2195 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 2900 RENAISSANCE SQUARE 76105 817 900-1912 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 8401 ANDERSON ST 76120 817 276-9041 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 7451 MCCART AVE 76133 817 361-7284 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 6513 MEADOWBROOK DR 76112 817 492-0532 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 8520 N BEACH ST 76137 817 514-9524 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 7401 PARK VISTA BLVD 76137 817 605-0404 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 9500 CLIFFORD ST 76108 817 367-0818 N

WALMART STORES INC FORT WORTH WAL-MART PHARMACY 717 W BERRY ST 76110 817 840-0263 N

WALMART STORES INC FORT WORTH WALMART PHARMACY 105312 3851 AIRPORT FREEWAY 76111 817 759-1926 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FORT WORTH WALMART PHARMACY 10-5764 2401 AVONDALE HASLET ROAD 76052 817 302-1731 N

WALMART STORES INC FORT WORTH WELLCARE PHARMACY 6901 MCCART AVE STE 225 761336379 817 263-5050 N COMMUNITY INDEPENDENT PHARMACY

NETW FORT WORTH WESTPOINT PHARMACY 9501 CLIFFORD ST STE E 761084461 817 246-6600 N

ELEVATE PROVIDER NETWORK FRANKLIN DUFFEY DRUG COMPANY 311 N CENTER 77856 979 828-3536 N

ELEVATE PROVIDER NETWORK FRANKSTON MAXWELL PHARMACY 626 N HWY 155 75763 903 876-2323 N

ELEVATE PROVIDER NETWORK FRANKSTON WALMART PHARMACY 10-4312 440 E PINE ST 75763 903 876-3020 N

WALMART STORES INC FREDERICKSBURG PRESCRIPTION LABORATORY 205 W WINDCREST 78624 830 997-2163 N

ACCESSHEALTH FREDERICKSBURG VALU MED PHARMACY INC 707 N LLANO ST 786243922 830 997-8155 N COMMUNITY INDEPENDENT PHARMACY

NETW FREDERICKSBURG WAL-MART PHARMACY 1435 E MAIN ST 78624 830 997-3047 N

WALMART STORES INC FREDRICKSBURG HEB PHARMACY 407 S ADAMS 78624 830 997-8809 N

HEB GROCERY COMPANY LP FREEPORT CVS PHARMACY 1853 W SECOND ST 77541 979 233-5415 N

CVS PHARMACY INC FREEPORT FREEPORT PHARMACY 323 S BRAZOSPORT BLVD 77541 979 871-9189 N

ACCESSHEALTH PLUS FREER FREER PHARMACY LLC 717 E RILEY ST SUITE C 78357 361 394-7733 N

THIRD PARTY STATION FRESNO KROGER PHARMACY 10250 FRESNO STATE HWY 6 77545 281 431-6113 N

THE KROGER CO FRIENDSWOOD CVS PHARMACY 3226 FM 528 77546 281 482-3418 N

CVS PHARMACY INC FRIENDSWOOD HEB PHARMACY 701 W PARKWOOD 77546 281 996-9971 N

HEB GROCERY COMPANY LP FRIENDSWOOD KROGER PHARMACY 3135 FM 528 77546 281 557-4894 N

THE KROGER CO FRIENDSWOOD KROGER PHARMACY 151 N FRIENDSWOOD DR 77546 281 992-1710 N

THE KROGER CO FRIENDSWOOD PARKWOOD PHARMACY 405 E PARKWOOD 77546 832 569-4059 N

TPN FRIENDSWOOD SAMS PHARMACY 155 W EL DORADO BLVD 77546 281 286-4517 N

WALMART STORES INC FRIENDSWOOD WAL-MART PHARMACY 150 W EL DORADO BLVD 77546 281 480-6164 N

WALMART STORES INC FRIONA BI-WIZE PHARMACY 902 MAIN ST 790352042 806 250-2270 N

ELEVATE PROVIDER NETWORK FRISCO COSTCO PHARMACY #1097 11220 DALLAS PARKWAY 75033 469 200-7108 N

COSTCO PHARMACIES FRISCO CVS PHARMACY 9075 LEGACY DRIVE 75033 214 387-3094 N

CVS PHARMACY INC FRISCO CVS PHARMACY 7230 PRESTON RD 75034 972 335-4979 Y

CVS PHARMACY INC FRISCO CVS PHARMACY 5401 LEBANON 75034 972 624-8170 N

CVS PHARMACY INC FRISCO CVS PHARMACY # 12740 ELDORADO PARKWAY 75035 401 765-1500

CVS PHARMACY INC FRISCO CVS PHARMACY # 270 STONEBROOK PKWY 75034 214 469-1143

CVS PHARMACY INC FRISCO DRUG CRAFTERS 5680 FRISCO SQUARE BLVD STE

1100 75034 214 618-3511 N

TRINET FRISCO KROGER PHARMACY 3205 MAIN ST 75034 972 731-0615 N

THE KROGER CO FRISCO KROGER PHARMACY 12221 CUSTER RD 75034 214 491-5001 N

THE KROGER CO FRISCO KROGER PHARMACY 4851 LEGACY DRIVE 75034 972 377-0251 N

THE KROGER CO

Page 40: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FRISCO KROGER PHARMACY 7500 PRESTON STONEBROOK 75034 972 377-0840 N

THE KROGER CO FRISCO PARKSIDE PHARMACY 6449 COIT RD STE 116 750358670 972 712-0649

EPIC PHARMACY NETWORK INC FRISCO STONEBRIAR PHARMACEUTICAL SERVICES

LLC 5575 WARREN PKWY STE 216 750341917 214 618-2486

THIRD PARTY STATION CP FRISCO TARGET PHARMACY 4885 ELDORADO PKWY 75034 972 464-5746 N

TARGET PHARMACIES FRISCO TARGET PHARMACY 3201 PRESTON RD 75034 972 668-6909 N

TARGET PHARMACIES FRISCO UNITED MARKET STREET PHARMACY 11999 N DALLAS PARKWAY 75034 214 872-1515 N

UNITED PHARMACY TX FRISCO WAL-MART PHARMACY 12220 FM 423 75034 469 362-8641 N

WALMART STORES INC FRISCO WAL-MART PHARMACY 4268 LEGACY DR 750340812 972 624-6818 N

WALMART STORES INC FRISCO WALMART PHARMACY 10-5866 8555 PRESTON RD 75034 214 436-5142 N

WALMART STORES INC FRITCH FRITCH DRUG AND GIFT SHOPPE 105 BROADWAY 79036 806 857-3176 N

ACCESSHEALTH FT STOCKTON BAGGETT PHARMACY 509 N MAIN ST 797355623 432 336-2297 N

ACCESSHEALTH FT STOCKTON NOLEN PHARMACY 700 W DICKINSON BLVD 797354230 432 336-2201 N

ELEVATE PROVIDER NETWORK FT STOCKTON WAL-MART PHARMACY 2610 W DICKSON ST 79735 432 336-7531 N

WALMART STORES INC FT WORTH A AND P PHARMACY 2329 N RIVERSIDE DR 76111 817 838-2319 N

ACCESSHEALTH PLUS FT WORTH BEST VALUE COUNTRY DAY PHARMACY 6020 HARRIS PARKWAY 761324102 817 738-0722 N

ELEVATE PROVIDER NETWORK FT WORTH BEST VALUE RIDGLEA DRUG 5932 LOVELL AVE 761075030 817 737-6655 N

ELEVATE PROVIDER NETWORK FT WORTH COSTCO PHARMACY 5300 OVERTON RIDGE BLVD 76132 817 210-0002 N

COSTCO PHARMACIES FT WORTH CVS PHARMACY 4333 WESTERN CENTER BLVD 76137 817 232-1634 Y

CVS PHARMACY INC FT WORTH CVS PHARMACY 4140 E LANCASTER 76103 817 534-0261 Y

CVS PHARMACY INC FT WORTH CVS PHARMACY 3145 MANSFIELD HWY 76119 817 535-1182 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 700 W SEMINARY DR 76115 817 926-2661 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 3614 CAMP BOWIE BLVD 76107 817 870-1873 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 8520 CAMP BOWIE W 76116 817 560-0130 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 1201 N BEACH ST 76111 817 834-6369 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 6548 MEADOWBROOK DR 76112 817 457-3680 N

CVS PHARMACY INC FT WORTH CVS PHARMACY 2706 JACKSBORO HWY 76114 817 626-8255 Y

CVS PHARMACY INC FT WORTH DANIEL DRUG INC 3409 W 7TH ST 761072718 817 332-6386 N

TPN FT WORTH HALLS PHARMACY 708 PENNSYLVANIA AVE 76104 817 877-3677 N

ACCESSHEALTH PLUS FT WORTH INDUSTRIAL & FAMILY PHARMACY 2301 NE 28TH ST 761067408 817 625-6265 N

ACCESSHEALTH PLUS FT WORTH JPS HEALTH NETWORK PHARMACY 4701 BRYANT IRVIN RD N 76107 817 702-6717 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA FT WORTH JPS HEALTH SYSTEM OUTPATIENT

PHARMA 4701 BRYANT IRVIN RD N STE LL215

761077627 817 702-6718

FT WORTH JPS HLTH SYS OP PHCY 1500 S MAIN ST 76104 817 702-3553 N JPS HEALTH SYSTEM OUTPATIENT PHARMA

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network FT WORTH JPS VIOLA M PITTS/ COMO PHRM 4701 BRYANT IRVIN RD N 76107 817 702-7481 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA FT WORTH LAKE WORTH PHARMACY 4504 BOAT CLUB RD 76135 817 237-7877 N

ELEVATE PROVIDER NETWORK FT WORTH MED STORE LLP 4004 E BELKNAP ST 76111 817 834-3001 Y

ELEVATE PROVIDER NETWORK FT WORTH PERRONE LEGEND PHARMACY 3921 HIGHWAY 377 761167895 817 738-2135 N

ELEVATE PROVIDER NETWORK FT WORTH RIDGMAR PHARMACY 2524 MALL CIRCLE 76116 817 737-7377 N

ELEVATE PROVIDER NETWORK FT WORTH RX.COM COMMUNITY PHARMACY 401 S JIM WRIGHT FWY STE 102 761082681 817 547-1000 N COMMUNITY INDEPENDENT PHARMACY

NETW FT WORTH SOLEO HEALTH 4108 AMON CARTER BLVD 76155 817 923-4495 N

TPN FT WORTH TCHD DIAMOND HILL COMM CLNC PHCY 3308 DEEN RD 761066524 817 702-7105 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA FT WORTH TCHD STOP SIX COMM CLINIC PHY 3301 STALLCUP RD 76119 817 702-7234 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA FT WORTH TEXAS HEALTH CARE PHARMACY 7413 PEBBLE DR 76118 817 595-9770 Y

GERIMED LTC NETWORK INC FT WORTH THE CENTER PHARMACY 800 W MAGNOLIA AVE 76104 817 333-0180 N

THIRD PARTY STATION CP FT WORTH TOWER MEDIC PHARMACY INC 607 W MAGNOLIA AVE 76104 817 336-8133 N COMMUNITY INDEPENDENT PHARMACY

NETW FT WORTH WAL-MART PHARMACY 10-0590 6300 OAKMONT BLVD 761322807 817 263-6572 N

WALMART STORES INC FT WORTH XPRESS COMPOUNDING 1000 W WEATHERFORD ST STE

120 761021842 817 207-0110 N

TRINET FT WORTH XPRESS LONG TERM CARE PHARMACY 915 W BELKNAP 76102 817 441-5211 N

TRINET FT. WORTH KROGER PHARMACY 3510 ALTA MESA 76133 817 292-3777 N

THE KROGER CO FT. WORTH KROGER PHARMACY 6080 S HULEN 76132 817 346-0487 N

THE KROGER CO FT. WORTH SAVON PHARMACY 4400 WESTERN BLVD 76137 817 232-1023 N

ALBERTSONS LLC FT. WORTH SAVON PHARMACY 3525 SYCAMORE SCHOOL RD 76133 817 346-4457 N

ALBERTSONS LLC FT. WORTH SAVON PHARMACY #4286 6700 W FREEWAY 76116 817 377-8078 N

ALBERTSONS LLC FT. WORTH WALMART PHARMACY 10-3043 4536 HERITAGE TRACE PKWY 76244 817 898-6076 N

WALMART STORES INC FT. WORTH WALMART PHARMACY 10-4165 2245 JACKSBORO HWY 76114 817 569-6241 N

WALMART STORES INC FULSHEAR CVS PHARMACY # 5902 FM 1463 RD 77441 281 232-7014

CVS PHARMACY INC GAINESVILLE CVS PHARMACY 1520 N GRAND AVE 76240 940 665-0314 N

CVS PHARMACY INC GAINESVILLE KIOWA HOMETOWN PHARMACY AND

HOME MEDICAL 1201 OLIVE ST 76240 940 668-7384 N

ELEVATE PROVIDER NETWORK GAINESVILLE PLAZA PHARMACY 411 N GRAND AVE 762404323 940 665-8401 N

ACCESSHEALTH PLUS GAINESVILLE WAL-MART PHARMACY 10-0185 1800 LAWRENCE ST 76240 940 665-2839 N

WALMART STORES INC GALVESTON BROADWAY DRUG STORE INC 2027 BROADWAY ST 775504683 409 765-7701 N

THIRD PARTY STATION CP GALVESTON CVS PHARMACY 2326 61ST ST 77551 409 740-0276 Y

CVS PHARMACY INC GALVESTON CVS PHARMACY 2425 AVE J 77550 409 763-3444 N

CVS PHARMACY INC GALVESTON KROGER PHARMACY 5730 SEAWALL BLVD 77551 409 741-9091 N

THE KROGER CO

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network GALVESTON SOUTHSIDE PHARMACY 8 707 23RD ST STE F 775502201 409 497-2767 N

ACCESSHEALTH PLUS GALVESTON TARGET PHARMACY 6128 BROADWAY ST 77551 409 740-0876 N

TARGET PHARMACIES GALVESTON UNIVERSITY OF TEXAS MEDICAL BRANCH

PHARMACY 301 UNIVERSITY BLVD 775550701 409 772-7129 N COMMUNITY INDEPENDENT PHARMACY

NETW GALVESTON WAL-MART PHARMACY 10-0504 6702 SEAWALL BLVD 77551 409 744-2238 N

WALMART STORES INC GARLAND BAYLOR SCOTT & WHITE PHARMACY #106 601 CLARA BARTON BLVD STE

140 750425755 972 485-3100 N

LEADER DRUG STORES INC GARLAND BRANDY PHARMACY 2231 PEGGY LANE #B 75042 972 272-6300 N

ACCESSHEALTH PLUS GARLAND CARE PLUS PHARMACY 1401 NORTHWEST HWY STE 107 750415264 972 468-0001 N

LEADER DRUG STORES INC GARLAND CARECHOICE PHARMACY 4750 N JUPITER RD STE 123 750445860 469 666-8866 N

ELEVATE PROVIDER NETWORK GARLAND CENTRO PHARMACY 405 MAYFIELD AVE 750415420 972 926-9500 N

THIRD PARTY STATION CP GARLAND CVS PHARMACY 1902 PLEASANT VALLEY RD 75040 972 675-0275 N

CVS PHARMACY INC GARLAND CVS PHARMACY 3034 S 1ST ST 75041 972 271-3811 N

CVS PHARMACY INC GARLAND CVS PHARMACY 5702 LAVON DR 75040 972 495-5595 N

CVS PHARMACY INC GARLAND CVS PHARMACY 1372 BELTLINE RD 75040 972 495-1933 N

CVS PHARMACY INC GARLAND CVS PHARMACY 2510 W WALNUT ST 75042 972 485-8200 Y

CVS PHARMACY INC GARLAND EVERCARE PHARMACY LLC 3565 W WALNUT ST 750426278 469 366-9015 N

ACCESSHEALTH PLUS GARLAND GARLAND INDEPENDENT PHARMACY 3641 BROADWAY BLVD STE 100 750431575 972 864-1110

AMERICAN PHARMACY NETWORK SOLUTIONS GARLAND HERITAGE PHARMACY 2636 W WALNUT ST 750425916 214 703-9000 N

ELEVATE PROVIDER NETWORK GARLAND KROGER PHARMACY 1406 W WALNUT 75042 972 494-9264 N

THE KROGER CO GARLAND KROGER PHARMACY 532 W I 30 75043 972 226-1132 N

THE KROGER CO GARLAND KROGER PHARMACY #557 6850 N SHILOH ROAD 75044 972 496-4503 N

THE KROGER CO GARLAND PHARMAX PHARMACY 3250 W WALNUT ST # STE106 750426307 972 487-2252 N

ELEVATE PROVIDER NETWORK GARLAND SAMS PHARMACY 5150 N GARLAND AVE 75040 972 530-8496 N

WALMART STORES INC GARLAND SAVON PHARMACY 5710 BROADWAY BLVD 75043 972 240-7438 N

ALBERTSONS LLC GARLAND TARGET PHARMACY 5301 N GARLAND AVE 75040 972 535-0253 N

TARGET PHARMACIES GARLAND TOTAL PHARMACY ENNIS 2046 FOREST LN STE 140 750427939 972 276-7071 N

ELEVATE PROVIDER NETWORK GARLAND WAL-MART PHARMACY 3959 BROADWAY BLVD 75043 972 926-6155 N

WALMART STORES INC GARLAND WAL-MART PHARMACY 1801 MARKETPLACE DR 750415605 972 279-8728 N

WALMART STORES INC GARLAND WAL-MART PHARMACY 5302 N GARLAND AVE 75044 972 495-2515 N

WALMART STORES INC GARLAND WAL-MART PHARMACY 555 W I 30 75043 972 303-5414 N

WALMART STORES INC GARLAND WAL-MART PHARMACY 10-2433 101 W BUCKINGHAM RD 75040 469 304-3427 N

WALMART STORES INC GARLAND WAL-MART PHARMACY 10-4046 1855 S GARLAND AVE 75043 972 535-1429 N

WALMART STORES INC GATESVILLE GATESVILLE DRUG CO LTD 2401 S STATE HIGHWAY 36 STE

100 765282517 254 865-2417 N

THIRD PARTY STATION

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network GATESVILLE HEB PHARMACY 1207 MAIN ST 76528 254 248-1781 N

HEB GROCERY COMPANY LP GATESVILLE WAL-MART PHARMACY 10-0476 2805 S STATE HIGHWAY 36 765282738 254 248-1130 N

WALMART STORES INC GEORGE WEST COBB'S PHARMACY 510 HOUSTON ST 780222340 361 449-2631 N

ELEVATE PROVIDER NETWORK GEORGETOWN BAYLOR SCOTT & WHITE PHARMACY#202 4945 WILLIAMS DR 786332008 512 942-3302 N

LEADER DRUG STORES INC GEORGETOWN CVS PHARMACY 4426 WILLIAMS DR 786281341 512 869-2506 N

CVS PHARMACY INC GEORGETOWN CVS PHARMACY 900 N AUSTIN AVE 78626 512 863-2581 N

CVS PHARMACY INC GEORGETOWN GALLAGHERS PHARMACY 2411 WILLIAMS DR 786283261 512 863-5579 N

ELEVATE PROVIDER NETWORK GEORGETOWN GUS'S DRUG STORE 702 E UNIVERSITY 78626 512 863-2506

ACCESSHEALTH PLUS GEORGETOWN HEB PHARMACY 1101 S IH 35 78626 512 869-4287 N

HEB GROCERY COMPANY LP GEORGETOWN HEB PHARMACY 4500 FM 2338 78628 512 763-1243 N

HEB GROCERY COMPANY LP GEORGETOWN LSCC GEORGETOWN PHARMACY-

WILLIAMS DRIVE 2423 WILLIAMS DRIVE 78628 512 686-0155 N

THIRD PARTY STATION CP GEORGETOWN MCCLURE'S COMPOUNDING PHARMACY 105 WILDWOOD DR STE 101 786331344 512 819-9848 N

ACCESSHEALTH PLUS GEORGETOWN TARGET PHARMACY 1021 W UNIVERSITY B3 78628 512 869-3170 N

TARGET PHARMACIES GEORGETOWN WAL-MART PHARMACY 620 S IH 35 78626 512 869-4966 N

WALMART STORES INC GIDDINGS PIERATTS PHARMACY 233 S MANSE 78942 979 542-3164 N COMMUNITY INDEPENDENT PHARMACY

NETW GIDDINGS WAL-MART PHARMACY 10-0473 2374 E AUSTIN ST 789423644 979 542-0589 N

WALMART STORES INC GILMER THE MED-SHOP PHARMACY 825 US HWY 271 N 75644 903 680-2600 N

ELEVATE PROVIDER NETWORK GILMER WAL-MART PHARMACY 10-0146 1923 N WOOD ST 756445237 903 797-6237 N

WALMART STORES INC GLADEWATER CVS PHARMACY 1402 E BROADWAY 75647 903 845-2271 N

CVS PHARMACY INC GLADEWATER WALKER PHARMACY 402B W UPSHUR 75647 903 845-2573 N

ACCESSHEALTH PLUS GLEN ROSE BEST VALUE MEDICAL CENTER PHARMACY 1100 BLUEBONNET 760431919 254 897-9917 N

ELEVATE PROVIDER NETWORK GLEN ROSE GLEN ROSE DISCOUNT DRUG 906 N EBIG BEND TRAIL 76043 254 897-2711 N

ACCESSHEALTH GODLEY WALMART PHARMACY 10-3820 501 N MAIN ST 760443732 817 389-2295 N

WALMART STORES INC GOLDTHWAITE MCMAHAN PHARMACY SERVICES 1503 W FRONT ST 76844 325 648-2484 N COMMUNITY INDEPENDENT PHARMACY

NETW GOLIAD GOLIAD PHARMACY AND GIFTS 208 S COMMERCIAL 77963 361 645-3261 N

ELEVATE PROVIDER NETWORK GONZALES HEB PHARMACY #641 1841 CHURCH ST 78629 830 672-6151 N

HEB GROCERY COMPANY LP GONZALES MOHRMANNS DRUG STORE 2405 WINDING WAY DR 786293246 830 672-2317 N

ACCESSHEALTH GONZALES WAL-MART PHARMACY 10-0290 1114 E SARAH DEWITT DR 78629 830 672-2811 N

WALMART STORES INC GORMAN GORMAN PHARMACY 117 S KENT 76454 254 734-2859 COMMUNITY INDEPENDENT PHARMACY

NETW GRAHAM JORDAN PHARMACY 1332 HWY 16 SOUTH 76450 940 549-1011 N

ELEVATE PROVIDER NETWORK GRAHAM MEDICINE CHEST PHARMACY 814 MONTGOMERY RD 76450 817 549-8360 N

ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network GRAHAM UNITED PHARMACY 1229 HIGHWAY 16 SOUTH 76450 940 549-3000 N

UNITED PHARMACY TX GRAHAM WAL-MART PHARMACY 10-0353 2121 HWY 16 SOUTH 76450 940 549-7763 N

WALMART STORES INC GRANBURY BEST VALUE RONS PHARMACY 420 W PEARL 76048 817 573-1143 N

ELEVATE PROVIDER NETWORK GRANBURY BROOKSHIRES PHARMACY 1301 S MORGAN 76048 817 279-9840 N

BROOKSHIRE GROCERY COMPANY GRANBURY CVS PHARMACY 1101 E HWY 377 76048 817 573-8877 N

CVS PHARMACY INC GRANBURY GRANBURY DRUG I 602 S MORGAN ST 760481962 817 573-1164 N

TRINET GRANBURY HEB PHARMACY 3804 E HIGHWAY 377 76049 817 579-2512 N

HEB GROCERY COMPANY LP GRANBURY KROGER PHARMACY #917 3915 E US HIGHWAY 377 760497431 682 498-4223 N

THE KROGER CO GRANBURY PECAN DISCOUNT DRUG 9203 PLANTATION DRIVE, STE 1 76049 817 573-9344 N

ACCESSHEALTH PLUS GRANBURY WAL-MART PHARMACY 10-0371 735 E HIGHWAY 377 760482578 817 573-8864 N

WALMART STORES INC GRAND PRAIRIE CVS PHARMACY 5195 LAKE RIDGE PARKWAY 75052 972 522-0395

CVS PHARMACY INC GRAND PRAIRIE CVS PHARMACY 701 E MAIN ST 75050 972 264-2371 N

CVS PHARMACY INC GRAND PRAIRIE CVS PHARMACY 810 W PIONEER PKWY 75051 972 641-5744 Y

CVS PHARMACY INC GRAND PRAIRIE CVS PHARMACY 4203 S CARRIER PKWY 75052 972 642-3910 N

CVS PHARMACY INC GRAND PRAIRIE GIBSON PHARMACY 2505 S CARRIER PKY 75052 972 264-0268 N

TRINET GRAND PRAIRIE KROGER PHARMACY 514 S CARRIER PARKWAY 750511501 972 264-0301 N

THE KROGER CO GRAND PRAIRIE KROGER PHARMACY 313 E PIONEER PKWY 75051 972 264-3011 N

THE KROGER CO GRAND PRAIRIE LAKE RIDGE PHARMACY 4927 LAKE RIDGE PKWY STE 180 750523072 972 522-7606 N

TRINET GRAND PRAIRIE LAKEPOINTE PHARMACY 2715 OSLER DR 750511051 469 733-1033 N

ELEVATE PROVIDER NETWORK GRAND PRAIRIE PROFESSIONAL PHARMACY PLUS 2771 SHERMAN ST 75051 972 809-0984

TPN GRAND PRAIRIE SAMS PHARMACY 2325 W INTERSTATE 20 75052 972 660-1527 N

WALMART STORES INC GRAND PRAIRIE SAVON PHARMACY 215 N CARRIER PKWY 75050 972 642-8888 N

ALBERTSONS LLC GRAND PRAIRIE SAVON PHARMACY 4126 S CARRIER PKWY 75052 972 642-0488 N

ALBERTSONS LLC GRAND PRAIRIE TARGET PHARMACY 5270 STATE HIGHWAY 360 75052 469 348-2101 N

TARGET PHARMACIES GRAND PRAIRIE WAL-MART PHARMACY 2225 W INTERSTATE 20 75052 972 660-8500 N

WALMART STORES INC GRAND PRAIRIE ZING PHARMACY 2615 W PIONEER PKWY STE 139 750513618 214 788-2826 N

ACCESSHEALTH PLUS GRAND PRARIE KROGER PHARMACY 2525 1 20 75052 972 988-1366 N

THE KROGER CO GRAND SALINE BROOKSHIRES PHARMACY 205 W FRANK 75140 903 962-4063 N

BROOKSHIRE GROCERY COMPANY GRAND SALINE ECONOMY DRUG 511 E GARLAND ST 751401984 903 962-3900 N

ELEVATE PROVIDER NETWORK GRANDVIEW WALMART PHARMACY 10-3822 416 N 3RD ST 760501933 817 866-2829 N

WALMART STORES INC GRAPEVINE BAYLOR SCOTT & WHITE PHARMACY #107 1600 W COLLEGE ST 76051 817 388-3090 N

LEADER DRUG STORES INC GRAPEVINE CVS PHARMACY 2051 HALL JOHNSON RD 76051 817 410-8808 N

CVS PHARMACY INC GRAPEVINE CVS PHARMACY 3701 IRA E WOODS AVE 760514213 817 251-2411 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network GRAPEVINE CVS PHARMACY 2105 W NORTHWEST HWY 76051 817 416-2501 N

CVS PHARMACY INC GRAPEVINE GRAPEVINE DRUG MART 1115 W NORTHWEST HWY STE H 760515029 817 481-5780 N

ACCESSHEALTH PLUS GRAPEVINE MINYARD PHARMACY #76 4000 WILLIAM D TATE 76051 817 684-9211 N

ACCESSHEALTH PLUS GRAPEVINE RECEPT PHARMACY 1469 W STATE HIGHWAY 114

STE 598 760518626 817 571-8745 N

RECEPT HEALTHCARE SERVICES GRAPEVINE SAMS PHARMACY 1701 W STATE HIGHWAY 114 76051 817 416-0561 N

WALMART STORES INC GRAPEVINE TARGET PHARMACY 1101 IRA E WOODS AVE 76051 817 601-0350 N

TARGET PHARMACIES GRAPEVINE TRIWEST SPECIALTY PHARMACY 1940 ENCHANTED WAY STE 103A 760510965 972 914-4990

TPN GRAPEVINE WAL-MART PHARMACY 10-10266 1601 W STATE HIGHWAY 114 76051 817 488-6682 N

WALMART STORES INC GRAPEVINE YOUR RX PHARMACY 2637 IRA E WOODS AVE STE 200 760519012 817 416-2222 N

ELEVATE PROVIDER NETWORK GREENVILLE BROOKSHIRES PHARMACY 6410 WESLEY ST 75401 903 455-1076 N

BROOKSHIRE GROCERY COMPANY GREENVILLE CVS PHARMACY 5010 WESLEY ST 754026307 903 455-1010 N

CVS PHARMACY INC GREENVILLE MEDICINE SHOPPE 3001 JOE RAMSEY BLVD E 754017714 903 455-7200 N

MEDICINE SHOPPE INTERNATIONAL INC GREENVILLE SUPER 1 PHARMACY 4811 WESLEY ST 75401 903 454-8701 N

BROOKSHIRE GROCERY COMPANY GREENVILLE TOTAL CARE PHARMACY # 2 5127 WESLEY ST 75401 903 259-6338 N

EPIC PHARMACY NETWORK INC GREENVILLE WAL-MART PHARMACY 7401 INTERSTATE HIGHWAY 30 754027121 903 454-6646 N

WALMART STORES INC GREENVILLE WALMART PHARMACY 10-4453 4715 WESLEY ST 754015647 903 259-5292 N

WALMART STORES INC GROESBECK GROESBECK CITY DRUG 404 S DR J B RIGGS DR 76642 254 729-3092 N

ELEVATE PROVIDER NETWORK GROESBECK PHARMACY PLUS #2 209 N ELLIS ST 76642 254 729-3375 N

ELEVATE PROVIDER NETWORK GROVES BRUCES PHARMACY 6001 39TH ST 776194694 409 962-4431 N

LEADER DRUG STORES INC GUN BARREL CITY CVS PHARMACY 1279 W MAIN ST 75156 903 887-6498 N

CVS PHARMACY INC GUN BARREL CITY GUN BARREL CITY PHARMACY 300 N GUN BARREL LN 75156 903 887-3606 N

ELEVATE PROVIDER NETWORK GUN BARREL CITY WAL-MART PHARMACY 10-0516 1200 W MAIN 75156 903 887-2133 N

WALMART STORES INC HALE CENTER HALE CENTER CLINICAL PHARMACY 601 AVE G 790410957 806 839-2466 N

ELEVATE PROVIDER NETWORK HALLETTSVILLE HALLETTSVILLE PHARMACY 304 N TEXANA 77964 361 798-5010 N

THIRD PARTY STATION CP HALLETTSVILLE WAL-MART PHARMACY 1506 N TEXANA 77964 361 798-4379 N

WALMART STORES INC HALLSVILLE BROOKSHIRES PHARMACY 590 W MAIN ST 75650 903 668-1409 N

BROOKSHIRE GROCERY COMPANY HALTOM CITY CVS PHARMACY 3220 DENTON HWY 76117 817 831-4488 N

CVS PHARMACY INC HALTOM CITY HALTOM PHARMACY LLC 5310 E BELKNAP ST STE E 76117 817 838-2500 N

ELEVATE PROVIDER NETWORK HALTOM CITY KROGER PHARMACY 3304 DENTON HWY 76117 817 831-0216 N

THE KROGER CO HAMILTON HAMILTON CITY DRUG 105 E HENRY ST 76531 254 386-3121 N

TPN HARKER HEIGHTS CVS PHARMACY # 800 E FM 2410 RD 765485731 254 698-1716

CVS PHARMACY INC HARKER HEIGHTS HEB PHARMACY 601 INDIAN TRAIL 76548 254 699-8810 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HARKER HEIGHTS SAM'S PHARMACY 10-6245 600 W CENTRAL TEXAS

EXPRESSWAY 76548 254 415-4892 N

WALMART STORES INC HARKER HEIGHTS TARGET PHARMACY 201 E CENTRAL TEXAS EXPY 765482747 254 953-5881 N

TARGET PHARMACIES HARKER HEIGHTS WAL-MART PHARMACY 2020 HEIGHTS DRIVE 76548 254 699-3222 N

WALMART STORES INC HARKER HEIGHTS WALMART PHARMACY 10-6459 960 E FM 2410 76548 254 698-6011 N

WALMART STORES INC HARLINGEN CARE RX PHARMACY 4501 HALE AVE 785509296 956 365-4677 N

ELEVATE PROVIDER NETWORK HARLINGEN CVS PHARMACY 118 E HARRISON AVE 785509132 956 423-3373

CVS PHARMACY INC HARLINGEN CVS PHARMACY # 2015 N 77 SUNSHINE STRIP STE A 785508398 956 423-2986

CVS PHARMACY INC HARLINGEN HARLINGEN PHARMACY 1616 N ED CAREY DR 785508286 956 230-3200 N

LEADER DRUG STORES INC HARLINGEN HEB PHARMACY 613 S EPWY 83 78550 956 428-9647 N

HEB GROCERY COMPANY LP HARLINGEN HEB PHARMACY 1213 S COMMERCE 78550 956 425-4423 N

HEB GROCERY COMPANY LP HARLINGEN HEB PHARMACY 1103 MORGAN 78550 956 440-1787 N

HEB GROCERY COMPANY LP HARLINGEN KMART PHARMACY7077 1129 MORGAN BLVD 785505152 956 428-4158 N

K MART PHARMACY HARLINGEN MUNIZ RIO GRANDE PHARMACY 1117 S COMMERCE 78550 956 423-1753 N

ELEVATE PROVIDER NETWORK HARLINGEN PETES PHARMACY 721 W HARRISON AVE STE A 78550 956 425-2424 N

THIRD PARTY STATION CP HARLINGEN SALINAS PHARMACY 1022 S F ST 785506749 956 425-1156 N

LEADER DRUG STORES INC HARLINGEN SAM'S CLUB PHARMACY 10-6269 621 N EXPRESSWAY 77 78550 956 507-7305

WALMART STORES INC HARLINGEN TARGET PHARMACY 1002 DIXIELAND RD 78552 956 440-8329 N

TARGET PHARMACIES HARLINGEN WAL-MART PHARMACY 10-0595 1801 W LINCOLN AVE 78552 956 425-7753 N

WALMART STORES INC HARLINGTON F STREET PHARMACY 1206 S F ST 78550 956 364-1810 N

ACCESSHEALTH PLUS HASKELL HASKELL CLINICAL SERVICES 100 S AVE E 79521 940 864-2674 N

GERIMED LTC NETWORK INC HASKELL THE DRUG STORE 100 S AVE E 795215795 940 864-2673 N

ELEVATE PROVIDER NETWORK HASKELL WALMART PHARMACY 10-2779 5 N 14TH ST 795213164 940 864-8085 N

WALMART STORES INC HASLET CVS PHARMACY # 13901 SENDERA RANCH BLVD 760525832 817 439-8704

CVS PHARMACY INC HASLET HASLET PHARMACY 1205 AVONDALE HASLET RD STE

# 200 760523512 682 593-9272 N COMMUNITY INDEPENDENT PHARMACY

NETW HAWKINS BROOKSHIRES PHARMACY 1477 N BEULAH ST 75765 903 769-3344 N

BROOKSHIRE GROCERY COMPANY HEARNE WILSON DRUG 118 W 4TH ST 778592506 979 279-2173 N

ELEVATE PROVIDER NETWORK HEATH CVS PHARMACY # 4282 RIDGE RD 75032 972 722-2040

CVS PHARMACY INC HEBBRONVILLE COUNTY PHARMACY 602 E GALBRAITH ST 783613401 361 527-3231 N

ELEVATE PROVIDER NETWORK HELOTES CVS PHARMACY # 08990 12980 BANDERA RD 780234098 210 372-0386

CVS PHARMACY INC HELOTES WAL-MART PHARMACY 12550 LESLIE RD 78023 210 507-4982 N

WALMART STORES INC HEMPHILL K-C DRUGS #2 2155 WORTH ST 75948 409 787-2345 N

THIRD PARTY STATION CP HEMPSTEAD WAL-MART PHARMACY 625 HWY 290 EAST 77445 979 826-3378 N

WALMART STORES INC

Page 47: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HENDERSON CVS PHARMACY 725 E MAIN ST 75652 903 657-7586 N

CVS PHARMACY INC HENDERSON KROGER PHARMACY 2415 HIGHWAY 79S 756544411 903 657-8596 N

THE KROGER CO HENDERSON RAY PHARMACY 220 ZEID BLVD 75652 903 657-2588 N

ELEVATE PROVIDER NETWORK HENDERSON STRONG HURT PHARMACY 111 E MAIN ST 756523167 903 657-3587 N

ELEVATE PROVIDER NETWORK HENDERSON THE MEDICINE SHOPPE 612 E MAIN ST 75652 903 657-1593 N

MEDICINE SHOPPE INTERNATIONAL INC HENDERSON WAL-MART PHARMACY 10-0165 2121 HWY 79 SOUTH 75654 903 657-2757 N

WALMART STORES INC HENRIETTA HENRIETTA PHARMACY 124 N BRIDGE 76365 940 538-4361 N

ELEVATE PROVIDER NETWORK HEREFORD CVS PHARMACY 101 W PARK AVE 79045 806 364-2300 N

CVS PHARMACY INC HEREFORD HEREFORD HEALTH MART PHARMACY 809 S 25 MILE AVE 79045 806 364-3400 N

ACCESSHEALTH PLUS HEREFORD WAL-MART PHARMACY 300 W 15TH ST 79045 806 364-4459 N

WALMART STORES INC HEWITT LYNN'S PHARMACY HEWITT 511 N HEWITT DR STE 1 766433093 254 666-5000 N

ELEVATE PROVIDER NETWORK HICKORY CREEK/DENTO WAL-MART PHARMACY 1035 HICKORY CREEK BLVD 75065 940 321-5686 N

WALMART STORES INC HICO BEST VALUE HICO PHARMACY W 1ST AND WALNUT 76457 254 796-4271

ELEVATE PROVIDER NETWORK HIDALGO WALMART PHARMACY 10-3567 3000 N JACKSON RD 785573882 956 904-4829 N

WALMART STORES INC HIGHLAND VILLAGE KROGER PHARMACY 2240 FM 407 75077 972 317-5738 N

THE KROGER CO HIGHLAND VILLAGE WAL-MART PHARMACY 3060 FM 407 75077 972 317-1947 N

WALMART STORES INC HILLSBORO BROOKSHIRES PHARMACY 120 S WACO 76645 254 580-2953 N

BROOKSHIRE GROCERY COMPANY HILLSBORO EAGLE DRUG 101 JANE LN 766452673 254 582-5363 N

THIRD PARTY STATION CP HILLSBORO T B BOND PHARMACY 60 W ELM ST 76645 254 582-2561 N

ELEVATE PROVIDER NETWORK HILLSBORO WAL-MART PHARMACY 10-0211 401 COKE ST 76645 254 582-7435 N

WALMART STORES INC HONDO HEB PHARMACY 609 19TH ST 78861 830 426-5312 N

HEB GROCERY COMPANY LP HONDO WAL-MART PHARMACY 10-0443 109 22ND ST 78861 830 426-3305 N

WALMART STORES INC HONEY GROVE HONEY GROVE PHARMACY 435 S 5TH ST 754461427 903 378-2901 N

ELEVATE PROVIDER NETWORK HOOKS WHISENHUNT'S CITY PHARMACY 102 MAIN ST 755610129 903 547-2782 N

ELEVATE PROVIDER NETWORK HORIZON CITY WAL-MART PHARMACY 13900 HORIZON BLVD 79928 915 206-6215 N

WALMART STORES INC HORSESHOE BAY BAY PHARMACY 7405 HWY 2147 78657 830 598-1900 N

THIRD PARTY STATION CP HOUSTON 1960 PHARMACY 724 CYPRESS CREEK PKWY STE

100 77090 281 893-6000 N

TRINET HOUSTON 1ST CHOICE PRESCIPTIONS 2056 ANTOINE DR 77055 832 582-8109

THIRD PARTY STATION CP HOUSTON ACARIAHEALTH PHARMACY #11 1311 W SAM HOUSTON

PARKWAY N #130 77043 832 900-1367 N

HOUSTON ACCREDO HEALTH GROUP INC 9307 KIRBY DR 77054 713 791-1552 N

ACCREDO HEALTH GROUP INC HOUSTON ADVANCEPHARM 2646 S LOOP W STE 330 770542773 713 661-5711 N

TRINET HOUSTON AFRA PHARMACY 8141 LONG POINT RD 77055 832 831-9694 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON AKO PHARMACY 11811 FALLBROOKS DR, STE B1 77065 281 890-9922 N

