205 Prescription Formulary and Network Pharmacies H5826_MA_254_205_v_02_FormularyPharmacytier Accepted Offered by
Community HealthFirst MA Special Needs Plan (HMO SNP) 205 Prescription Formulary (List of Covered s) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT SOME OF THE DRUGS WE COVER IN THIS PLAN HPMS approved formulary file submission ID 0005059, Version 6, Approved 08/08/204 This formulary was updated on 08/22/204. For more recent information or other questions, please contact Community Health Plan of Washington at -800-944-247 or for TTY users, Dial 7--, 7 days a week, 8am 8pm or visit www.healthfirst.chpw.org. Note to existing members: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list (formulary) refers to we, us, or our, it means Community Health Plan of Washington.. When it refers to plan or our plan, it means Community HealthFirst MA Special Needs Plan. This document includes a list of the drugs (formulary) for our plan which is current as of October, 204. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January, 205 and from time to time during the year. Community Health Plan of of WWashington is is a Coordinated Care Plan with a Medicare Advantage contract. Enrollment and a contract in Community with the Washington Health Plan State of W Mashington edicaid depends Program. on Enrollment contract renewal. in Community Health Plan of Washington depends on contract renewal. H5826_MA_254_205_v_0 MAM_254_205_v0_F 2_FormularyPharmacytier
What is the Community HealthFirst MA Special Needs Plan Formulary? A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Community HealthFirst MA Special Needs Plan network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage. Can the Formulary (drug list) change? Generally, if you are taking a drug on our 205 formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the 205 coverage year except when a new, less expensive generic drug becomes available or when new adverse information about the safety or effectiveness of a drug is released. Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year. We feel it is important that you have continued access for the remainder of the coverage year to the formulary drugs that were available when you chose our plan, except for cases in which you can save additional money or we can ensure your safety. If we remove drugs from our formulary, [or] add prior authorization, quantity limits and/or step therapy restrictions on a drug [or move a drug to a higher cost-sharing tier], we must notify affected members of the change at least 60 days before the change becomes effective, or at the time the member requests a refill of the drug, at which time the member will receive a 60-day supply of the drug. If the Food and Administration deems a drug on our formulary to be unsafe or the drug s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. The enclosed formulary is current as of October, 204. To get updated information about the drugs covered by Community HealthFirst MA Special Needs Plan, please contact us. Our contact information appears on the front and back cover pages. We regularly review and update the formulary. The notice of these changes is posted monthly at www.healthfirst.chpw.org/for-members-prescription-coverage/formulary. How do I use the Formulary? There are two ways to find your drug within the formulary: 2
Medical Condition The formulary begins on page 8. The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, Cardiovascular, Hypertension/ Lipids. If you know what your drug is used for, look for the category name in the list that begins on page number 8. Then look under the category name for your drug. Alphabetical Listing If you are not sure what category to look under, you should look for your drug in the Index that begins on page 6. The Index provides an alphabetical list of all of the drugs included in this document. Both brand name drugs and generic drugs are listed in the Index. Look in the Index and find your drug. Next to your drug, you will see the page number where you can find coverage information. Turn to the page listed in the Index and find the name of your drug in the first column of the list. What are generic drugs? Community HealthFirst MA Special Needs Plan covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs. Are there any restrictions on my coverage? Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include: Prior Authorization: Community HealthFirst MA Special Needs Plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval from our plan before you fill your prescriptions. If you don t get approval, our plan may not cover the drug. Quantity Limits: For certain drugs, Community HealthFirst MA Special Needs Plan limits the amount of the drug that our plan will cover. For example, our plan provides 68 tablets per prescription for bupropion hcl. This may be in addition to a standard one-month or three-month supply. Step Therapy: In some cases, Community HealthFirst MA Special Needs Plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if A and B both treat your medical condition, our plan may not cover B unless you try A first. If A does not work for you, we will then cover B. 3
You can find out if your drug has any additional requirements or limits by looking in the formulary that begins on page 8. You can also get more information about the restrictions applied to specific covered drugs by visiting our Web site. We have posted on line documents that explain our prior authorization and step therapy restrictions. You may also ask us to send you a copy. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You can ask Community HealthFirst MA Special Needs Plan to make an exception to these restrictions or limits or for a list of other, similar drugs that may treat your health condition. See the section, How do I request an exception to the Community HealthFirst MA Special Needs Plan s formulary? on page 4 for information about how to request an exception. What if my drug is not on the Formulary? If your drug is not included in this formulary (list of covered drugs), you should first contact Member Services and ask if your drug is covered. If you learn that Community HealthFirst MA Special Needs Plan does not cover your drug, you have two options: You can ask Member Services for a list of similar drugs that are covered by Community HealthFirst MA Special Needs Plan. When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by our plan. You can ask Community HealthFirst MA Special Needs Plan to make an exception and cover your drug. See below for information about how to request an exception. How do I request an exception to the Community HealthFirst MA Special Needs Plan s Formulary? You can ask us to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make. You can ask us to cover a drug even if it is not on our formulary. If approved, this drug will be covered at a pre-determined cost-sharing level, and you would not be able to ask us to provide the drug at a lower cost-sharing level. You can ask us to waive coverage restrictions or limits on your drug. For example, for certain drugs, our plan limits the amount of the drug that we will cover. If your drug has a quantity limit, you can ask us to waive the limit and cover a greater amount. Generally, Community HealthFirst MA Special Needs Plan will only approve your request for an exception if the alternative drugs included on the plan s formulary or 4
additional utilization restrictions would not be as effective in treating your condition and/or would cause you to have adverse medical effects. You should contact us to ask us for an initial coverage decision for a formulary or utilization restriction exception. When you request a formulary or utilization restriction exception you should submit a statement from your prescriber or physician supporting your request. Generally, we must make our decision within 72 hours of getting your prescriber s supporting statement. You can request an expedited (fast) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 72 hours for a decision. If your request to expedite is granted, we must give you a decision no later than 24 hours after we get a supporting statement from your doctor or other prescriber. What do I do before I can talk to my doctor about changing my drugs or requesting an exception? As a new or continuing member in our plan you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan. For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 34-day supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. After your first 34-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days. If you are a resident of a long-term care facility, we will allow you to refill your prescription until we have provided you with a 9 and may be up to 98-day transition supply, consistent with dispensing increment, (unless you have a prescription written for fewer days). We will cover more than one refill of these drugs for the first 90 days you are a member of our plan. If you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90days of membership in our plan, we will cover a 34-day emergency supply of that drug (unless you have a prescription for fewer days) while you pursue a formulary exception. Community HealthFirst MA Special Needs Plan will extend an override to current enrollees who experience level of care changes, such as a change in treatment settings. This allowance will be made for the 30-day period following the level of care change. 5