TRINET HOUSTON A-LIST PHARMACY LLC 5205 DOWLING ST STE B 77004 713 529-2728 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON ALTUS PHARMACY 1535 W LOOP S BUILDING 77027 972 432-6550 N

TRINET HOUSTON ALTUS PHARMACY 10851 SCARSDALE BLVD, SUITE

160B 77089 281 481-0398 N

TRINET HOUSTON ANCHOR PHARMACY 11008 BELLAIRE BLVD 770722606 281 495-1282 N

TRINET HOUSTON A-PLUS PHARMACY 5700 S GESSNER, STE G 770712249 713 750-9160 N

TRINET HOUSTON APOTEK PHARMACY 5201 HARRISBURG BLVD 77011 713 928-3210 N

THIRD PARTY STATION HOUSTON ASTRO PHARMACY, LLC 10530 NORTHWEST FWY 770928205 713 957-4600 N

TRINET HOUSTON AZMO PHARMACY COMPOUNDING 7825 HIGHWAY 6 N STE 106 770951705 281 861-9000 N

THIRD PARTY STATION CP HOUSTON AZTECA PHARMACY 3100 BROADWAY ST 77017 713 644-3600 N

TPN HOUSTON B.V.M. PHARMACY INC. 9325 KEMPWOOD DR SUITE B 77080 713 460-5100 N

TRINET HOUSTON BAIJES BISSONNET PHARMACY 9801 BISSONNET ST STE F 770368224 281 974-3573 N

TRINET HOUSTON BAO CHAU PHARMACY 12002 VETERANS MEMORIAL

DRIVE 77067 281 631-0600 N

ELEVATE PROVIDER NETWORK HOUSTON BARKER CYPRESS PHARMACY 1855 BARKER CYPRESS RD STE

140 770847210 281 579-9393 N

ELEVATE PROVIDER NETWORK HOUSTON BARKER CYPRESS PHARMACY AND

COMPOUNDING 8300 HOMESTEAD RD 770282149 713 631-3117

TRINET HOUSTON BELLAIRE DISCOUNT PHY 10515 BELLAIRE BLVD 77072 281 568-1888 N

ELEVATE PROVIDER NETWORK HOUSTON BEMAJ PHARMACY INC 10039 BISSONNET 77036 713 774-7200 N

LEADER DRUG STORES INC HOUSTON BIG TEX PHARMACY LLC 10900 GULF FREEWAY STE A3 77034 713 283-1310 N

TRINET HOUSTON BIOCARE PHARMACY 10603 BELLAIRE BLVD 77072 281 530-5800 N

ELEVATE PROVIDER NETWORK HOUSTON BIOCURE LLC 8700 COMMERCE PARK DR STE

241 770367432 713 360-2100 N

THIRD PARTY STATION HOUSTON BIZMART PHARMACY 9504 LONG POINT RD STE L 770554226 713 465-2300 N

TRINET HOUSTON BIZMART PHARMACY II 779 NORMANDY ST SUITE #130A 77015 832 767-2438 N

TRINET HOUSTON BLUE MINT PHARMACY 9888 BISSONNET ST STE 210 770368441 713 773-2535 N

TRINET HOUSTON BLUEBONNET APOTHECARY SERVICES 4712 AIRLINE DR STE F 770223076 713 691-6200 N

TRINET HOUSTON BOTICA FAMILIAR PHARMACY 12333 S MAIN ST 77035 713 918-6402 N

TRINET HOUSTON BRETSHIRE PHARMACY INC. 7030 BRETSHIRE DR 770163704 713 635-8800 N

TRINET HOUSTON BRIARGROVE PHARMACY 6435 SAN FELIPE 77057 713 783-5704

EPIC PHARMACY NETWORK INC HOUSTON BRIGHTMED PHARMACY 9630 CLAREWOOD DR SUITE A-

14 77036 713 772-7700 N

ELEVATE PROVIDER NETWORK HOUSTON BWM PHARMACY AND MEDICAL SUPPLY

INC 11850 FM 1960 RD WEST 770653840 281 469-1882 N

TRINET HOUSTON BZ PHARMACY INC. 7715 VETERANS MEMORIAL DR 77088 713 973-7500 N

THIRD PARTY STATION

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON C & C PHARMACY 8208 GULF FREEWAY 77017 713 641-6300 N

ELEVATE PROVIDER NETWORK HOUSTON CAMPBELLS COMPOUNDING

INCORPORATED 6603 KIRBY DR 77005 713 668-4833 N

TRINET HOUSTON CANAL HEALTHCARE SOLNS. LLC. 7648 CANAL ST 770121144 713 924-6067 N

THIRD PARTY STATION CP HOUSTON CARE PLUS PHARMACY 10301 CLUB CREEK DR 770367129 713 778-1773 N

TRINET HOUSTON CARECO PHARMACY 15003 FM 529 RD STE H 770953247 832 803-0388 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON CEDRA PHARMACY 1607 S POST OAK LANE 77056 713 621-0621 N

ACCESSHEALTH PLUS HOUSTON CEGO INFUSION PHARMACY 6300 RICHMOND AVE 77057 713 541-6000 N

TPN HOUSTON CHOICE PHARMACY 9207 COUNTRY CREEK DR STE

202 770367711 713 778-0463 N

TRINET HOUSTON CK PHARMACY 5990 AIRLINE DR 77076 713 697-0610 N

ELEVATE PROVIDER NETWORK HOUSTON CLINICAL CARE PHARMACY 2770 N SAM HOUSTON PKWY

WEST 77038 281 272-8700 N

ELEVATE PROVIDER NETWORK HOUSTON COMMUNITY EXPRESS PHARMACY 9820 GULF FWY STE A10 770341020 832 941-0901 N

TRINET HOUSTON COMPOUNDING SHOP PHARMACY 11851A WILCREST DR 770311919 281 495-2230 N

TRINET HOUSTON COMPOUNDING SOLUTIONS 11240 FM 1960 W 77064 281 477-7686 N

TRINET HOUSTON CORNERSTONE RX PHARMACY 7255 BISSONNETSTREET 77074 713 771-8217 N

TRINET HOUSTON COSTCO PHARMACY 1150 BUNKER HILL ROAD 77055 713 576-2052 N

COSTCO PHARMACIES HOUSTON COSTCO PHARMACY 12405 N GESSNER ROAD 77064 832 912-2352 N

COSTCO PHARMACIES HOUSTON COSTCO PHARMACY 3836 RICHMOND AVE 77027 832 325-5859 N

COSTCO PHARMACIES HOUSTON CROSSWAY PHARMACY LLC 3044 ANTOINE 77092 713 290-0322 N

TRINET HOUSTON CULLEN CARE PHARMACY 5751 BLYTHEWOOD ST 77021 713 747-2100 N

TPN HOUSTON CULLEN CARE PHARMACY 9406 CULLEN BLVD STE C 770513321 713 264-0699 N

TPN HOUSTON CVS PHARMACY 9101 HWY 6 N 77095 281 859-6667 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 7102 BEECHNUT ST 77074 713 771-6652 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 5510 W OREM DRIVE 770851250 713 723-1118 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 8234 BROADWAY ST 77061 713 640-3917 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 15411 WALLISVILLE RD 77049 281 459-2740 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 3811 OLD SPANISH TRAIL 77021 713 741-7900 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1003 RICHMOND AVE 77006 713 807-8491 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 5725 N ELDRIDGE PKWY 77041 713 856-1464 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 6545 WESTHEIMER 77057 713 243-8050 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 12234 JONES RD 77070 281 517-5691 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4755 WESTHEIMER RD 77027 713 386-1093 Y

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON CVS PHARMACY 11112 RICHMOND AVE 77042 713 458-2871 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 11540 WESTHEIMER RD 770776708 281 679-8031 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 110 W 20TH ST 77008 832 673-7131 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 3140 FM 1960 RD W 77068 281 880-1092 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 13555 BEECHNUT ST 77083 281 776-3858 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 5401 WASHINGTON AVE 77007 713 861-3883 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 5603 FM 1960W 77069 281 397-4030 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 14115 E SAM HOUSTON

PARKWAY NORTH 770445131 281 459-1826 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 7950 S GESSNER RD 77036 713 484-6011 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 3939 BELLAIRE BLVD 77025 832 778-9025 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 6161 TELEPHONE RD 77087 713 645-3354 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1339 S DAIRY ASHFORD 77077 281 493-3260 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 2910 WESTHEIMER RD 77098 713 526-0062 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4150 N SHEPHERD DR 77018 713 884-4040 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1002 GESSNER DRIVE 77055 713 647-0259

CVS PHARMACY INC HOUSTON CVS PHARMACY 19715 TOMBALL HWY 77070 281 517-1766 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1001 WAUGH DRIVE 77019 713 807-7859 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 2455 ELDRIDGE PKWY 77077 281 752-5324 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 806 S 75TH ST 77023 713 926-8848 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 3401 TIDWELL RD 77093 713 691-6571 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1000 ELGIN ST 77004 713 526-4478 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 9455 HAMMERLY BLVD 770805448 713 722-1491 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 8550 W AIRPORT BLVD 77071 713 596-2163 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 2266 W HOLCOMBE BLVD 77030 713 218-2180 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 10222 E FWY 770291906 713 455-2341 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 6079 HWY 6 N 77084 281 855-5460 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 402 GRAY ST 77002 713 982-5527 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 11600 FM 1960 RD WEST 77065 281 517-7260 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 9292 WESTHEIMER RD 77063 713 782-2421 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 6011 KIRBY DR 77005 713 522-3983 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4702 IRVINGTON BLVD 77009 713 694-9158 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 519 E TIDWELL RD 77022 713 692-3400 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON CVS PHARMACY 12585 RICHMOND AVE 770822487 281 749-8863 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 10902 BISSONNET RD 77099 281 776-3874 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 7710 GESSNER RD 77040 713 849-1100 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 9411 N FWY 77037 281 447-0358 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 7900 S MAIN 770252807 713 660-8934 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 6532 SAN FELIPE RD 77057 713 789-1681 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4516 HARRISBURG BLVD 770114016 713 224-6504 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 917 MAIN ST 77002 713 982-5565 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 980 CLEARLAKE CITY BLVD 77062 281 480-4410 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 15010 MEMORIAL DR 77079 281 368-1600 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 1325 FM 1960 W 77090 281 444-4582 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 6504 W LITTLE YORK 77040 713 937-9600 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 5204 RICHMOND AVE 77056 713 961-4349 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 2828 SPEARS RD 77067 281 583-6250 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 8620 JONES RD 77065 281 517-4222 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 14606 RICHMOND AVE 77082 281 509-3440 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4131 ALDINE MAIL RTE 77039 281 985-4741 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 959 BAY AREA BLVD 77058 281 212-8040 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 12601 TOMBALL PARKWAY 77086 281 272-7190 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 12260 BELLAIRE BLVD 77072 281 776-3867 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 9838 BUFFALO SPEEDWAY 77025 713 218-4491 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 4451 W FUQUA ST 77045 713 433-6447 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 4700 KIRBY DRIVE 77098 713 533-2200 Y

CVS PHARMACY INC HOUSTON CVS PHARMACY 8201 KATY FREEWAY 77024 713 957-7500 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 5212 ANTOINE DR 77092 713 682-2533 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 10904 SCARSDALE BLVD STE 200 77089 281 481-0797 N

CVS PHARMACY INC HOUSTON CVS PHARMACY 5402 WESTHEIMER RD STE K 77056 713 877-1479 N

CVS PHARMACY INC HOUSTON CVS PHARMACY # 9410 FUQUA ST 770753907 713 987-9479

CVS PHARMACY INC HOUSTON CVS PHARMACY # 10200 CULLEN BLVD 770471140 713 731-4413

CVS PHARMACY INC HOUSTON CVS PHARMACY # 1525 N LOOP W 770081650 713 868-7456

CVS PHARMACY INC HOUSTON CVS PHARMACY # 2111 W ALABAMA ST 770982401 713 874-1085

CVS PHARMACY INC HOUSTON CVS PHARMACY # 12502 MEMORIAL DR 770246000 713 465-6443

CVS PHARMACY INC HOUSTON CVS PHARMACY # 9125 HILLCROFT ST 770962903 713 271-0998

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON CVS PHARMACY # 2469 BAY AREA BLVD 77058 281 486-0613 N

CVS PHARMACY INC HOUSTON CVS PHARMACY # 06409 4314 N FWY 770226203 713 695-4845

CVS PHARMACY INC HOUSTON CYPRESS COMPOUNDING PHARMACY 9511 HUFFMEISTER RD STE 104 770952892 832 617-0290 N

TPN HOUSTON DARCY PHARMACY 11210 BELLAIRE BLVD 77072 281 988-8300 N

ELEVATE PROVIDER NETWORK HOUSTON DB PHARMACY, PLLC 12100-E VETERANS MEMORIAL

DR 77067 281 397-7711 N

THIRD PARTY STATION CP HOUSTON DELIVERX 241 E CROSSTIMBERS ST UNIT C 770224417 832 767-2122 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON DIMENSION PHARMACY 8880 BELLAIRE BLVD 770712249 713 541-4700 N

TRINET HOUSTON DISCOUNT PHARMACY 8213 HOMESTEAD RD STE D 770282153 713 635-5560 N

LEADER DRUG STORES INC HOUSTON DISTINGUISHED PHARMACY 12134 BEECHNUT ST 770724830 281 495-0201 N

TRINET HOUSTON DOLLAR RX PHARMACY 8721 JENSEN DR 77093 713 694-1470 N

ELEVATE PROVIDER NETWORK HOUSTON DOW PHARMACY 8800 LONG POINT RD 770553006 713 722-7999 N

ELEVATE PROVIDER NETWORK HOUSTON DREAM PHARMACY MEMORIAL 1140 BUSINESS CENTER DR 770432740 713 465-1117

TPN HOUSTON EAGLE PHARMACY 11329 BISSONNET 77099 713 827-1202 N

TRINET HOUSTON ECO PHARMACY OF KATY WEST 19255 PARK ROW STE 103 770847309 281 206-7388 N

ACCESSHEALTH PLUS HOUSTON ECO PHARMACY OF WILLOWBROOK, LLC 13325 HARGRAVE RD STE 260 770704539 281 955-7500 N

ACCESSHEALTH PLUS HOUSTON ELITE PHARMACY 11569 S WILCREST DR 770994752 832 230-5229 N

TRINET HOUSTON EMERALD PHARMACY LLC 12863 GULF FWY 770344807 281 484-7100 N

TRINET HOUSTON EMPIRE RX 12361 MAIN ST 770356200 832 500-5847

TRINET HOUSTON EMPIRICAL PHARMACY 9715 TELEPHONE RD 77075 713 991-0072 N

TRINET HOUSTON ENNIS ST. PHARMACY 4702 ENNIS ST 770046132 713 524-7600 N

TRINET HOUSTON EXCEL PHARMACY INC 8600 W AIRPORT BLVD STE B 770712483 713 995-1272 N

TRINET HOUSTON EXPERIANCARE PHARMACY LLC 3730 KIRBY DR 770983930 713 524-3330 N

TRINET HOUSTON EXPRESS SPECIALTY PHARMACY 837 CYPRESS CREEK PKWY STE

105A 77090 281 453-7205 N

TRINET HOUSTON EXPRESS SPECIALTY PHARMACY 20320 NW FRWY 77065 281 453-7450 N

TRINET HOUSTON FALCON PHARMACY OF TEXAS INC 8145 HIGHWAY 6 S STE 114A 770835763 281 776-9600

TRINET HOUSTON FAMACIA DEL SOL INC 6300 HILLCROFT 101 77081 713 776-0806 N

ELEVATE PROVIDER NETWORK HOUSTON FAMILY CARE PHARMACIES 12350 WESTHEIMER STE D 77077 281 589-7670 N

TRINET HOUSTON FAMILY PHARMACY CARE 12121 RICHMOND AVE STE 126 770822453 281 315-3770 N

THIRD PARTY STATION CP HOUSTON FAMILYRX PHARMACY INC 9511 HUFFMEISTER RD STE 103 770952865 281 855-4343 N

THIRD PARTY STATION CP HOUSTON FARMACIA ETC 6015 HILLCROFT 77081 713 774-5100 N

ELEVATE PROVIDER NETWORK HOUSTON FRIENDSWOOD HEALTH MART PHARMACY 1560 W BAY AREA BLVD #180 77546 281 218-6116 N

ACCESSHEALTH PLUS HOUSTON GALAXY PHARMACY 12303 WESTHEIMER RD SUITE D 77077 281 496-6600

TRINET

Page 53: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON GENESIS DRUG INC 302 W GULFBANK RD 77037 281 999-4210 N

LEADER DRUG STORES INC HOUSTON GILLTOP PHARMACY LLC 14522 S POST OAK RD STE 108A 770456038 832 831-7381 N

TRINET HOUSTON GOOD SAMARITAN PHARMACY &

COMPOUNDING 10122 LONG POINT RD STE 104 770434319 832 804-6605 N

TRINET HOUSTON GROVEWAY PHARMACY 4501 GROVEWAY 77087 713 644-9400 N

ELEVATE PROVIDER NETWORK HOUSTON HEALTH FIT PHARMACY 3620 KATY FWY STE A 770073646 713 802-2441 N

TRINET HOUSTON HEALTH RX SCRIPTS, LLC 900 S WAYSIDE DR 770233427 832 740-4353 N

HOUSTON HEALTHCHOICE PHARMACY 10001 W BELLFORT ST STE K 770312559 281 741-8358 N

TRINET HOUSTON HEB PHARMACY 3111 WOODRIDGE SUITE 500 77087 713 847-0071 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 12680 W LAKE HOUSTON PKWY 77044 281 436-0748 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 1550 FRY ROAD 77084 281 829-2565 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 10919 LOUETTA RD 77070 281 257-4655 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 9710 KATY FREEWAY 77055 713 647-5960 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 5225A BUFFALO SPEEDWAY 77005 713 664-3426 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 4955 HWY 6 N 77084 281 463-9148 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 5895 SAN FELIPE ST 77057 713 278-8474 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 11815 WESTHEIMER 77077 281 497-8479 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 10100 BEECHNUT 77072 281 564-5209 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 10251 KEMPWOOD 77043 713 996-0449 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 1701 W ALABAMA ST 77098 713 807-7293 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 4303 KINGWOOD 77339 281 361-0083 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 9503 JONES RD 77065 281 894-5237 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY 9828 BLACKHAWK BLVD 77075 713 991-1351 N

HEB GROCERY COMPANY LP HOUSTON HEB PHARMACY #713 3501 CLEAR LAKE CITY BLVD 77059 210 938-2713 N

HEB GROCERY COMPANY LP HOUSTON HEIGHTS PHARMACY 5225 KATY FWY STE 105A 770072292 713 487-3313 N

RECEPT HEALTHCARE SERVICES HOUSTON HICARE PHARMACY 7814 ALMEDA ROAD 770543235 713 799-8880 N

THIRD PARTY STATION CP HOUSTON HOPE PHARMACY 1919 N LOOP WEST, 77008 713 864-0100 N

ELEVATE PROVIDER NETWORK HOUSTON HPB PHARMACY 6410 FANNIN ST 77030 713 799-1472 N

ELEVATE PROVIDER NETWORK HOUSTON INTRACARE COMMUNITY PHARMACY 1120 CYPRESS STATION DR 77090 713 790-7821 N

ELEVATE PROVIDER NETWORK HOUSTON INWOOD PHARMACY 13300 HARGRAVE RD 77070 281 664-8829 N

ELEVATE PROVIDER NETWORK HOUSTON IRVINGTON FAMILY PHARMACY 3815 IRVINGTON BLVD STE E 770094843 713 694-8399 N

TRINET HOUSTON J & I PHARMACY 13249 BELLAIRE BLVD 77083 281 372-6526 N

LEADER DRUG STORES INC HOUSTON J & J PHARMACY 13415 WOODFOREST BLVD 77015 713 330-4400 N

ACCESSHEALTH PLUS

Page 54: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON J DYKES PHARMACY 4901 YALE 77018 713 691-5100 N

TPN HOUSTON JACINTO PHARMACY INC 10805 MARKET ST RD 770292391 713 455-1361 N

ACCESSHEALTH HOUSTON JACKS APOTHECARY 8109 CULLEN BLVD 770512015 713 733-7424 N

ELEVATE PROVIDER NETWORK HOUSTON JACOBS DISCOUNT PHARMACY 8118 LONG POINT RD 770552006 713 469-3502 N

TRINET HOUSTON JAMES PHARMACY 12950 S POST OAK 77045 713 721-3800 N

THIRD PARTY STATION HOUSTON JL WELLNESS PHARMACY 9210 HIGHWAY 6 S 770836385 281 741-1960 N

TRINET HOUSTON KASE RX PHARMACY 8353 SOUTHWEST FWY 770741602 713 777-9200 N

TRINET HOUSTON KEYSTONE PHARMACY 9301 GULF FREEWAY 77017 832 834-3312 N

TRINET HOUSTON KHARISMA PHARMACY 8608 S BRAESWOOD BLVD 77031 832 409-5586 N

TRINET HOUSTON KIM LONG PHARMACY 7601 W SAM HOUSTON PKWY S 77072 713 777-1414 N

TRINET HOUSTON KIMMY PHARMACY 8388 W SAM HOUSTON PKWY S

STE 186 770725081 281 564-5400 COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON KINGS RX PHARMACY 9501 LONG POINT RD STE J 770554223 713 465-6007

TRINET HOUSTON KINGSBRIDGE RX PHARMACY 6720 HIGHWAY 6 S 770831512 281 495-3500 N

TRINET HOUSTON KINGSLEY PHARMACY 2626 S LOOP W STE 115 770542648 713 664-6333 N

TRINET HOUSTON KREMCO PHARMACY LLC 10815 BEECHNUT ST STE 125 770724491 281 564-7500 N

TRINET HOUSTON KROGER PHARMACY 7747 KIRBY DR 77030 713 661-7440 N

THE KROGER CO HOUSTON KROGER PHARMACY 12620 WOODFOREST 200 77015 713 451-8184 N

THE KROGER CO HOUSTON KROGER PHARMACY 2300 N GESSNER 77080 713 467-9425 N

THE KROGER CO HOUSTON KROGER PHARMACY 1520 ELDRIDGE 77077 281 496-7719 N

THE KROGER CO HOUSTON KROGER PHARMACY 11701 S SAM HOUSTON PKWY 77089 281 484-3294 N

THE KROGER CO HOUSTON KROGER PHARMACY 12434 TOMBALL PARKWAY 77086 281 272-0050 N

THE KROGER CO HOUSTON KROGER PHARMACY 10306 S POST OAK 77035 713 729-5161 N

THE KROGER CO HOUSTON KROGER PHARMACY 1801 S VOSS ROAD 77057 713 780-7643 N

THE KROGER CO HOUSTON KROGER PHARMACY 16400 EL CAMINO REAL 77062 281 286-8364 N

THE KROGER CO HOUSTON KROGER PHARMACY 1950 EL DORADO 77062 281 480-7092 N

THE KROGER CO HOUSTON KROGER PHARMACY 9919 WESTHEIMER ELMSIDE 77042 713 532-5858 N

THE KROGER CO HOUSTON KROGER PHARMACY 1938 W GRAY 77019 713 521-2317 N

THE KROGER CO HOUSTON KROGER PHARMACY 12222 JONES RD 77070 832 912-7578 N

THE KROGER CO HOUSTON KROGER PHARMACY 1990 OLD SPANISH TRAIL 77054 713 791-1306 N

THE KROGER CO HOUSTON KROGER PHARMACY 5235 ALDINE MAIL ROUTE 77039 281 449-0338 N

THE KROGER CO HOUSTON KROGER PHARMACY 14344 MEMORIAL DR 77079 281 497-3565 N

THE KROGER CO HOUSTON KROGER PHARMACY 14710 WOODFOREST 77015 713 453-8446 N

THE KROGER CO

Page 55: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON KROGER PHARMACY 6160 HWY 6 AT LITTLE YORK 77084 281 345-1425 N

THE KROGER CO HOUSTON KROGER PHARMACY 9303 HWY 6 SOUTH 77083 713 474-2111 N

THE KROGER CO HOUSTON KROGER PHARMACY 8550 HWY 6 N W RD 77095 281 463-2409 N

THE KROGER CO HOUSTON KROGER PHARMACY 1035 N SHEPHERD 77008 713 880-4661 N

THE KROGER CO HOUSTON KROGER PHARMACY 10010 CYPRESSWOOD DR 77070 281 807-1056 N

THE KROGER CO HOUSTON KROGER PHARMACY 1505 WIRT 77055 713 722-7282 N

THE KROGER CO HOUSTON KROGER PHARMACY 3300 MONTROSE BLVD 77006 713 526-1239 N

THE KROGER CO HOUSTON KROGER PHARMACY 1352 W 43RD ST 77018 713 681-0821 N

THE KROGER CO HOUSTON KROGER PHARMACY 6322 TELEPHONE RD 77087 713 644-1815 N

THE KROGER CO HOUSTON KROGER PHARMACY 6749 AIRLINE 77076 713 692-5163 N

THE KROGER CO HOUSTON KROGER PHARMACY 12555 BRIAR FOREST DR 77077 281 496-1092 N

THE KROGER CO HOUSTON KROGER PHARMACY 5150 BUFFALO SPEEDWAY 77005 713 661-0291 N

THE KROGER CO HOUSTON KROGER PHARMACY 12400 FM 1960 77065 832 237-4890 N

THE KROGER CO HOUSTON KROGER PHARMACY 13133 VETERANS MEMORIAL 77014 281 440-7456 N

THE KROGER CO HOUSTON KROGER PHARMACY 1440 STUDEMONT ST 77007 832 708-2287 N

THE KROGER CO HOUSTON KROGER PHARMACY 9125 W SAM HOUSTON

PARKWAY 77064 281 477-0585 N

THE KROGER CO HOUSTON KROGER PHARMACY 6350 N ELDRIDGE PARKWAY 77041 713 896-8487 N

THE KROGER CO HOUSTON KROGER PHARMACY 9330 JONES ROAD 77065 281 894-4859 Y

THE KROGER CO HOUSTON KROGER PHARMACY 360 FM 1960 WEST 77090 281 397-6622 N

THE KROGER CO HOUSTON KWIK MEDS PHARMACY LLC 1900 N LOOP W STE 170 77018 281 501-2228 N

TRINET HOUSTON LA PLAZA PHARMACY-1 6655 HILLCROFT 770814801 713 644-9400 N

ELEVATE PROVIDER NETWORK HOUSTON LEADCARE PHARMACY INC 9908 S GESSNER DRIVE 77071 713 774-8180 N

THIRD PARTY STATION HOUSTON LELAND PHARMACY 5412 FARMER ST 770204720 713 673-8000 N

TPN HOUSTON LIFE PHARMACY 5800 BELLAIRE BLVD 77081 713 665-5050 N

TRINET HOUSTON LIFECARE PHARMACY 7135 SOUTHWEST FWY 770742001 713 772-3000

THIRD PARTY STATION HOUSTON LITTLE YORK PHARMACY 7404 AIRLINE DR STE E 770761069 832 767-2139 COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON LOTUS PHARMACY 8200 WILCREST DR, SUITE 8 770724328 281 983-9382 N

LEADER DRUG STORES INC HOUSTON LOVING CARE PHARMACY 4406 AIRLINE DR 770222901 713 808-9103 N

TRINET HOUSTON LYONS PHARMACY 5602 LYONS AVE 770204730 713 675-9667 N

ACCESSHEALTH PLUS HOUSTON MACE RX PHARMACY, LLC 8775 S GESSNER RD 770742915 832 917-5550 N

TRINET HOUSTON MADONNA PHARMACY INC 10333 HARWIN DR STE 450 770361561 832 831-8114 N

TRINET HOUSTON MAIN MEDICAL PLAZA PHARMACY 10019 S MAIN 77025 713 667-5003 N

ACCESSHEALTH PLUS

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON MARITIME PHARMACY 900 BROADWAY ST 77012 713 921-1052 N

THIRD PARTY STATION CP HOUSTON MAS PHARMACY RX 9355 LONG POINT RD STE L 770554481 713 465-6113 N

TRINET HOUSTON MASWOSWES ALTERNATIVE PHARMACY

SERVICES 14625 BEECHNUT ST UNIT 1A 770834436 832 230-5115 N

TRINET HOUSTON MAVIS O PHARMACY 10080 BELLAIRE BLVD STE 102 770725249 281 498-1161 N

THIRD PARTY STATION CP HOUSTON MAXIMUM CARE PHARMACY 16251 S POST OAK RD STE A 77053 281 438-6161 N

THIRD PARTY STATION CP HOUSTON MAXOR PHARMACY 1919 LA BRANCH ST 77002 713 756-5300 N

MAXOR NATIONAL PHCY SRVS LLC HOUSTON MAXOR PHARMACY 1046B HERCULES 77058 281 480-0327 N

MAXOR NATIONAL PHCY SRVS LLC HOUSTON MAYFLOWER PHARMACY 8323 SOUTHWEST FWY STE 115 770741615 713 981-5900 N

TRINET HOUSTON MCA PHARMACY, LLC 1201 DAIRY ASHFORD, SUITE 200 77079 713 482-4444 N

ACCESSHEALTH PLUS HOUSTON MED RX PHARMACY 4000 FULTON ST, STE C 77009 713 695-5000 N

TRINET HOUSTON MED SCRIPTS PHARMACY 10039 BISSONNET ST STE 116 77036 832 371-6100 N

TPN HOUSTON MED SOLUTION PHARMACY 10680 JONES ROAD 770655594 281 890-9922 N

ELEVATE PROVIDER NETWORK HOUSTON MED VALT PHARMACY LLC 9117 STELLA LINK RD 77025 713 349-9882 N

ACCESSHEALTH PLUS HOUSTON MEDCARE PHARMACY 11322 BELLAIRE BLVD STE 116 770725700 281 561-0088 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON MEDCARE RX PHARMACY 7052 BISSONNET ST 77074 713 272-9600 N

ELEVATE PROVIDER NETWORK HOUSTON MEDCO SPECIALTY PHARMACY 10305 ROUND UP LN STE 200 770645560 713 980-2814 N

TRINET HOUSTON MEDEX PHARMACY 9600 FONDREN RD #B3 77096 713 771-3800 N

TRINET HOUSTON MEDEX PLUS, INC. 5420 DASHWOOD DR STE 201 770815332 713 664-8800 N

TRINET HOUSTON MEDICAL SQUARE PHARMACY 1401 WIRT RD STE E 770554904 713 468-3236 N

LEADER DRUG STORES INC HOUSTON MEDICINE SHOPPE 5910 SCOTT ST 77021 713 741-5104 N

ACCESSHEALTH PLUS HOUSTON MEDICINE SHOPPE 5600 MYKAWA 770331009 713 641-3414 N

MEDICINE SHOPPE INTERNATIONAL INC HOUSTON MEDI-SCRIPT PHARMACY 8121 BROADWAY ST STE 105 770611341 713 910-3774 N

TRINET HOUSTON MEDRX COMPOUNDING & PHARMACY

LIMITED COMPANY 601 WAYSIDE DR STE D 770113614 832 767-5466 N

TRINET HOUSTON MEDSAVER PHARMACY 10701 W BELLFORT ST STE B #

172 770994748 281 988-0880 N

TRINET HOUSTON MED-TECH SPECIALTY PHARMACY LLC 17215 RED OAK DR SUITE 103 770902697 281 397-1476 N

TRINET HOUSTON MEDWORLD PHARMACY INC 12390 KINGSRIDE LN 770244117 713 647-0200 N

ACCESSHEALTH PLUS HOUSTON MEMORIAL PHARMACY 10101 SOUTHWEST FWY STE 315 770741111 832 358-8500 N

TRINET HOUSTON MERCURY DRIVE PHARMACY 918 MERCURY DR 770292002 713 674-6122 N

ACCESSHEALTH HOUSTON MEYERLAND PHARMACY, LLC 10547 S POST OAK RD 770353305 713 728-8000 N

TRINET HOUSTON MIDTOWN SPECIALTY RX 1701 WEBSTER ST STE D 770035800 713 874-9190 N

TRINET HOUSTON MOBILECARE PHARMACY 3918 LEELAND ST 77003 713 600-0075 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON NEIGHBORCARE- EAGLES TRACE, L.L.C. 14703 EAGLE VISTA DR STE 100 77077 281 249-7290 N

ACCESSHEALTH PLUS HOUSTON NIBA PHARMACY 13018 WOODFOREST STE N 77015 713 451-3328 N

THIRD PARTY STATION HOUSTON NNWOOD PHARMACY LLC 8240 ANTOINE DRIVE 77088 281 448-8836 N

TRINET HOUSTON ON TIME PHARMACY 14455 CULLEN BLVD 77047 713 731-0880 N

TRINET HOUSTON PATIENT CARE PHARMACY 6366 MARTIN LUTHER KING JR

BLVD 770214421 281 501-2325 N

TRINET HOUSTON PAVILION PHARMACY 1740 W 27TH ST 77008 713 868-1601 N

ACCESSHEALTH HOUSTON PHAM FAMILY PHARMACY INC 3918 LEELAND ST 77003 210 366-1212 N

TRINET HOUSTON PHARMACARE PLUS 6720 SANDS POINT DR STE 105 770743744 832 269-5348 N

TPN HOUSTON PHARMACARE TEXAS, INC. 9100 SOUTHWEST FWY STE 130 770741584 832 886-2357 N

TPN HOUSTON PHARMACY & MARKETPLACE CAFE 5927 ALMEDA RD STE G 770047791 713 526-1843 N

THIRD PARTY STATION CP HOUSTON PHARMACY DEPOT 4832 MOUNT HOUSTON RD 770931633 281 987-3300 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON PHARMACY PLUS 6776 SOUTHWEST FWY 77074 713 782-0558 N

ELEVATE PROVIDER NETWORK HOUSTON PHARMACY45 8221 GULF FWY 77017 713 847-9900 N

TRINET HOUSTON PHARMSERV INC 6828 RANCHESTER DR 77036 713 988-0883 N

ACCESSHEALTH PLUS HOUSTON PINEY POINT PHARMACY 2532 FONDREN RD 770632308 713 782-6212 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON PLATINUM RX NORTH 5627 ALDINE BENDER RD STE 7 770324517 281 227-1010 N

TRINET HOUSTON PLAZA PHARMACY 17030 NANES DR 77090 281 880-8300

TRINET HOUSTON PRECIOUS PLACE'S PHARMACY 11336 BEECHNUT ST STE A8 770724212 281 760-3660 N

TRINET HOUSTON PRESTIGE PHARMACY 6550 MAPLE RIDGE 77081 832 778-6552 N

ELEVATE PROVIDER NETWORK HOUSTON PRICELINE PHARMACY II 11811 FM 1960 STE 198 77065 409 832-0010 N

TRINET HOUSTON PRIMARY CARE PHARMACY LLC 6612 HORNWOOD SUITE C H 77074 832 433-7346 N

TRINET HOUSTON PRIMECARE PHARMACY 5900 CHIMNEY ROCK RD STE AC 770812706 713 661-7746 N

ELEVATE PROVIDER NETWORK HOUSTON PRO MED PHARMACY 2421 ALDINE MAIL RD STE B 770395530 281 372-8522 N

TRINET HOUSTON PROCARE RX 16300 KUYKENDAHL RD STE 370 770682751 281 580-4500 N

ACCESSHEALTH PLUS HOUSTON PROSCRIPT AMERICA 4151 SOUTHWEST FWY STE 373 770277312 832 647-0011 COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON PROVEN CARE PHARMACY, LLC 10950 BISSONNET ST STE # 220 770991707 281 983-9333 N

TRINET HOUSTON PUBLIC PHARMACY 6510 HILLCROFT ST # STE100 77081 713 663-7800 N

ACCESSHEALTH HOUSTON PUMPS IT PHARMACY 10601 GRANT RD STE 101 770704449 281 955-8900 N

THIRD PARTY STATION HOUSTON PVE PHARMACY 226 E CROSSTIMBERS ST STE 2 77022 713 884-1443 N

TRINET HOUSTON PYRAMIDS PHARMACY 1201 DAIRY ASHFORD RD 77079 281 589-2400 N

ACCESSHEALTH PLUS HOUSTON RAPID PHARMACY 6120 RICHMOND AVE STE A 770576210 832 962-4991 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON RECEPT PHARMACY #31 8111 N STADIUM DR STE 200A 770541842 713 627-2370 N

RECEPT HEALTHCARE SERVICES HOUSTON RELIANCE PHARMACY 7707 FANNIN 77054 713 797-1107 N

TRINET HOUSTON RICHMOND PHARMACY 9536 RICHMOND AVE STE I 770633845 832 991-8997 N

ACCESSHEALTH PLUS HOUSTON RITEMED PHARMACY LLC 10301 HARWIN DR STE 3 770362793 713 772-4242 N

TRINET HOUSTON ROSA PHARMACY 11002 SCARSDALE BLVD 77089 281 481-6602 N

THIRD PARTY STATION CP HOUSTON ROSE PHARMACY, LLC 7447 HARWIN DR STE 188 770362367 713 952-9568 N

TRINET HOUSTON RUSHMED PHARMACY P.L.L.C 5326 W BELLFORT ST # STE101 770353041 832 582-8542 N

TPN HOUSTON RX MAX PHARMACY 5858 S GESSNER DR STE 124 770362646 713 772-1363 N

TRINET HOUSTON RX PHARMACY 5600 S WILLOW DRIVE 77035 713 723-4601

TRINET HOUSTON S & K MED PHARMACY 1396 ELDRIDGE PKWY STE D 770772545 281 752-7244 N

TRINET HOUSTON SAGE PHARMACY AND STORES, LLC 3730D S GESSNER RD 770635132 713 339-1855 N

TRINET HOUSTON SAMS PHARMACY 10488 OLD KATY ROAD 77043 713 468-7047 N

WALMART STORES INC HOUSTON SAMS PHARMACY 7950 FM 1960 77070 832 237-8298 N

WALMART STORES INC HOUSTON SAMS PHARMACY 325 E RICHEY ROAD 77073 281 821-1096 N

WALMART STORES INC HOUSTON SAMS PHARMACY 13600 E FREEWAY 77015 713 330-8581 N

WALMART STORES INC HOUSTON SAMS PHARMACY 5310 S RICE AVE 77081 832 778-9807 N

WALMART STORES INC HOUSTON SAMS PHARMACY 11101 FUQUA ST 77089 713 378-9584 N

WALMART STORES INC HOUSTON SAMS PHARMACY 12205 W ROAD 77065 281 807-5194 N

WALMART STORES INC HOUSTON SAMS PHARMACY 1615 S LOOP WEST 77054 713 791-9345 N

WALMART STORES INC HOUSTON SAMS PHARMACY 10-6346 13331 WESTHEIMER RD 77082 281 829-9121 N

WALMART STORES INC HOUSTON SANTA MARIA PHARMACY 5727 RAMPART ST STE, A8 77081 713 592-5300 N

TRINET HOUSTON SEM PHARMACY & MEDICAL SUPPLY 16316 FM 529 77095 281 861-7788 N

TRINET HOUSTON SENA RX PHARMACY, INC. 5050 FM 1960 RD W STE 125 770694525 281 440-0018 N

ACCESSHEALTH PLUS HOUSTON SOLEO HEALTH INC. 8275 EL RIO 77054 832 981-1000 N

TPN HOUSTON SOLUTIONS IN PHARMACY 7951 KATY FWY STE M 770241947 713 957-8000 N

TPN HOUSTON SOUTH BELT PHARMACY 12600B SCARSDALE BLVD 77089 281 481-6600 N

THIRD PARTY STATION HOUSTON SOUTHEND PHARMACY 10910 W BELLFORT ST 77099 281 498-1450 N

TRINET HOUSTON SOUTHSIDE INFUSION 7700 MAIN ST 77030 713 660-8888 N

LEADER DRUG STORES INC HOUSTON SOUTHSIDE PHARMACY 7700 MAIN 77030 713 660-8888 N

ACCESSHEALTH PLUS HOUSTON SOUTHSIDE PHARMACY 3 7700 MAIN ST STE 260 770304456 832 553-1374 N

ACCESSHEALTH PLUS HOUSTON SOUTHSIDE PHARMACY II 1200 BINZ ST STE 260 770046925 832 553-1315 N

ACCESSHEALTH PLUS HOUSTON SOUTHWEST COMMUNITY PHARMACY 9769 BEECHNUT ST 77074 713 272-7734 N

TRINET HOUSTON SOUTHWEST PHARMACY 8282 BELLAIRE 77036 713 270-7366 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON SOUTHWEST PHARMACY 17115 RED OAK DR STE 105 770902607 281 893-8665 N