For more information For more detailed information about your Community HealthFirst MA Special Needs Plan prescription drug coverage, please review your Evidence of Coverage and other plan materials. If you have questions about Community HealthFirst MA Special Needs Plan, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. If you have general questions about Medicare prescription drug coverage, please call Medicare at -800-MEDICARE (-800-633-4227) 24 hours a day/7 days a week. TTY users should call -877-486-2048. Or, visit http://www.medicare.gov. Community HealthFirst MA Special Needs Plan s Formulary The formulary that begins on page 8 provides coverage information about the drugs covered by our plan. If you have trouble finding your drug in the list, turn to the Index that begins on page 6. The first column of the chart lists the drug name. Brand name drugs are capitalized (e.g., CRESTOR and generic drugs are listed in lower-case italics (e.g., simvastatin.) The information in the column tells you if Community HealthFirst MA Special Needs Plan has any special requirements for coverage of your drug. 6
Below is a list of abbreviations that may appear on the following pages in the column that tells you if there are any special requirements for coverage of your drug. List of Abbreviations B/D PA: This prescription drug may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the drug to make the determination. LA: Limited Availability. This prescription may be available only at certain pharmacies. For more information, please call Customer Service. MO: Mail-Order. This prescription drug is available through our mail-order service, as well as through our retail network pharmacies. Consider using mail order for your long-term (maintenance) medications (such as high blood pressure medications). Retail network pharmacies may be more appropriate for short-term prescriptions (such as antibiotics). PA: Prior Authorization. The Plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval before you fill your prescriptions. If you don t get approval, we may not cover the drug. QL: Quantity Limit. For certain drugs, the Plan limits the amount of the drug that we will cover. ST: Step Therapy. In some cases, the Plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if A and B both treat your medical condition, we may not cover B unless you try A first. If A does not work for you, we will then cover B. 7
Name ANTI - INFECTIVES ANTIFUNGAL AGENTS ABELCET B/D PA; MO AMBISOME B/D PA; MO amphotericin b B/D PA; MO CANCIDAS B/D PA; MO clotrimazole mucous membrane fluconazole fluconazole in dextrose(iso-o) intravenous piggyback 400 mg/200 ml flucytosine griseofulvin microsize griseofulvin ultramicrosize itraconazole ; QL (20 ketoconazole oral LAMISIL ORAL GRANULES IN PACKET MYCAMINE NOXAFIL ORAL nystatin oral suspension nystatin oral tablet SPORANOX ORAL SOLUTION terbinafine oral voriconazole ANTIVIRALS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 8 Name abacavir abacavirlamivudinezidovudine acyclovir oral acyclovir sodium intravenous solution B/D PA adefovir amantadine hcl oral APTIVUS ORAL CAPSULE APTIVUS ORAL SOLUTION ATRIPLA BARACLUDE cidofovir B/D PA; MO COMPLERA CRIXIVAN didanosine EDURANT EMTRIVA EPIVIR ORAL SOLUTION EPIVIR HBV ORAL SOLUTION EPZICOM famciclovir foscarnet B/D PA; MO FUZEON ganciclovir sodium INTELENCE ORAL TABLET 00 MG, 200 MG