THIRD PARTY STATION HOUSTON SPG PHARMACY CARE 6831 S GESSNER DR 770364613 713 272-6400 N

TRINET HOUSTON SPRING PARK PHARMACY 510 WAUGH DRIVE 77019 832 538-1380 N

TRINET HOUSTON SPRING BRANCH PHARMACY 2600 GESSNER DR 77080 713 690-0001 N

TRINET HOUSTON ST JOSEPH PROFESSIONAL PHARMACY 2000 CRAWFORD ST 770029006 713 659-3030 N

ELEVATE PROVIDER NETWORK HOUSTON STAR REX PHARMACY LLC 11110 E FWY 770291914 832 767-0816 N

TRINET HOUSTON STEEPLECHASE EXPRESS RX 10694 JONES RD, STE 115 77065 281 894-9900

TRINET HOUSTON STERLING PHARMACY 9798 BELLAIRE BLVD 770363428 713 995-8885

TRINET HOUSTON SUPREME COMPOUNDING 7346 ANTOINE DR 77088 281 272-0813 N

TRINET HOUSTON SUPREME PHARMACY 4544 HIGHWAY 6 N 770843402 281 550-2100 N

TRINET HOUSTON TABB PHARMACY 9730 SOUTHWEST FWY STE UC #

100 770741352 713 772-8222 N

TRINET HOUSTON TARGET PHARMACY 19955 KATY FWY 77094 281 492-7906 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 6801 FM 1960 RD W 77069 281 716-1106 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 21515 TOMBALL PARKWAY 77070 281 379-2861 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 2700 ELDRIDGE PKWY 77082 281 810-5252 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 4323 SAN FELIPE ST 77027 713 331-0166 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 2580 SHEARN 77007 713 331-0377 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 10801 WESTHEIMER RD 77042 713 580-0178 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 6955 HIGHWAY 6 N 77084 281 858-7452 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 8503 S SAM HOUSTON PKWY E 77075 713 343-8301 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 8500 S MAIN ST 77025 713 661-8213 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 300 MEYERLAND PLAZA MALL 77096 713 292-0031 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 8605 WESTHEIMER RD 77063 713 331-0374 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 13250 NORTHWEST FWY 77040 713 343-2258 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 984 GESSNER ROAD 77024 713 300-0228 N

TARGET PHARMACIES HOUSTON TARGET PHARMACY 12701 FM 1960 ROAD W 77065 281 949-2220 N

TARGET PHARMACIES HOUSTON TD PHARMACY 12319 BELLAIRE BLVD STE 400 770722590 281 741-8472 N

TRINET HOUSTON TEJAS PHARMACY #2 5228 ALDINE MAIL RT 77039 281 741-3385 N

TRINET HOUSTON TEXAS CHILDREN'S HOSPITAL PHARMACY

GREENSPOINT 700 N SAM HOUSTON PKWY W 770674338 832 828-1605 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON TEXAS CHILDREN'S HOSPITAL PHARMACY-

SOUTHWEST 9700 BISSONNET ST STE 1000W 770368001 832 733-1400 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON TEXAS CHILDRENS HOSPITAL PHCY 6621 FANNIN ST 770302399 832 824-5250 Y COMMUNITY INDEPENDENT PHARMACY

NETW

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON TEXAS RXSOLUTIONS AND

COMPOUNDING PHARMACY 7505 FANNIN ST #140 77054 713 790-1228 N

ELEVATE PROVIDER NETWORK HOUSTON TEXAS UNICARE PHARMACY 2424 W HOLCOMBE BLVD STE

101 770301933 832 834-3222 N

ACCESSHEALTH PLUS HOUSTON THE MEDICINE MAN PHARMACY 7652 BELLFORT ST 770611768 713 644-1343 N

ELEVATE PROVIDER NETWORK HOUSTON THE PEOPLES PHARMACY 8503 E GULF FREEWAY 77017 713 378-4450 N

TRINET HOUSTON THE RITE PHARMACY 2600 S LOOP W STE 425 77054 713 665-7483 N

TRINET HOUSTON TIDWELL PROFESSIONAL PHARMACY 2310 TIDWELL RD 77093 713 694-5977 N

TPN HOUSTON TIDWELL RX 712 E TIDWELL RD STE C 770221842 713 884-8020 N

TRINET HOUSTON TONNA PHARMACY 5225 KATY FWY STE 101A 770072292 281 953-0030 N

TRINET HOUSTON TOTAL CARE CAC PHARMACY LLC 14755 N FWY STE 200 770906503 281 377-8137 N

TRINET HOUSTON TRACE PHARMACY 8104 SOUTHWEST FWY STE B 770741704 713 981-6600 N

TRINET HOUSTON TRINITY MED RX 4101 SAN JACINTO ST 77004 713 874-1777 N

TRINET HOUSTON TRIPLE A PHARMACY 11450 SPACE CENTER BLVD 770593641 281 974-3713 N

TRINET HOUSTON TRUECARE ALLIED PHARMACY AND

MEDICAL SUPPLIES INC 3003 S LOOP W STE 450 770541315 281 652-8080 N

THIRD PARTY STATION HOUSTON U.J. PHARMACY 11965 BISSONNET ST 77099 281 495-5777 N

TPN HOUSTON UNICARE PHARMACY INC 11847 BISSONNET ST 770991904 281 498-1141 N

TRINET HOUSTON UPTOWN PHARMACY 1607 S POST OAK LANE 77056 713 621-0621 N

ACCESSHEALTH PLUS HOUSTON VALUE RX PHARMACY 138 E LITTLE YORK RD 770761412 281 501-3151 N

THIRD PARTY STATION CP HOUSTON VILLAGE COMPOUNDING PHARMACY 975 CORBINDALE RD 77024 713 464-5069 N

TRINET HOUSTON VILLAGE FAMILY PHARMACY 9055 KATY FWY STE 101 77024 713 373-3300 N

ACCESSHEALTH PLUS HOUSTON VINTAGE PHARMACY PLUS 11550 LOUETTA RD 77070 281 251-3911 N

ACCESSHEALTH PLUS HOUSTON VITA-CARE PHARMACY 2500 FONDREN 77063 713 781-8675 N

ELEVATE PROVIDER NETWORK HOUSTON WALLIS PHARMACY 5620 E SAM HOUSTON PKWY

NORTH 77015 281 457-3838 N

THIRD PARTY STATION HOUSTON WAL-MART PHARMACY 13003 TOMBALL PKWY 770863122 281 668-2883 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 15955 FM 529 ROAD 77095 281 855-1305 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 3450 FM 1960 WEST 77068 281 440-0741 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 5655 E SAM HOUSTON PKWY N 77015 713 450-3681 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 9555 SO POST OAK ROAD 77096 713 551-9154 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 11755 BEECHNUT ST 77072 832 328-1653 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 2700 S KIRKWOOD DRIVE 77077 281 558-5703 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 4810 HWY 6 NORTH 77084 281 859-6850 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 13750 I-10 EAST 770155929 713 453-2316 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HOUSTON WAL-MART PHARMACY 9460 W SAM HOUSTON PKWY S 77099 281 568-3134 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 13484 NORTHWEST FREEWAY 77040 713 690-6966 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 2727 DUNVALE ROAD 77063 713 977-2570 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 111 YALE ST 770073730 713 860-0707 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 2740 GESSNER ROAD 77080 713 934-8107 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 12353 FM 1960 WEST 77065 832 912-7331 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 1118 SIBLER RD 77055 713 797-2422 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 10411 N FREEWAY 45 77037 281 999-9963 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 10750 WESTVIEW DRIVE 77043 713 984-8035 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 6060 N FRY ROAD 77449 281 550-9800 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 4412 N FWY 770223606 713 300-0518 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 9700 HILLCROFT ST 77096 713 283-7437 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 9598 ROWLETT ROAD 77075 832 386-0160 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 11242 S GESSNER ROAD 77071 713 771-8316 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 10-0597 7075 FM 1960 RD WEST 77069 281 893-1701 N

WALMART STORES INC HOUSTON WAL-MART PHARMACY 10-0772 3506 S HWY 6 SOUTH 77082 281 561-0846 N

WALMART STORES INC HOUSTON WALMART PHARMACY 10-3584 5405 S RICE AVE 770812113 713 860-9245 N

WALMART STORES INC HOUSTON WALMART PHARMACY 10-5612 2391 S WAYSIDE DR 770233910 713 300-3662 N

WALMART STORES INC HOUSTON WELLNESS PHARMACY LLC 1480 WILCREST DR 77042 713 532-0008 N

TRINET HOUSTON WELLNESS PLUS PHARMACY INC 13141 FM 1960 W STE 200 77065 832 604-7418 N COMMUNITY INDEPENDENT PHARMACY

NETW HOUSTON WESLEY UNITED PHARMACY 5302 CANAL ST 770112258 713 514-9494 N

TRINET HOUSTON WEST AVE PHARMACY 2800 KIRBY DR STE A200 770981736 832 831-9480 N

TPN HOUSTON WESTMONT PHARMACY INC 1140 WESTMONT DR 77015 713 453-1780 N

TRINET HOUSTON WESTVIEW PHARMACY 2323 WIRT RD 77055 713 365-9393 N

ACCESSHEALTH HOUSTON WILLOWBROOK

PHARMACY/COMPOUNDING 8945 HIGHWAY 6 N STE 255 770952458 281 859-3103 N

TRINET HOUSTON WINSTON'S PHARMACY 8405 ALMEDA GENOA RD STE

UANDS 770752503 713 944-6000 N

THIRD PARTY STATION HOUSTON XPRESS PHARMACY 7555 BELLAIRE BLVD STE B 770365055 713 541-3300

TRINET HOUSTON YOUR PHARMACY INC. 7400 HARWIN DR STE 253 770362030 713 781-1010 N

TRINET HOUSTON ZOETIC COMPOUNDING PHARMACY 10674 WESTHEIMER RD 770423486 832 487-9287 N

ACCESSHEALTH PLUS HUBBARD HUBBARD CITY DRUG 200 N MAGNOLIA ST 766482446 254 576-2241 N

ELEVATE PROVIDER NETWORK HUDSON OAKS TACKETT COMPOUNDING PHARMACY 3500 FORT WORTH HWY 760878781 817 441-7046 N

ELEVATE PROVIDER NETWORK HUDSON OAKS WAL-MART PHARMACY 2801 E INTERSTATE 20 76087 817 599-3750 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HUGHES SPRINGS THE MED SHOP 111 E 2ND ST 75656 903 639-3508 N

THIRD PARTY STATION CP HUGHES SPRINGS WALMART PHARMACY 10-4327 870 TAYLOR ST 75656 903 639-4830 N

WALMART STORES INC HUMBLE AIRPORT MCKAY PHARMACY 18648 MCKAY DR STE 110 773385716 832 644-1456 N COMMUNITY INDEPENDENT PHARMACY

NETW HUMBLE COSTCO PHARMACY #1228 21802 TOWNSEN WEST 77338 425 416-5259

COSTCO PHARMACIES HUMBLE CVS PHARMACY 214 W FIRST ST 77338 281 446-0246 N

CVS PHARMACY INC HUMBLE CVS PHARMACY 7214 FM 1960 E 77346 281 852-4700 Y

CVS PHARMACY INC HUMBLE CVS PHARMACY 5440 ATASCOCITA RD 77346 281 812-4377 N

CVS PHARMACY INC HUMBLE CVS PHARMACY # 8789 FM 1960 BYPASS RD W 773384021 281 548-1020

CVS PHARMACY INC HUMBLE CVS PHARMACY # 8000 N SAM HOUSTON PKWY 77396 281 454-0101 N

CVS PHARMACY INC HUMBLE DEERBROOK PHARMACY SERVICES, LLC 9816 MEMORIAL BLVD STE 105 77338 281 446-0061 N

THIRD PARTY STATION CP HUMBLE DOUGHERTY'S PHARMACY HUMBLE, LLC 211 FM 1960 BYPASS RD E 77338 281 446-9191 N

LEADER DRUG STORES INC HUMBLE DOYFRAN PHARMACY 9701 N SAM HOUSTON PKWY E

STE 110 773964636 281 973-8042 N

TRINET HUMBLE GREATER TEXAS PHARMACY 1485 FM 1960 BYPASS RD E 773383909 832 644-9895 N

ACCESSHEALTH PLUS HUMBLE HEB PHARMACY 7405 FM 1960 EAST 77346 281 812-4729 N

HEB GROCERY COMPANY LP HUMBLE KROGER PHARMACY 3820 ATASCOCITA RAOD 77396 281 812-6397 N

THE KROGER CO HUMBLE KROGER PHARMACY 19611 EASTEX FREEWAY 77338 281 446-2620 N

THE KROGER CO HUMBLE KROGER PHARMACY 19300 LAKE HOUSTON PARKWAY 77346 281 812-4499 N

THE KROGER CO HUMBLE KROGER PHARMACY #190 9475 FM 1960 BYPASS W 773380000 281 973-5090 N

THE KROGER CO HUMBLE MEMORIAL CARE PHARMACY 8901 FM 1960 BYPASS RD W STE

102 773384019 832 777-6448 N

TRINET HUMBLE PRIZE PHARMACY 9761 FM 1960 BYPASS RD W 77338 281 973-8683 N

TRINET HUMBLE SAMS PHARMACY 9665 FM 1960 BYPASS 77338 281 540-7016 N

WALMART STORES INC HUMBLE TARGET PHARMACY 20777 HWY 59 77338 281 540-2126 N

TARGET PHARMACIES HUMBLE WAL-MART PHARMACY 9235 N SAM HOUSTON PKWY E 77396 281 441-2670 N

WALMART STORES INC HUMBLE WAL-MART PHARMACY 9451 FM 1960 BYPASS 77338 281 540-8861 N

WALMART STORES INC HUMBLE WAL-MART PHARMACY 10-0744 6626 FM 1960 EAST 77346 281 852-4466 N

WALMART STORES INC HUMBLE WALMART PHARMACY 10-7309 12312 WILL CLAYTON PKWY 773463889 281 318-2107 N

WALMART STORES INC HUMBLE WELLCARE SPECIALTY PHARMACY, LLC 18321 W LAKE HOUSTON PKWY

STE 280 773463587 281 973-4371 N

ACCESSHEALTH PLUS HUNTINGTON LOPERS FAMILY PHARMACY 116 HWY 69 N 75949 936 422-4440 N

THIRD PARTY STATION CP HUNTSVILLE CVS PHARMACY 1569 11TH ST 77340 936 295-6448 Y

CVS PHARMACY INC HUNTSVILLE CVS PHARMACY # 2421 SAM HOUSTON AVE 773405862 936 439-9038

CVS PHARMACY INC HUNTSVILLE KROGER PHARMACY 223 INTERSTATE 45 S 77340 936 291-7977 N

THE KROGER CO

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network HUNTSVILLE MCNEASE DRUGS 103 MEDICAL PARK LANE 77340 936 293-8333 N

ACCESSHEALTH HUNTSVILLE TARGET PHARMACY 259 INTERSTATE 45 S 773404903 936 649-3074 N

TARGET PHARMACIES HUNTSVILLE WAL-MART PHARMACY 10-0285 141 INTERSTATE 45 S 773404243 936 295-3041 N

WALMART STORES INC HURST CARIE BOYDS PRESCRIPTION SHOP 122 GRAPEVINE HWY 76054 817 282-9376 N

ACCESSHEALTH HURST CVS PHARMACY 1233 PRECINCT LINE RD 76053 817 595-2484 N

CVS PHARMACY INC HURST KROGER PHARMACY 708 E PIPELINE 76053 817 285-8851 N

THE KROGER CO HURST MIDCITIES PHARMACY 2000 PRECINCT LINE RD STE 102 760543185 817 605-3500 N

ACCESSHEALTH PLUS HURST TARGET PHARMACY 1400 PRECINCT LINE RD 76053 817 282-8917 N

TARGET PHARMACIES HURST WAL-MART PHARMACY 1732 PRECINCT LINE ROAD 76054 817 503-7731 N

WALMART STORES INC HURST WALMART PHARMACY 10-7347 720 W PIPELINE RD 760534928 817 799-3525

WALMART STORES INC HUTTO CVS PHARMACY # 301 FM 685 78634 512 846-1003

CVS PHARMACY INC IDALOU DRISCOLL PHARMACY 816 FRONTAGE RD 79329 806 892-2561 N

ELEVATE PROVIDER NETWORK INGLESIDE JERRYS PHARMACY 2793 MAIN ST 78362 361 776-2577 N

ACCESSHEALTH IOWA PARK HUGHES PHARMACY 120 W PARK AVE 763672805 940 592-4191 N

ELEVATE PROVIDER NETWORK IOWA PARK IOWA PARK PHARMACY 405 SE ACCESS RD 763676985 940 592-2731 N

ACCESSHEALTH PLUS IRVING AA PHARMACY LLC 1817 W PIONEER DR 750616843 469 351-3462 N

ACCESSHEALTH PLUS IRVING ACCREDO HEALTH GROUP INC 4343 W ROYAL LANE 75063 972 929-6800 N

ACCREDO HEALTH GROUP INC IRVING ACCREDO HEALTH GROUP INC 4343 W ROYAL LANE 75063 972 929-6800 N

ACCREDO HEALTH GROUP INC IRVING ALPHA PHARMACY 8787 N MACARTHUR BLVD STE

120 750635448 469 262-5742 N

EPIC PHARMACY NETWORK INC IRVING AMERICAN SPECIALTY PHARMACY 7415 LAS COLINAS BLVD STE 100 750637569 214 379-2780 N

TPN IRVING BAYLOR SCOTT & WHITE PHARMACY #108 1901 N MACARTHUR BLVD 75061 972 579-4074 N

LEADER DRUG STORES INC IRVING BOARDWALK PHARMACY 1110 COTTONWOOD LANE 75038 972 812-7559 N

ELEVATE PROVIDER NETWORK IRVING BROWNS PHARMACY 2021 N MACARTHUR BLVD STE

120 750612170 972 254-8156 N

ACCESSHEALTH PLUS IRVING CVS PHARMACY 3401 W WALNUT HILL LANE 75038 972 443-0683 N

CVS PHARMACY INC IRVING CVS PHARMACY 1333 S STOREY RD 75060 972 986-8588 N

CVS PHARMACY INC IRVING CVS PHARMACY 5500 N MCARTHUR 75038 972 518-1325 N

CVS PHARMACY INC IRVING CVS PHARMACY 2222 N STORY RD 75062 972 255-4155 Y

CVS PHARMACY INC IRVING CVS PHARMACY 410 W ROCHELLE RD 75062 972 258-6015 N

CVS PHARMACY INC IRVING CVS PHARMACY 934 E IRVING BLVD 75060 972 579-0211 Y

CVS PHARMACY INC IRVING CVS PHARMACY # 8580 N MACARTHUR BLVD 750634111 469 420-9260

CVS PHARMACY INC IRVING GENERX DISCOUNT PHARMACY 1202 W PIONEER DR 75061 972 417-8895 N

ELEVATE PROVIDER NETWORK IRVING IRVING PHARMACY 2000 ESTERS RD STE 202 750618019 972 313-0585 N

TPN

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network IRVING KROGER PHARMACY 7505 N MACARTHUR BLVD 75063 972 373-8158 N

THE KROGER CO IRVING KROGER PHARMACY 515 S MACARTHUR 75060 972 254-9105 N

THE KROGER CO IRVING KROGER PHARMACY 3612 N BELTLINE RD 75062 972 252-6450 N

THE KROGER CO IRVING KROGER PHARMACY 2201 W GRAUWYLER ROAD 75061 972 790-5747 N

THE KROGER CO IRVING LAS COLINAS PHARMACY 6420 N MACARTHUR BLVD, STE

100 750392848 972 580-1814 N

ACCESSHEALTH PLUS IRVING LINDSEYS PHARMACY 2616 TEXAS DR 750626085 972 252-8644 N

ELEVATE PROVIDER NETWORK IRVING MACARTHUR HEALTH MART PHARMACY 5477 N MACARTHUR BLVD 75038 972 756-9515 N

ACCESSHEALTH PLUS IRVING MERIDIAN PHARMACY GROUP 1111 S IRVING HEIGHTS BLVD 75060 214 492-0123 N

ELEVATE PROVIDER NETWORK IRVING MINYARD PHARMACY 2200 W SHADY GROVE 75060 972 790-3753 N

ACCESSHEALTH PLUS IRVING PHARMACIA SANA 1901 W IRVING BLVD STE 101 750616841 469 647-5291 N

ACCESSHEALTH PLUS IRVING PHARMACY PLUS #8 825 W ROYAL LANE 75039 972 401-3333 N

ELEVATE PROVIDER NETWORK IRVING PROFESSIONAL PHARMACY II 1221 W AIRPORT FWY STE 111 750626296 972 514-1277 N

ELEVATE PROVIDER NETWORK IRVING SAMS PHARMACY 1213 MARKET PLACE BLVD 75063 972 401-0230 N

WALMART STORES INC IRVING SS PHARMACY 2625 TEXAS DR 750627016 817 632-7779

EPIC PHARMACY NETWORK INC IRVING TARGET PHARMACY 7845 N MACARTHER BLVD 75063 972 869-0474 N

TARGET PHARMACIES IRVING TOTAL CARE PHARMACY AND

COMPOUNDING 3636 N MACARTHUR BLVD STE 100

750623691 972 570-4800 N ELEVATE PROVIDER NETWORK

IRVING UNIVERSAL MED SUPPLY 2049 W WALNUT HILL LANE 75038 972 228-1820 N

IRVING WAL-MART PHARMACY 1635 MARKET PLACE BLVD 75063 214 574-4522 N WALMART STORES INC

IRVING WAL-MART PHARMACY 4100 W AIRPORT FREEWAY 75061 972 313-0701 N WALMART STORES INC

ITALY WALMART PHARMACY 10-2345 721 DALE EVANS DR 76651 972 483-1258 N WALMART STORES INC

JACINTO CITY REDI-MED PHARMACY LLC 1520 HOLLAND ST 770292848 281 428-1212 N TPN

JACKSBORO CITY DRUG STORE 104 E BELKNAP 764582493 940 567-5576 N ELEVATE PROVIDER NETWORK

JACKSONVILLE CVS PHARMACY 824 S JACKSON ST 75766 903 586-3581 N CVS PHARMACY INC

JACKSONVILLE PORTER PHARMACY 308 W LARISSA ST 75766 903 586-9804 N ELEVATE PROVIDER NETWORK

JACKSONVILLE WAL-MART PHARMACY 10-0180 1311 S JACKSON 75766 903 586-1164 N WALMART STORES INC

JASPER MEDICINE SHOPPE PHARMACY 494 SPRINGHILL ST 75951 409 384-3432 N MEDICINE SHOPPE INTERNATIONAL INC

JASPER WAL-MART PHARMACY 10-0214 800 W GIBSON 75951 409 384-7108 N WALMART STORES INC

JEFFERSON CITY DRUG 109 W LAFAYETTE ST 75657 903 665-2521 N TRINET

JERSEY VILLAGE JERSEY VILLAGE PHARMACY-COMPOUNDING

17400 HWY 290 SUITE 400 77040 281 416-5800 N TPN

JOAQUIN BLOUNT PHARMACY 13290 HWY 84 E 759540506 936 269-3922 N COMMUNITY INDEPENDENT PHARMACY NETW

JOHNSON CITY JOHNSON CITY PHARMACY 405 HWY 281 SOUTH 78636 830 868-7185 N ACCESSHEALTH PLUS

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network JOSHUA BEST VALUE DANS PHARMACY 3521 B WILSHIRE BLVD 76058 817 484-3267 N

ELEVATE PROVIDER NETWORK JOSHUA BROOKSHIRE PHARMACY #133 1001 JOSHUA STATION

BOULEVARD 76058 817 556-2389 N

BROOKSHIRE GROCERY COMPANY JOSHUA JOSHUA PHARMACY 504 N BROADWAY 760580710 817 295-8531 N

ACCESSHEALTH PLUS JOURDANTON JOURDANTON PHARMACY 1810 E STATE HWY 97 78026 830 770-0770 N COMMUNITY INDEPENDENT PHARMACY

NETW JUNCTION CITY PHARMACY OF JUNCTION 1610 MAIN ST 768493518 325 446-2511 N

ACCESSHEALTH PLUS JUSTIN JUSTIN FAMILY PHARMACY 120 W 4TH ST 762475014 940 648-2222 N

ACCESSHEALTH PLUS KARNES CITY JAYS CITY PHARMACY 214 E CALVERT AVE 78118 830 780-2224 N

ACCESSHEALTH KATY BROOKSHIRE BROTHERS PHARMACY OF

KATY 5249 FRANZ RD 77493 281 391-7051 N

ELEVATE PROVIDER NETWORK KATY COSTCO PHARMACY #1167 23645 KATY FREEWAY 77494 281 347-9910 N

COSTCO PHARMACIES KATY CVS PHARMACY 1616 S MASON RD 77450 281 395-5707 Y

CVS PHARMACY INC KATY CVS PHARMACY 602 W GRAND PARKWAY S 77494 281 392-3808 Y

CVS PHARMACY INC KATY CVS PHARMACY 3103 N FRY RD 77449 281 646-2966 N

CVS PHARMACY INC KATY CVS PHARMACY 110 WESTGREEN BLVD 77450 281 578-8163 N

CVS PHARMACY INC KATY CVS PHARMACY 3050 W GRAND PRKWY 77494 281 392-3788 N

CVS PHARMACY INC KATY CVS PHARMACY 3080 S FRY RD 77450 281 829-2046 N

CVS PHARMACY INC KATY CVS PHARMACY # 24950 FRANZ RD 774935811 281 574-8282

CVS PHARMACY INC KATY CVS PHARMACY # 10522 SPRING GREEN BLVD 77494 281 392-3352

CVS PHARMACY INC KATY CVS PHARMACY # 2720 FM 1463 77494 281 769-9255

CVS PHARMACY INC KATY HEALTH-RITE PHARMACY 1801 N MASON RD STE B 774492844 832 437-2216 N

THIRD PARTY STATION KATY HEB PHARMACY 1621 MASON ROAD 77450 281 599-0958 N

HEB GROCERY COMPANY LP KATY HEB PHARMACY 6711 S FRY RD 77449 281 392-1188 N

HEB GROCERY COMPANY LP KATY HEB PHARMACY 25675 NELSON WAY 77494 281 574-1804 N

HEB GROCERY COMPANY LP KATY HELPING HAND PHARMACY, LLC 529 S MASON RD 774502491 281 492-0031 N

TRINET KATY HQ PHARMACY 21214 KINGSLAND BLVD STE B 774505898 281 579-2700 N

TRINET KATY KATY MEDICAL COMPLEX PHARMACY 21700 KINGSLAND BLVD 77450 281 829-6497 N

ELEVATE PROVIDER NETWORK KATY KATY PHARMACY I 20005 KATY FWY 774502238 281 578-1515 N

LEADER DRUG STORES INC KATY KINGSLAND PHARMACY 21214 KINGSLAND BLVD 77450 281 599-7880

TRINET KATY KROGER PHARMACY 6055 FRY ROAD 77449 281 858-7613 N

THE KROGER CO KATY KROGER PHARMACY 22150 WESTHEIMER PKWY 77450 281 828-8778 N

THE KROGER CO KATY KROGER PHARMACY 1550 GRAND PKWY 77493 281 693-0606 N

THE KROGER CO KATY KROGER PHARMACY 1705 FRY RD 77449 281 398-3135 N

THE KROGER CO KATY KROGER PHARMACY #146 1712 SPRING GREEN BLVD 774946910 281 769-4361 N

THE KROGER CO

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network KATY PREMIER PHARMACY 3616 N FRY RD STE 220 774498668 281 579-0550 N

TRINET KATY PSC PHARMACY 23510 KINGSLAND BLVD STE 104 774944125 281 665-8899 N COMMUNITY INDEPENDENT PHARMACY

NETW KATY RITE CHOICE PHARMACY,LLC 9727 SPRING GREEN BLVD 77494 832 913-6905 N

TPN KATY SAMS PHARMACY 20424 KATY FREEWAY 77449 281 578-5593 N

WALMART STORES INC KATY SINA PHARMACY 3815 N FRY RD STE 600 774496735 281 717-4521 N

TRINET KATY TARGET PHARMACY 23710 WESTHEIMER PKWY 77494 281 392-8385 N

TARGET PHARMACIES KATY WAL-MART PHARMACY 25108 MARKET PLACE DRIVE 77494 281 644-6412 N

WALMART STORES INC KATY WAL-MART PHARMACY 10-0768 1313 FRY ROAD 77449 281 578-1272 N

WALMART STORES INC KATY WALMART PHARMACY 10-4468 20903 HIGHLAND KNOLLS DR 774501490 832 772-9970 N

WALMART STORES INC KATY WALMART PHARMACY 10-7310 24919 WESTHEIMER PKWY 774947313 281 769-4210 N

WALMART STORES INC KAUFMAN BROOKSHIRES PHARMACY 2235 S WASHINGTON 75142 972 962-8547 N

BROOKSHIRE GROCERY COMPANY KAUFMAN CVS PHARMACY 102 E MULBERRY ST 75142 972 932-6585 N

CVS PHARMACY INC KAUFMAN MEDICATION STATION 700 ED HALL DRIVE 75142 972 932-6855 N COMMUNITY INDEPENDENT PHARMACY

NETW KAUFMAN WALMART PHARMACY 10-4164 300 KINGS FORT PARKWAY 75142 469 595-7076 N

WALMART STORES INC KEENE KEENE PHARMACY 114 S OLD BETSY RD 76059 817 558-3341 N

LEADER DRUG STORES INC KELLER CVS PHARMACY 801 N TARRANT PKWY 76248 817 428-5446 N

CVS PHARMACY INC KELLER CVS PHARMACY 4464 N TARRANT PKWY 76248 817 431-4998 N

CVS PHARMACY INC KELLER CVS PHARMACY 101 RUFE SNOW DR N 76248 817 431-3513 N

CVS PHARMACY INC KELLER HEALTHCARE PHARMACY LLC 100 BOURLAND RD STE# 160 76248 817 337-9998 N COMMUNITY INDEPENDENT PHARMACY

NETW KELLER HERITAGE PHARMACY 3529 HERTIAGE TRACE PKWY 76244 817 741-7100 N

ELEVATE PROVIDER NETWORK KELLER KROGER PHARMACY 2061 RUFE SNOW DR 76248 817 605-8728 N

THE KROGER CO KELLER KROGER PHARMACY 976 PRICE HIGHWAY 1709 76248 817 431-5178 N

THE KROGER CO KELLER WAL-MART PHARMACY 2130 RUF SNOW DRIVE 76248 817 427-9237 N

WALMART STORES INC KEMAH WAL-MART PHARMACY 255 FM 518 77565 281 538-9978 N

WALMART STORES INC KEMP KEMP FAMILY PHARMACY 1224 S ELM 751430569 903 498-8523 N

ELEVATE PROVIDER NETWORK KEMP WALMART PHARMACY 10-2349 221 S STATE HWY 274 75143 903 498-7010 N

WALMART STORES INC KENEDY HEB PHARMACY 107 N SUNSET STRIP 78119 830 583-9155 N

HEB GROCERY COMPANY LP KENEDY THE PRESCRIPTION SHOP 143 CRAIG ST 78119 830 583-9652 N

ACCESSHEALTH KENEDY WALMART PHARMACY 100524 200 BUSINESS PARK DR 78119 830 583-9832 N

WALMART STORES INC KENNEDALE RAYS PHARMACY 301 W KENNEDALE PKWY 760602421 817 478-8225 N

TPN KERMIT KERMIT PHARMACY 810 MYER LANE 79745 432 586-2556 N

ACCESSHEALTH KERMIT LOWES MARKETPLACE PHARMACY 310 E AUSTIN ST 797453099 432 586-3479 N

LEADER DRUG STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network KERRVILLE ANNIE'S APOTHECARY 1228 BANDERA HWY 780289640 830 257-0732 N

THIRD PARTY STATION CP KERRVILLE CVS PHARMACY 112 MAIN ST 78028 830 895-3311 N

CVS PHARMACY INC KERRVILLE HEB PHARMACY 300 MAIN ST 78028 830 896-0227 N

HEB GROCERY COMPANY LP KERRVILLE HEB PHARMACY 313 SIDNEY BAKER SOUTH 78028 830 792-5465 N

HEB GROCERY COMPANY LP KERRVILLE KERRVILLE DRUG COMPANY 1050 JUNCTION HWY 78028 830 895-3784 N

ACCESSHEALTH KERRVILLE MEDICAL ARTS PHARMACY 200 WESLEY DR 780285809 830 896-0167 N

ACCESSHEALTH PLUS KERRVILLE THE MEDICINE STOP 1000 E MAIN 78028 830 896-7440 N

TRINET KERRVILLE WAL-MART PHARMACY 10-0508 1216 JUNCTION HWY 78028 830 896-5511 N

WALMART STORES INC KILGORE BROOKSHIRES PHARMACY 747 HWY 259 NORTH 75662 903 984-8639 N

BROOKSHIRE GROCERY COMPANY KILGORE CARDINAL PHARMACY 5309 FM 1252 W 75662 903 983-3372 N

THIRD PARTY STATION KILGORE CVS PHARMACY # 1000 STONE RD 756625476 903 984-0646 N

CVS PHARMACY INC KILGORE WAL-MART PHARMACY 10-0572 1201 STONE ST 75662 903 983-1056 N

WALMART STORES INC KILLEEN BAYLOR SCOTT & WHITE PHARMACY #231 2500 CROSS DR 76543 254 953-7777 N

LEADER DRUG STORES INC KILLEEN CVS PHARMACY # 3300 W STAN SCHLUETER LOOP 76549 254 526-4566

CVS PHARMACY INC KILLEEN CVS PHARMACY # 2502 TRIMMIER RD 765421907 254 554-0580

CVS PHARMACY INC KILLEEN HEB PHARMACY 2511 TRIMMIER RD 76541 254 634-2370 N

HEB GROCERY COMPANY LP KILLEEN KILLEEN PHARMACY 218 E AVE B 765415223 254 247-3979 N

KILLEEN KMART PHARMACY3475 1101 S FORT HOOD ST 765417451 254 526-2444 N

K MART PHARMACY KILLEEN METROPLEX HOSPITAL 2201 S CLEAR CREEK RD 76549 254 519-8272 N

TPN KILLEEN WAL-MART PHARMACY 10-0407 1400 LOWES BLVD 76542 254 526-4433 N

WALMART STORES INC KILLEEN WALMART PHARMACY 10-3449 3801 W STAN SCHLUETER LOOP 765495396 254 669-6133 N

WALMART STORES INC KILLEEN WALMART PHARMACY 10-6286 3404 W STAN SCHLUETER LOOP 765494705 254 669-6169 N

WALMART STORES INC KINGSLAND KINGSLAND HEALTH MART 306 RANCH ROAD 2900 78639 325 388-4593 N

ACCESSHEALTH KINGSVILLE CVS PHARMACY 1000 E KING AVE 78363 361 592-9397 N

CVS PHARMACY INC KINGSVILLE HARREL'S KINGSVILLE PHARMACY 204 E KLEBERG AVE 78363 361 592-9385 N

ELEVATE PROVIDER NETWORK KINGSVILLE HEB PHARMACY 409 E KLEBERG 78363 361 595-5641 N

HEB GROCERY COMPANY LP KINGSVILLE WAL-MART PHARMACY 10-0442 1133 GENERAL CAVAZOS BLVD 783637142 361 595-5440 N

WALMART STORES INC KINGWOOD CVS PHARMACY 4520 KINGWOOD DR 77345 281 360-4800 N

CVS PHARMACY INC KINGWOOD CVS PHARMACY 1350 KINGWOOD DR 77339 281 358-3143 N

CVS PHARMACY INC KINGWOOD KROGER PHARMACY 3410 N PARK DRIVE 77339 281 361-7404 N

THE KROGER CO KINGWOOD KROGER PHARMACY #359 25651 US HWY 59 77339 281 713-9447 N

THE KROGER CO KINGWOOD MILLENNIUM PHARMACY #2 22730 PROFESSIONAL DR STE

110 773396004 281 312-8585 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network KINGWOOD PATIENT DIRECT PHARMACY INC 22710 PROFESSIONAL DR 77339 281 312-8590 N

TRINET KINGWOOD WAL-MART PHARMACY 2165 NORTHPARK DRIVE 77339 281 358-5650 N

WALMART STORES INC KIRBYVILLE BROOKSHIRE BROTHERS PHARMACY OF

KIRBYVILLE 1005 S MARGARET 75956 409 423-2248 N

ELEVATE PROVIDER NETWORK KRUM S & J PHARMACY KRUM 820 E MCCART 76249 940 482-1972 N

LEADER DRUG STORES INC KYLE CVS PHARMACY 102 N US 81 78640 512 268-0390 N

CVS PHARMACY INC KYLE HEB PHARMACY 5401 S FM 1626 78640 512 268-7955 N

HEB GROCERY COMPANY LP KYLE TARGET PHARMACY 5188 KYLE CENTER DR 786406137 512 268-7551 N

TARGET PHARMACIES KYLE WALMART PHARMACY 5754 KYLE PARKWAY 78640 512 268-0412 N

WALMART STORES INC LA BLANCA LA BLANCA PHARMACY 18360 FM 493 78558 956 262-7662 N

ELEVATE PROVIDER NETWORK LA FERIA CVS PHARMACY # 224 N MAIN ST 78559 956 797-2366 N

CVS PHARMACY INC LA GRANGE WAL-MART PHARMACY 10-0846 1915 W STATE HWY 71 78945 979 968-8465 N

WALMART STORES INC LA MARQUE CVS PHARMACY # 204 NEWMAN RD 775683439 409 938-1149

CVS PHARMACY INC LA MARQUE HART PHARMACY 202 HWY 3 775684241 409 938-3787 N

THIRD PARTY STATION CP LA MARQUE SAMS PHARMACY 6614 GULF FREEWAY 77568 409 978-2456 N

WALMART STORES INC LA MARQUE WAL-MART PHARMACY 10-0529 6410 INTERSTATE 45 775683085 409 986-7726 N

WALMART STORES INC LA MESA CVS PHARMACY 2304 LUBBOCK HWY 79331 806 872-8810 N

CVS PHARMACY INC LA PORTE WAL-MART PHARMACY 9025 SPENCER HIGHWAY 77571 281 479-9364 N

WALMART STORES INC LAGO VISTA CVS PHARMACY 20601 FM 1431 78645 512 267-8010 N

CVS PHARMACY INC LAGRANGE HEB PHARMACY 450 E TRAVIS 78945 979 968-8677 N

HEB GROCERY COMPANY LP LAKE JACKSON CVS PHARMACY 117 OYSTER CREEK DR 77566 979 297-3254 N

CVS PHARMACY INC LAKE JACKSON HEB PHARMACY 97 OYSTER CREEK DR 77566 979 299-0105 N

HEB GROCERY COMPANY LP LAKE JACKSON MEDICINE SHOPPE 109B ABNER JACKSON PARKWAY 775664157 979 297-9503 N

MEDICINE SHOPPE INTERNATIONAL INC LAKE JACKSON STARR PLUS PHARMACY, LLC. 208 OAK DR S STE 302 775665640 979 297-3800 N

TRINET LAKE JACKSON TARGET PHARMACY 202 HIGHWAY 332 W 77566 979 299-2330 N

TARGET PHARMACIES LAKE JACKSON WAL-MART PHARMACY 10-0808 121 HWY 332 WEST 77566 979 297-8578 N

WALMART STORES INC LAKE WORTH BROOKSHIRES PHARMACY 6708 LAKE WORTH BLVD 76135 817 237-7580 N

BROOKSHIRE GROCERY COMPANY LAKE WORTH CVS PHARMACY 6640 LAKE WORTH BLVD 76135 817 237-3363 N

CVS PHARMACY INC LAKE WORTH NUCARE PHARMACY 6050 LAKE WORTH BLVD 76135 817 238-7773 N

ELEVATE PROVIDER NETWORK LAKE WORTH SAVON PHARMACY 6308 LAKE WORTH BLVD 76135 817 237-8128 N

ALBERTSONS LLC LAKE WORTH TARGET PHARMACY 6604 LAKE WORTH BLVD 76135 817 302-0084 N

TARGET PHARMACIES LAKE WORTH WAL-MART PHARMACY 6360 LAKE WORTH BLVD 76135 817 237-1118 N

WALMART STORES INC LAKEWAY CVS PHARMACY 2306 RR 620 SOUTH 78734 512 263-6000 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LAKEWAY HEB PHARMACY #714 2000 RANCH ROAD 620 S STE A 787346238 512 263-8481 N

HEB GROCERY COMPANY LP LAKEWAY HILL COUNTRY APOTHECARY 1310 RANCH ROAD 620 S 787346300 512 351-9139 N

TRINET LAMESA JONES MCCALL PHARMACY 1605 N BRYAN AVE 793313144 806 872-5453 N

ACCESSHEALTH LAMPASAS CATTLES PHARMACY INC 202 N KEY AVE 765501843 512 556-5141 N COMMUNITY INDEPENDENT PHARMACY

NETW LAMPASAS HODGES & SARGENT PHARMACY 210 S KEY AVE 765502722 512 556-3392 N

ELEVATE PROVIDER NETWORK LAMPASAS WAL-MART PHARMACY 1710 CENTRAL TEXAS

EXPRESSWAY 76550 512 556-6333 N

WALMART STORES INC LANCASTER CVS PHARMACY 1225 N BLUEGROVE RD 75146 972 227-2145 N

CVS PHARMACY INC LANCASTER MINYARD PHARMACY 1450 W PLEASANT RUN RD 751461392 972 227-2126 N

ACCESSHEALTH PLUS LANCASTER MORNING STAR PHARMACY AND

MEDICAL SUPPLY 2700 W PLEASANT RUN RD # W250

751461079 972 224-1340 N ACCESSHEALTH PLUS

LANCASTER RITE CARE PHARMACY III 3250 W PLEASANT RUN RD STE 165

751461071 214 331-4500 N TPN

LANCASTER WAL-MART PHARMACY 10-0471 150 N BECKLEY 75146 972 223-4196 N WALMART STORES INC

LANCASTER WALMART PHARMACY 10-7224 350 N BLUEGROVE RD 75146 214 459-9922 N WALMART STORES INC

LANTANA CVS PHARMACY # 7000 JUSTIN RD # FM407 762268412 940 584-0365 CVS PHARMACY INC

LAPORTE DEANGELO PHARMACY 1309 W FAIRMONT PKWY SUIT P 77571 281 842-8500 N TRINET

LAPORTE KROGER PHARMACY 1300 FAIRMONT PARKWAY 77571 281 842-1022 N THE KROGER CO

LAPORTE MEDICINE SHOPPE PHARMACY 800 S BROADWAY 775715324 281 471-1241 N MEDICINE SHOPPE INTERNATIONAL INC

LAREDO CVS PHARMACY # 819 CORPUS CHRISTI ST 78040 956 723-2911 CVS PHARMACY INC

LAREDO CVS PHARMACY # 1019 E CALTON RD 78041 956 723-4800 CVS PHARMACY INC

LAREDO CVS PHARMACY # 3527 JAIME ZAPATA MEMORIAL HWY STE 102

780434788 956 717-1515 CVS PHARMACY INC

LAREDO EL RIO FAMILY CENTER PHARMACY 2100 CORPUS CHRISTI 78043 956 723-2001 N ELEVATE PROVIDER NETWORK

LAREDO EL RIO PHARMACY 6801 MCPHERSON RD 78045 956 796-9600 N ELEVATE PROVIDER NETWORK

LAREDO GATEWAY COMMUNITY HEALTH CENTER, INC. MAIN CLINIC

1515 PAPPAS ST 78041 956 523-3605 N LEADER DRUG STORES INC

LAREDO GATEWAY COMMUNITY HEALTH CENTER, INC. SOUTH CLINIC

2007 S ZAPATA HWY 78046 956 795-8101 N LEADER DRUG STORES INC

LAREDO HEB PHARMACY 2310 E SAUNDERS 78041 956 724-1141 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 1301 GUADALUPE ST 78040 956 724-1126 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 1911 NE BOB BULLOCK 78045 956 764-5050 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 7811 MC PHERSON RD 78043 956 712-8053 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 2314 S ZAPATA HWY 78046 956 795-0700 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 210 W DEL MAR 78041 956 712-3251 N HEB GROCERY COMPANY LP

LAREDO HEB PHARMACY 4801 SAN DARIO 78040 956 725-0171 N HEB GROCERY COMPANY LP

LAREDO KMART PHARMACY4809 5001 SAN DARIO AVE 780415777 956 729-1907 N K MART PHARMACY

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LAREDO LAKESIDE PHARMACY 2337 ENDEAVOR DR 78041 956 725-6337 N

ACCESSHEALTH LAREDO LAKESIDE PHARMACY SOUTH 4151 JAIME ZAPATA MEMORIAL

HWY STE 208 780434782 956 724-2090 N

LEADER DRUG STORES INC LAREDO LAN RX PHARMACY II 2110 LOMAS DEL SUR 78046 956 725-6000 N

ACCESSHEALTH PLUS LAREDO LANRX PHARMACY 1901 FREES ST STE 2 780467129 956 568-9230 N

ACCESSHEALTH PLUS LAREDO LAREDO DOWNTOWN PHARMACY INC 1219 MATAMOROS ST 78040 956 726-4512 N

ACCESSHEALTH LAREDO MARTINEZ PHARMACY 1407 JACAMAN 78041 956 722-7600 N

LEADER DRUG STORES INC LAREDO MEDCENTER PHARMACY 1419 E BUSTAMANTE ST 78041 956 791-1991 N

ACCESSHEALTH LAREDO MEDICAL PLAZA PHARMACY 10710 MCPHERSON RD STE 102 780456363 956 718-2770 N

ACCESSHEALTH LAREDO TARGET PHARMACY 7501 SAN DARIO AVE 78045 956 722-1205 N

TARGET PHARMACIES LAREDO TARGET PHARMACY 1910 BOB BULLOCK LOOP 78043 956 718-3236 N

TARGET PHARMACIES LAREDO WAL-MART PHARMACY 2320 BOB BULLOCK LOOP 78043 956 791-0559 N

WALMART STORES INC LAREDO WAL-MART PHARMACY 2615 NE BOB BULLOCK LOOP 78045 956 231-5595 N

WALMART STORES INC LAREDO WAL-MART PHARMACY 4401 HIGHWAY 83 SOUTH 78046 956 727-1731 N

WALMART STORES INC LAREDO WAL-MART PHARMACY 10-0554 5610 SAN BERNARDO AVE 78041 956 723-1411 N

WALMART STORES INC LAVERNIA HEB PHARMACY 14414 US HWY 87 WEST 78121 830 779-3730 N

HEB GROCERY COMPANY LP LEAGUE CITY CVS PHARMACY 102 W MAIN ST 77573 281 338-4010 N

CVS PHARMACY INC LEAGUE CITY CVS PHARMACY 201 S FM 270 77573 281 554-7600 N

CVS PHARMACY INC LEAGUE CITY CVS PHARMACY 3013 MARINA BAY DR 775732875 281 538-2416 N

CVS PHARMACY INC LEAGUE CITY CVS PHARMACY 5002 W MAIN ST 77573 281 557-4374 N

CVS PHARMACY INC LEAGUE CITY CVS PHARMACY 2700 W MAIN ST 77573 281 332-7430 N

CVS PHARMACY INC LEAGUE CITY CVS PHARMACY 1295 E LEAGUE CITY PARKWAY 77573 281 332-8290 N

CVS PHARMACY INC LEAGUE CITY DEVEREUX TEXAS TREATMENT NETWORK 1150 DEVEREUX DR 775732043 281 316-5438 N

ELEVATE PROVIDER NETWORK LEAGUE CITY HEB PHARMACY 2955 S GULF FREEWAY 77573 281 337-5210 N

HEB GROCERY COMPANY LP LEAGUE CITY HEB PHARMACY 2755 E LEAGUE CITY PKWY 77573 281 334-2012 N

HEB GROCERY COMPANY LP LEAGUE CITY KROGER PHARMACY 250 S FM 270 77573 281 332-2551 N

THE KROGER CO LEAGUE CITY KROGER PHARMACY 200 GULF FREEWAY SOUTH 77573 281 332-5323 N

THE KROGER CO LEAGUE CITY KROGER PHARMACY #398 2750E LEAGUE CITY PKWY 775733359 281 521-2561 N

THE KROGER CO LEAGUE CITY RX TO GO PHARMACY 1100 GULF FWY S STE 290 775735153 281 557-0220 N

ELEVATE PROVIDER NETWORK LEAGUE CITY UTMB SPECIALTY CARE CENTER AT

VICTORY LAKES 2240 GULF FWY S 775735143 832 505-1103 N COMMUNITY INDEPENDENT PHARMACY

NETW LEAGUE CITY WALMART PHARMACY 10-4618 2625 W MAIN ST 775731813 479 204-8550 N

WALMART STORES INC LEAGUE CITY WALMART PHARMACY 10-5388 1701 W FM 646 RD 77573 281 337-9713 N

WALMART STORES INC LEANDER CVS PHARMACY 500 N BAGDAD RD 786417806 512 259-0130

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LEANDER HEB PHARMACY 651 N US HWY 183 78641 512 528-7777 N

HEB GROCERY COMPANY LP LEONARD LEONARD PHARMACY 122 W COLLINS ST 75452 903 587-3363 N

ELEVATE PROVIDER NETWORK LEONARD WALMART PHARMACY 10-3832 420 S US 69 75452 903 587-2876 N

WALMART STORES INC LEVELLAND CVS PHARMACY 402 COLLEGE AVE 79336 806 894-8521 N

CVS PHARMACY INC LEVELLAND UNITED PHARMACY 511 COLLEGE AVE 79336 806 894-7315 N

UNITED PHARMACY TX LEVELLAND WAL-MART PHARMACY 407 E HIGHWAY 114 793362629 806 894-7583 N

WALMART STORES INC LEWISVILLE COMMUNITY CARE PHARMACY 1301 FM 407 JUSTIN RD STE 212 750772184 972 317-5599 N

ELEVATE PROVIDER NETWORK LEWISVILLE COSTCO PHARMACY 851 STATE HIGHWAY 121 75067 469 948-1053 N

COSTCO PHARMACIES LEWISVILLE CVS PHARMACY 1496 FM 407 75077 972 317-2392 N

CVS PHARMACY INC LEWISVILLE CVS PHARMACY 100 W CORPORATE DRIVE 75067 972 459-7743 N

CVS PHARMACY INC LEWISVILLE CVS PHARMACY # 1099 W MAIN ST 75067 972 436-3553 N

CVS PHARMACY INC LEWISVILLE FIRST STOP PHARMACY 101 E CORPORATE DR STE 220 750676604 972 299-8990 N

ACCESSHEALTH PLUS LEWISVILLE KROGER PHARMACY #599 4620 STATE HIGHWAY 121 750564530 469 535-2480 N

THE KROGER CO LEWISVILLE SAMS PHARMACY 751 W MAIN 75067 972 353-0022 N

WALMART STORES INC LEWISVILLE SAVON PHARMACY 1087 W MAIN ST 75067 972 420-8590 N

ALBERTSONS LLC LEWISVILLE SONEXUS HEALTH PHARMACY SERVICES 2730 EDMONDS LN STE 400 750676731 972 350-9940 N

LEADER DRUG STORES INC LEWISVILLE TARGET PHARMACY 4760 STATE HWY 121 750562913 469 287-0347 N

TARGET PHARMACIES LEWISVILLE TARGET PHARMACY 725 HEBRON PARKWAY 75057 972 459-5906 N

TARGET PHARMACIES LEWISVILLE WAL-MART PHARMACY 1515 FM 407 75077 972 966-6518 N

WALMART STORES INC LEWISVILLE WAL-MART PHARMACY 190 E FM 3040 75067 972 315-9236 N

WALMART STORES INC LEWISVILLE WAL-MART PHARMACY 100217 801 W MAIN 75067 972 221-1150 N

WALMART STORES INC LIBERTY CVS PHARMACY 2005 HWY 90 77575 936 336-7233 N

CVS PHARMACY INC LIBERTY RODGER'S PHARMACY 1909 GRAND AVE 775754803 936 776-5228 N

ELEVATE PROVIDER NETWORK LIBERTY TPS/LIBERTY RX 1710 N MAIN ST 775753728 936 334-8000 N

ACCESSHEALTH PLUS LIBERTY WAL-MART PHARMACY 2121 HWY 146 BYPASS 77575 936 336-2257 N

WALMART STORES INC LIBERTY HILL LIBERTY HILL PHARMACY &

COMPOUNDING CENTER 13740 W STATE HIGHWAY 29 STE 4

786426283 512 766-5479 N COMMUNITY INDEPENDENT PHARMACY NETW

LINDALE BROOKSHIRES PHARMACY 521 S MAIN 75771 903 882-1309 N BROOKSHIRE GROCERY COMPANY

LINDALE CVS PHARMACY # 504 S MAIN ST 75771 903 882-3158 N CVS PHARMACY INC

LINDALE EAGLE PHARMACY 1404 S MAIN ST 757716267 903 881-5752 N ACCESSHEALTH PLUS

LINDALE ELLIOTTS PHARMACY 14077 FM 849 75771 903 882-3312 N LEADER DRUG STORES INC

LINDALE WAL-MART PHARMACY 105 CENTENNIAL BLVD 75771 903 882-5840 N WALMART STORES INC

LINDEN POWERS PHARMACY NO 1 INC 702 W HOUSTON ST 75563 903 756-7923 N TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LITTLE ELM CVS PHARMACY # 2591 FM 423 750686664 972 731-8032 N

CVS PHARMACY INC LITTLE ELM KROGER PHARMACY #580 2671 LITTLE ELM PARKWAY 75068 469 888-5519 N

THE KROGER CO LITTLE ELM LITTLE ELM PHARMACY 800 W ELDORADO PKWY 75068 972 294-2877 N

ELEVATE PROVIDER NETWORK LITTLEFIELD LOWES MARKET PLACE PHARMACY 102 W WAYLON JENNINGS BLVD 793393806 806 385-4250 N

LEADER DRUG STORES INC LITTLEFIELD PRESCRIPTION SHOP 1506 A S SUNSET 79339 806 385-4491

LEADER DRUG STORES INC LIVE OAK RX PLUS PHARMACY OF LIVE OAK 12315 JUDSON RD STE 108 782333263 210 646-0207 N

ACCESSHEALTH PLUS LIVINGSTON CVS PHARMACY 1500 W CHURCH ST 77351 936 327-2561 N

CVS PHARMACY INC LIVINGSTON LIVINGSTON PHARMACY 714 W CHURCH ST 77351 936 327-5510 N

ACCESSHEALTH PLUS LIVINGSTON WAL-MART PHARMACY 1620 W CHURCH 77351 936 327-1294 N

WALMART STORES INC LLANO CORNER DRUG STORE 600 BESSEMER AVE 786432058 325 247-4155 N

ACCESSHEALTH LOCKHART HEB PHARMACY 403 S COLORADO 78644 512 398-6797 N

HEB GROCERY COMPANY LP LOCKHART WAL-MART PHARMACY 10-0292 1904 S COLORADO ST 78644 512 398-2364 N

WALMART STORES INC LOCKHART WESTYS PHARMACY 113 S MAIN ST 78644 512 398-2114 N

THIRD PARTY STATION LOCKNEY HOMETOWN PHARMACY 309 N MAIN ST 792410277 806 652-3353 N

TRINET LONE STAR WALMART PHARMACY 10-4331 914 N MAIN ST 75668 903 656-1710 N

WALMART STORES INC LONGVEIW TARGET PHARMACY 3092 N EASTMAN RD STE 100 756057950 903 323-5001 N

TARGET PHARMACIES LONGVIEW BROOKSHIRES PHARMACY 3354 GILMER ROAD 75604 903 297-6963 N

BROOKSHIRE GROCERY COMPANY LONGVIEW CVS PHARMACY 119 W MARSHALL AVE 75601 903 753-2686 Y

CVS PHARMACY INC LONGVIEW CVS PHARMACY 1754 W LOOP 281 75604 903 759-3816 N

CVS PHARMACY INC LONGVIEW DRUG EMPORIUM 2321 W LOOP 281 756042563 903 297-0558 N

EPIC PHARMACY NETWORK INC LONGVIEW KMART PHARMACY7056 1100 MC CANN 75601 903 758-0024 N

K MART PHARMACY LONGVIEW KROGER PHARMACY 701 W MARSHALL 75601 903 758-0323 N

THE KROGER CO LONGVIEW LOUIS MORGAN DRUGS 1900 S HIGH ST 756023299 903 758-8286 N

ELEVATE PROVIDER NETWORK LONGVIEW LOUIS MORGAN DRUGS # 4 110 JOHNSTON ST 756013999 903 758-6164 N

ELEVATE PROVIDER NETWORK LONGVIEW MED SHOP TOTAL CARE PHARMACY 470 E LOOP 281 75605 903 234-0080 N

THIRD PARTY STATION LONGVIEW MEDICAL PARK PHARMACY 709 HOLLYBROOK 75605 903 234-8326 N

ELEVATE PROVIDER NETWORK LONGVIEW MEDICAL PLAZA PHARMACY 707 E MARSHALL AVE 75601 903 757-3477 N

ELEVATE PROVIDER NETWORK LONGVIEW SAMS PHARMACY 3310 N 4TH ST 75605 903 663-2749 N

WALMART STORES INC LONGVIEW SAVON PHARMACY 3603 MCCANN RD 75605 903 663-2056 N

ALBERTSONS LLC LONGVIEW SUPER 1 PHARMACY 1800 S HIGH 75602 903 234-2785 N

BROOKSHIRE GROCERY COMPANY LONGVIEW SUPER 1 PHARMACY 1217 E MARSHALL 75601 903 753-1964 N

BROOKSHIRE GROCERY COMPANY LONGVIEW WAL-MART PHARMACY 4006 ESTES PARKWAY 75603 903 234-2083 N

WALMART STORES INC LONGVIEW WAL-MART PHARMACY 10-0398 515 E LOOP 281 75605 903 663-0898 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LONGVIEW WAL-MART PHARMACY 10-0399 2440 GILMER ROAD 75604 903 759-1966 N

WALMART STORES INC LONGVIEW WALMART PHARMACY 10-4114 3812 GILMER RD 756041173 903 475-0452 N

WALMART STORES INC LOS FRESNOS LOS FRESNOS PHARMACY 810 W OCEAN BLVD 78566 956 233-3400 N

LEADER DRUG STORES INC LOS FRESNOS WALMART PHARMACY 10-2765 1004 W OCEAN BLVD 785663666 956 233-1822 N

WALMART STORES INC LUBBOCK AMIGOS PHARMACY 112 N UNIVERISTY AVE 79415 806 763-5908 N

UNITED PHARMACY TX LUBBOCK APOTHECARE OF TEXAS 5214 98TH ST STE 303 794244493 806 368-8317 N

GERIMED LTC NETWORK INC LUBBOCK BEST DISCOUNT PHARMACY 2316 34TH ST 79411 806 795-4353 N

ELEVATE PROVIDER NETWORK LUBBOCK BRIOVARX, LLC 6310 GENOA AVE 79424 806 687-9957 N

BRIOVARX LLC LUBBOCK CAPROCK COMPOUNDING PHARMACY 3007 50TH ST 794134101 806 589-6333 N

ACCESSHEALTH PLUS LUBBOCK CAPROCK DISCOUNT DRUG 2625 50TH ST 794134597 806 792-6122 N

TRINET LUBBOCK COSTCO PHARMACY #1163 6020 34TH ST 79407 806 784-1460 N

COSTCO PHARMACIES LUBBOCK CVS PHARMACY 3801 19TH ST 79410 806 796-2339 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY 5208 98TH ST 79424 806 794-1024 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY 3401 82ND ST 79423 806 797-3888 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY 5805 82ND ST 79424 806 698-8462 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY 3402 SLIDE RD 79414 806 797-8840 Y

CVS PHARMACY INC LUBBOCK CVS PHARMACY 6420 19TH ST 79407 806 797-3877 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY 3402 50TH ST 79413 806 797-4444 N

CVS PHARMACY INC LUBBOCK CVS PHARMACY # 608 N SLIDE RD 79416 806 762-1001

CVS PHARMACY INC LUBBOCK CVS PHARMACY # 1401 UNIVERSITY AVE 794013611 401 765-1500

CVS PHARMACY INC LUBBOCK DRUG EMPORIUM 5109 82ND ST 794243025 806 794-0022 N

EPIC PHARMACY NETWORK INC LUBBOCK GOLDEN USA PHARMACY 4120 34TH ST 79410 806 368-9472 N

THIRD PARTY STATION CP LUBBOCK GRACE PHARMACY 4515 MARSHA SHARP FREEWAY 79407 806 740-3305 N COMMUNITY INDEPENDENT PHARMACY

NETW LUBBOCK IVSOLUTIONS OF LUBBOCK 3706-A 20TH ST 79410 806 791-4663 N

MAXOR NATIONAL PHCY SRVS LLC LUBBOCK KMART PHARMACY4972 6501 UNIVERSITY AVE 79413 806 788-0101 N

K MART PHARMACY LUBBOCK MARKET STREET PHARMACY 3405 50TH ST 79413 806 791-0972 N

UNITED PHARMACY TX LUBBOCK MARKET STREET PHARMACY #553 4425 19TH ST 79407 806 788-2015 Y

UNITED PHARMACY TX LUBBOCK PARKWAY PHARMACY 1824 PARKWAY DR 794034406 806 767-9999 N

ACCESSHEALTH PLUS LUBBOCK SAMS PHARMACY 6016 MARSHA SHARP FWY 79407 806 785-2710 N

WALMART STORES INC LUBBOCK SOUTHWEST HEMATOLOGY ONCOLOGY

ASSOCIATES LLC 4002 21ST ST 79410 806 793-8310 N

ELEVATE PROVIDER NETWORK LUBBOCK TARGET PHARMACY 6064 BROWNFIELD ROAD 79407 806 788-3601 N

TARGET PHARMACIES LUBBOCK TARGET PHARMACY 7302 UNIVERSITY AVE 79423 806 748-6456 N

TARGET PHARMACIES

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LUBBOCK TEXAS COMPOUNDING SERVICES 2420 QUAKER AVE STE 203 794101837 806 799-8920

TRINET LUBBOCK THE APOTHECARY SPECIALTY PHARMACY 5214 98TH ST STE 302 794244493 806 368-8396 N

ACCESSHEALTH PLUS LUBBOCK TTUHSC PHARMACY 3601 4TH ST 79430 806 743-3270 N

LEADER DRUG STORES INC LUBBOCK TWIN OAKS PHARMACY 3436 34TH ST 794102830 806 799-3636 N

ACCESSHEALTH PLUS LUBBOCK TWIN OAKS SPECIALTY PHARMACY 3434 34TH ST STE B 794102802 806 701-5455 N

ACCESSHEALTH PLUS LUBBOCK UNITED PHARMACY 8010 FRANKFORD 79424 806 783-0241 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 4205 98TH 79423 806 798-6115 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 1318 BROADWAY 79401 806 763-9999 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 401 SLIDE RD 79416 806 796-1895 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 2630 PARKWAY DR 79403 806 765-7014 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 2703 82ND ST 79423 806 745-3907 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY 1701 50TH ST 79412 806 747-3503 N

UNITED PHARMACY TX LUBBOCK UNITED PHARMACY TX 7830 ORLANDO AVE 794231942 806 791-0220

LUBBOCK WAL-MART PHARMACY 6315 82ND ST 79424 806 698-8259 N

WALMART STORES INC LUBBOCK WAL-MART PHARMACY 702 W LOOP 289 79416 806 793-3001 N

WALMART STORES INC LUBBOCK WAL-MART PHARMACY 1911 MARSHA SHARP FWY 794154036 806 747-3915 N

WALMART STORES INC LUBBOCK WAL-MART PHARMACY 10-0861 4215 S LOOP 289 79423 806 793-8816 N

WALMART STORES INC LUBBOCK WALMART PHARMACY 10-6898 11415 QUAKER AVE 79423 806 392-9609

WALMART STORES INC LUCAS WALMART PHARMACY 2662 W LUCAS RD 75002 469 675-8110 N

WALMART STORES INC LUFKIN ABELDT'S GASLIGHT PHARMACY 200 GASLIGHT BLVD 759042667 936 639-2346 N

ELEVATE PROVIDER NETWORK LUFKIN CVS PHARMACY 1204 E LUFKIN AVE 75901 936 634-3344 N

CVS PHARMACY INC LUFKIN CVS PHARMACY 923 W FRANK ST 75904 936 634-4449 Y

CVS PHARMACY INC LUFKIN KMART PHARMACY7912 3061 JOHN REDDITT DR 759045697 936 632-5566 N

K MART PHARMACY LUFKIN MEDICINE SHOPPE 903 W FRANK AVE 759043344 936 634-3006 N

MEDICINE SHOPPE INTERNATIONAL INC LUFKIN SAMS PHARMACY 407 N BRENTWOOD 75901 936 639-1748 N

WALMART STORES INC LUFKIN TIMBERLAND MC PHARMACY 800 S TIMBERLAND DR 759014832 936 632-2260

ELEVATE PROVIDER NETWORK LUFKIN WAL-MART PHARMACY 10-0140 2500 DANIEL MCCALL DRIVE 75904 936 639-2275 N

WALMART STORES INC LULING DISMUKES PHARMACY 511 E DAVIS ST 786482317 830 875-2811 N

ACCESSHEALTH PLUS LUMBERTON CVS PHARMACY # 100 S LHS DRIVE 776578600 409 751-0521

CVS PHARMACY INC LUMBERTON KING'S PHARMACY OF LUMBERTON 139 N LHS DRIVE 77657 409 755-1145 N

ELEVATE PROVIDER NETWORK LUMBERTON MARKET BASKET PHARMACY 421 S MAIN ST 77657 409 755-4932 N

LEADER DRUG STORES INC LUMBERTON WAL-MART PHARMACY 10-0384 100 N LHS DRIVE 77657 409 755-2568 N

WALMART STORES INC LYTLE CVS PHARMACY # 19244 MCDONALD ST 78052 830 772-3404

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network LYTLE HEB PHARMACY 19337 MCDONALD ST 78052 830 772-5748 N

HEB GROCERY COMPANY LP LYTLE SUPER DRUG MART 19010 PRIEST BLVD 78052 830 709-0360 N

ELEVATE PROVIDER NETWORK MABANK BROOKSHIRE PHARMACY 1200 S 3RD ST 75147 903 887-6011 N

BROOKSHIRE GROCERY COMPANY MABANK MABANK FAMILY PHARMACY 207 N 3RD ST 75147 903 887-3711 N

ACCESSHEALTH MADISONVILLE WAL-MART PHARMACY 10-0446 1620 E MAIN 77864 936 348-2659 N

WALMART STORES INC MAGNOLIA KROGER PHARMACY 6616 FM 1488 77355 936 321-9870 N

THE KROGER CO MAGNOLIA MAGNOLIA PHARMACY 18230 FM 1488 77354 281 356-9089 N

ELEVATE PROVIDER NETWORK MAGNOLIA TARGET PHARMACY 32858 FM 2978 RD 77354 281 296-3050 N

TARGET PHARMACIES MAGNOLIA TEXAS PROFESSIONAL PHARMACY-

MAGNOLIA 18602 FM 1488, 77355 281 356-2216 N

ACCESSHEALTH PLUS MAGNOLIA TRIUMPH PHARMACY 6875 FM 1488 RD STE 300 773544522 281 252-4200 N

THIRD PARTY STATION CP MALAKOFF MALAKOFF PHARMACY 409 W ROYALL BLVD 75148 903 489-1909 N

ELEVATE PROVIDER NETWORK MANOR MANOR PHARMACY 14008 SHADOWN GLEN BLVD 78653 512 642-8000 N COMMUNITY INDEPENDENT PHARMACY

NETW MANOR WAL-MART PHARMACY 10-3169 11923 US HWY 290 E 78653 512 651-9128 N

WALMART STORES INC MANSFIELD CVS PHARMACY 2882 N FM 157 76063 817 453-4080 N

CVS PHARMACY INC MANSFIELD CVS PHARMACY 2200 MATLOCK RD 76063 817 453-0360 N

CVS PHARMACY INC MANSFIELD CVS PHARMACY 1100 N WALNUT CREEK DR 76063 817 473-0271 N

CVS PHARMACY INC MANSFIELD CVS PHARMACY # 3802 E BROAD ST 760635617 817 473-1373

CVS PHARMACY INC MANSFIELD KK'S PHARMACY #251 980 N WALNUT CREEK DR, #118 76063 817 453-5700 N

ELEVATE PROVIDER NETWORK MANSFIELD KROGER PHARMACY 3001 MATLOCK 76063 817 473-0081 N

THE KROGER CO MANSFIELD KROGER PHARMACY #594 3300 E BROAD ST 760635626 817 435-5418 N

THE KROGER CO MANSFIELD MELROSE PHARMACY 2860 N FM 157 76063 817 453-4444 N

THIRD PARTY STATION MANSFIELD RAYS PHARMACY 1831 E BROAD ST #101 760639171 817 473-1145 N

TPN MANSFIELD SAM'S PHARMACY 1740 N FM 157 76063 817 779-6061 N

WALMART STORES INC MANSFIELD SHATIFF PHARMACY 2771 E BROAD ST STE 219 760639157 817 225-4136 N

ACCESSHEALTH PLUS MANSFIELD TARGET PHARMACY 1801 HIGHWAY 287 NORTH 76063 817 453-0259 N

TARGET PHARMACIES MANSFIELD WAL-MART PHARMACY 10-0284 930 N WALNUT CREEK SUITE 800 76063 817 473-3014 N

WALMART STORES INC MANSFIELD WALMART PHARMACY 10-2397 2951 MATLOCK RD 76063 817 453-5635 N

WALMART STORES INC MARBLE FALLS ATKINS EXPRESS PHARMACY 2607 HWY 281 NORTH 786543807 830 693-3784 N

ACCESSHEALTH PLUS MARBLE FALLS ATKINS PHARMACY SERVICES 701 THIRD ST 78654 830 693-2972 N

ACCESSHEALTH PLUS MARBLE FALLS CVS PHARMACY # 302 GATEWAY N 786546317 401 765-1500

CVS PHARMACY INC MARBLE FALLS HEB PHARMACY 1503 HIGHWAY 1431 W 78654 830 693-4810 N

HEB GROCERY COMPANY LP MARBLE FALLS WAL-MART PHARMACY 10-0781 2700 US HIGHWAY 281 786543878 830 693-5529 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MARLIN GIBSON PHARMACY 423 LIVE OAK 766612367 254 883-2451 N COMMUNITY INDEPENDENT PHARMACY

NETW MARLIN SANITARIUM DRUG STORE 156 COLEMAN ST 766610004 254 883-3541 N COMMUNITY INDEPENDENT PHARMACY

NETW MARLIN WAL-MART PHARMACY 10-0320 600 S STATE HIGHWAY 6 766613527 254 883-9296 N

WALMART STORES INC MARSHALL CVS PHARMACY 400 E END BLVD N 75670 903 935-6661 N

CVS PHARMACY INC MARSHALL KROGER PHARMACY 300 E END BLVD 75670 903 935-7410 N

THE KROGER CO MARSHALL MATTHEWSON DRUG CO 717 S WASHINGTON 75670 903 938-6741 N

GERIMED LTC NETWORK INC MARSHALL SUPER 1 PHARMACY 207 E END BLVD NORTH 75670 903 938-3096 N

BROOKSHIRE GROCERY COMPANY MARSHALL WAL-MART PHARMACY 1701 E END BLVD N 75670 903 938-3555 N

WALMART STORES INC MASON SCRIPT SHOPPE 211 MOODY ST 76856 325 347-6248 N

THIRD PARTY STATION CP MATHIS CVS PHARMACY # 213 E SAN PATRICIO 78368 361 547-2577

CVS PHARMACY INC MATHIS MATHIS CARE PHARMACY 217 S HIGHWAY 359 78368 361 678-4302 N

LEADER DRUG STORES INC MAUD WALMART PHARMACY 10-4345 114 REDWATER BLVD W 75567 903 671-3139 N

WALMART STORES INC MAURICEVILLE MAURICEVILLE FAMILY PHARMACY 10897 HWY 12 77626 409 745-3784 N

TRINET MC ALLEN WAL-MART PHARMACY 10-0452 2800 NOLANA AVE 78504 956 631-8305 N

WALMART STORES INC MCALLEN AMERICAN SPECIALTY PHARMACY 1401 E RIDGE RD STE B 78503 956 284-6687

TPN MCALLEN APPLE PHARMACY 2501 N 23RD 78501 956 627-6652 N

ELEVATE PROVIDER NETWORK MCALLEN CVS PHARMACY 5600 N 23RD 78504 956 683-1762

CVS PHARMACY INC MCALLEN DLS PHARMACY 1301 E FERN AVE #B-1 78501 956 631-7900 N

ACCESSHEALTH PLUS MCALLEN FAMILY PRACTICE CENTER 501 N WARE RD 785018055 956 668-0044 N

EMEDRX SOLUTIONS MCALLEN FREDS PHARMACY 3001 N 23RD ST 78574 956 994-1044 N

MCALLEN HEB PHARMACY 3601 PECAN ST 78501 956 971-9131 N

HEB GROCERY COMPANY LP MCALLEN HEB PHARMACY 200 US EXPRESSWAY 83 78501 956 630-2911 N

HEB GROCERY COMPANY LP MCALLEN HEB PHARMACY 901 TRENTON ROAD 78501 956 618-1889 N

HEB GROCERY COMPANY LP MCALLEN HEB PHARMACY 3200 N TENTH 78501 956 631-6148 N

HEB GROCERY COMPANY LP MCALLEN JAY'S PHARMACY 610 S BROADWAY ST 785014906 956 682-4525 N

LEADER DRUG STORES INC MCALLEN LEES LEGEND PHCY AND MED EQUIP CO 1901 S 1ST 78503 956 686-3716 N

LEADER DRUG STORES INC MCALLEN LEES PHARMACY NORTH 5120 N 10TH 78504 956 630-5500 N

LEADER DRUG STORES INC MCALLEN MED-AID BICENTENNIAL PHARMACY 400 S BICENTENNIAL BLVD 78501 956 618-3100 N

ACCESSHEALTH PLUS MCALLEN SAENZ MEDICAL PHARMACY NOLANA 801 E NOLANA 78504 956 687-2500 N

ACCESSHEALTH PLUS MCALLEN SAENZ MEDICAL PHARMACY NORTH 6900 N 10TH 78501 956 928-0911 N

ACCESSHEALTH PLUS MCALLEN SAENZ MEDICAL PHARMACY OF MCALLEN,

INC. 212 LINDBERG AVE 785012920 956 630-6465 N

ACCESSHEALTH PLUS MCALLEN SAENZ MEDICAL PHARMACY RIDGE 1200 E RIDGE RD 78503 956 630-2500 N

ACCESSHEALTH PLUS

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MCALLEN SAMS PHARMACY 1400 E JACKSON 78503 956 683-8895 N

WALMART STORES INC MCALLEN SAMS PHARMACY 7601 N 10TH ST 785047737 956 278-8833 N

WALMART STORES INC MCALLEN TARGET PHARMACY 3600 NOLANA AVE 78504 956 618-7701 N

TARGET PHARMACIES MCALLEN TARGET PHARMACY 708 E EXPRESSWAY 83 78503 956 686-4068 N

TARGET PHARMACIES MCALLEN TARGET PHARMACY 7400 N 10TH ST 78504 956 686-9260 N

TARGET PHARMACIES MCALLEN WALMART PHARMACY 10-6098 800 E NOLANA AVE 78501 956 800-6082 N

WALMART STORES INC MCALLEN WALMART PHARMACY 10-6786 5700 N 23RD ST 785043907 956 800-6853 N

WALMART STORES INC MCALLEN WAL-MART PHARMACY10-0397 1200 E JACKSON AVE 78503 956 686-1840 N

WALMART STORES INC MCCAMEY SERENITY PARK PHARMACY 507 S BURLESON AVE 79752 325 884-2579 N

LEADER DRUG STORES INC MCKINNEY APOLLO PHARMACY 4987 W UNIVERSITY DR STE 120 750715072 469 442-0148

EPIC PHARMACY NETWORK INC MCKINNEY BAYLOR SCOTT & WHITE PHARMACY #105 5236 W UNIVERSITY DR STE 1900 750717822 469 764-7100 N

LEADER DRUG STORES INC MCKINNEY CVS PHARMACY 8995 STACY ROAD 75070 972 569-9423 N

CVS PHARMACY INC MCKINNEY CVS PHARMACY 159 S CENTRAL EXPY 75070 972 562-8323 Y

CVS PHARMACY INC MCKINNEY CVS PHARMACY 6301 ELDORADO PKWY 75070 972 542-4356 N

CVS PHARMACY INC MCKINNEY CVS PHARMACY 2100 EL DORADO PKWY 75070 214 585-0472 N

CVS PHARMACY INC MCKINNEY CVS PHARMACY 8953 VIRGINIA PARKWAY 75071 214 592-0872

CVS PHARMACY INC MCKINNEY CVS PHARMACY # 2313 W UNIVERSITY AVE 750713318 972 548-2856

CVS PHARMACY INC MCKINNEY CVS PHARMACY # 6161 W UNIVERSITY DR 75071 214 592-9444

CVS PHARMACY INC MCKINNEY KROGER PHARMACY 2901 S LAKE FOREST DRIVE 75070 972 540-1172 N

THE KROGER CO MCKINNEY KROGER PHARMACY 1707 W UNIVERSITY 75069 972 548-9633 N

THE KROGER CO MCKINNEY MCKINNEY PHARMACY 1601 W UNIVERSITY DR 750691242 972 542-4481 N

ELEVATE PROVIDER NETWORK MCKINNEY MINYARD PHARMACY #73 3001 S HARDIN BLVD 75070 972 547-7110 N

ACCESSHEALTH PLUS MCKINNEY NORTH CENTRAL PHARMACY 2741 VIRGINIA PKWY STE 800 750715027 972 540-9900 N

ACCESSHEALTH PLUS MCKINNEY PHARMA PLUS PHARMACY 5881 VIRGINIA PKWY STE 400 75070 214 585-4600 N

ELEVATE PROVIDER NETWORK MCKINNEY SAMS PHARMACY 1670 W UNIVERSITY DRIVE 75069 972 562-4401 N

WALMART STORES INC MCKINNEY SAVON PHARMACY 3001 S CENTRAL EXPY 75069 972 548-1088 N

ALBERTSONS LLC MCKINNEY SAVON PHARMACY 6800 W VIRGINIA PKWY 75070 972 542-0010 N

ALBERTSONS LLC MCKINNEY SUPER 1 PHARMACY 208 N CENTRAL 75069 972 548-7025 N

BROOKSHIRE GROCERY COMPANY MCKINNEY TARGET PHARMACY 2025 N CENTRAL EXPWY 75070 469 525-4975 N

TARGET PHARMACIES MCKINNEY TARGET PHARMACY 8900 STATE HWY 121 75070 972 439-3398 N

TARGET PHARMACIES MCKINNEY UNITED PHARMACY 6100 W ELDORADO PKWY 75070 972 548-5150 N

UNITED PHARMACY TX MCKINNEY WAL-MART PHARMACY 5001 MCKINNEY RANCH

PARKWAY 75070 972 529-2187 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MCKINNEY WAL-MART PHARMACY 10-0206 2041 REDBUD BLVD 75069 972 542-2619 N

WALMART STORES INC MCKINNEY WALMART PHARMACY 10-5311 1721 N CUSTER RD 75070 972 548-8348 N

WALMART STORES INC MCKINNEY WALMART PHARMACY 10-6966 3400 VIRGINIA PKWY 750713405 214 250-5009

WALMART STORES INC MEADOWS PLACE CVS PHARMACY 12381 W BELLFORT 77477 281 776-3070 N

CVS PHARMACY INC MELISSA CVS PHARMACY # 2600 SAM RAYBURN HWY 75454 972 837-1061

CVS PHARMACY INC MELISSA MEDPRO PHARMACY AND WELLNESS

CENTER 2212 SAM RAYBURN HWY STE 100

75454 972 837-2900 N ELEVATE PROVIDER NETWORK

MEMPHIS MEMPHIS DRUG 506 W NOEL ST 792453328 806 259-5067 N ACCESSHEALTH

MERCEDES MID VALLEY PHARMACY 805 W BUSINESS HWY 83 78570 956 565-4111 N ELEVATE PROVIDER NETWORK

MERKEL MERKEL DRUG CO 121 EDWARDS ST 795363801 325 928-5012 N ACCESSHEALTH

MERKEL WALMART PHARMACY 10-2461 1003 TELEPHONE CIR 79536 325 928-4436 N WALMART STORES INC

MESQUITE APPLE DRUGS 1900 OATES DR STE 138 751506802 972 270-0041 N TRINET

MESQUITE CVS PHARMACY 500 N GALLOWAY STE 2 75149 972 288-4485 Y CVS PHARMACY INC

MESQUITE CVS PHARMACY # 1413 OATS DRIVE 751501345 972 613-7001 N CVS PHARMACY INC

MESQUITE CVS PHARMACY # 05990 904 E CARTWRIGHT RD 751496623 972 222-3404 CVS PHARMACY INC

MESQUITE GALLOWAY PHARMACY 910 N GALLOWAY AVE # 100 751492409 972 216-7000 N TRINET

MESQUITE KEARNEY PARK PHARMACY 502 W KEARNEY ST STE 900 751493477 972 329-1168 N ELEVATE PROVIDER NETWORK

MESQUITE KROGER PHARMACY 3600 GUS THOMASSON ROAD 75150 972 270-2401 N THE KROGER CO

MESQUITE KROGER PHARMACY 525 N GALLOWAY 75149 972 288-6403 N THE KROGER CO

MESQUITE KROGER PHARMACY 1919 FAITHON P LUCAS BLVD 75181 469 726-0013 N THE KROGER CO

MESQUITE MINYARD PHARMACY 4414 GUS THOMASSON 75150 972 613-5787 N ACCESSHEALTH PLUS

MESQUITE SAFE PHARMACY 2920 MOTLEY DR 75150 855 226-6567 N SAV MOR DRUG STORES

MESQUITE SAVON PHARMACY 2828 MOTLEY DR 75150 972 270-4448 N ALBERTSONS LLC

MESQUITE SAVON PHARMACY #4187 1500 S BELTLINE RD 75149 972 285-1352 N ALBERTSONS LLC

MESQUITE TARGET PHARMACY 1629 N TOWN E BLVD 751504105 214 302-2961 N TARGET PHARMACIES

MESQUITE VERDE PHARMACY 2929 N GALLOWAY AVE STE 116 751504800 972 807-2493 N COMMUNITY INDEPENDENT PHARMACY NETW

MESQUITE WAL-MART PHARMACY 915 N TOWN E BLVD 75150 972 613-7950 N WALMART STORES INC

MESQUITE WAL-MART PHARMACY 10-0789 200 US HWY 80 EAST 75149 972 289-5319 N WALMART STORES INC

MEXIA CVS PHARMACY # 827 E MILAM ST 766672447 254 472-0306 CVS PHARMACY INC

MEXIA HEB PHARMACY 701 E MILAM ST 76667 254 562-5123 N HEB GROCERY COMPANY LP

MEXIA WAL-MART PHARMACY 1406 E MILAM 76667 254 562-5551 N WALMART STORES INC

MIDLAND ALBERTSONS MARKET PHARMACY #671 3317 N MIDLAND DR 79703 432 689-8708 N UNITED PHARMACY TX

MIDLAND ALBERTSONS MARKET PHARMACY #672 1002 ANDREWS HWY 79701 432 694-9673 N UNITED PHARMACY TX

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MIDLAND CVS PHARMACY # 5315 BRIARWOOD AVE 79707 432 689-2901

CVS PHARMACY INC MIDLAND CVS PHARMACY # 04356 301 ANDREWS HWY 797016333 432 685-3092

CVS PHARMACY INC MIDLAND GRAHAM PHARMACY 1601 W WALL ST 797016549 432 684-0569 N

THIRD PARTY STATION CP MIDLAND HEB PHARMACY 3325 W WADLEY 79707 432 697-1484 N

HEB GROCERY COMPANY LP MIDLAND HEB PHARMACY #717 5407 ANDREWS HWY 797062851 210 938-2717 N

HEB GROCERY COMPANY LP MIDLAND MARKET STREET PHARMACY #674 4706 N MIDKIFF RD 79705 432 699-7578 Y

UNITED PHARMACY TX MIDLAND MEDICAL CENTER PHARMACY 3510 N MIDKIFF 797054834 432 697-7500

LEADER DRUG STORES INC MIDLAND MIDLAND DME LLC 1913 HERITAGE BLVD STE A 797079752 432 520-8396 N

EMEDRX SOLUTIONS MIDLAND PROVIDE RX 2208 N LOOP 250 W 79707 432 689-3355

ELEVATE PROVIDER NETWORK MIDLAND SAM'S CLUB PHARMACY 10-8288 1500 TRADEWINDS BLVD 797062833 432 253-7669 N

WALMART STORES INC MIDLAND SUPER MERCADO PHARMACY 2208 N BIG SPRING 79705 432 682-9501 N

ACCESSHEALTH MIDLAND WAL-MART PHARMACY 200 W INTERSTATE 20 79701 432 684-4425 N

WALMART STORES INC MIDLAND WAL-MART PHARMACY 10-0608 4517 N MIDLAND DRIVE 79707 432 697-2299 N

WALMART STORES INC MIDLOTHIAN ALL CARE PHARMACY 1441 S MIDLOTHIAN PKWY STE

140 760655592 972 775-5222 N COMMUNITY INDEPENDENT PHARMACY

NETW MIDLOTHIAN BROOKSHIRES PHARMACY 1400 E HWY 287 76065 972 775-6878 N

BROOKSHIRE GROCERY COMPANY MIDLOTHIAN CVS PHARMACY 100 E MAIN ST 76065 972 775-8203 N

CVS PHARMACY INC MIDLOTHIAN WAL-MART PHARMACY 400 N HIGHWAY 67 76065 972 775-4708 N

WALMART STORES INC MILLSAP ALPHA CARE PHARMACY 1130 FM 1189 STE 109 760663542 817 550-6332 N

RECEPT HEALTHCARE SERVICES MINEOLA BROOKSHIRES PHARMACY 1224 N PACIFIC AVE 75773 903 569-5504 N

BROOKSHIRE GROCERY COMPANY MINEOLA CVS PHARMACY # 210 E BROAD ST 75773 903 569-5343 N

CVS PHARMACY INC MINEOLA KELLY DRUG INC 125 E BROAD 75773 903 569-3882 N

THIRD PARTY STATION CP MINEOLA WAL-MART PHARMACY10-0251 135 NE LOOP 564 75773 903 569-5485 N

WALMART STORES INC MINERAL WELLS BEST VALUE WADDY PHARMACY 106 SW 6TH AVE 76067 940 325-0734 N

ELEVATE PROVIDER NETWORK MINERAL WELLS CVS PHARMACY 102 FM 1821 N 76067 940 325-3358 N

CVS PHARMACY INC MINERAL WELLS DIAMOND PHARMACY 100 SE 17TH AVE 760675607 940 325-2541 N

ELEVATE PROVIDER NETWORK MINERAL WELLS WAL-MART PHARMACY 10-0804 601 N FM 1821 76067 940 325-9401 N

WALMART STORES INC MISSION AG PHARMACY 2408 N CONWAY AVE 785742347 956 580-7791 N

ACCESSHEALTH PLUS MISSION CENTRX PHARMACY AT MISSION 900 E EXPRESSWAY 83, SUITE A 78572 956 445-5383 N

ELEVATE PROVIDER NETWORK MISSION CVS PHARMACY # 2300 N CONWAY AVE 785742345 956 424-0591

CVS PHARMACY INC MISSION CVS PHARMACY # 2314 E EXPRESSWAY 83 785728685 956 585-3990

CVS PHARMACY INC MISSION HEALTH PLUS PHARMACY (FARMACIA

SALUD MAS 3401 W MILE 5 ROAD 78574 956 424-3535 Y

MISSION HEB PHARMACY 820 S CONWAY 78572 956 581-2173 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MISSION HEB PHARMACY 2409 E EXPRESSWAY 83 78572 956 205-6755 N

HEB GROCERY COMPANY LP MISSION HEB PHARMACY 200 E GRIFFIN PARKWAY 78572 956 424-7920 N

HEB GROCERY COMPANY LP MISSION LETDIN PHARMACY 1512 E GRIFFIN PKWY STE 1 785722424 956 581-9566 N

PPOK RXSELECT PHCY NETWORK MISSION MISSION PLAZA PHARMACY 906 S BRYAN RD 785726605 956 581-8833 N

ELEVATE PROVIDER NETWORK MISSION NUESTRA CLINICA DEL VALLE 611 N BRYAN RD 78572 956 580-3304 N

TRINET MISSION PALOMA'S PHARMACY 909 BUSINESS PARK DR STE 2 785726054 956 424-6268 N COMMUNITY INDEPENDENT PHARMACY

NETW MISSION QUEEN PHARMACY 8305 N LA HOMA RD 78574 956 583-5552 N

ELEVATE PROVIDER NETWORK MISSION RICHARD'S PHARMACY 1112 E GRIFFIN PKWY STE B 78572 956 581-4200 N

ACCESSHEALTH PLUS MISSION SAENZ MEDICAL PHARMACY LONE STAR 2121 E GRIFFIN PKWY 78572 956 519-6500 N

ACCESSHEALTH PLUS MISSION STARR PHARMACY #2 1300 S BRYAN RD STE 101 785726688 956 271-4258 N

LEADER DRUG STORES INC MISSION TARGET PHARMACY 2427 E US EXPRESSWAY 83 78572 956 928-7281 N

TARGET PHARMACIES MISSION TLC PHARMACY AND MEDICAL

EQUIPMENT 2120 E GRIFFIN PARKWAY 78572 956 581-5499 N

LEADER DRUG STORES INC MISSION TLC PHARMACY AND MEDICAL

EQUIPMENT #2 1242 E BUSINESS HIGHWAY 83 78572 956 583-2700 N

ELEVATE PROVIDER NETWORK MISSION WAL-MART PHARMACY 10-0395 2410 E EXPRESSWAY 83 78572 956 585-5783 N

WALMART STORES INC MISSION WALMART PHARMACY 10-6850 1006 N BRYAN RD 78572 956 391-3422 N

WALMART STORES INC MISSION WESTSIDE PHARMACY 200 N PALMVIEW DR 78572 956 584-3458 N COMMUNITY INDEPENDENT PHARMACY

NETW MISSOURI CITY CVS PHARMACY 1302 FM 1092 77459 281 499-5537 N

CVS PHARMACY INC MISSOURI CITY CVS PHARMACY 2781 DULLES AVE 77459 281 403-2320 N

CVS PHARMACY INC MISSOURI CITY CVS PHARMACY 1610 CARTWRIGHT RD 77489 281 835-0907 Y

CVS PHARMACY INC MISSOURI CITY CVS PHARMACY 6220 SIENNA PKWY 77459 281 778-9980 N

CVS PHARMACY INC MISSOURI CITY ECO PHARMACY OF SIENNA PLANTATION 8721 HIGHWAY 6 # 200 774597151 832 440-0085 N

ACCESSHEALTH PLUS MISSOURI CITY EDS PHARMACY 3740 CARTWRIGHT RD 77459 281 499-4555 N

ELEVATE PROVIDER NETWORK MISSOURI CITY HEALTHSCRIPTS OF AMERICA-SOUTHWEST

TEXAS, LLC 2803 DULLES AVE STE 2817 774592950 281 499-3481 N

TRINET MISSOURI CITY HEB PHARMACY 4724 HWY 6 77459 281 403-1861 N

HEB GROCERY COMPANY LP MISSOURI CITY HEB PHARMACY 8900 HWY 6 78382 281 778-1350 N

HEB GROCERY COMPANY LP MISSOURI CITY KORNER PHARMACY 2503 CARTWRIGHT RD 774592606 281 969-7940 N

TRINET MISSOURI CITY KROGER PHARMACY 6200 HWY 6 SOUTH 77459 281 208-1741 N

THE KROGER CO MISSOURI CITY TARGET PHARMACY 6000 HWY 6 77459 281 403-6584 N

TARGET PHARMACIES MISSOURI CITY UPSHAW PHARMACY 7125 W FUQUA RD 77489 281 416-9123 N

TRINET MISSOURI CITY WAL-MART PHARMACY 5501 HWY 6 77459 281 403-0037 N

WALMART STORES INC MISSOURI CITY WALMART PHARMACY 10-5449 9929 HIGHWAY 6 774594149 281 835-0016 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network MONAHANS LOWES MARKETPLACE PHARMACY 1201 STOCKTON 797567434 432 943-4445 N

LEADER DRUG STORES INC MONAHANS MONAHANS PHARMACY 801 E 4TH ST 797564015 432 943-4212 N

ELEVATE PROVIDER NETWORK MONTGOMERY CVS PHARMACY 15270 HWY 105 WEST 77356 936 588-0666 N

CVS PHARMACY INC MONTGOMERY CVS PHARMACY # 2180 WOODFOREST PARKWAY N 77316 936 588-6061

CVS PHARMACY INC MONTGOMERY LAKESIDE PHARMACY 16955 WALDEN RD STE 100 773563227 936 448-6337 N

ELEVATE PROVIDER NETWORK MONTGOMERY WAL-MART PHARMACY 18700 HIGHWAY 105 W 773565625 936 582-1005 N

WALMART STORES INC MOUNT PLEASANT THURMAN'S PRO-MED PHARMACY 402 N MADISON AVE 754553949 903 572-6337 N

ELEVATE PROVIDER NETWORK MOUNT PLEASANT WAL-MART PHARMACY 10-0131 2311 S JEFFERSON 75455 903 572-7924 N

WALMART STORES INC MOUNT VERNON TIGERX PHARMACY 405 HIGHWAY 37 SOUTH 75457 903 537-4700 N

ACCESSHEALTH PLUS MT PLEASANT CLINIC PHARMACY 412 N JEFFERSON 754553672 903 572-8548 N COMMUNITY INDEPENDENT PHARMACY

NETW MT PLEASANT CVS PHARMACY 601 S JEFFERSON AVE 75455 903 572-3448 N

CVS PHARMACY INC MT PLEASANT MEDICAL CENTER FAMILY PHARMACY 2001 N JEFFERSON 132 75455 903 572-6418 N

ACCESSHEALTH PLUS MT PLEASANT SUPER 1 PHARMACY 602 JEFFERSON PARK 75455 903 575-1610 N

BROOKSHIRE GROCERY COMPANY MT VERNON BROOKSHIRES PHARMACY 306 STATE HWY 37 SOUTH 75457 903 537-2886 N

BROOKSHIRE GROCERY COMPANY MULESHOE K & K PHARMACY 1411 W AMERICAN BLVD 793473123 806 686-0881 N

ELEVATE PROVIDER NETWORK MULESHOE UNITED PHARMACY 104 W 9TH ST 79347 806 272-3169 N

UNITED PHARMACY TX MURPHY CVS PHARMACY # 750 E FM 544 75094 972 429-5047

CVS PHARMACY INC MURPHY INVERNESS LONE STAR PHARMACY, LLC 223 E FM 544 STE 806 750944029 972 535-2020 N

TRINET MURPHY SAVON PHARMACY 200 E FM 544 75094 972 578-9855 N

ALBERTSONS LLC MURPHY WAL-MART PHARMACY 115 W FM 544 750944001 972 516-0264 N

WALMART STORES INC N RICHLAND HILLS KROGER PHARMACY #535 9150 N TARRANT PKWY 761828676 817 918-3387 N

THE KROGER CO N RICHLAND HILLS SAMS PHARMACY 6375 NE LOOP 820 76180 817 428-3714 N

WALMART STORES INC N RICHLAND HILLS TARGET PHARMACY 8532 DAVIS BLVD 76182 817 503-0615 N

TARGET PHARMACIES N RICHLAND HILLS WAL-MART PHARMACY 10-0807 6401 NE LOOP 820 76180 817 498-4411 N

WALMART STORES INC N. RICHLAND HILLS KROGER PHARMACY 7201 GRAPEVINE HWY 76180 817 281-8310 N

THE KROGER CO NACOGDOCHES CVS PHARMACY 1424 N ST 75961 936 569-9596 N

CVS PHARMACY INC NACOGDOCHES KROGER PHARMACY 1215 N ST 75961 936 569-9884 N

THE KROGER CO NACOGDOCHES M AND S PHARMACY INC 917 E AUSTIN ST 75965 936 564-7373 N

LEADER DRUG STORES INC NACOGDOCHES STRIPLING'S PHARMACY 1205 N MOUND ST 75961 936 564-4646 N

LEADER DRUG STORES INC NACOGDOCHES THE MEDICINE SHOPPE 212 N ST 75961 936 569-6430 N

MEDICINE SHOPPE INTERNATIONAL INC NACOGDOCHES WAL-MART PHARMACY 10-0163 4810 N ST 75965 936 564-1158 N

WALMART STORES INC NACOGDOCHES WALMART PHARMACY 10-4674 1030 N UNIVERSITY DR 759614208 479 204-1258 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network NAPLES WALMART PHARMACY 10-4338 504 WL DOC DODSON E 755686371 903 897-2922 N

WALMART STORES INC NASSAU BAY CVS PHARMACY 1610 NASA RD 1 77058 281 333-3985 Y

CVS PHARMACY INC NAVASOTA WAL-MART PHARMACY 10-0293 1712 E WASHINGTON 77868 936 825-2185 N

WALMART STORES INC NEDERLAND BETTER LIVING MEDICAL 1039 N TWIN CITY HWY 776273828 409 727-8660 N

TRINET NEDERLAND CVS PHARMACY 2712 HIGHWAY 365 77627 409 721-5846 N

CVS PHARMACY INC NEW BOSTON BROOKSHIRES PHARMACY 210 N MCCOY BLVD 75570 903 628-7459 N

BROOKSHIRE GROCERY COMPANY NEW BOSTON WAL-MART PHARMACY 100181 800 JAMES BOWIE DRIVE 75570 903 628-6561 N

WALMART STORES INC NEW BRAUNFELS 10 MINUTE PHARMACY 18 GRUENE PARK DR 781302460 830 387-4914 N

ACCESSHEALTH PLUS NEW BRAUNFELS COMAL DRUG HEALTHMART 544 N UNION ST 781304195 830 625-2421 N

ACCESSHEALTH PLUS NEW BRAUNFELS CVS PHARMACY 210 N BUSINESS IH 35 78130 830 629-5096 N

CVS PHARMACY INC NEW BRAUNFELS CVS PHARMACY # 2020 S WALNUT AVE 78130 830 608-0538

CVS PHARMACY INC NEW BRAUNFELS GRUENE ROAD PHARMACY LLC 910 GRUENE RD # 3 781303919 830 387-4378 N

ACCESSHEALTH PLUS NEW BRAUNFELS HEB PHARMACY 415 N NEW BRAUNFELS 78202 210 226-8642 N

HEB GROCERY COMPANY LP NEW BRAUNFELS HEB PHARMACY 1655 HWY 46 WEST 78132 830 626-0385 N

HEB GROCERY COMPANY LP NEW BRAUNFELS HEB PHARMACY 651 S WALNUT 78130 830 609-1944 N

HEB GROCERY COMPANY LP NEW BRAUNFELS HILLTOP PHARMACY 631 LAKEVIEW BLVD 78130 830 627-0069 Y

ELEVATE PROVIDER NETWORK NEW BRAUNFELS HUMANA PHARMACY, INC. 1860 SEGUIN AVE 781303916 830 387-7560 N

PRESCRIBEIT RX NEW BRAUNFELS HUNTER'S CREEK PHARMACY 213 HUNTER'S VILLAGE 78132 830 515-1278 N

RECEPT HEALTHCARE SERVICES NEW BRAUNFELS WAL-MART PHARMACY 10-0865 1209 S INTERSTATE 35 78130 830 629-9011 N

WALMART STORES INC NEW BRAUNFIELDS TARGET PHARMACY 135 CREEKSIDE WAY 781306248 830 608-3281 N

TARGET PHARMACIES NEW WAVERLY YOUR NEW WAVERLY PHARMACY LLC 9320C STATE HIGHWAY 75 S 77358 936 344-2424 N

LEADER DRUG STORES INC NIXON MAIN DRUG CO INC 201 N NIXON AVE 78140 830 582-1851 N

LEADER DRUG STORES INC NOCONA GIBBS DRUG STORE 216 CLAY ST 76255 940 825-3226 N

ELEVATE PROVIDER NETWORK NORTH RICHLAND HILLS CVS PHARMACY 6320 RUFE SNOW DR 76180 817 656-9861 N

CVS PHARMACY INC NORTH RICHLAND HILLS CVS PHARMACY # 9200 N TARRANT PARKWAY 76180 817 428-5844

CVS PHARMACY INC NORTH RICHLAND HILLS CVS PHARMACY # 6401 PRECINCT LINE RD 76180 817 485-8302 N

CVS PHARMACY INC NORTH RICHLAND HILLS KROGER PHARMACY 9135 BOULEVARD 26 76180 817 605-3937 N

THE KROGER CO NORTH RICHLAND HILLS RSVP #700 7904 NE LOOP 820 76180 855 362-7878 N

TRINET NORTH RICHLAND HILLS WAL-MART PHARMACY 9101 N TARRANT PKWY 761828655 817 605-8190 N

WALMART STORES INC ODESSA ALBERTSONS MARKET PHARMACY #675 4950 E 42ND ST 79762 432 367-4612 N

UNITED PHARMACY TX ODESSA ALBERTSONS MARKET PHARMACY #676 2751 COUNTY RD W 79764 432 333-1591 N

UNITED PHARMACY TX ODESSA ALBERTSONS MARKET PHARMACY #677 1350 E 8TH ST 79760 432 332-7361 N

UNITED PHARMACY TX ODESSA CVS PHARMACY 100 E UNIVERSITY BLVD 797627665 432 332-0908 Y

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ODESSA CVS PHARMACY # 4101 E 42ND ST 797627239 432 366-1160

CVS PHARMACY INC ODESSA EVANS PRESCRIPTION PHARMACY 310 N DOTSY AVE 797634342 432 337-2361 N

ELEVATE PROVIDER NETWORK ODESSA GOLDER PHARMACY 319 N GOLDER 797615009 432 337-7311 N

ELEVATE PROVIDER NETWORK ODESSA GUNDLAPALLIS ADVANCED PAIN CENTER 801 N JACKSON AVE 797614002 432 333-5200 N

EMEDRX SOLUTIONS ODESSA HEB PHARMACY 2501 W UNIVERSITY BLVD 79764 432 332-0475 N

HEB GROCERY COMPANY LP ODESSA HEB PHARMACY 3801 E 42ND ST 79762 432 362-4555 N

HEB GROCERY COMPANY LP ODESSA HEB PHARMACY 540 W 5TH ST 79761 432 332-1623 N

HEB GROCERY COMPANY LP ODESSA LAWRENCE BROS PHARMACY 1613 W COUNTY RD 797632960 432 332-1231 N

LEADER DRUG STORES INC ODESSA LOWES MARKETPLACE PHCY 1107 E 42ND ST 797627723 432 367-3407 N

LEADER DRUG STORES INC ODESSA SAMS PHARMACY 4230 JOHN BEN SHEPPARD

PKWY 79762 432 362-0634 N

WALMART STORES INC ODESSA TARGET PHARMACY 3909 E 42ND ST 79762 432 366-1913 N

TARGET PHARMACIES ODESSA TOWN AND COUNTRY DRUG 2745 N GRANDVIEW 797626992 432 366-2868 N

ACCESSHEALTH ODESSA UNIVERSITY PHARMACY INC 4850 E UNIVERSITY AVE 797628106 432 366-8821 N

ACCESSHEALTH ODESSA WAL-MART PHARMACY 2450 W LOOP 338 79763 432 332-6004 N

WALMART STORES INC ODESSA WAL-MART PHARMACY 10-0537 4210 JOHN BEN SHEPHERD

PKWY 79762 432 368-7744 N

WALMART STORES INC OLNEY CUB DRUG INC 116 E MAIN ST 763741922 940 564-5551 N

ELEVATE PROVIDER NETWORK ORANGE CVS PHARMACY 2425 N 16TH ST 77630 409 886-3546 N

CVS PHARMACY INC ORANGE CVS PHARMACY 290 STRICKLAND DRIVE 77630 409 886-3534 N

CVS PHARMACY INC ORANGE KROGER PHARMACY 1600 N 16TH ST 77630 409 886-1362 N

THE KROGER CO ORANGE SHOLARS MEDICINE CHEST 1301 W PARK ST 776304948 409 883-4352 N

ELEVATE PROVIDER NETWORK ORANGE GROVE CVS PHARMACY # 407 E ORANGE ST 78372 361 384-3090

CVS PHARMACY INC OVERTON LOUIS MORGAN DRUGS 101 N RUSK ST 756841333 903 834-3178 N

ELEVATE PROVIDER NETWORK OVERTON OVERTON PHARMACY 104 W HENDERSON ST 756841613 903 834-0154 N

ELEVATE PROVIDER NETWORK OZONA VILLAGE DRUG 902 11TH ST 76943 325 392-2666 N

ELEVATE PROVIDER NETWORK PALACIOS PALACIOS PRESCRIPTION SHOPPE 321 MAIN ST 774655461 361 972-3608 N

ELEVATE PROVIDER NETWORK PALESTINE BRATTONS PHARMACY 2305 W OAK ST 758021985 903 731-4734 N

ACCESSHEALTH PALESTINE BROOKSHIRES PHARMACY 2107 S LOOP 256 75801 903 723-1092 N

BROOKSHIRE GROCERY COMPANY PALESTINE CVS PHARMACY # 1919 S LOOP 256 75801 903 729-6055 N

CVS PHARMACY INC PALESTINE HOMETOWN PHARMACY 101 MEDICAL DR 75801 903 729-3100 N

ACCESSHEALTH PLUS PALESTINE KROGER PHARMACY 325 E SPRING ST 75801 903 729-5362 N

THE KROGER CO PALESTINE WAL-MART PHARMACY 10-0345 2223 S LOOP 256 75801 903 723-0685 N

WALMART STORES INC PALMER WALMART PHARMACY 10-3834 428 N DALLAS ST 75152 972 449-3506 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PALMHURST HEB PHARMACY #674 120 E MILE 3 ROAD 78573 956 583-3229 N

HEB GROCERY COMPANY LP PALMHURST WAL-MART PHARMACY 215 E MILE 3 ROAD 78574 956 519-2240 N

WALMART STORES INC PALMVIEW HEB PHARMACY 2206 W PALMA VISTA DR 78572 956 585-3959 N

HEB GROCERY COMPANY LP PAMPA B & B PHARMACY 300 N BALLARD ST 79065 806 665-5788 N

ELEVATE PROVIDER NETWORK PAMPA CVS PHARMACY 1300 N HOBART ST 79065 806 665-2705 N

CVS PHARMACY INC PAMPA HEARD JONES HEALTHMART 114 N CUYLER ST 79065 806 669-7478 N

ACCESSHEALTH PLUS PAMPA KEYES PHARMACY 928 N HOBART ST 790655204 806 669-1202 N

ACCESSHEALTH PAMPA UNITED PHARMACY 1420 N HOBART 79065 806 665-7642 N

UNITED PHARMACY TX PAMPA WAL-MART PHARMACY 10-0600 2801 N CHARLES ST 79065 806 669-1231 N

WALMART STORES INC PANTEGO CVS PHARMACY 2500 W PARK ROW DR 76013 817 795-1919 N

CVS PHARMACY INC PANTEGO WAL-MART PHARMACY 2610 W PIONEER PARKWAY 76013 817 303-4302 N

WALMART STORES INC PARIS AGAPE CARE PHARMACY 1021 S COLLEGIATE DRIVE 75460 903 905-4961 N

ACCESSHEALTH PLUS PARIS BROOKSHIRES PHARMACY 925 CLARKSVILLE 75460 903 785-3297 N

BROOKSHIRE GROCERY COMPANY PARIS CVS PHARMACY 507 CLARKSVILLE ST 75460 903 784-7434 N

CVS PHARMACY INC PARIS CVS PHARMACY 3710 LAMAR AVE 75462 903 785-0736 Y

CVS PHARMACY INC PARIS KROGER PHARMACY 1310 CLARKSVILLE ROAD 75460 903 785-1922 N

THE KROGER CO PARIS PARIS APOTHECARY 707 LAMAR AVE 754604460 903 785-4208 N

ELEVATE PROVIDER NETWORK PARIS WAL-MART PHARMACY 10-0148 3855 LAMAR AVE 75460 903 785-8734 N

WALMART STORES INC PASADENA BAYSHORE HEALTH MART 3315 BURKE RD STE 100 775041873 281 984-5000 N

ACCESSHEALTH PLUS PASADENA BAYSHORE PHARMACY 4024A BROOKHAVEN 77504 713 944-8893 N

ELEVATE PROVIDER NETWORK PASADENA BURKE FAMILY PHARMACY 4002 BURKE RD STE 400 775043451 832 243-6262 N

TRINET PASADENA CRENSHAW PHARMACY 5010 CRENSHAW RD STE 160 775053047 281 998-2777 N

ELEVATE PROVIDER NETWORK PASADENA CVS PHARMACY 5610 SPENCER HWY 77505 281 991-2593 N

CVS PHARMACY INC PASADENA CVS PHARMACY 930 SOUTHMORE 77502 713 740-9120 Y

CVS PHARMACY INC PASADENA CVS PHARMACY 4101 FAIRMONT PKWY 77504 281 998-2319 N

CVS PHARMACY INC PASADENA CVS PHARMACY 3342 SPENCER HWY 77504 713 378-2851 Y

CVS PHARMACY INC PASADENA DT PHARMACY 3911 WOODLAWN AVE 775041909 832 775-0060 N

TRINET PASADENA FAMILY PHARMACY CARE 4949 FAIRMONT PARKWAY 77505 832 900-7712 N

THIRD PARTY STATION CP PASADENA HEB PHARMACY 6210 FAIRMONT PARKWAY 77505 281 487-6170 N

HEB GROCERY COMPANY LP PASADENA KROGER PHARMACY 6767 SPENCER HWY 77505 281 998-7755 N

THE KROGER CO PASADENA KROGER PHARMACY 3550 SPENCER HWY 77504 713 944-0722 N

THE KROGER CO PASADENA KROGER PHARMACY 2619 RED BLUFF RD 77506 713 475-0939 N

THE KROGER CO PASADENA PCF PHARMACY 2615 STRAWBERRY RD 775025103 713 947-6767 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PASADENA PHARMHOUSE PHARMACY 4500 E SAM HOUSTON PKWY S

STE 100 77505 281 998-9400 N

ACCESSHEALTH PASADENA PREMIERCARE PHARMACY 5108 FAIRMONT PKWY STE A 775053756 281 991-1300 Y

TRINET PASADENA STRAWBERRY FAMILY DRUG 1802 STRAWBERRY ROAD 77502 713 740-9033 N

TRINET PASADENA TARGET PHARMACY 5757 FAIRMONT PARKWAY 77505 281 504-0144 N

TARGET PHARMACIES PASADENA WAL-MART PHARMACY 1107 S SHAVER ST 77506 713 534-6665 N

WALMART STORES INC PASADENA WAL-MART PHARMACY 10-0752 5200 FAIRMONT PKWY 77505 281 487-8091 N

WALMART STORES INC PASADENA WOODLAWN PHARMACY 3801 VISTA ROAD 77504 713 928-3044 N

TRINET PEARLAND COSTCO PHARMACY #1221 3500 BUSINESS CENTER DRIVE 77584 281 707-7011 N

COSTCO PHARMACIES PEARLAND COUNTRY PLACE PHARMACY 2404 SMITH RANCH RD STE 100 77584 713 436-3344 N

ELEVATE PROVIDER NETWORK PEARLAND CVS PHARMACY 9522 BROADWAY ST 775847724 713 436-8151 N

CVS PHARMACY INC PEARLAND CVS PHARMACY 11600 SHADOW CREEK 77584 713 436-8250 N

CVS PHARMACY INC PEARLAND CVS PHARMACY 2900 BROADWAY ST 77581 281 997-4400 N

CVS PHARMACY INC PEARLAND CVS PHARMACY # 12806 BROADWAY ST 77584 713 436-1298

CVS PHARMACY INC PEARLAND FAMILY PHARMACY CARE 10905 MEMORIAL HERMANN DR

STE 102 775843490 281 315-3770 N

THIRD PARTY STATION CP PEARLAND GALE COMPOUNDING PHARMACY 12234 SHADOW CREEK PKWY

STE 4110 775847333 281 668-6209 N

TPN PEARLAND HAZEL'S COMPOUNDING RX PHARMACY 1801 COUNTRY PLACE PKWY 775845120 713 340-0202 N

ACCESSHEALTH PLUS PEARLAND HEALTHSCRIPTS OF AMERICA - PEARLAND,

LLC 1849 PEARLAND PKWY STE 103 775815343 832 770-8180 N

TRINET PEARLAND HEB PHARMACY 2710 PEARLAND PKWY 77581 281 485-5047 N

HEB GROCERY COMPANY LP PEARLAND HEB PHARMACY 2805 BUSINESS CENTER DR 77581 713 578-6155 N

HEB GROCERY COMPANY LP PEARLAND KROGER PHARMACY 3245 E BROADWAY 77581 281 485-1323 N

THE KROGER CO PEARLAND KROGER PHARMACY 8323 BROADWAY 77584 281 997-6500 N

THE KROGER CO PEARLAND KROGER PHARMACY 11003 SHADOW CREEK PKWY 77584 281 669-1250 N

THE KROGER CO PEARLAND MASTERY PHARMACY 2950 CULLEN PARKWAY 77584 713 665-9995 N

THIRD PARTY STATION PEARLAND MEDX PHARMACY 6302 BROADWAY ST STE 100 775817879 281 506-2453 N

THIRD PARTY STATION CP PEARLAND PHARMCARE 1834 BROADWAY ST 775815606 281 996-7500 N

ELEVATE PROVIDER NETWORK PEARLAND ROYAL PHARMACY 12002 SHADOW CREEK PKWY

STE 106 775847325 346 207-8588 N

TPN PEARLAND RX CARE PHARMACY 7121 BROADWAY ST 77581 281 412-0377 N

ELEVATE PROVIDER NETWORK PEARLAND SAMS PHARMACY 15800 S FWY 775841834 713 986-0087 N

WALMART STORES INC PEARLAND SMITH RANCH PHARMACY 2813 SMITH RANCH RD STE B 775845254 281 306-1383 N

RECEPT HEALTHCARE SERVICES PEARLAND TARGET PHARMACY 3045 SILVERLAKE VILLAGE DR 77584 713 436-2516 N

TARGET PHARMACIES PEARLAND TODAH PHARMACY LLC 2011 E BROADWAY #125 77581 281 485-4512 N

TRINET

Page 86: Ambetter from Superior HealthPlan: Pharmacies ... from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network City Name Address 1 Zip Code Phone 24-Hour Chain Name

Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PEARLAND WAL-MART PHARMACY 1710 BROADWAY ST 77581 281 482-5516 N

WALMART STORES INC PEARLAND WAL-MART PHARMACY 10505 BROADWAY 77584 713 436-5844 N

WALMART STORES INC PEARLAND WAL-MART PHARMACY 10-0872 1919 N MAIN 77581 281 485-2818 N

WALMART STORES INC PEARLAND WALMART PHARMACY 10-7361 12631 BROADWAY ST 775841932 713 570-7930 N

WALMART STORES INC PEARSALL HEB PHARMACY 225 S IH 35 78061 830 334-3374 N

HEB GROCERY COMPANY LP PEARSALL WAL-MART PHARMACY 10-0478 819 N OAK ST 78061 830 334-4185 N

WALMART STORES INC PECOS PROFESSIONAL PHARMACY 925 DAGGETT 79772 432 447-2266 N

ACCESSHEALTH PECOS WAL-MART PHARMACY 1903 S CEDAR 79772 432 445-4255 N

WALMART STORES INC PENITAS PENITAS FAMILY PHARMACY 2308 EXPRESSWAY 83 785768399 956 580-3500 N

LEADER DRUG STORES INC PENITAS SAENZ MEDICAL PHARMACY OF PENITAS 3201 EXPRESSWAY 83 785760214 956 585-2704 N

ACCESSHEALTH PLUS PENITAS WAL-MART PHARMACY 1705 EXPRESSWAY 83 78576 956 580-1511 N

WALMART STORES INC PERRYTON RED'S PHARMACY, LLC 3010 GARRETT DR 790705322 806 435-3759 N

ELEVATE PROVIDER NETWORK PERRYTON UNITED PHARMACY 2802 HWY 83 SOUTH 79070 806 435-2211 N

UNITED PHARMACY TX PETERSBURG PORTER DRUG 1522 MAIN ST 79250 806 667-2231 N

ELEVATE PROVIDER NETWORK PFLUGERVILLE CVS PHARMACY 1604 W PECAN ST 78660 512 990-8010 N

CVS PHARMACY INC PFLUGERVILLE CVS PHARMACY # 1605 WELLS BRANCH PKWY 78660 512 989-5559

CVS PHARMACY INC PFLUGERVILLE CVS PHARMACY # 2013 KELLY LN 78660 512 990-0814

CVS PHARMACY INC PFLUGERVILLE GRAND AVENUE PHARMACY 1615 GRAND AVE PKWY STE 104 786602060 512 377-1999 N

ELEVATE PROVIDER NETWORK PFLUGERVILLE HEB PHARMACY 1434 WELLS BRANCH PKWY 78660 512 251-5286 N

HEB GROCERY COMPANY LP PFLUGERVILLE HEB PHARMACY 201 N FM 685 78660 512 251-9037 N

HEB GROCERY COMPANY LP PFLUGERVILLE TARGET PHARMACY 18700 LIMESTONE COMMERCIAL

DR STE 100 786606545 512 687-2065 N

TARGET PHARMACIES PFLUGERVILLE WALMART PHARMACY 10-5479 1548 FM 685 78660 512 252-0197 N

WALMART STORES INC PHARR COSTCO PHARMACY #1108 1501 W KELLY AVE 78577 956 354-3901 N

COSTCO PHARMACIES PHARR CVS PHARMACY # 1301 S CAGE BLVD 785776227 956 787-2854

CVS PHARMACY INC PHARR HEB PHARMACY 1300 S CAGE BLVD 78577 956 781-6626 N

HEB GROCERY COMPANY LP PHARR J & L PHARMACY 900 W SAM HOUSTON BLVD STE

3 785775215 956 782-1156 N

ACCESSHEALTH PHARR LAS MILPAS PHCY 7013 S CAGE STE D 78577 956 702-2211 N

TRINET PHARR MARIO'S RX PHARMACY 6201 S CAGE BLVD STE 5A 785775612 956 702-5050 N

TRINET PHARR PHARR FAMILY PHARMACY 710 S CAGE BLVD 78577 956 782-8494 N

ACCESSHEALTH PHARR PHARRMACY 1002 W SAM HOUSTON 78577 956 283-0911 N

ACCESSHEALTH PLUS PILOT POINT AXTELL PHARMACY 1246 HWY 377 S 762581029 940 686-2218 N

ACCESSHEALTH PLUS PILOT POINT PELZELS HOMETOWN PHARMACY 1340 N HWY 377 76258 940 686-0123 N

ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PINELAND PINELAND PHARMACY 105 TIMBERLAND HWY 75968 409 584-2689 N COMMUNITY INDEPENDENT PHARMACY

NETW PIPE CREEK SUPER DRUG MART TELEPHARMACY 146 LAUREL VISTA DR 78063 830 751-2700

ELEVATE PROVIDER NETWORK PITTSBURG CVS PHARMACY 100 N GREER BLVD 75686 903 856-3686 N

CVS PHARMACY INC PITTSBURG PARKER DRUG 114 QUITMAN ST 756861322 903 856-3626 N

THIRD PARTY STATION PITTSBURG THE DRUGSTORE 19 COUNTY ROAD 4114 STE 1 756864199 903 708-7500 N

ELEVATE PROVIDER NETWORK PLAINVIEW AMIGOS PHARMACY 2403 N COLUMBIA 79072 806 293-3820 N

UNITED PHARMACY TX PLAINVIEW CVS PHARMACY 1801 W 5TH ST 79072 806 291-0031 N

CVS PHARMACY INC PLAINVIEW WAL-MART PHARMACY 1501 N I 27 79072 806 293-4219 N

WALMART STORES INC PLANO AMERICAN SPECIALTY PHARMACY 2743 W 15TH ST 750757525 214 919-2090

TPN PLANO BAYLOR SCOTT & WHITE PHARMACY #109 4716 ALLIANCE BLVD STE 280 750935371 469 814-5780 N

LEADER DRUG STORES INC PLANO COSTCO PHARMACY 3800 N CENTRAL EXPRESSWAY 75074 972 244-0002 N

COSTCO PHARMACIES PLANO COSTCO PHARMACY 1701 DALLAS PKWY 75093 972 246-2202 N

COSTCO PHARMACIES PLANO COURAGE PHARMACY 3200 14TH ST SUITE 404 75074 972 943-0628 N

ACCESSHEALTH PLUS PLANO CVS PHARMACY 2140 HEDGCOXE RD 75025 972 517-6414 N

CVS PHARMACY INC PLANO CVS PHARMACY 10001 CUSTER RD 750258309 469 342-6810

CVS PHARMACY INC PLANO CVS PHARMACY 6761 PRESTON RD 750242504 972 403-7357 Y

CVS PHARMACY INC PLANO CVS PHARMACY 2101 W SPRING CREEK PKWY 75023 972 943-0601 N

CVS PHARMACY INC PLANO CVS PHARMACY 1501 INDEPENDENCE PKWY 75075 972 596-4300 N

CVS PHARMACY INC PLANO CVS PHARMACY 4201 E PARK 75074 972 424-0067 N

CVS PHARMACY INC PLANO CVS PHARMACY 525 PARKER RAOD 75023 972 424-3675

CVS PHARMACY INC PLANO CVS PHARMACY 2200 COIT RD 75075 972 867-5353 N

CVS PHARMACY INC PLANO CVS PHARMACY 2454 JUPITER RD 75074 972 578-8607 Y

CVS PHARMACY INC PLANO CVS PHARMACY 6401 W PARKER RD 75093 972 403-8128 N

CVS PHARMACY INC PLANO CVS PHARMACY # 5920 W PARK BLVD 750934304 972 248-7572

CVS PHARMACY INC PLANO CVS PHARMACY # 8940 COIT RD 75025 972 377-4966 Y

CVS PHARMACY INC PLANO GRACE PHARMACY 4032 MCDERMOTT RD STE 160 750247733 972 907-1833 N

ACCESSHEALTH PLUS PLANO KROGER PHARMACY 7100 INDEPENDENCE PWKY 75025 972 491-2596 N

THE KROGER CO PLANO KROGER PHARMACY 2925 CUSTER ROAD 75075 972 612-1864 N

THE KROGER CO PLANO KROGER PHARMACY 3305 N DALLAS PARKWAY 75093 972 608-4694 N

THE KROGER CO PLANO KROGER PHARMACY 9700 COIT ROAD 750255832 214 705-9097 N

THE KROGER CO PLANO KROGER PHARMACY 4017 14TH ST 75074 972 424-7529 N

THE KROGER CO PLANO KROGER PHARMACY #481 4836 W PARK BLVD 75093 972 964-8287 N

THE KROGER CO

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PLANO MARKET STREET PHARMACY 566 1929 PRESTON ROAD 75093 972 713-5515 N

UNITED PHARMACY TX PLANO MEDPRO PHARMACY #2 1120 E PARKER RD STE 210 750745329 972 312-9148 N

ELEVATE PROVIDER NETWORK PLANO PARKWAY PHARMACY 4708 ALLIANCE BLVD 75093 972 985-2600 N

ACCESSHEALTH PLUS PLANO PLANO CARE PHARMACY 2001 COIT RD STE 310 750753764 469 443-4488 N

EPIC PHARMACY NETWORK INC PLANO SAMS PHARMACY 1200 E SPRING CREEK PKWY 75074 972 516-8525 N

WALMART STORES INC PLANO SAMS PHARMACY 301 COIT ROAD 75075 972 519-0296 N

WALMART STORES INC PLANO SAMS PHARMACY 8621 OHIO DRIVE 75024 469 633-0041 N

WALMART STORES INC PLANO SAVON PHARMACY 1301 CUSTER RD 75074 972 423-7557 N

ALBERTSONS LLC PLANO TARGET PHARMACY 120 W PARKER RD 75075 972 633-1365 N

TARGET PHARMACIES PLANO TARGET PHARMACY 2200 DALLAS PARKWAY 75093 972 473-6335 N

TARGET PHARMACIES PLANO TEXAS HEALTH PRESCRIPTION SHOP

PLANO 6130 W PARKER RD STE 100 75093 972 981-8445 N

LEADER DRUG STORES INC PLANO TEXAS RX PHARMACY 6020 W PARKER RD 75093 972 378-4107 N

ELEVATE PROVIDER NETWORK PLANO TEXASSTAR PHARMACY 3033 W PARKER ROAD 75023 972 519-8475 N

ELEVATE PROVIDER NETWORK PLANO THE PHARMACOMPOUNDIA 6101 WINDHAVEN PKWY STE

120 750938289 972 378-6867 N

TPN PLANO THE PHARMACOMPOUNDIA - CLINICAL

PHARMACEUTICS 6001 WINDHAVEN PKWY STE 220

750938022 972 473-6867 N TPN

PLANO THRIVE PHARMACY SOLUTIONS 5425 W SPRING CREEK PKWY #190

75024 214 291-5087 ACCESSHEALTH PLUS

PLANO WAL-MART PHARMACY 6000 COIT RD 75023 972 985-3081 N WALMART STORES INC

PLANO WAL-MART PHARMACY 6001 CENTRAL EXPY 75023 972 422-9651 N WALMART STORES INC

PLANO WAL-MART PHARMACY 425 COIT ROAD 75075 972 599-9066 N WALMART STORES INC

PLANO WAL-MART PHARMACY 3513 E PARK BLVD 750743112 469 304-3148 N WALMART STORES INC

PLANO WAL-MART PHARMACY 1700 DALLAS PARKWAY 75093 972 931-5176 N WALMART STORES INC

PLANO WAL-MART PHARMACY 8801 OHIO DRIVE 75024 972 731-9588 N WALMART STORES INC

PLANO WAL-MART PHARMACY 8040 INDEPENDENCE PARKWAY 75025 972 396-6408 N WALMART STORES INC

PLANO WAL-MART PHARMACY 3100 CUSTER RD 750752060 972 244-6722 N WALMART STORES INC

PLANO WAL-MART PHARMACY 10-4182 3312 PRESTON ROAD 750937404 469 304-3124 N WALMART STORES INC

PLANO WILLOW BEND PHARMACY 5944 W PARKER RD 75093 214 473-8682 N THIRD PARTY STATION CP

PLEASANTON CENTER PHARMACY 105 N SMITH ST 780644109 830 569-2512 N ELEVATE PROVIDER NETWORK

PLEASANTON HEB PHARMACY 219 W OAKLAWN 78064 830 281-8190 N HEB GROCERY COMPANY LP

PLEASANTON REXCO PHARMACY 120 N SMITH ST 780644110 830 569-4060 N ACCESSHEALTH

PLEASANTON WAL-MART PHARMACY 10-0757 2151 W OAKLAWN 78064 830 569-5565 N WALMART STORES INC

PONDER GREENBRIAR PHARMACY 250 E FM 2449 76259 940 479-0111 N ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network PORT ARANSAS CVS PHARMACY # 710 HIGHWAY 361 78373 361 749-2277

CVS PHARMACY INC PORT ARTHUR CVS PHARMACY 4101 TWIN CITY HWY 77642 409 960-6122

CVS PHARMACY INC PORT ARTHUR HEB PHARMACY 4800 HWY 365 77642 409 722-4066 N

HEB GROCERY COMPANY LP PORT ARTHUR KING'S PHARMACY #4 1948 9TH AVE 776422762 409 983-3384 N

ELEVATE PROVIDER NETWORK PORT ARTHUR KING'S PHARMACY MID-COUNTY 8455 9TH AVE 77642 409 722-3392 N

ELEVATE PROVIDER NETWORK PORT ARTHUR MAXOR PHARMACY 3701 HIGHWAY 73 77642 409 989-5643 N

MAXOR NATIONAL PHCY SRVS LLC PORT ARTHUR PAT WOOD DRUG STORE 3648 GULFWAY DR 77642 409 985-8874 N

ELEVATE PROVIDER NETWORK PORT ARTHUR TARGET PHARMACY 3100 HIGHWAY 365 STE 90 77642 409 729-3379 N

TARGET PHARMACIES PORT ARTHUR WAL-MART PHARMACY 10-0408 8585 MEMORIAL BLVD 77642 409 724-0054 N

WALMART STORES INC PORT ARTHUR WAL-MART PHARMACY 10-0449 4999 TWIN CITY HWY 77642 409 963-2182 N

WALMART STORES INC PORT ISABEL WAL-MART PHARMACY 10-0413 1401 W HWY 100 78578 956 943-3512 N

WALMART STORES INC PORT LAVACA CVS PHARMACY 325 S HWY 35 BY PASS 77979 361 552-7486 N

CVS PHARMACY INC PORT LAVACA HEB PHARMACY 101 CALHOUN PLAZA 77979 361 552-4563 N

HEB GROCERY COMPANY LP PORT LAVACA MEDICINE MAN PHARMACY-PORT LAVACA 1202 N VIRGINIA ST 779792507 361 482-0345 N

ELEVATE PROVIDER NETWORK PORT LAVACA WAL-MART PHARMACY 400 TINEY BROWNING BLVD 77979 361 552-3525 N

WALMART STORES INC PORT NECHES MARKET BASKET PHARMACY 864 MAGNOLIA 776513712 409 722-0411 N

LEADER DRUG STORES INC PORTER CVS PHARMACY 23865 FM 1314 RD 77365 281 354-1815 N

CVS PHARMACY INC PORTER KROGER PHARMACY 23611 HIGHWAY 59 N 77365 281 354-5687 N

THE KROGER CO PORTER WAL-MART PHARMACY 10-0297 23561 US HWY 59 77365 281 354-5125 N

WALMART STORES INC PORTLAND CVS PHARMACY 1627 WILDCAT DR 78374 361 643-1552 N

CVS PHARMACY INC PORTLAND HEB PHARMACY 1600 WILDCAT DRIVE 78374 361 643-1514 N

HEB GROCERY COMPANY LP PORTLAND KMART PHARMACY7296 1400 WILDCAT DR 783742813 361 643-8576 N

K MART PHARMACY PORTLAND WALMART PHARMACY 2000 US HIGHWAY 181 78374 361 643-8679 N

WALMART STORES INC POTEET CVS PHARMACY # 9014 N STATE HWY 16 78065 830 742-4500

CVS PHARMACY INC POTTSBORO BROOKSHIRE PHARMACY #127 11205 N HWY 289 75076 903 786-3150 N

BROOKSHIRE GROCERY COMPANY POTTSBORO FAMILY PHARMACY OF POTTSBORO 111 HWY 120 E 750769801 903 786-2006 N

ELEVATE PROVIDER NETWORK PRINCETON CVS PHARMACY # 311 E PRINCETON DR 754079008 972 736-2259

CVS PHARMACY INC PRINCETON PRINCETON PHARMACY 201 E PRINCETON DR STE 104 754079005 972 736-3777 N

EPIC PHARMACY NETWORK INC PROSPER CVS PHARMACY # 201 S PRESTON RD 750788585 972 347-6375 N

CVS PHARMACY INC PROSPER KROGER PHARMACY #573 1250 N PRESTON RD 750788798 713 507-6276

THE KROGER CO PROSPER PROSPER PHARMACY 1000 N PRESTON RD 75078 214 338-4010 N

EPIC PHARMACY NETWORK INC PROSPER STAR CARE PHARMACY 321 N PRESTON RD 750788879 972 347-6331 N

ACCESSHEALTH PLUS QUANAH UNITED PHARMACY 1000 W 11TH ST 79252 940 663-2733 N

UNITED PHARMACY TX

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network QUINLAN BROOKSHIRES PHARMACY 8934 HWY 34 SOUTH 75474 903 356-6020 N

BROOKSHIRE GROCERY COMPANY QUINLAN SAVE MART PHARMACY 741 E QUINLAN PKWY 75474 903 356-2449 N

ACCESSHEALTH PLUS QUINLAN WAL-MART PHARMACY 8801 HIGHWAY 34 SOUTH 75474 903 356-1013 N

WALMART STORES INC QUITMAN BROOKSHIRES PHARMACY 502C E GOODE 75783 903 763-1420 N

BROOKSHIRE GROCERY COMPANY QUITMAN SCOTT'S QUITMAN PHARMACY 310 E GOODE ST 757832535 903 763-9600 N

ELEVATE PROVIDER NETWORK RANKIN RANKIN COUNTY HOSPITAL PHARMACY 1611 SPUR 576 79778 432 693-1272

THIRD PARTY STATION CP RAYMONDVILLE CVS PHARMACY # 111 E HIDALGO AVE 785802510 401 765-1500

CVS PHARMACY INC RAYMONDVILLE RAYMONDVILLE FAMILY PHARMACY 180 N 7TH ST 78580 956 689-6337 N

ELEVATE PROVIDER NETWORK RAYMONDVILLE WAL-MART PHARMACY 14091 FM 490 78580 956 689-6419 N

WALMART STORES INC RAYMONDVILLE WATSONS CITY DRUG 192 S 7TH ST 785802597 956 689-2161 Y

RED OAK BROOKSHIRES PHARMACY 105 E OVILLA ROAD 75154 972 617-8570 N

BROOKSHIRE GROCERY COMPANY RED OAK CVS PHARMACY 105 HARRIS AVE 75154 972 617-0034 Y

CVS PHARMACY INC RED OAK RED OAK DRUG 106 E OVILLA RD 75154 972 617-2222 N COMMUNITY INDEPENDENT PHARMACY

NETW RED OAK WAL-MART PHARMACY 100 RYAN DR 75154 972 515-2066 N

WALMART STORES INC RHOME BEST VALUE RHOME PHARMACY 400 S MAIN ST 76078 817 638-5561 N

ELEVATE PROVIDER NETWORK RICHARDSON ARAPAHO PHARMACY 57 ARAPAHO VILLAGE 75080 972 235-7133 N

THIRD PARTY STATION CP RICHARDSON CVS PHARMACY 325 W SPRING VALLEY RD 750814037 972 997-9088 N

CVS PHARMACY INC RICHARDSON CVS PHARMACY 2129 E BELTLINE RD 75081 972 235-8431 N

CVS PHARMACY INC RICHARDSON CVS PHARMACY 605 W CAMPBELL RD 75080 972 231-3522 N

CVS PHARMACY INC RICHARDSON CVS PHARMACY 1425 E BUCKINGHAM RD 75081 972 231-8713 N

CVS PHARMACY INC RICHARDSON DANA DISCOUNT PHARMACY 1701 NCOLLINS BLVD 75080 972 231-8885 N

ACCESSHEALTH PLUS RICHARDSON FAMILY DISCOUNT PHARMACY 970 N COIT ROAD 75080 972 235-0444 N

ELEVATE PROVIDER NETWORK RICHARDSON GASTON PHARMACY 1260 W SPRING VALLEY ROAD 75080 214 628-3177 N

EPIC PHARMACY NETWORK INC RICHARDSON HEIGHTS COMMUNITY PHARMACY 1112 N FLOYD RD STE 9 750804213 972 234-8500 N

ELEVATE PROVIDER NETWORK RICHARDSON KROGER PHARMACY 160 N COIT 75080 972 497-9339 N

THE KROGER CO RICHARDSON MERIDIAN PHARMACY GROUP, INC. 708 W SPRING VALLEY RD 75080 469 330-8300 N

TPN RICHARDSON PHARMETRICS SPECIALTY GROUP OF

DALLAS 1110 E COLLINS BLVD STE 100 750812340 972 677-7891 N

TRINET RICHARDSON RENNER PHARMACY 3005 E RENNER RD STE 120 750823570 972 646-8554 N

LEADER DRUG STORES INC RICHARDSON SAVON PHARMACY 2165 E BUCKINGHAM DR 75081 972 680-8477 N

ALBERTSONS LLC RICHARDSON SENDERRA RX 1301 E ARAPAHO RD STE 101 750812497 888 777-5547 N

ELEVATE PROVIDER NETWORK RICHARDSON TARGET PHARMACY 601 S PLANO ROAD 75081 214 530-0184 N

TARGET PHARMACIES RICHARDSON WAL-MART PHARMACY 1501 E BUCKINGHAM ROAD 75081 972 235-9391 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network RICHLAND HILLS CVS PHARMACY # 7200 BOULEVARD 26 761808606 817 284-3469 N

CVS PHARMACY INC RICHLAND HILLS WALMART PHARMACY 10-6578 6604 BOULEVARD 26 761801520 682 757-9067 N

WALMART STORES INC RICHMOND ACCESSHEALTH 400 AUSTIN ST 77469 281 633-3188 N

THIRD PARTY STATION CP RICHMOND ALLCARE PHARMACY LLC 7120 FM 1464 RD STE D 774076400 281 419-8820 N

TRINET RICHMOND CVS PHARMACY 1410 CRABB RIVER RD 77469 281 545-8843 N

CVS PHARMACY INC RICHMOND CVS PHARMACY 6900 GRAND MISSION BLVD 77407 281 239-6517

CVS PHARMACY INC RICHMOND CVS PHARMACY # 11950 MASON RD 774065709 832 595-8871

CVS PHARMACY INC RICHMOND CVS PHARMACY # 10420 FM 1464 77407 281 240-0123

CVS PHARMACY INC RICHMOND KROGER PHARMACY 8011 W GRAND PARKWAY

SOUTH 77469 281 341-2761 N

THE KROGER CO RICHMOND KROGER PHARMACY 6425 FM 1464 RD 774078287 281 277-2242 N

THE KROGER CO RICHMOND KROGER PHARMACY #038 25050 FM 1093 77406 832 586-7376 N

THE KROGER CO RICHMOND MARISTE PHARMACY 8433 FM 1464 SUITE G 77407 713 234-7190

TRINET RICHMOND METSCRIPT PHARMACY 7790 W GRAND PARKWAY

SOUTH 77406 281 762-6375 N

ELEVATE PROVIDER NETWORK RICHMOND METSCRIPT PHARMACY 1300 MAIN ST 77469 281 277-2707 N

ELEVATE PROVIDER NETWORK RICHMOND NBJ PHARMACY INC. 7830 W GRAND PKWY S STE 160 774065817 832 222-9450 N COMMUNITY INDEPENDENT PHARMACY

NETW RICHMOND RICHMOND PHARMACY 1601 MAIN ST 77469 281 762-7462 N

EPIC PHARMACY NETWORK INC RICHMOND SAM'S CLUB PHARMACY 10-6867 22402 BELLAIRE BLVD 774073903 281 202-0345 N

WALMART STORES INC RICHMOND WAL-MART PHARMACY 5660 W GRAND PKWY S 774065880 832 595-0419

WALMART STORES INC RICHMOND WAL-MART PHARMACY 10-0546 5330 FM1640 77469 281 342-7921 N

WALMART STORES INC RIO GRANDE CITY APPLE PHARMACY #2 2791 PHARMACY RD 78582 956 352-6485 N

ELEVATE PROVIDER NETWORK RIO GRANDE CITY CVS PHARMACY # 5322 E US HIGHWAY 83 STE C-1 785829462 956 488-8700

CVS PHARMACY INC RIO GRANDE CITY FRED'S PHARMACY 2790 PHARMACY RD 785829410 956 487-2711 COMMUNITY INDEPENDENT PHARMACY

NETW RIO GRANDE CITY HEB PHARMACY 4031 E HWY 83 78582 956 487-0905 N

HEB GROCERY COMPANY LP RIO GRANDE CITY LINO'S PHARMACY 201 N FM 3167 78582 956 488-1811 N

ACCESSHEALTH PLUS RIO GRANDE CITY RINGGOLD PHARMACY 1623 E HIGHWAY 83 78582 956 488-1660 N

THIRD PARTY STATION RIO GRANDE CITY WAL-MART PHARMACY 4534 E HWY 83 78582 956 487-0711 N

WALMART STORES INC RIVER OAKS CVS PHARMACY 5301 RIVER OAKS BLVD 76114 817 732-7713 N

CVS PHARMACY INC ROANOKE CVS PHARMACY # 1305 N HWY 377 76262 682 831-1923

CVS PHARMACY INC ROANOKE MINYARD PHARMACY #49 1108 N HWY 377 76262 817 491-4003 N

ACCESSHEALTH PLUS ROANOKE ROANOKE PHARMACY 207 E BYRON NELSON BLVD 76262 817 491-9111 N

ACCESSHEALTH PLUS ROANOKE WAL-MART PHARMACY 1228 N HIGHWAY 377 76262 682 831-1957 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ROBINSON BROOKSHIRES PHARMACY 100 PEPLOW 76706 254 662-6403 N

BROOKSHIRE GROCERY COMPANY ROBINSON PHARMACY PLUS #4 635 N ROBINSON DR 767065330 254 662-4444 N

ELEVATE PROVIDER NETWORK ROBSTOWN CVS PHARMACY 1000 N FIRST ST 78380 361 387-7591 N

CVS PHARMACY INC ROBSTOWN MODERN PHARMACY 305 W AVE A 783803209 361 387-4721 N COMMUNITY INDEPENDENT PHARMACY

NETW ROCKDALE CVS PHARMACY # 1525 W CAMERON AVE 76567 512 446-3220 N

CVS PHARMACY INC ROCKDALE WAL-MART PHARMACY 10-0280 709 W HWY 79 76567 512 446-3401 N

WALMART STORES INC ROCKPORT HEB PHARMACY 1409 HWY N BUSINESS 78382 361 729-0530 N

HEB GROCERY COMPANY LP ROCKPORT JERRYS PHARMACY 2205 STATE HWY 35 N 783823325 361 729-5545 N

ACCESSHEALTH ROCKPORT WAL-MART PHARMACY 10-0440 2401 HWY 35 NORTH 78382 361 729-9841 N

WALMART STORES INC ROCKWALL COSTCO PHARMACY 1225 STATE HWY 276 75032 972 772-1609 N

COSTCO PHARMACIES ROCKWALL CVS PHARMACY 1220 HORIZON RD 750325401 972 771-1381 Y

CVS PHARMACY INC ROCKWALL CVS PHARMACY # 2004 N GOLIAD ST 75087 972 722-4706 N

CVS PHARMACY INC ROCKWALL KROGER PHARMACY 2935 RIDGE ROAD 750325804 972 771-3208 N

THE KROGER CO ROCKWALL LAKEPOINTE PHARMACY #1 1005 W RALPH HALL PKWY 75032 972 722-4339 N

ELEVATE PROVIDER NETWORK ROCKWALL SUPER DRUG 3021 RIDGE RD 75032 972 772-0500 N

EPIC PHARMACY NETWORK INC ROCKWALL WAL-MART PHARMACY 850 W RUSK ST 75087 972 772-6853 N

WALMART STORES INC ROCKWALL WAL-MART PHARMACY 10-0259 782 INTERSTATE 30 75087 972 771-8612 N

WALMART STORES INC ROMA LINO'S PHARMACY 708 GRANT ST 78584 956 849-1811 N

ACCESSHEALTH PLUS ROSEBUD ROSEBUD PHARMACY 112 N 4TH ST 76570 254 583-2727 N

THIRD PARTY STATION CP ROSENBERG AVENUE H PHARMACY 3926 AVE H STE 2 774712842 832 945-5611 N

TRINET ROSENBERG C - MED PHARMACY AND HEALTH CARE

SERVICES LLC 5633 AVE I, SUITE #C 77471 832 363-3787 N

TRINET ROSENBERG CVS PHARMACY 5305 AVE I 77471 281 232-1830 N

CVS PHARMACY INC ROSENBERG JOE'S PHARMACY 1221 1ST ST 774713203 281 762-1231 N

TRINET ROSENBERG PIONEER PHARMACY 5101 AVE H STE 18 774712024 561 441-1621 N

TRINET ROSENBERG ROSENBERG 9 PHARMACY 4114 AVE H 774712833 281 762-0874 N

TRINET ROSENBERG TARGET PHARMACY 23912 COMMERCIAL DR 77471 281 232-1241 N

TARGET PHARMACIES ROSENBERG TRIDENT PHARMACY 2307 4TH ST 77471 281 238-8440 N

ELEVATE PROVIDER NETWORK ROSENBURG KROGER PHARMACY 24401 BRAZOS TOWN CROSSING 77471 281 232-1237 N

THE KROGER CO ROSHARON CVS PHARMACY # 15027 STATE HWY 6 77583 401 765-1500

CVS PHARMACY INC ROSHARON SAVANNAH PHARMACY 15028 HIGHWAY 6 775833261 281 710-4451 N

TRINET ROTAN CLINIC PHARMACY - ROTAN 774 STATE HIGHWAY 70 N 79546 325 735-2500 N

ACCESSHEALTH PLUS ROUND ROCK BAYLOR SCOTT & WHITE PHARMACY #201 425 UNIVERSITY BLVD 786651054 512 509-3600 N

LEADER DRUG STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network ROUND ROCK CVS PHARMACY 800 W OLD SETTLERS BLVD 78681 512 255-1331 N

CVS PHARMACY INC ROUND ROCK CVS PHARMACY 1855 GATTIS SCHOOL RD 78664 512 238-6268 N

CVS PHARMACY INC ROUND ROCK CVS PHARMACY 501 UNIVERSITY BLVD 78665 512 310-8791 N

CVS PHARMACY INC ROUND ROCK CVS PHARMACY 2001 E PALM VALLEY BLVD 78665 512 244-1069 N

CVS PHARMACY INC ROUND ROCK CVS PHARMACY # 7001 WYOMING SPRINGS 78681 512 716-0757

CVS PHARMACY INC ROUND ROCK HEB PHARMACY 1700 E PALM VALLEY BLVD 78664 512 255-0617 N

HEB GROCERY COMPANY LP ROUND ROCK HEB PHARMACY 3750 GATTIS SCHOOL RD 78664 512 341-3776 N

HEB GROCERY COMPANY LP ROUND ROCK HEB PHARMACY 250 UNIVERSITY BLVD 78665 512 863-9279 N

HEB GROCERY COMPANY LP ROUND ROCK HEB PHARMACY 16900 N FM 620 78681 512 238-7905 N

HEB GROCERY COMPANY LP ROUND ROCK HEB PHARMACY 603 LOUIS HENNA BLVD BLDG A 78664 512 828-0814 N

HEB GROCERY COMPANY LP ROUND ROCK LSCC A&M PHARMACY 3950 N AW GRIMES 78665 512 524-9260 N

THIRD PARTY STATION CP ROUND ROCK QUICK MESA PARK PHARMACY 701 E PALM VALLEY BLVD 786643245 512 255-2144 N COMMUNITY INDEPENDENT PHARMACY

NETW ROUND ROCK SAMS PHARMACY 130 SUNDANCE PKWY SUITE 300 78681 512 828-0557 N

WALMART STORES INC ROUND ROCK WAL-MART PHARMACY 10-0475 2701 S IH 35 78664 512 244-9051 N

WALMART STORES INC ROUND ROCK WALMART PHARMACY 10-5480 4700 E PALM VALLEY BLVD 78665 512 218-9185 N

WALMART STORES INC ROWLETT CVS PHARMACY # 3430 LAKEVIEW PKWY 75088 972 475-2597 N

CVS PHARMACY INC ROWLETT CVS PHARMACY # 8626 LAKEVIEW PKWY 750889306 972 412-3746

CVS PHARMACY INC ROWLETT MINYARD PHARMACY #91 8505 LAKEVIEW PKWY 750889035 972 475-0678 N

ACCESSHEALTH PLUS ROWLETT TARGET PHARMACY 4701 LAKEVIEW PKWY 75088 972 265-6061 N

TARGET PHARMACIES ROWLETT WAL-MART PHARMACY 2501 LAKEVIEW PKWY 75089 214 607-9138 N

WALMART STORES INC ROWLETT WALMART PHARMACY 10-7240 8800 LAKEVIEW PKWY 750884498 972 202-8504 N

WALMART STORES INC ROYSE CITY CVS PHARMACY # 476 W I-30 75189 972 635-2470

CVS PHARMACY INC ROYSE CITY ROYSE CITY PHARMACY 205 E MAIN ST 75189 972 635-2451

AMERICAN PHARMACY NETWORK SOLUTIONS ROYSE CITY WALMART PHARMACY 10-5987 494 W INTERSTATE 30 75189 972 635-2734 N

WALMART STORES INC RUSK CHAPMAN PHARMACY 108 E 5TH ST 757851310 903 683-2422 N

ELEVATE PROVIDER NETWORK RUSK PRESCRIPTION PHARMACY 156 W 5TH ST 75785 903 683-5436 N COMMUNITY INDEPENDENT PHARMACY

NETW S ANTONIO SAMS PHARMACY 12919 SAN PEDRO AVE 78216 210 404-1376 N

WALMART STORES INC SACHSE KROGER PHARMACY 5190 HWY 78 75048 972 675-1066 N

THE KROGER CO SACHSE WALMART PHARMACY 10-5673 8015 WOODBRIDGE PARKWAY 75048 469 440-0297

WALMART STORES INC SACHSE WALMART PHARMACY 10-6851 6750 MURPHY RD 750482800 469 366-3957 N

WALMART STORES INC SAGINAW CVS PHARMACY 1301 N SAGINAW 76179 817 847-6918 N

CVS PHARMACY INC SAGINAW SAGINAW PHARMACY 200 W J BOAZ RD 76179 817 405-3333 N

EPIC PHARMACY NETWORK INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAGINAW SAVON PHARMACY 1201 N SAGINAW BLVD 76179 817 232-3877 N

ALBERTSONS LLC SAGINAW WALMART PHARMACY 10-5316 1401 N SAGINAW BLVD 76179 817 306-4785 N

WALMART STORES INC SALADO BAYLOR SCOTT & WHITE PHARMACY #232 3525 FM 2484 76571 254 947-7555 N

LEADER DRUG STORES INC SAN ANGELO ALBERTSONS MARKET PHARMACY #678 3121 SUNSET DR 76904 325 942-6658 N

UNITED PHARMACY TX SAN ANGELO COMMUNITY PHARMACY 3520 KNICKERBOCKER RD 76904 325 949-4577 N

ACCESSHEALTH SAN ANGELO CVS PHARMACY 4210 COLLEGE HILLS BLVD 76904 325 942-8602 N

CVS PHARMACY INC SAN ANGELO CVS PHARMACY 318 W BEAUREGARD 76903 325 653-4289 Y

CVS PHARMACY INC SAN ANGELO HEB PHARMACY 3301 SHERWOOD WAY 76901 325 942-0454 N

HEB GROCERY COMPANY LP SAN ANGELO LOWE'S MARKETPLACE PHARMACY # 38 2 S MAIN ST 769035927 325 658-6551 N

LEADER DRUG STORES INC SAN ANGELO LOWE'S PHARMACY # 39 1926 N BRYANT BLVD 769033744 325 653-3271 N

LEADER DRUG STORES INC SAN ANGELO MEDI MART PHARMACY 2102 PECOS ST 769013061 325 949-5381 N

ELEVATE PROVIDER NETWORK SAN ANGELO MEDICAL ARTS PHARMACY 2102 PECOS ST 76901 325 949-4636 N

ELEVATE PROVIDER NETWORK SAN ANGELO MYERS DRUG INC 29 S CHADB0URNE 769035891 325 655-3146 N

ACCESSHEALTH PLUS SAN ANGELO SAMS PHARMACY 5749 SHERWOOD WAY 76901 325 223-1426 N

WALMART STORES INC SAN ANGELO SHANNON PHARMACY 119 E BEAUREGARD 769035918 325 655-8191 N

ACCESSHEALTH PLUS SAN ANGELO WAL-MART PHARMACY 610 W 29TH ST 76903 325 653-7088 N

WALMART STORES INC SAN ANGELO WAL-MART PHARMACY 10-0601 5501 SHERWOOD WAY 76904 325 942-7682 N

WALMART STORES INC SAN ANGELO WALMART PHARMACY 10-7220 1852 SHERWOOD WAY 769013960 325 276-6948 N

WALMART STORES INC SAN ANTONIO 15RX PHARMACY 11398 BANDERA RD STE 302 782506843 210 684-1579 N

LEADER DRUG STORES INC SAN ANTONIO 15RX PHARMACY 11212 STATE HIGHWAY 151 STE

110 782514500 210 543-1579 N

LEADER DRUG STORES INC SAN ANTONIO 15RX PHARMACY 10415 STATE HWY 151 78251 210 684-1579 N

LEADER DRUG STORES INC SAN ANTONIO ALAMO CITY PHARMACY 3338 OAKWELL CT STE 106 782183087 210 598-2695 N

ELEVATE PROVIDER NETWORK SAN ANTONIO AMERICAN SPECIALTY PHARMACY 2414 BABCOCK RD STE 111 782294870 210 615-7400

TPN SAN ANTONIO AMERICAN SPECIALTY PHARMACY 110 STONE OAK LOOP # 100 782583510 210 598-2678 N

TPN SAN ANTONIO APOTHECA COMPOUNDING PHARMACY 14603 HUEBER RD 78230 210 226-1112 N

THIRD PARTY STATION CP SAN ANTONIO APOTHECARE COMPOUNDING PHARMACY 9150 HUEBNER RD STE 125B 782401558 210 696-4100 N

ELEVATE PROVIDER NETWORK SAN ANTONIO ASTORIA PHARMACY 818 E GRAYSON ST 782081013 713 660-8888

TRINET SAN ANTONIO CAREPLUS CVS PHARMACY # 7950 FLOYD CURL DR 106

TOWER 1 78229 210 616-0080 N

PROCARE PHARMACY LLC SAN ANTONIO CAREPLUS CVS/PHARMACY # 9800 FREDERICKSBURG RD 78288 210 498-3784

CVS PHARMACY INC SAN ANTONIO CARVAJAL PHARMACY 3410 ROOSEVELT AVE 782142690 210 922-2176 N

ACCESSHEALTH SAN ANTONIO CARVAJAL PHARMACY CROCKETT PARK 1715 MCCULLOUGH AVE 782124046 210 977-1870 N

ACCESSHEALTH PLUS SAN ANTONIO CARVAJAL PHARMACY SOUTH SAN 7500 BARLITE BLVD # 201-B 782241361 210 977-1860 N

ACCESSHEALTH PLUS

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO COSTCO PHARMACY 5611 UTSA BLVD 78249 210 200-2022 N

COSTCO PHARMACIES SAN ANTONIO COSTCO PHARMACY 1201 N LOOP 1604 EAST 78232 210 403-4702 N

COSTCO PHARMACIES SAN ANTONIO CRAWFORD PHARMACY 711 PLEASANTON RD 782141305 210 932-1200

EPIC PHARMACY NETWORK INC SAN ANTONIO CVS PHARMACY 8602 HUEBNER RD 78240 210 691-0174 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 3027 NACOGDOCHES RD 78217 210 824-5928 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 9285 CULEBRA AVE 78251 210 521-5335 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 2801 NOGALITOS 78225 210 921-2090 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 7603 CULEBRA ROAD 782511437 210 680-0299 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 6539 DE ZAVALA RD 78249 210 561-1325 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 19202 BLANCO RD 78258 210 497-2845 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 103 S W MILITARY DRIVE 782211650 210 927-6755 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 120 E SONTERRA BLVD 78258 210 404-9006 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 9140 GUILBEAU RD 78250 210 520-5183 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 22202 BULVERDE ROAD 78261 210 497-0353

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 4805 MEDICAL DR 78229 210 616-0482 Y

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 9838 POTRANCO RD 78251 210 509-0319 Y

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 10225 WURZBACH RD 78230 210 690-1616 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 6470 N NEW BRAUNFELS AVE 78209 210 826-2391 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 5506 WALZEM RD 78218 210 653-2360 Y

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 2018 CULEBRA RD 782015813 210 785-9764 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 343 W HOUSTON ST STE 106 78205 210 225-4148 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 7208 FM 78 78244 210 666-0162

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 14900 JONES MALTSBERGER RD 78247 210 496-9545 Y

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 16580 HUEBNER RD 78248 210 479-8173 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 7202 SAN PEDRO 78216 210 340-0830 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY 4100 DE ZAVALA RD 78249 210 492-9741 N

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 15607 CHASE HILL BLVD 782561012 210 877-8353

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 22135 IH-10 W 78257 210 698-1643

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 300 E COMMERCE ST 782052922 210 228-9483

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 9686 MARBACH RD 782451822 210 645-6933

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 2920 E SOUTHCROSS BLVD 782231903 210 532-3923

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 118 S WW WHITE RD 78220 210 359-1429

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 23530 WILDERNESS OAK 782582406 210 481-7642

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO CVS PHARMACY # 919 WURZBACH PARKWAY 78231 210 764-1095

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 12835 POTRANCO RD 78253 210 679-0250

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 7031 MARBACH RD 78227 210 670-8086

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 5975 OLD PEARSALL RD 78242 210 623-6645

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 9050 FM 1560 N 78254 210 688-9160

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 5301 ALAMO PARKWAY 78253 210 688-9311

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 2502 MARSHALL RD 782591608 210 497-5889

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 17307 BULVERDE RD 78247 210 404-9054

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 10715 BANDERA RD 782506808 210 647-9815

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 01201 4730 FREDRICKSBURG RD 78229 210 348-8223

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 05858 15038 NACOGDOCHES RD 782471210 210 646-7045

CVS PHARMACY INC SAN ANTONIO CVS PHARMACY # 08978 20203 STONE OAK PKWY 78258 210 481-5598

CVS PHARMACY INC SAN ANTONIO DAVILA PHARMACY 1423 GUADALUPE ST 782075513 210 226-5293 N

ELEVATE PROVIDER NETWORK SAN ANTONIO DUNCAN PHARMACY 3110 NOGALITOS 78225 210 532-1345 N

ELEVATE PROVIDER NETWORK SAN ANTONIO EMPIRE PHARMACY 2207 S ZARZAMORA 78207 210 223-3863 N

EPIC PHARMACY NETWORK INC SAN ANTONIO GALAXY SPECIALTY PHARMACY 2829 BABCOCK RD STE 120 782296009 210 617-4311 N COMMUNITY INDEPENDENT PHARMACY

NETW SAN ANTONIO GARZA PHARMACY 311 CAMDEN 782152003 210 225-4561 N

ACCESSHEALTH SAN ANTONIO GOOD LIFE PHARMACY 26108 OVERLOOK PKWY BLDG 4 782606046 210 819-4515 N

ACCESSHEALTH PLUS SAN ANTONIO HEB GROCERY COMPANY LP PO BOX 839986 782833986 210 938-8269

SAN ANTONIO HEB PHARMACY 23635 WILDERNESS OAK 78258 210 490-2677 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 8503 NW MILITARY HWY 78230 210 479-4350 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 12018 PERRIN BEITEL RD 78217 210 655-9542 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 1015 SWW WHITE RD 78220 210 337-7549 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 4821 BROADWAY 78209 210 824-0515 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 4100 S NEW BRAUNFELS 78223 210 531-3160 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 9900 WURZBACH RD 78230 210 696-1073 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 14087 O CONNOR 78247 210 637-0033 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 302 VALLEY HI DR 78227 210 673-1760 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 108 N ROSILLO 78207 210 227-0211 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 9238 N LOOP 1604 WEST 78249 210 682-3419 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6000 W AVE 78213 210 341-3875 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6580 FM 78 78244 210 666-1212 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO HEB PHARMACY 10718 POTRANCO RD 78251 210 681-2301 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 2929 THOUSAND OAKS DR 78247 210 491-9976 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 999 E BASSE STE 150 78209 210 822-0270 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 5601 BANDERA RD STE 11 78238 210 647-2709 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 300 W OLMOS 78212 210 829-1705 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 735 SW MILITARY DRIVE 78221 210 927-6875 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6818 S ZARZAMORA 78224 210 927-4596 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 8219 MARBACH ROAD 78227 210 673-3230 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 2118 FREDERICKSBURG 78201 210 737-2040 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 3323 SE MILITARY 78223 210 333-1031 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 1955 NACOGDOCHES 78209 210 930-3454 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6839 SAN PEDRO 78216 210 979-8660 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 1520 AUSTIN HWY 78218 210 828-6871 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 15000 SAN PEDRO 78232 210 494-3203 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 5910 BABCOCK 78240 210 641-6405 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 11551 W AVE 78213 210 340-7786 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 2130 CULEBRA RD 78228 210 737-1040 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 721 CASTROVILLE RD 78237 210 436-6465 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 12777 IH 10 WEST 78230 210 558-3027 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 8300 FLOYD CURL DR STE 105 78229 210 593-0291 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 1150 NW LOOP 1604 78248 210 408-8145 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6520 FRATT RD 78218 877 432-9355 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 20935 US HIGHWAY 281 NORTH 78258 210 491-2450 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 6030 MONTGOMERY RD 78239 210 657-0322 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 9255 FM 471 WEST 78250 210 680-2958 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 18140 SAN PEDRO 78232 210 490-5593 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 10660 FM 471 W 78251 210 684-1234 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 24165 I 10 W STE 300 78256 210 687-1072 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 7951 GUILBEAU ROAD 78250 210 523-0481 N

HEB GROCERY COMPANY LP SAN ANTONIO HEB PHARMACY 1601 NOGALITOS ST 78204 210 229-1825 N

HEB GROCERY COMPANY LP SAN ANTONIO HIGH PERFORMANCE PHARMACY LLC 21 SPURS LANE 78240 210 691-4779 N

TRINET SAN ANTONIO HILL COUNTRY PHARMACY 2554 BOARDWALK ST 782174417 855 433-2876 N

RECEPT HEALTHCARE SERVICES SAN ANTONIO HILLS DRUG STORE 705 W KIRK 78226 210 225-7283 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO HOAST PHARMACY 4411 MEDICAL DR 78229 210 595-5691 N

ACCESSHEALTH SAN ANTONIO HOSPITAL PHARMACEUTICAL

CONSULTING 4742 DODGE ST 782173711 844 870-5146 N

THIRD PARTY STATION SAN ANTONIO HUEBNER FAMILY PHARMACY 9150 HUEBNER RD SUITE 125A 78240 210 696-2700 N

ELEVATE PROVIDER NETWORK SAN ANTONIO HUMANA PHARMACY, INC. 9727 POTEET JOURDANTON FWY

STE 105-111 782114574 210 236-3385 N

PRESCRIBEIT RX SAN ANTONIO INVENTIVE INFUSION SOLUTIONS 18866 STONE OAK PKWY 782584181 210 494-4272 N

THIRD PARTY STATION SAN ANTONIO LAUREL HEIGHTS PHARMACY 2602 N MAIN AVE 782122996 210 736-3161

EPIC PHARMACY NETWORK INC SAN ANTONIO LEGENDS PHARMACY 6601 BLANCO RD STE 125 782166102 210 735-2323 N

LEADER DRUG STORES INC SAN ANTONIO LIFECARE PHARMACY 315 N SAN SABA # STE110 782073154 210 212-7455 N

EPIC PHARMACY NETWORK INC SAN ANTONIO LIFEWATCH PHARMACY 2523 BOARDWALK ST 782174417 615 537-5926 N

ACCESSHEALTH PLUS SAN ANTONIO LIV-WELL PHARMACY 607 CAMDEN ST STE 102 782152100 210 390-0091 N

RECEPT HEALTHCARE SERVICES SAN ANTONIO MARIO'S PHARMACY 2515 BROADWAY ST 782151037 210 354-0101 N

ELEVATE PROVIDER NETWORK SAN ANTONIO MEDICAL CENTER PHARMACY 1342 FAIR AVE 782231438 210 534-5457 N

ELEVATE PROVIDER NETWORK SAN ANTONIO MEDICAL CENTER PHARMACY-STONE OAK 540 OAK CENTRE DR STE 153 782583936 210 332-9862 N

ACCESSHEALTH PLUS SAN ANTONIO MISSION PHARMACY 3267 ROOSEVELT AVE 782142599 210 923-4389 N COMMUNITY INDEPENDENT PHARMACY

NETW SAN ANTONIO NETCARE PHARMACY 810 SE MILITARY DR 78214 210 923-4404 N

ELEVATE PROVIDER NETWORK SAN ANTONIO NETCARE PHARMACY #1 6428 BANDERA RD 78238 210 256-8629 N

ELEVATE PROVIDER NETWORK SAN ANTONIO OAK HILLS PHARMACY 7711 LOUIS PASTEUR DR STE 100 78229 210 614-4100 N

ACCESSHEALTH SAN ANTONIO OAKDELL LONGTERM CARE PHARMACY 7220 LOUIS PASTEUR 782294504 210 614-6200 N

PPOK RXSELECT PHCY NETWORK SAN ANTONIO OAKDELL PHARMACY 7220 LOUIS PASTEUR DR 782294534 210 614-6200 N

PPOK RXSELECT PHCY NETWORK SAN ANTONIO OAKDELL PHARMACY IN STONE OAK 104 GALLERY CIR STE 104 782583330 210 496-7070 N

PPOK RXSELECT PHCY NETWORK SAN ANTONIO ORTIZ PHARMACY, INC. 2515 CASTROVILLE RD 782373659 210 432-2361 N COMMUNITY INDEPENDENT PHARMACY

NETW SAN ANTONIO PIONEER PHARMACY 4503 DE ZAVALA RD STE 108 782492060 210 492-3005 N

THIRD PARTY STATION CP SAN ANTONIO PREMIER PHARMACY 2425 BABCOCK RD STE 108A 782294899 210 298-9000 N

ELEVATE PROVIDER NETWORK SAN ANTONIO RAST RX 19272 STONE OAK PKWY STE 101 782583372 855 567-3432 N

RECEPT HEALTHCARE SERVICES SAN ANTONIO RECEPT PHARMACY 5282 MEDICAL DR STE 160 782294870 210 614-5506 N

RECEPT HEALTHCARE SERVICES SAN ANTONIO RITE AWAY PHARMACY & MEDICAL

SUPPLY # 2 2716 SW MILITARY DR STE 102 782241009 210 927-3742 N

ACCESSHEALTH PLUS SAN ANTONIO RITE-AWAY PHARMACY #5 2115 PLEASANTON RD 78221 210 923-7717 N

ACCESSHEALTH PLUS SAN ANTONIO RITE-AWAY PHARMACY #6 426 CASTROVILLE RD 78207 210 433-9991 N

ACCESSHEALTH PLUS SAN ANTONIO RITE-AWAY PHARMACY & MEDICAL

SUPPLY 2235 THOUSAND OAKS DR STE 102

782323967 210 490-2733 N ACCESSHEALTH PLUS

SAN ANTONIO RIVER MEDICAL PHARMACY, INC. 4752 RESEARCH DR 782405002 210 877-6180 N LEADER DRUG STORES INC

SAN ANTONIO SAM'S CLUB PHARMACY 10-4939 3239 GOLIAD RD 78223 210 507-0492 WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO SAMS PHARMACY 12349 N IH 35 78233 210 599-1505 N

WALMART STORES INC SAN ANTONIO SAMS PHARMACY 5055 LOOP 410 NW 78229 210 682-7144 N

WALMART STORES INC SAN ANTONIO SAMS PHARMACY 3150 SW MILITARY DRIVE 78224 210 932-0906 N

WALMART STORES INC SAN ANTONIO SAMS PHARMACY 5565 DEZAVALA RD 78249 210 877-1572 N

WALMART STORES INC SAN ANTONIO SAM'S PHARMACY 10-4914 2530 MARSHALL RD 78259 210 810-4202 N

WALMART STORES INC SAN ANTONIO SHAVANO OAKS PHARMACY 3603 PAESANOS PARKWAY 782311267 210 448-9080 N

ELEVATE PROVIDER NETWORK SAN ANTONIO SHAVANO OAKS PHARMACY @ BROOKS 3124 SIDNEY BROOKS ST STE 570

# B2 782355113 210 441-4484 N

ELEVATE PROVIDER NETWORK SAN ANTONIO SHAVANO OAKS PHARMACY @

WESTOVER HILLS 3903 WISEMAN BLVD # STE313 782514401 210 441-4501 N

ELEVATE PROVIDER NETWORK SAN ANTONIO SMART PHARMACY LLC 4390 CALLAGHAN RD 782283401 210 452-8025 N

ACCESSHEALTH PLUS SAN ANTONIO SONTERRA RX 1162 E SONTERRA BLVD STE 100 782584048 210 490-7711 Y

THIRD PARTY STATION CP SAN ANTONIO SOUTH SAN MEDICAL BUILDING

PHARMACY 919 SW MILITARY DR STE 105 782211400 210 922-1816 N

ELEVATE PROVIDER NETWORK SAN ANTONIO SPECIALTY PHARMACEUTICAL SOLUTIONS 4503 DE ZAVALA RD STE 112 782492060 210 375-4620

RECEPT HEALTHCARE SERVICES SAN ANTONIO STONE OAK PHARMACY 18866 STONE OAK PKWY 78258 210 494-4272 N

THIRD PARTY STATION CP SAN ANTONIO TALON COMPOUNDING PHARMACY 2950 THOUSAND OAKS 78247 210 424-0025 N

TRINET SAN ANTONIO TARGET PHARMACY 7014 FM 78 78244 210 424-3005 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 22832 US HWY 281 N 78264 210 679-2369 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 746 NW LOOP 410 782165609 210 424-2302 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 11311 BANDERA ROAD 78250 210 682-2533 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 18255 BLANCO RD 78258 210 764-7972 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 13700 SAN PEDRO AVE 78232 210 545-9208 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 17502 LACANTERA PKWY 78257 210 247-0114 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 3227 SE MILITARY DR 78223 210 247-0083 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 5355 W LOOP 1604 N 782535300 210 424-1911 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 2810 SW MILITARY DR 78224 210 927-4752 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 1223 AUSTIN HWY 782094854 210 202-3579 N

TARGET PHARMACIES SAN ANTONIO TARGET PHARMACY 8223 STATE HIGHWAY 151 78245 210 247-0017 N

TARGET PHARMACIES SAN ANTONIO THE START CENTER PHARMACY 4383 MEDICAL DR STE 113 782293307 210 593-2660 N

ELEVATE PROVIDER NETWORK SAN ANTONIO TRINITY RX 102 PALO ALTO 78211 210 927-4744 N

ACCESSHEALTH SAN ANTONIO UBA PHARMACY 5445 WALZEM RD 78218 210 646-8804 N

ELEVATE PROVIDER NETWORK SAN ANTONIO UROLOGY SAN ANTONIO PHARMACY 7909 FREDERICKSBURG RD STE

110-A 782293425 210 582-5649 N

THIRD PARTY STATION SAN ANTONIO VAMPSRX 2004 E HOUSTON ST 78202 210 224-7676 N COMMUNITY INDEPENDENT PHARMACY

NETW

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO WAL-MART PHARMACY 3302 SOUTHEAST MILITARY

DRIVE 78223 210 337-4434 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 8923 W MILITARY DRIVE 78245 210 675-8480 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 8500 JONES MALTSBURGER 78216 210 377-3139 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 8030 BANDERA ROAD 78250 210 520-6824 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 5555 DE ZAVALA ROAD 78249 210 558-4330 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 4096 N FOSTER RD 782441874 210 507-4962 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 1200 S E MILITARY DRIVE 78214 210 921-1992 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 6703 E LESLIE ROAD 78254 210 688-3890 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 1430 AUSTIN HIGHWAY 78209 210 637-1888 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 4331 THOUSAND OAKS DR 78217 210 591-4979 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 2100 LOOP 410 SE 78220 210 648-7534 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 5025 LOOP 410 NORTHWEST 78229 210 523-1123 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 11210 POTRANCO ROAD 78253 210 679-9208 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 1515 N FM 1604 E 782321431 210 491-9001 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 1603 VANCE JACKSON ROAD 78213 210 737-0754 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 10-0765 16503 NACOGDOCHES ROAD 78247 210 650-0647 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 10-0999 7239 SW LOOP 410 78227 210 247-5912 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-2769 5626 WALZEM RD 782182105 210 507-0652 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-2835 9006 GUILBEAU RD 782502652 210 536-3158 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-3058 918 BANDERA RD 782284923 210 536-0575 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 10-3106 8538 IH 35 SOUTH 78211 210 810-3686 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-3107 24403 IH 10W 78255 210 276-2527

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 10-4131 9427 CULEBRA RD 78251 210 526-6007

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-4162 12639 BLANCO RD 78231 210 591-6285 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-4661 6938 WALZEM RD 78239 210 507-0912 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-4670 3418 E SOUTHCROSS BLVD 782231633 210 253-8114 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-5224 4226 DE ZAVALA DR 78249 210 774-2736

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-5226 9526 W MILITARY DR 78251 210 536-2090

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-5290 1515 S ELLISON DR 78245 210 276-2014

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-5490 9005 FM 1560 N 78254 479 204-1258 N

WALMART STORES INC SAN ANTONIO WALMART PHARMACY 10-6589 3175 NACOGDOCHES RD BLDG 1 78217 210 536-0006 N

WALMART STORES INC SAN ANTONIO WAL-MART PHARMACY 10-7263 1 LONE STAR PASS STE 46 782643650 210 628-4012

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SAN ANTONIO WHITE CROSS PHARMACY 1303 MCCULLOUGH 78212 210 227-7200 N

ACCESSHEALTH SAN ANTONIO ZIKAM NEIGHBORHOOD PHARMACY 21920 BULVERDE RD # 102/103 782592181 210 503-5063 N

ACCESSHEALTH PLUS SAN ANTONTIO AVITA DRUGS 7302 LOUIS PASTEUR DR 78229 210 231-0383 N

ACCESSHEALTH SAN ANTONTIO OAKDELL PHARMACY AT THE QUARRY 423 TREELINE PARK 78209 210 822-6330 N

PPOK RXSELECT PHCY NETWORK SAN AUGUSTINE SAN AUGUSTINE DRUG CO 104 E COLUMBIA 759721995 936 275-3401 N

ELEVATE PROVIDER NETWORK SAN BENITO FRYS PRESCRIPTION PHCY 311 N SAM HOUSTON BLVD 78586 956 399-2453 N

LEADER DRUG STORES INC SAN BENITO HEB PHARMACY 1095 W BUSINESS 77 78586 956 399-5149 N

HEB GROCERY COMPANY LP SAN BENITO MEDICINE SHOPPE 205 W HIGHWAY 77 785865143 956 399-1411 N

MEDICINE SHOPPE INTERNATIONAL INC SAN BENITO SALINAS PHARMACY 500 N SAM HOUSTON BLVD 78586 956 399-5501 N

LEADER DRUG STORES INC SAN BENITO WAL-MART PHARMACY 1126 W US HIGHWAY 77 785864337 956 399-2373 N

WALMART STORES INC SAN DIEGO LA HACIENDA PHARMACY INC 213 S DR E E DUNLAP ST 78384 361 279-3869 N

ELEVATE PROVIDER NETWORK SAN JUAN CVS PHARMACY # 100 E FM 495 785893710 956 283-7880

CVS PHARMACY INC SAN JUAN HEB PHARMACY 901 W EXPRESSWAY 83 78589 956 783-1275 N

HEB GROCERY COMPANY LP SAN JUAN MARTIN DRUG CO 601 S NEBRASKA 785892699 956 787-1861 N COMMUNITY INDEPENDENT PHARMACY

NETW SAN MARCOS B AND J PHARMACY 2111 HUNTER RD 78666 512 392-3301 N

ACCESSHEALTH PLUS SAN MARCOS CVS PHARMACY 105 WONDER WORLD DR 786665936 512 392-7012

CVS PHARMACY INC SAN MARCOS CVS PHARMACY 920 HIGHWAY 80 78666 512 396-1111 N

CVS PHARMACY INC SAN MARCOS CVS PHARMACY # 301 N EDWARD GARY ST 786665707 512 353-0247

CVS PHARMACY INC SAN MARCOS HEB PHARMACY 641 E HOPKINS 78666 512 396-2892 N

HEB GROCERY COMPANY LP SAN MARCOS HEB PHARMACY 200 W HOPKINS 78666 512 396-0303 N

HEB GROCERY COMPANY LP SAN MARCOS MEDPARK PHARMACY 2004 MEDICAL PKY A 786667523 512 353-8900 N

LEADER DRUG STORES INC SAN MARCOS SAMS PHARMACY 1350 LEAH AVE 78666 512 392-1387 N

WALMART STORES INC SAN MARCOS TARGET PHARMACY 700 BARNES DR 786666187 512 392-7961 N

TARGET PHARMACIES SAN MARCOS TEXAS STATE UNIVERSITY STUDENT

HEALTH CENTER PHARMACY 298 STUDENT CENTER DR 78666 512 245-3590 N

ELEVATE PROVIDER NETWORK SAN MARCOS THORPE LANE PHARMACY 1346 THORPE LANE 786667114 512 212-7404 N

LEADER DRUG STORES INC SAN MARCOS WAL-MART PHARMACY 10-0404 1015 HWY 80 78666 512 353-3000 N

WALMART STORES INC SAN SABA EVERETT'S PHARMACY 401 W WALLACE 76877 325 372-3033 N

ELEVATE PROVIDER NETWORK SANGER S&J PHARMACY 801 E CHAPMAN DR # 100 76266 940 458-4448 N

ELEVATE PROVIDER NETWORK SANTA FE CVS PHARMACY 13802 HIGHWAY 6 77517 409 925-0164 N

CVS PHARMACY INC SANTA FE LONE STAR PHARMACY 4111 FM 1764 STE F 77510 409 925-9995 N

ELEVATE PROVIDER NETWORK SANTA FE MEDICINE MAN PHARMACY 13250 HIGHWAY 6 775107682 409 927-1979 N

ELEVATE PROVIDER NETWORK SCHERTZ CVS PHARMACY 2693 FM 3009 78154 210 658-3087 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SCHERTZ HEB PHARMACY 17460 IH 35 N 78154 210 651-4148 N

HEB GROCERY COMPANY LP SCHERTZ SCHERTZ PHARMACY 5000 SCHERTZ PKWY STE 401 781541457 210 651-6337 N

ELEVATE PROVIDER NETWORK SCHERTZ WAL-MART PHARMACY 6102 FM 3009 78154 210 651-9079 N

WALMART STORES INC SCHULENBURG APOTHECARY OF MED ASSOCIATES 38 E AVE 789561534 979 743-3265 N

SEABROOK CVS PHARMACY 2800 BAYPORT BLVD 77586 281 474-4042 N

CVS PHARMACY INC SEABROOK KROGER PHARMACY 1905 EL MAR 77586 281 474-7666 N

THE KROGER CO SEABROOK MEDICINE SHOPPE PHARMACY 4614 NASA PKWY 775865414 832 864-3785 N

MEDICINE SHOPPE INTERNATIONAL INC SEAGOVILLE BROOKSHIRE PHARMACY 125 HALL ST 75159 972 287-1680

BROOKSHIRE GROCERY COMPANY SEAGOVILLE GIBSON DISCOUNT PHARMACY 112 HALL RD 751592916 972 287-7070 N

ACCESSHEALTH PLUS SEAGOVILLE WAL-MART PHARMACY 220 N HIGHWAY 175 75159 972 287-2914 N

WALMART STORES INC SEALY CVS PHARMACY 802 MEYER ST 77474 979 885-3538 N

CVS PHARMACY INC SEALY SEALY PHARMACY 707 MEYER ST 774742715 979 256-3045 N

ACCESSHEALTH PLUS SEALY WAL-MART PHARMACY 310 OVERCREEK WAY 77474 979 627-0102 N

WALMART STORES INC SEGUIN CEDAR VIEW PHARMACY 519 N KING ST 781554859 830 372-3000 N

ACCESSHEALTH SEGUIN CVS PHARMACY 110 S KING ST 78155 830 379-9741 N

CVS PHARMACY INC SEGUIN HEB PHARMACY 1340 E COURT ST 78155 830 379-0160 N

HEB GROCERY COMPANY LP SEGUIN PARKERS CITY PHARMACY 1005 E COURT ST 78155 830 379-1450 N

ELEVATE PROVIDER NETWORK SEGUIN WAL-MART PHARMACY 550 S HIGHWAY 123 BYP 781559752 830 372-5880 N

WALMART STORES INC SELMA COSTCO PHARMACY 15330 IH 35 NORTH 78154 210 332-1081 N

COSTCO PHARMACIES SELMA TARGET PHARMACY 8234 AGORA PARKWAY 78154 210 945-9759 N

TARGET PHARMACIES SEMINOLE OSWALT PHARMACY 701 HOBBS HWY 793603401 432 758-3656 N

ACCESSHEALTH SEMINOLE WAL-MART PHARMACY 10-0626 2000 HOBBS HIGHWAY 79360 432 758-3270 N

WALMART STORES INC SEVEN POINTS BROOKSHIRES PHARMACY 210 S SEVEN POINTS 75143 903 432-2516 N

BROOKSHIRE GROCERY COMPANY SEVEN POINTS GIBSON PHARMACY 205 W CEDAR CREEK PKWY 75143 903 432-3494 N

LEADER DRUG STORES INC SEYMOUR FERGESON DRUG 101 N WASHINGTON 76380 940 889-3622 N

LEADER DRUG STORES INC SEYMOUR SEYMOUR PHARMACY 201 STADIUM DR STE 1 76380 940 888-2222 N

ACCESSHEALTH PLUS SHALLOWATER SHALLOWATER PHARMACY 1502 12TH ST, SUITE B 79363 806 832-0250

LEADER DRUG STORES INC SHAMROCK MARKET SQUARE PHARMACY 1814 N BILL MACK 79079 806 256-3111 N

THIRD PARTY STATION SHENANDOAH SAMS PHARMACY 19091 INTERSTATE 45 SOUTH 77385 936 271-1760 N

WALMART STORES INC SHENANDOAH VILLAGE PHARMACY 1490 RESEARCH FOREST DR 773814370 832 948-1012 N

ACCESSHEALTH PLUS SHEPHERD JC'S TRUECARE PHARMACY 11011 HWY 150 77371 936 628-2099 N

ELEVATE PROVIDER NETWORK SHERMAN CARERX PHARMACY AT SHERMAN 1733 TEXOMA PKWY STE 200 750902613 903 893-1700 N

ACCESSHEALTH PLUS SHERMAN CVS PHARMACY 1830 TEXOMA PKWY 75090 903 893-5511 Y

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SHERMAN HERITAGE PARKWAY PHARMACY 3429 N FM 1417 750926634 903 893-8222 N

ACCESSHEALTH PLUS SHERMAN KROGER PHARMACY 1820 LOY LAKE RD 75090 903 868-1565 N

THE KROGER CO SHERMAN MEDICINE SHOPPE PHARMACY 1624 N TRAVIS ST 75092 903 892-9291 N

MEDICINE SHOPPE INTERNATIONAL INC SHERMAN SAMS PHARMACY 3333 N US HIGHWAY 75 750902525 903 891-4440 N

WALMART STORES INC SHERMAN SAVON PHARMACY 100 E TAYLOR 75090 903 868-9414 N

ALBERTSONS LLC SHERMAN SHERMAN PHARMACY 600 E TAYLOR ST STE 101 750902827 903 328-6655 N

EPIC PHARMACY NETWORK INC SHERMAN TARGET PHARMACY 4160 TOWN CENTER RD 75090 903 892-4416 N

TARGET PHARMACIES SHERMAN WAL-MART PHARMACY 401 E HWY 82 75090 903 893-9090 N

WALMART STORES INC SHERMAN WALMART PHARMACY 10-3521 2210 N FM 1417 75092 903 209-4907 N

WALMART STORES INC SHINER QUALITY PHARMACY 724 N AVE E 77984 361 594-2262 N

ACCESSHEALTH PLUS SHINER SHINER FAMILY PHARMACY 408 N AVE B 77984 361 594-2394 N

ELEVATE PROVIDER NETWORK SILSBEE CVS PHARMACY 685 HIGHWAY 96 S 77656 409 385-5276 N

CVS PHARMACY INC SILSBEE WAL-MART PHARMACY 10-0383 1100 US HIGHWAY 96 N 776567298 409 385-1441 N

WALMART STORES INC SINTON MOORES PHARMACY 200 S RACHAL ST 783872552 361 364-1416 N

ELEVATE PROVIDER NETWORK SLATON CVS PHARMACY HWY 84 AND US HWY 41 79364 806 828-6266 N

CVS PHARMACY INC SLATON SLATON PHARMACY 165 S 9TH ST STE A 79364 806 828-4444 N

ACCESSHEALTH PLUS SMITHVILLE SMITHVILLE PHARMACY 1404A NE LOOP 230 78957 512 237-5216 N

THIRD PARTY STATION CP SNYDER CVS PHARMACY 3611 COLLEGE AVE 79549 325 573-2673 N

CVS PHARMACY INC SNYDER MCWILLIAMS PHARMACY 3706 COLLEGE AVE 795494625 325 573-7582 N

ACCESSHEALTH PLUS SNYDER UNITED PHARMACY 3500 COLLEGE 79549 325 574-1683 N

UNITED PHARMACY TX SNYDER WAL-MART PHARMACY 10-1272 5110 COLLEGE AVE 795496112 325 573-1965 N

WALMART STORES INC SOCORRO WAL-MART PHARMACY 10301 ALAMEDA AVE 799271605 915 245-3493 N

WALMART STORES INC SONORA EVERETTS PHARMACY SONORA 417 HWY 277 N 76950 325 387-2541 N

ELEVATE PROVIDER NETWORK SOUTH PADRE ISLAND CVS PHARMACY 1500 PADRE BLVD 785976726 956 761-3476

CVS PHARMACY INC SOUTHLAKE COSTCO PHARMACY 2601 E STATE HWY 114 76092 817 749-2802 N

COSTCO PHARMACIES SOUTHLAKE CVS PHARMACY 100 E SOUTHLAKE BLVD 76092 817 421-2454 N

CVS PHARMACY INC SOUTHLAKE KROGER PHARMACY 2110 E SOUTHLAKE BLVD 76092 817 421-7487 N

THE KROGER CO SOUTHLAKE PHARMACY PLUS #9 721 SOUTHLAKE BLVD 76092 817 410-1000 N

ELEVATE PROVIDER NETWORK SOUTHLAKE WAL-MART PHARMACY 2201 W SOUTHLAKE BLVD 760926700 817 601-0949 N

WALMART STORES INC SPEARMAN HANSFORD PHARMACY 710 S ROLAND ST 790813499 806 659-2226 N

ELEVATE PROVIDER NETWORK SPRING BETTER BALANCE PHARMACY INC 5834 LOUETTA ROAD 77379 281 205-7091 N

THIRD PARTY STATION CP SPRING BUDGET PHARMACY 19786 INTERSTATE 45 773732941 713 694-3785 N

TRINET SPRING CVS PHARMACY 4343 CYPRESSWOOD DR 77388 281 528-5029 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SPRING CVS PHARMACY 24802 ALDINE WESTFIELD 77373 281 288-1561 N

CVS PHARMACY INC SPRING CVS PHARMACY 8754 SPRING CYPRESS RD 77379 281 257-4320 N

CVS PHARMACY INC SPRING CVS PHARMACY 22560 ALDINE WESTFIELD RD 77373 281 353-6078 N

CVS PHARMACY INC SPRING CVS PHARMACY 8317 LOUETTA RD 77379 832 717-3386 N

CVS PHARMACY INC SPRING CVS PHARMACY 6945 CYPRESSWOOD DR 77379 281 257-7894 Y

CVS PHARMACY INC SPRING CVS PHARMACY 2106 RAYFORD RD 77386 281 298-4530 N

CVS PHARMACY INC SPRING CVS PHARMACY 25110 GROGANS MILL RD 77380 281 363-2290 Y

CVS PHARMACY INC SPRING CVS PHARMACY 3850 FM 2920 77388 281 528-2810 N

CVS PHARMACY INC SPRING CVS PHARMACY # 3487 RAYFORD RD 773863649 281 907-6036

CVS PHARMACY INC SPRING HEB PHARMACY 7310 LOUETTA 77379 281 251-0255 N

HEB GROCERY COMPANY LP SPRING HEB PHARMACY 130 SAWDUST ROAD 77380 281 292-0774 N

HEB GROCERY COMPANY LP SPRING HEB PHARMACY 3540 RAYFORD RD 77386 281 353-2420 N

HEB GROCERY COMPANY LP SPRING HEB PHARMACY #610 2121 FM 2920 RD 77388 281 907-7950 N

HEB GROCERY COMPANY LP SPRING KROGER PHARMACY 15802 CHAMPION FOREST DR 77379 281 370-9481 N

THE KROGER CO SPRING KROGER PHARMACY 6060 FM 2920 77379 281 370-4110 N

THE KROGER CO SPRING KROGER PHARMACY 2301 RAYFORD ROAD 77386 832 813-0410 N

THE KROGER CO SPRING KROGER PHARMACY 18518 KUYKENDAHL 77379 281 350-3591 N

THE KROGER CO SPRING KROGER PHARMACY 8745 SPRING CYPRESS 77379 832 717-4111 N

THE KROGER CO SPRING KROGER PHARMACY 5671 TREASCHWIG 77373 281 443-2883 N

THE KROGER CO SPRING RAYFORD PHARMACY 7623 LOUETTA RD STE 104 773797237 832 953-2926 N COMMUNITY INDEPENDENT PHARMACY

NETW SPRING SCRIPTS PHARMACY 20423 KUYKENDAHL RD STE 250 773793492 832 610-3480 N

TRINET SPRING STERLING RIDGE ORTHOPAEDICS &

SPORTS MEDICINE PHARMACY 20639 KUYKENDAHL RD STE 300 773793318 832 698-0115 N

ACCESSHEALTH PLUS SPRING TARGET PHARMACY 19511 I45 NORTH 77388 281 288-5018 N

TARGET PHARMACIES SPRING THE WOODLANDS APOTHECARY 9303 PINECROFT DR STE 300 773803180 281 962-7006 N

TRINET SPRING WAL-MART PHARMACY 21150 KUYKENDAHL ROAD 77379 281 288-9362 N

WALMART STORES INC SPRING WAL-MART PHARMACY 10-0602 1025 SAWDUST RD 77380 281 292-1721 N

WALMART STORES INC SPRING WAL-MART PHARMACY 10-0849 155 LOUETTA XING 773733007 281 651-0216 N

WALMART STORES INC SPRING WALMART PHARMACY 10-5353 24809 ALDINE WESTFIELD RD 773735927 281 203-3320 N

WALMART STORES INC SPRING BRANCH CVS PHARMACY # 19995 STATE HIGHWAY 46 W 780706809 830 438-8001

CVS PHARMACY INC SPRING BRANCH HEB PHARMACY 20725 HWY 46 WEST 78070 830 438-4010 N

HEB GROCERY COMPANY LP SPRING BRANCH NORTH SHORE PHARMACY 113 STARGRASS STE 100 780705067 830 214-2920 N

SPRING BRANCH WALMART PHARMACY 10-3056 305 SINGING OAKS 78070 506 855-2148 N

WALMART STORES INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SPRINGTOWN BROOKSHIRES PHARMACY 501 HIGHWAY 199 EAST 76082 817 220-1178 N

BROOKSHIRE GROCERY COMPANY SPUR DANAS PHARMACY INC 315 BURLINGTON AVE 793702812 806 271-3394 N

LEADER DRUG STORES INC STAFFORD 1 STOP PHARMACY 11725 W BELLFORT ST 774771301 832 328-5996 N

TRINET STAFFORD DR PHARMACY 103 AVE F 77477 832 539-6386 N

TRINET STAFFORD PHARMACY 4 LESS 432 MURPHY RD 774775448 281 969-5077 N

TRINET STAFFORD PR PHARMACY LLC 720 FM 1092 77477 832 230-8027 N

TRINET STAFFORD SAMS PHARMACY 12300 S W FREEWAY 77477 281 295-2512 N

WALMART STORES INC STAFFORD STAFFORD PHARMACY & DME 2448 S MAIN ST 774775522 281 969-5901 N

TRINET STAFFORD TRINITY PHARMACY SOLUTIONS 508 MURPHY RD STE E 774775449 713 697-8082 N

TPN STAFFORD WAL-MART PHARMACY 11210 W AIRPORT BLVD 77477 281 933-5252 N

WALMART STORES INC STAFFORD WELLMART PHARMACY 802 FM 2234 RD STE 2A 774776400 281 208-7138 N

THIRD PARTY STATION STAMFORD COUNTRY DRUG STORE 1517 COLUMBIA ST 79553 325 773-2441 N

ACCESSHEALTH STAMFORD WAL-MART PHARMACY 2614 N SWENSON ST 79553 325 773-2779 N

WALMART STORES INC STEPHENS WALMART PHARMACY 10-438 3800 W WALKER ST 764243917 254 559-2262 N

WALMART STORES INC STEPHENVILLE CVS PHARMACY 2565 W WASHINGTON ST 76401 254 965-5085 N

CVS PHARMACY INC STEPHENVILLE HEB PHARMACY 2150 W WASHINGTON 76401 254 965-2267 N

HEB GROCERY COMPANY LP STEPHENVILLE RIVER NORTH PHARMACY 150 RIVER N BLVD 764011879 254 918-2201 N

LEADER DRUG STORES INC STEPHENVILLE TANGLEWOOD PHARMACY 2445 A NORTHWEST LOOP 76401 254 968-7657 Y

PPOK RXSELECT PHCY NETWORK STEPHENVILLE WAL-MART PHARMACY 10-0610 2765 W WASHINGTON 76401 254 968-0660 N

WALMART STORES INC STRATFORD ELK PHARMACY 317 N MAIN ST 79084 806 366-5505 N

LEADER DRUG STORES INC SUGAR LAND ACCU-CARE PHARMACY 3745 HIGHWAY 6 774785515 832 939-9052 N

LEADER DRUG STORES INC SUGAR LAND ADMIX COMPOUNDING PHARMACY 1403 HIGHWAY 6 STE 300B 774784929 832 532-3113 N

TRINET SUGAR LAND CHOICE SPECIALTY PHARMACY 1403 HIGHWAY 6 STE 700A 774784930 832 944-6112 N

ELEVATE PROVIDER NETWORK SUGAR LAND COSTCO PHARMACY #1146 17520 SOUTHWEST FREEWAY 77479 281 566-6730 N

COSTCO PHARMACIES SUGAR LAND CVS PHARMACY 1250 HWY 6 77478 281 313-7600 N

CVS PHARMACY INC SUGAR LAND CVS PHARMACY 13829 SOUTHWEST FWY 77478 281 491-7551 N

CVS PHARMACY INC SUGAR LAND CVS PHARMACY 2102 ELDRIDGE RD 77478 281 242-2890 N

CVS PHARMACY INC SUGAR LAND CVS PHARMACY 5757 NEW TERRITORY BLVD 77479 281 565-5905 N

CVS PHARMACY INC SUGAR LAND CVS PHARMACY # 4523 L J PARKWAY 77479 281 265-0562

CVS PHARMACY INC SUGAR LAND DELIVERIT PHARMACY INC 13303 W AIRPORT BLVD 774785800 281 277-1071 Y

ACCESSHEALTH PLUS SUGAR LAND HEALTH CHECK PHARMACY 3533 TOWN CENTER BLVD S STE

500 774791456 281 201-8232 N

TRINET SUGAR LAND HEALTHQUEST PHARMACY 2600 CORDES DR STE F 774791352 832 222-0100 N

TRINET

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network SUGAR LAND HEALTHSCRIPTS SPECIALTY PHARMACY,

LLC 13020 DAIRY ASHFORD, SUITE 301

77478 855 777-1772 N TRINET

SUGAR LAND KROGER PHARMACY 4825 SWEETWATER BLVD 77479 281 494-6555 N THE KROGER CO

SUGAR LAND METSCRIPT PHARMACY 4888 HWY 90 A 77498 281 277-2700 N ELEVATE PROVIDER NETWORK

SUGAR LAND NAHS PHARMACY II 11677 S HIGHWAY 6 774981302 832 939-8950 N TRINET

SUGAR LAND PRO MED RX 13134 DAIRY ASHFORD RD STE # 900

774783756 281 313-0730 N TRINET

SUGAR LAND PRO PHARMACY HEALTH, INC. 14021 SOUTHWEST FWY # 409B 774783550 281 491-0767 N TRINET

SUGAR LAND SAMS PHARMACY 351 HIGHWAY 6 77478 281 295-2535 N WALMART STORES INC

SUGAR LAND SUGAR LAND COMPOUNDING PHARMACY 14823 SOUTHWEST FWY 77478 281 302-6080 N TRINET

SUGAR LAND TARGET PHARMACY 16300 SOUTHWEST FREEWAY 77479 281 340-0565 N TARGET PHARMACIES

SUGAR LAND VITAMED PHARMACY 16126 SOUTHWEST FWY STE # 180

774792638 281 313-0234 N TRINET

SUGAR LAND WAL-MART PHARMACY 345 HWY 6 77478 281 340-0909 N WALMART STORES INC

SUGARLAND CAMPBELLS COMPOUNDING PHARMACY 4760 SWEETWATER BLVD 77479 281 980-2555 N TRINET

SUGARLAND CVS PHARMACY 16515 LEXINGTON BLVD 77479 281 980-6666 N CVS PHARMACY INC

SUGARLAND CVS PHARMACY # 10110 S HWY 6 77478 281 988-1952 N CVS PHARMACY INC

SUGARLAND HEB PHARMACY 530 HIGHWAY 6 77479 281 240-6370 N HEB GROCERY COMPANY LP

SUGARLAND HEB PHARMACY 19900 SOUTHWEST FRWY 77479 281 239-2053 N HEB GROCERY COMPANY LP

SUGARLAND KROGER PHARMACY 11565 STATE HWY 6 SO 77478 281 340-1504 N THE KROGER CO

SUGARLAND VITA CARE PHARMACY II 1429 HWY 6 S #100 77478 281 277-2800 N ELEVATE PROVIDER NETWORK

SULPHUR SPRINGS BROOKSHIRES PHARMACY 809 GILMER ROAD 75482 903 885-7532 N BROOKSHIRE GROCERY COMPANY

SULPHUR SPRINGS CODY DRUG 1505 S BROADWAY ST 754824921 903 885-2639 N ACCESSHEALTH PLUS

SULPHUR SPRINGS CVS PHARMACY 1101 GILMER ST 75482 903 885-0546 N CVS PHARMACY INC

SULPHUR SPRINGS CVS PHARMACY # 1312 CHURCH ST 75482 903 885-7591 N CVS PHARMACY INC

SULPHUR SPRINGS WAL-MART PHARMACY 10-0417 1750 S BROADWAY 75482 903 885-1578 N WALMART STORES INC

SUNNYVALE CVS PHARMACY 3601 N BELT LINE RD 75182 972 279-6997 N CVS PHARMACY INC

SWEETWATER BROOKSHIRES PHARMACY 501 E BROADWAY 79556 325 236-6883 N BROOKSHIRE GROCERY COMPANY

SWEETWATER KMART PHARMACY4808 210 SW GEORGIA AVE 79556 325 235-4077 N K MART PHARMACY

SWEETWATER MALONEY PRESCRIPTION PHARMACY 1405 HAILEY ST 795562507 325 236-6394 N ELEVATE PROVIDER NETWORK

SWEETWATER THE MEDICINE PLACE 1410 LAMAR ST 795566516 325 236-6809 N ELEVATE PROVIDER NETWORK

SWEETWATER WAL-MART PHARMACY 407 N E GEORGIA AVE 79556 325 236-9588 N WALMART STORES INC

TAFT TAFT PHARMACY 213 MEYERS 783902705 361 528-2012 N ELEVATE PROVIDER NETWORK

TAHOKA TAHOKA DRUG 1610 MAIN ST 79373 806 561-4041 TRINET

TAYLOR CVS PHARMACY 1609 N MAIN ST 76574 512 352-5214 N CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network TAYLOR HEB PHARMACY 100 CARLOS G PARKER BLVD NW

STE 101 76574 512 352-2024 N

HEB GROCERY COMPANY LP TAYLOR PFENNIGS PRESCRIPTION PHARMACY 511 N MAIN ST 76574 512 352-5233 N COMMUNITY INDEPENDENT PHARMACY

NETW TAYLOR SCHWENKER PHARMACY 2407 N MAIN ST 765741897 512 352-3659 N COMMUNITY INDEPENDENT PHARMACY

NETW TAYLOR WAL-MART PHARMACY 3701 N MAIN ST 76574 512 352-6333 N

WALMART STORES INC TEAGUE PHARMACY PLUS #1 600 MAIN ST 758601621 254 739-2585 N

ELEVATE PROVIDER NETWORK TEMPLE BAYLOR SCOTT & WHITE PHARMACY #227 937 CANYON CREEK DR 76502 254 774-1600 N

LEADER DRUG STORES INC TEMPLE BAYLOR SCOTT & WHITE PHARMACY #228 1605 S 31ST ST 765085385 254 215-9100 N

LEADER DRUG STORES INC TEMPLE BAYLOR SCOTT & WHITE PHARMACY #230 514 W ADAMS 76501 254 774-1050 N

LEADER DRUG STORES INC TEMPLE CVS PHARMACY 2674 S 31ST ST 76504 254 773-9953 N

CVS PHARMACY INC TEMPLE HEB PHARMACY 3002 S 31ST ST 76502 254 773-2177 N

HEB GROCERY COMPANY LP TEMPLE HEB PHARMACY 1314 W ADAMS 76501 254 773-4585 N

HEB GROCERY COMPANY LP TEMPLE KINGS DAUGHTERS PHARMACY II INC 1905 SW H K DODGEN LOOP 765021814 254 778-1731 N

LEADER DRUG STORES INC TEMPLE SAMS PHARMACY 1414 MARLAND WOOD ROAD 76502 254 742-1073 N

WALMART STORES INC TEMPLE TARGET PHARMACY 3550 S GENERAL BRUCE DR STE A

100 76504 254 295-1058 N

TARGET PHARMACIES TEMPLE WAL-MART PHARMACY 10-0746 3401 S 31ST ST 76502 254 778-4636 N

WALMART STORES INC TEMPLE WALMART PHARMACY 10-6929 6801 W ADAMS AVE 76502 254 598-7594 N

WALMART STORES INC TEMPLE WESTSIDE DRUG 1516 S 31ST ST 765046706 254 778-2773 N

ACCESSHEALTH PLUS TERRELL BASS RUTLEDGE DRUG 201 W MOORE AVE STE 1 75160 972 563-3311 N

LEADER DRUG STORES INC TERRELL BASS RUTLEDGE DRUG 601 W MOORE AVE 75160 972 563-3311

LEADER DRUG STORES INC TERRELL BROOKSHIRES PHARMACY 1400 W MOORE ST 75160 972 563-2693 N

BROOKSHIRE GROCERY COMPANY TERRELL CVS PHARMACY 1870 W MOORE AVE 75160 972 563-7636 N

CVS PHARMACY INC TERRELL WAL-MART PHARMACY 10-0265 1900 W MOORE AVE 75160 972 563-5767 N

WALMART STORES INC TEXARKANA CVS PHARMACY # 1901 RICHMOND RD 755032424 903 255-0316

CVS PHARMACY INC TEXARKANA KMART PHARMACY7309 4520 W 7TH ST 75501 903 838-7539 N

K MART PHARMACY TEXARKANA PLEASANT GROVE PHARMACY 3302 RICHMOND RD 755032134 903 832-4545 N

THIRD PARTY STATION TEXARKANA RED RIVER PHARMACY SERVICES LLC 1327 COLLEGE DR 75503 903 792-7435 N

THIRD PARTY STATION TEXARKANA SAMS PHARMACY 3610 SAINT MICHAEL DR 755032341 903 838-0597 N

WALMART STORES INC TEXARKANA SAVON PHARMACY 4415 W 7TH 75501 903 831-5882 N

ALBERTSONS LLC TEXARKANA SAVON PHARMACY 2315 RICHMOND RD 75501 903 832-3524 N

ALBERTSONS LLC TEXARKANA SUPER 1 PHARMACY 2610 RICHMOND ROAD 75503 903 832-2258 N

BROOKSHIRE GROCERY COMPANY TEXARKANA TARGET PHARMACY 102 RICHMOND RANCH ROAD 75501 903 223-0270 N

TARGET PHARMACIES

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network TEXARKANA WAL-MART PHARMACY 4000 NEW BOSTON ROAD 75501 903 831-3023 N

WALMART STORES INC TEXARKANA WALMART PHARMACY 10-4367 3302 SUMMERHILL RD 75503 903 716-7019 N

WALMART STORES INC TEXARKANA WALMART PHARMACY 10-4371 3520 RICHMOND RD 755030705 903 716-7110 N

WALMART STORES INC TEXAS CITY CVS PHARMACY 2902 PALMER HWY 77590 409 945-3426 N

CVS PHARMACY INC TEXAS CITY HEB PHARMACY #662 3502 PALMER HWY 775906548 409 943-4249 N

HEB GROCERY COMPANY LP TEXAS CITY KROGER PHARMACY 3541 PALMER HWY146 77590 409 945-3436 N

THE KROGER CO TEXAS CITY MAINLAND PHARMACY 811 6TH ST N # 100 775907686 409 945-2368 N

THIRD PARTY STATION TEXAS CITY TEXAS CITY PHARMACY 2506 25TH AVE NORTH 77590 409 655-3033 N

TRINET THE COLONY CVS PHARMACY 6749 MAIN ST 75056 972 625-3207 N

CVS PHARMACY INC THE COLONY CVS PHARMACY 5300 S COLONY 75056 972 624-0605 N

CVS PHARMACY INC THE COLONY KROGER PHARMACY 6805 NMAIN 75056 972 370-1006 N

THE KROGER CO THE COLONY TRINITY NORTH PHARMACY 6053 MAIN ST 75056 214 494-6222 N

ELEVATE PROVIDER NETWORK THE COLONY WAL-MART PHARMACY 10-0426 4691 STATE HWY 121 75056 972 625-3784 N

WALMART STORES INC THE WOODLANDS ACP SCRIPTLINK 17350 ST LUKES WAY 773844100 281 458-1800 N

ACCESSHEALTH PLUS THE WOODLANDS CVS PHARMACY 6700 WOODLANDS PKWY STE

500 77382 281 419-7681 Y

CVS PHARMACY INC THE WOODLANDS CVS PHARMACY 4775 W PANTHER CREEK DR STE

A 100 77381 281 363-9174 N

CVS PHARMACY INC THE WOODLANDS CVS PHARMACY 4747 RESEARCH FOREST DR STE

450 77381 281 364-7277 N

CVS PHARMACY INC THE WOODLANDS CVS PHARMACY # 3705 FM 1488 RD 773843951 281 298-8705

CVS PHARMACY INC THE WOODLANDS GHPMA2 17521 ST LUKES WAY 77384 936 447-9432 N

TRINET THE WOODLANDS HEB PHARMACY 10777 KUYKENDAHL RD 77382 281 292-8026 N

HEB GROCERY COMPANY LP THE WOODLANDS HEB PHARMACY 3601 FM 1488 RD 77384 936 321-2748 N

HEB GROCERY COMPANY LP THE WOODLANDS HEB PHARMACY 9595 SIX PINES RD 77380 281 292-3962 N

HEB GROCERY COMPANY LP THE WOODLANDS KROGER PHARMACY 6700 WOODLANDS PKWY 600 773822879 281 296-0249 N

THE KROGER CO THE WOODLANDS KROGER PHARMACY 8000 RESEARCH FOREST DR 77382 281 419-1137 N

THE KROGER CO THE WOODLANDS KROGER PHARMACY 4747 RESEARCH FOREST 77381 281 298-6165 N

THE KROGER CO THE WOODLANDS MILLENNIUM PHARMACY 9319 PINECROFT DR STE 110 77380 281 298-1129 N

TRINET THE WOODLANDS PINECROFT PHARMACY 9305 PINECROFT DRIVE 77380 281 466-3650 N

ACCESSHEALTH PLUS THE WOODLANDS SOUTHSIDE PHARMACY 9 1111 MEDICAL PLAZA DR STE 160 773803477 832 813-5296 N

ACCESSHEALTH PLUS THE WOODLANDS TARGET PHARMACY 1100 LAKE WOODLANDS DRIVE 77380 281 419-6944 N

TARGET PHARMACIES THE WOODLANDS WAL-MART PHARMACY 10001 WOODLANDS PARKWAY 77382 281 419-5945 N

WALMART STORES INC THE WOODLANDS WAL-MART PHARMACY 3040 COLLEGE PARK DRIVE 77384 936 271-0755 N

WALMART STORES INC THREE RIVERS CAMPBELL DRUG STORE 101 W THORNTON 780710400 361 786-3757 N

ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network TIMPSON BUSSEY DRUG 443 AUSTIN ST 759750458 936 254-2471 N COMMUNITY INDEPENDENT PHARMACY

NETW TOMBALL CVS PHARMACY 815 W MAIN ST 77375 281 255-8265 N

CVS PHARMACY INC TOMBALL CVS PHARMACY 24203 TOMBALL PKWY 77375 281 255-4020 N

CVS PHARMACY INC TOMBALL CVS PHARMACY # 24048 KUYKENDAHL RD 773755326 281 255-3897

CVS PHARMACY INC TOMBALL FIRST CARE PHARMACY 24922 TOMBALL PARKWAY 77375 832 698-1532 N

THIRD PARTY STATION CP TOMBALL GLOYERS PHARMACY INC 1010 W MAIN ST 77375 281 351-5454 N

LEADER DRUG STORES INC TOMBALL HEB PHARMACY 28520 TOMBALL PKWY 77375 281 351-1972 N

HEB GROCERY COMPANY LP TOMBALL HEB PHARMACY 26500 KUYKENDAHL RD 77375 281 255-2248 N

HEB GROCERY COMPANY LP TOMBALL KROGER PHARMACY 14060 FM 2920 77375 281 516-2486 N

THE KROGER CO TOMBALL KROGER PHARMACY #117 24350 KUYKENDAHL RD 773755119 281 205-0533 N

THE KROGER CO TOMBALL MS PHARMACY 27721 TOMBALL PARKWAY 77375 832 698-1565 N

ACCESSHEALTH PLUS TOMBALL SADDLEBROOK PHARMACY 25201 KUYKENDAHL RD STE 300 773753351 832 698-2104 N COMMUNITY INDEPENDENT PHARMACY

NETW TOMBALL TARGET PHARMACY 14302 FM 2920 RD 77377 281 255-6289 N

TARGET PHARMACIES TOMBALL TEXAS ORTHOPAEDIC & SPORTS MEDICINE 13603 MICHEL RD 773756410 281 351-7261 N

EMEDRX SOLUTIONS TOMBALL TMP PHARMACY 455 SCHOOL ST 77375 281 290-7741 N

THIRD PARTY STATION CP TOMBALL TOMBALL HEALTH MART PHARMACY 506 GRAHAM DRIVE 77375 832 559-6413 N

ACCESSHEALTH PLUS TOMBALL TOMBALL PROFESSIONAL ATRUIM PHRM 425 HOLDERRIETH BLVD 773754551 281 351-8239 N COMMUNITY INDEPENDENT PHARMACY

NETW TOMBALL WAL-MART PHARMACY 22605 TOMBALL PARKWAY 77375 281 374-9523 N

WALMART STORES INC TOMBALL WAL-MART PHARMACY 10-0703 27650 TOMBALL PKWY 77375 281 351-2144 N

WALMART STORES INC TROUP TROUP PHARMACY 501 W DUVAL ST 757892113 903 842-3074 N

ELEVATE PROVIDER NETWORK TULIA MOORE THAN MEDICINE 105 SW 2ND ST 79088 806 995-3551 N

ELEVATE PROVIDER NETWORK TYLER AMERICAN SPECIALTY PHARMACY 1109 E 5TH ST 757013318 903 354-0231 N

TPN TYLER BROOKSHIRE GROCERY COMPANY 1600 W S W LOOP 323 757101411 903 877-6827

TYLER BROOKSHIRE PHARMACY 6991 OLD JACKSONVILLE HWY 757030579 903 747-3508 N

BROOKSHIRE GROCERY COMPANY TYLER BROOKSHIRES PHARMACY 2734 E FIFTH ST 75707 903 526-4092 N

BROOKSHIRE GROCERY COMPANY TYLER BROOKSHIRES PHARMACY 2020 ROSELAND BLVD 75701 903 597-1358 N

BROOKSHIRE GROCERY COMPANY TYLER BROOKSHIRES PHARMACY 100 RICE ROAD 75703 903 561-7943 N

BROOKSHIRE GROCERY COMPANY TYLER CHAPEL HILL PHARMACY LTD 12445 HWY 64E 75707 903 566-0326 N

THIRD PARTY STATION CP TYLER CRAIG PHARMACY 1863 TROUP HIGHWAY 757013341 903 595-3737 N

ELEVATE PROVIDER NETWORK TYLER CVS PHARMACY 2626 E 5TH ST 75701 903 531-2550 N

CVS PHARMACY INC TYLER CVS PHARMACY 1702 S BROADWAY AVE 75701 903 526-8183 N

CVS PHARMACY INC TYLER CVS PHARMACY 1710 W GENTRY PKWY 75702 903 595-4179 N

CVS PHARMACY INC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network TYLER CVS PHARMACY 4922 S BROADWAY AVE 75703 903 561-6262 Y

CVS PHARMACY INC TYLER DRUG EMPORIUM 5614 S BROADWAY 757034347 903 534-9105 N

EPIC PHARMACY NETWORK INC TYLER FAMILY FIRST PHARMACY 16623 OLD JACKSONVILLE HWY 75703 903 561-2822 N

ELEVATE PROVIDER NETWORK TYLER GOODS MEDICINE CHEST 2130 GRANDE BLVD 75703 903 939-8500 N

ELEVATE PROVIDER NETWORK TYLER GOODS MEDICINE CHEST 807 S BECKHAM AVE 75701 903 592-8283 N

ELEVATE PROVIDER NETWORK TYLER KINSEY'S PHARMACY 4290 KINSEY DR 75703 903 561-5656 N

ELEVATE PROVIDER NETWORK TYLER MAJORS PHARMACY 108 SHELLEY DR 75701 903 595-1132 N

THIRD PARTY STATION TYLER ROSELAND PHARMACY 1814 ROSELAND BLVD SUITE 220 75711 903 531-0590 N COMMUNITY INDEPENDENT PHARMACY

NETW TYLER SAMS PHARMACY 2025 S SOUTHWEST LOOP 323 75701 903 597-1863 N

WALMART STORES INC TYLER STEPHENSON PHARMACY 1000 S FLEISHEL 75701 903 593-0236 N COMMUNITY INDEPENDENT PHARMACY

NETW TYLER SUPER 1 FOODS PHARMACY #642 172 CENTENNIAL PKWY 75703 903 525-6923 N

BROOKSHIRE GROCERY COMPANY TYLER SUPER 1 PHARMACY 3828 TROUP HWY 75703 903 581-9666 N

BROOKSHIRE GROCERY COMPANY TYLER SUPER 1 PHARMACY 113 NW LOOP 323 75702 903 593-5369 N

BROOKSHIRE GROCERY COMPANY TYLER SUPER 1 PHARMACY 1105 E GENTRY PKWY 75702 903 535-9467 N

BROOKSHIRE GROCERY COMPANY TYLER TARGET PHARMACY 7003 S BROADWAY 75703 903 939-8550 N

TARGET PHARMACIES TYLER THO PHARMACY 721 A CLINIC DR 75701 903 595-7086 N

ELEVATE PROVIDER NETWORK TYLER TYLERRX PHARMACY 2415 E 5TH ST 757013523 903 593-1400 N COMMUNITY INDEPENDENT PHARMACY

NETW TYLER UTHCT PHARMACY 11937 US HWY 271 75708 903 877-7088 N

THIRD PARTY STATION CP TYLER WAL-MART PHARMACY 1900 E SE LOOP 323 757018337 903 508-6127 N

WALMART STORES INC TYLER WAL-MART PHARMACY 3820 STATE HIGHWAY 64 W 757046924 903 597-3888 N

WALMART STORES INC TYLER WAL-MART PHARMACY 6801 S BROADWAY 75703 903 581-4842 N

WALMART STORES INC TYLER WAL-MART PHARMACY 5050 TROUP HWY 75703 903 534-1122 N

WALMART STORES INC TYLER WALMART PHARMACY 10-4605 5976 OLD JACKSONVILLE HWY 757030582 479 204-8550 N

WALMART STORES INC TYLER WALMART PHARMACY 10-5700 2151 FRANKSTON HWY 757013808 479 204-1258 N

WALMART STORES INC TYLER WOODY WEAVER PHARMACY 2726 W GENTRY 757021635 903 593-2533 N

ELEVATE PROVIDER NETWORK UNIVERSAL CITY CVS PHARMACY 1836 PAT BOOKER RD 78148 210 658-8011 N

CVS PHARMACY INC UNIVERSAL CITY HEB PHARMACY 910 KITTY HAWK 78148 210 945-2120 N

HEB GROCERY COMPANY LP UVALDE HEB PHARMACY 227 E MAIN 78801 830 278-2581 N

HEB GROCERY COMPANY LP UVALDE LIFECARE PHARMACY 1001 E MAIN ST 788014831 830 591-1000 N

LEADER DRUG STORES INC UVALDE WAL-MART PHARMACY 10-0782 3100 E MAIN 78801 830 278-6221 N

WALMART STORES INC VAN BROOKSHIRES PHARMACY 706 W MAIN 75790 903 963-3834 N

BROOKSHIRE GROCERY COMPANY VAN ALSTYNE CITY DRUG 209 E JEFFERSON 75495 903 482-5279 N

ELEVATE PROVIDER NETWORK

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network VERNON FAMILY PHARMACY 1720 HILLCREST DR 76384 940 552-2999 N

ACCESSHEALTH PLUS VERNON HILLCREST PHARMACY 1015 HILLCREST DR 763843133 940 552-9501 N

ELEVATE PROVIDER NETWORK VERNON UNITED PHARMACY 3000 WILBARGER 76384 940 552-2600 N

UNITED PHARMACY TX VERNON WAL-MART PHARMACY 3800 HWY 287 WEST 76384 940 552-8069 N

WALMART STORES INC VICTORIA CASTLE HILLS PHARMACY LLC 3412 SAM HOUSTON DR 77904 361 575-6328 N

ELEVATE PROVIDER NETWORK VICTORIA CENTRAL DRUG INC 3802 N LAURENT ST 77901 361 575-4713 N COMMUNITY INDEPENDENT PHARMACY

NETW VICTORIA CVS PHARMACY # 08923 2702 N NAVARRO ST 779013956 361 572-0354

CVS PHARMACY INC VICTORIA HARDING AND PARKER LEGEND

PHARMACY 2806 N NAVARRO ST 779013976 361 573-2476 N

LEADER DRUG STORES INC VICTORIA HEB PHARMACY 1505 E RIO GRANDE 77901 361 572-8001 N

HEB GROCERY COMPANY LP VICTORIA HEB PHARMACY 6106 N NAVARRO 77901 361 572-8575 N

HEB GROCERY COMPANY LP VICTORIA ROGERS PHARMACY 512 E RIO GRANDE 77901 361 572-0226 N

ELEVATE PROVIDER NETWORK VICTORIA ROGERS PHARMACY #1 4402 N LAURENT ST 77901 361 578-3521 N

ELEVATE PROVIDER NETWORK VICTORIA ROGERS PHARMACY #2 2700 CITIZENS PLAZA 77901 361 574-1544 N

ELEVATE PROVIDER NETWORK VICTORIA ROGERS PHARMACY #4 6502 NURSERY DR 77904 361 572-3106 N

ELEVATE PROVIDER NETWORK VICTORIA ROGERS PHARMACY #5 8621 N NAVARRO ST 779042603 361 573-1888 N

ELEVATE PROVIDER NETWORK VICTORIA TARGET PHARMACY 7608 ZAC LENTZ PKWY 77904 361 579-6716 N

TARGET PHARMACIES VICTORIA WAL-MART PHARMACY 10-0330 9002 N NAVARRO 77904 361 576-2132 N

WALMART STORES INC VICTORIA WAL-MART PHARMACY 10-4194 4101 HOUSTON HIGHWAY 77901 361 827-7275 N

WALMART STORES INC VIDOR CVS PHARMACY 1295 N MAIN ST 77662 409 769-5423 N

CVS PHARMACY INC VIDOR T AND T PHARMACY 315 N MAIN ST 776624935 409 769-2438 N

LEADER DRUG STORES INC VIDOR VIDOR FAMILY PHARMACY 1130 N MAIN ST 776623739 409 769-2406 N

TRINET VIDOR WAL-MART PHARMACY 10-0457 1350 N MAIN 77662 409 769-1691 N

WALMART STORES INC W ORANGE WAL-MART PHARMACY 10-0777 3115 EDGAR BROWN DR 77630 409 882-0551 N

WALMART STORES INC WACO BAYLOR SCOTT & WHITE PHARMACY #251 1412 N VALLEY MILLS 116 76710 254 761-5200 N

LEADER DRUG STORES INC WACO BAYLOR UNIVERSITY HLTH CTR PHY 209 SPEIGHT AVE 76706 254 710-4991 N

LEADER DRUG STORES INC WACO CIRCLE DRUG PHARMACY 3211 ROBINSON DR 76706 254 662-0774 N

ELEVATE PROVIDER NETWORK WACO CVS PHARMACY 601 N VALLEY MILLS DR 76710 254 741-0237 N

CVS PHARMACY INC WACO CVS PHARMACY # 820 S 5TH ST 767061110 254 296-0175

CVS PHARMACY INC WACO DRUG EMPORIUM 5900 BOSQUE BLVD 767104320 254 772-0011 N

EPIC PHARMACY NETWORK INC WACO FAMILY HEALTH CENTER PHCY 1600 PROVIDENCE DR 767072291 254 313-4521 N

THIRD PARTY STATION WACO FHC MEDICAID PHARMACY 1600 PROVIDENCE DRIVE 76707 254 313-4541 N

THIRD PARTY STATION WACO HEB PHARMACY 9100 WOODWAY DRIVE 76712 254 751-0912 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network WACO HEB PHARMACY 1821 S VALLEY MILLS DR 76711 254 757-3344 N

HEB GROCERY COMPANY LP WACO HEB PHARMACY 1301 WOODED ACRES DR 76710 254 776-1027 Y

HEB GROCERY COMPANY LP WACO HEB PHARMACY 3801 N 19TH ST 76708 254 753-2226 N

HEB GROCERY COMPANY LP WACO LYNN'S LA VEGA PHARMACY 2401 E WACO DR 767053259 254 799-4949 N

ELEVATE PROVIDER NETWORK WACO PHARMACY PLUS #10 10412 CHINA SPRING HWY SUITE

A 76708 254 836-5255 N

ELEVATE PROVIDER NETWORK WACO PHARMACY PLUS #5 3308 HILLCREST DR 76708 254 756-5383 N

ELEVATE PROVIDER NETWORK WACO PHARMACY PLUS #6 829 A N LOOP 340 767052592 254 867-6700 N

ELEVATE PROVIDER NETWORK WACO SAMS PHARMACY 2301 E WACO DR 76705 254 799-5412 N

WALMART STORES INC WACO TARGET PHARMACY 5401 BOSQUE BLVD 76710 254 399-9140 N

TARGET PHARMACIES WACO WAL-MART PHARMACY 4320 FRANKLIN AVE 76710 254 751-0301 N

WALMART STORES INC WACO WALMART PHARMACY 10-5389 600 HEWITT DR 76712 254 666-7429 N

WALMART STORES INC WAKE VILLAGE WALMART PHARMACY 10-4373 200 WAKE VILLAGE RD 755016227 903 716-7174 N

WALMART STORES INC WALLER CVS PHARMACY 31013 FM 2920 RD 77484 936 372-9141 N

CVS PHARMACY INC WASKOM KILLION'S PHARMACY 396 W TEXAS AVE 756920687 903 687-2525 N COMMUNITY INDEPENDENT PHARMACY

NETW WASKOM WALMART PHARMACY 10-4320 1005 E TEXAS AVE 756923652 903 687-3007 N

WALMART STORES INC WATAUGA ALBERTSONS PHARMACY 6249 RUFE SNOW DRIVE 76148 817 428-0371 N

ALBERTSONS LLC WATAUGA SAVON PHARMACY 8428 DENTON HWY 76148 817 581-6223 N

ALBERTSONS LLC WATAUGA TARGET PHARMACY 8000 DENTON HIGHWAY 76148 817 427-1099 N

TARGET PHARMACIES WATAUGA TCHD GERTRUDE TARPLEY COMM CLINIC

PHARMACY 6601 WATAUGA RD 761483331 817 702-6640 N

JPS HEALTH SYSTEM OUTPATIENT PHARMA WAXAHACHIE BAYLOR SCOTT & WHITE PHARMACY #110 2460 N INTERSTATE HIGHWAY

35 E 751655240 469 843-7120 N

LEADER DRUG STORES INC WAXAHACHIE CVS PHARMACY 701 FERRIS AVE 75165 972 938-3120 Y

CVS PHARMACY INC WAXAHACHIE HEB PHARMACY 800 N HWY 77 75165 972 923-2297 N

HEB GROCERY COMPANY LP WAXAHACHIE TARGET PHARMACY 1316 N HIGHWAY 77 75165 972 923-9169 N

TARGET PHARMACIES WAXAHACHIE THE PRESCRIPTION SHOP 120 S GRAND AVE 75165 972 938-2642 N COMMUNITY INDEPENDENT PHARMACY

NETW WAXAHACHIE WAL-MART PHARMACY 10-0260 1200 N HWY 77 75165 972 938-8222 N

WALMART STORES INC WEATHERFORD BEST VALUE HOMETOWN PHARMACY 1702 SANTA FE DR 76086 817 594-3435 N

ELEVATE PROVIDER NETWORK WEATHERFORD BROOKSHIRES PHARMACY 601 W PALO PINTO 76086 817 596-4165 N

BROOKSHIRE GROCERY COMPANY WEATHERFORD CVS PHARMACY 407 S MAIN ST 76086 817 596-8374 N

CVS PHARMACY INC WEATHERFORD DAVIS CITY PHARMACY INC 111 TRINITY ST 76086 817 594-3851 N

ELEVATE PROVIDER NETWORK WEATHERFORD DAVIS CITY PHCY INSTITUTIONAL INC 113 AUSTIN AVE 76086 817 599-5590 N

GERIMED LTC NETWORK INC WEATHERFORD SAVON PHARMACY 225 E SPRING 76086 817 594-9816 N

ALBERTSONS LLC

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network WEATHERFORD TACKETT PHARMACY AND NUTRITION

CENTER 138 COLLEGE PARK DR STE 130 760866212 817 341-7046 N

ELEVATE PROVIDER NETWORK WEATHERFORD TARGET PHARMACY 122 E INTERSTATE 20 76087 817 594-4564 N

TARGET PHARMACIES WEATHERFORD TOWN CREEK PHARMACY 907 EUREKA ST STE B 760865880 817 458-5292 N

RECEPT HEALTHCARE SERVICES WEATHERFORD WAL-MART PHARMACY 1836 S MAIN ST 76086 817 599-4166 N

WALMART STORES INC WEBSTER BLOSSOM PHARMACY 250 BLOSSOM ST STE 105 775984204 281 724-0280 N

TPN WEBSTER CLEAR LAKE PROFESSIONAL BLDG

PHARMACY 251 MEDICAL CENTER BLVD 77598 281 332-2496 N

ELEVATE PROVIDER NETWORK WEBSTER MEDICAL PLAZA PHARMACY AT CLEAR

LAKE 250 BLOSSOM ST 775984218 281 332-2213 N

ELEVATE PROVIDER NETWORK WEBSTER PYRAMIDS PHARMACY WEBSTER 500 N KOBAYASHI STE E 775984820 281 724-0531 N

ACCESSHEALTH PLUS WEBSTER TARGET PHARMACY 1801 W BAY AREA BLVD 77598 281 819-4117 N

TARGET PHARMACIES WEBSTER WEBSTER PHARMACY 15610 HIGHWAY 3 77598 281 886-7164 N

TRINET WELLINGTON COLLINGSWORTH PHARMACY 1016 16TH ST 79095 806 447-1184 N

ELEVATE PROVIDER NETWORK WESLACO CENTRX PHARMACY AT WESLACO 330 W EXPRESSWAY 83 SUITE A 78599 956 246-4085 N

ELEVATE PROVIDER NETWORK WESLACO CVS PHARMACY 1602 E HIGHWAY 83 78596 956 447-1916

CVS PHARMACY INC WESLACO DADS PHARMACY 415 S AIRPORT DR 78596 956 447-1800 N

ACCESSHEALTH WESLACO DE LA ROSA PHARMACY & MEDICAL

EQUIPMENT 1500 E 6TH ST 78596 956 968-8995 N

LEADER DRUG STORES INC WESLACO HEB PHARMACY 310 N WESTGATE DR 78596 956 447-5912 N

HEB GROCERY COMPANY LP WESLACO HEB PHARMACY 1004 N TEXAS BLVD 78596 956 968-8859 N

HEB GROCERY COMPANY LP WESLACO PRO SCRIPT PHARMACY SERVICES 911 S AIRPORT DR 785965033 956 969-3784 N

ACCESSHEALTH WESLACO SANDER PHARMACY 916 E 6TH ST 785966498 956 968-4528 N

TRINET WESLACO WAL-MART PHARMACY 1310 N TEXAS BLVD 78596 956 968-8689 N

WALMART STORES INC WESLACO WALMART PHARMACY 10-6159 1600 S TEXAS BLVD 78596 956 854-2573 N

WALMART STORES INC WESLACO WESLACO PHARMACY 1102 S AIRPORT 78596 956 969-0636 N

ACCESSHEALTH PLUS WEST OLD CORNER DRUG 200 N MAIN ST 766911207 254 826-5122 N

ELEVATE PROVIDER NETWORK WEST WEST DRUG 206 N MAIN ST 766911207 254 826-5292 N

TRINET WEST COLUMBIA CVS PHARMACY 701 S 17TH ST 77486 979 345-5119 N

CVS PHARMACY INC WEST COLUMBIA WAL-MART PHARMACY 10-0482 301 N COLUMBIA DR 77486 979 345-6030 N

WALMART STORES INC WEST LAKE HILLS HEB PHARMACY 701 CAPITAL OF TEXAS HWY 78746 512 329-5184 N

HEB GROCERY COMPANY LP WESTWORTH VILLAGE SAMS PHARMACY 6760 WESTWORTH BLVD 76114 817 763-9820 N

WALMART STORES INC WESTWORTH VILLAGE WAL-MART PHARMACY 6770 WESTWORTH BLVD 76114 817 570-0827 N

WALMART STORES INC WHARTON CVS PHARMACY 1710 N RICHMOND RD 77488 979 532-8660 N

CVS PHARMACY INC WHARTON HEB PHARMACY 1616 N ALABAMA 77488 979 282-2883 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network WHARTON WAL-MART PHARMACY 10388 US 59 HWY 774887217 979 532-0641 N

WALMART STORES INC WHEELER HYLAND'S PHARMACY, LLC 109 W TEXAS ST 79096 806 826-5561 N

ELEVATE PROVIDER NETWORK WHITE OAK BROOKSHIRES PHARMACY 200 W HWY 80 75693 903 297-9896 N

BROOKSHIRE GROCERY COMPANY WHITEHOUSE BROOKSHIRES PHARMACY 601 HWY 110 N 75791 903 839-3715 N

BROOKSHIRE GROCERY COMPANY WHITEHOUSE CVS PHARMACY 100 E MAIN ST 75791 903 839-6274 N

CVS PHARMACY INC WHITEHOUSE WHITEHOUSE PHARMACY 301 HIGHWAY 110 N 757913111 903 839-4391 N

ELEVATE PROVIDER NETWORK WHITESBORO AXTELL RITE VALUE PHARMACY 304 ONE HALF CHARLIE DR 76273 903 564-3216 N

ACCESSHEALTH PLUS WHITESBORO HOMETOWN PHARMACY 310 CHARLIE DR 76273 903 564-1234 N

ELEVATE PROVIDER NETWORK WHITEWRIGHT WALMART PHARMACY 10-2364 301 S HIGHWAY 69 75491 903 364-2562 N

WALMART STORES INC WHITEWRIGHT WHITEWRIGHT PHARMACY 419 S US HIGHWAY 69 75491 903 364-5537 N

ELEVATE PROVIDER NETWORK WHITNEY BROOKSHIRES PHARMACY 1310 N BRAZOS 76692 254 694-4413 N

BROOKSHIRE GROCERY COMPANY WHITNEY EUBANK DRUG 1510 N BRAZOS 76692 254 694-3314 N

THIRD PARTY STATION WHITNEY PRESCRIPTION PHARMACY 203 E JEFFERSON 76692 254 694-2249

ACCESSHEALTH PLUS WICHITA FALLS CASH SAVER COST PLUS PHARMACY 2720 SW PKWY 76308 940 691-0801 N

LEADER DRUG STORES INC WICHITA FALLS CVS PHARMACY 3601 JACKSBORO HWY 76302 940 766-0174 Y

CVS PHARMACY INC WICHITA FALLS CVS PHARMACY 4600 SOUTHWEST PKWY 76310 940 696-0141 N

CVS PHARMACY INC WICHITA FALLS CVS PHARMACY 3201 SEYMOUR HWY 76309 940 766-1939 N

CVS PHARMACY INC WICHITA FALLS DOWNTOWN PHARMACY 1100 SCOTT ST 763014650 940 767-4345 N

TRINET WICHITA FALLS ENGLISH PHARMACY 2600 10TH ST 763092296 940 723-6060 N

ELEVATE PROVIDER NETWORK WICHITA FALLS FRANKLIN PHARMACY 1013 BROOK AVE 76301 940 723-7145 N COMMUNITY INDEPENDENT PHARMACY

NETW WICHITA FALLS GUFFEY'S DRUG STORE 1610 9TH ST 763014305 940 322-8626 N

EPIC PHARMACY NETWORK INC WICHITA FALLS MARKET STREET PHARMACY 4590 KELL BLVD 76309 940 692-3443 N

UNITED PHARMACY TX WICHITA FALLS SAMS PHARMACY 3801 KELL BLVD 76308 940 691-7296 N

WALMART STORES INC WICHITA FALLS UNITED PHARMACY 4516 JACKSBORO HWY 76302 940 767-3368 N

UNITED PHARMACY TX WICHITA FALLS UNITED PHARMACY 2522 IOWA PARK RD 76306 940 322-1114 N

UNITED PHARMACY TX WICHITA FALLS WAL-MART PHARMACY 3130 LAWRENCE RD 76308 940 689-9762 N

WALMART STORES INC WICHITA FALLS WAL-MART PHARMACY 10-0414 5131 GREENBRIAR RD 76302 940 397-9662 N

WALMART STORES INC WICHITA FALLS WAL-MART PHARMACY 10-0420 2700 CENTRAL FREEWAY 76305 940 855-2374 N

WALMART STORES INC WILLIS KROGER PHARMACY 12605 I 45 NORTH 77318 936 890-3949 N

THE KROGER CO WILLS POINT BROOKSHIRE PHARMACY 1105 W S COMMERCE 75169 903 873-8237 N

BROOKSHIRE GROCERY COMPANY WILLS POINT BRUCE AND HUMAN DRUG 145 N 4TH ST 751692040 903 873-2538 N

ACCESSHEALTH WIMBERLEY HEB PHARMACY #708 14501 RANCH ROAD 12 786766215 512 847-3048 N

HEB GROCERY COMPANY LP

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Ambetter from Superior HealthPlan: Pharmacies Participating in 90-Day Extended Network WIMBERLEY WIMBERLEY PHARMACY 120 JOE WIMBERLEY BLVD 78676 512 847-2288 N

ACCESSHEALTH PLUS WINNIE WILCOX PHARMACY 415 STATE HWY 124 77665 409 296-2497 N COMMUNITY INDEPENDENT PHARMACY

NETW WINNSBORO CVS PHARMACY # 604 S MAIN 75494 903 342-5217 N

CVS PHARMACY INC WINNSBORO SCOTTS PHARMACY 211 E COKE RD 754946334 903 342-3669 N

ELEVATE PROVIDER NETWORK WINTERS CASH SAVER COST PLUS PHARMACY 900 N MAIN ST 79567 325 754-5680 N

LEADER DRUG STORES INC WINTERS WALMART PHARMACY 10-2863 1010 N MAIN ST 795673205 325 754-4028 N

WALMART STORES INC WOODVILLE DOGWOOD PHARMACY AND GIFTS 205 S MAGNOLIA ST 759795289 409 283-2550

THIRD PARTY STATION CP WOODVILLE WAL-MART PHARMACY 10-0288 115 COBB MILL ROAD 75979 409 283-3701 N

WALMART STORES INC WOODVILLE WOODVILLE DRUG 1010 W BLUFF ST 75979 409 283-3073 N

THIRD PARTY STATION CP WOODWAY CVS PHARMACY 9001 WOODWAY DR 76712 254 776-4763 N

CVS PHARMACY INC WYLIE BROOKSHIRES PHARMACY 701 HWY 78 SOUTH 75098 972 442-5525 N

BROOKSHIRE GROCERY COMPANY WYLIE CVS PHARMACY 750 W FM 544 75098 972 429-0836 N

CVS PHARMACY INC WYLIE KROGER PHARMACY 2608 W FM 544 750984938 972 244-7681 N

THE KROGER CO WYLIE QUALITY CARE PHARMACY AND

COMPOUNDING II 2300 W FM 544 STE 130 750984931 972 442-5333 N

ELEVATE PROVIDER NETWORK WYLIE SAVON PHARMACY 921 S WESTGATE WAY 75098 972 429-4951 N

ALBERTSONS LLC WYLIE TARGET PHARMACY 3440 W FM 544 750989408 972 769-3944 N

TARGET PHARMACIES WYLIE WAL-MART PHARMACY 2050 N HIGHWAY 78 75098 972 429-5106 N

WALMART STORES INC WYLIE WALMART PHARMACY 10-6078 1400 MCCREARY RD 750988776 972 202-4368 N

WALMART STORES INC WYLIE WYLIE PHARMACY 430 S HIGHWAY 78 STE 160 750983974 972 429-9594 N

EPIC PHARMACY NETWORK INC YOAKUM CITY DRUG STORE 223 W GRAND AVE 779952613 361 293-2181 N

ACCESSHEALTH PLUS YOAKUM YOAKUM DISCOUNT PHARMACY 210 NELSON ST 77995 361 741-7455 N

ELEVATE PROVIDER NETWORK YOAKUM YOAKUM DISCOUNT PHARMACY 1200 CARL RAMERT DR STE A 779954868 361 293-6881 N

ELEVATE PROVIDER NETWORK YORKTOWN THE KRAEGE DRUG STORE 113 E MAIN ST 781640727 361 564-2216 N

ELEVATE PROVIDER NETWORK ZAPATA CVS PHARMACY # 1205 N HWY 83 78076 956 765-6001

CVS PHARMACY INC ZAPATA GARCIAS PILL BOX US HWY 83 AND 6TH 78076 956 765-6033 N

ACCESSHEALTH