Name INTELENCE ORAL TABLET 25 MG INVIRASE ISENTRESS ORAL POWDER IN PACKET ISENTRESS ORAL TABLET ISENTRESS ORAL TABLET,CHEWAB LE KALETRA lamivudine lamivudinezidovudine LEXIVA MODERIBA MODERIBA DOSE PACK ORAL TABLETS,DOSE PACK 400 MG (7)- 400 MG (7), 600 MG (7)- 600 MG (7) nevirapine NORVIR OLYSIO PA; MO PREZISTA ORAL SUSPENSION PREZISTA ORAL TABLET 50 MG, 600 MG, 75 MG, 800 MG RELENZA DISKHALER ; QL (60 per 80 days) RESCRIPTOR RETROVIR INTRAVENOUS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 9 Name REYATAZ RIBAPAK DOSE PACK ORAL TABLETS,DOSE PACK 400-400 MG (28)-MG (28), 600-400 MG (28)-MG (28), 600-600 MG (28)-MG (28) RIBASPHERE ORAL CAPSULE RIBASPHERE ORAL TABLET 200 MG, 600 MG RIBASPHERE ORAL TABLET 400 MG ribavirin rimantadine SELZENTRY SOVALDI PA; MO stavudine STRIBILD SUSTIVA SYNAGIS INTRAMUSCULA R SOLUTION 50 MG/0.5 ML TAMIFLU ORAL CAPSULE 30 MG TAMIFLU ORAL CAPSULE 45 MG, 75 MG TAMIFLU ORAL SUSPENSION FOR RECONSTITUTIO N ; LA ; QL (84 per 80 days) ; QL (42 per 80 days) ; QL (600 per 80 days) TIVICAY
Name TRUVADA TYZEKA valacyclovir ; QL (30 VALCYTE VICTRELIS VIDEX 2 GRAM PEDIATRIC VIRACEPT VIRAMUNE XR ORAL TABLET EXTENDED RELEASE 24 HR 00 MG VIRAZOLE VIREAD ZIAGEN ORAL SOLUTION zidovudine CEPHALOSPORINS cefaclor cefadroxil cefazolin injection recon soln gram cefazolin injection recon soln 0 gram, 500 mg cefazolin in dextrose (iso-os) intravenous piggyback gram/50 ml cefdinir cefditoren pivoxil cefepime Name cefotaxime injection recon soln gram, 2 gram, 500 mg cefotaxime injection recon soln 0 gram cefotetan cefoxitin intravenous recon soln gram cefoxitin intravenous recon soln 0 gram, 2 gram cefoxitin in dextrose, iso-osm cefpodoxime cefprozil ceftazidime injection recon soln gram, 6 gram ceftazidime injection recon soln 2 gram ceftriaxone injection recon soln 0 gram ceftriaxone injection recon soln 250 mg, 500 mg ceftriaxone intravenous cefuroxime axetil cefuroxime sodium injection cefuroxime sodium intravenous cephalexin SUPRAX ORAL CAPSULE You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 0
Name SUPRAX ORAL SUSPENSION FOR RECONSTITUTIO N 00 MG/5 ML, 200 MG/5 ML SUPRAX ORAL SUSPENSION FOR RECONSTITUTIO N 500 MG/5 ML SUPRAX ORAL TABLET SUPRAX ORAL TABLET,CHEWAB LE TEFLARO ERYTHROMYCINS / OTHER MACROLIDES azithromycin clarithromycin E.E.S. 400 E.E.S. GRANULES ERY-TAB ERYPED 200 ERYPED 400 ERYTHROCIN INTRAVENOUS RECON SOLN 500 MG ERYTHROCIN (AS STEARATE) erythromycin oral tablet erythromycin ethylsuccinate oral MISCELLANEOUS ANTIINFECTIVES You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. Name ALBENZA ALINIA amikacin injection solution 500 mg/2 ml atovaquone erythromycinsulfisoxazole atovaquoneproguanil aztreonam injection recon soln gram BACIIM bacitracin intramuscular BETHKIS B/D PA; MO; QL (224 per 28 days) CAPASTAT CAYSTON ; LA; QL (84 per 28 days) chloramphenicol sod succinate chloroquine phosphate oral clindamycin hcl clindamycin in dextrose 5 % CLINDAMYCIN PEDIATRIC clindamycin phosphate intravenous solution 600 mg/4 ml COARTEM colistin (colistimethate na) CUBICIN
Name dapsone DARAPRIM DORIBAX INTRAVENOUS SUSPENSION FOR RECONSTITUTIO N 500 MG ethambutol gentamicin injection solution 40 mg/ml gentamicin in nacl (iso-osm) intravenous piggyback 00 mg/00 ml, 60 mg/50 ml, 70 mg/50 ml, 80 mg/00 ml, 80 mg/50 ml, 90 mg/00 ml gentamicin sulfate (pf) intravenous solution 80 mg/8 ml hydroxychloroquine oral imipenem-cilastatin INVANZ INJECTION isoniazid injection isoniazid oral mefloquine meropenem intravenous recon soln 500 mg metronidazole oral capsule metronidazole oral tablet metronidazole in nacl (iso-os) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 2 Name NEBUPENT B/D PA; MO; QL (6 per 28 days) neomycin paromomycin PASER PENTAM polymyxin b sulfate PRIFTIN primaquine pyrazinamide quinine sulfate rifabutin rifampin SIRTURO ; LA streptomycin intramuscular STROMECTOL SYNERCID tinidazole tobramycin in 0.225 % nacl tobramycin in 0.9 % nacl intravenous piggyback 80 mg/00 ml tobramycin sulfate injection solution B/D PA; MO; QL (280 per 28 days) TRECATOR TYGACIL XIFAXAN
Name ZYVOX INTRAVENOUS PARENTERAL SOLUTION 600 MG/300 ML ZYVOX ORAL PENICILLINS amoxicillin amoxicillin-pot clavulanate ampicillin ampicillin sodium injection recon soln gram, 0 gram, 25 mg ampicillin-sulbactam injection recon soln 5 gram ampicillin-sulbactam injection recon soln 3 gram AUGMENTIN ORAL SUSPENSION FOR RECONSTITUTIO N 25-3.25 MG/5 ML BICILLIN C-R BICILLIN L-A dicloxacillin nafcillin injection recon soln gram, 0 gram nafcillin in dextrose iso-osm intravenous piggyback gram/50 ml You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 3 Name oxacillin injection recon soln 0 gram oxacillin intravenous recon soln 2 gram oxacillin in dextrose(iso-osm) penicillin g potassium injection recon soln 5 million unit penicillin g procaine intramuscular syringe.2 million unit/2 ml penicillin g sodium penicillin v potassium PFIZERPEN-G INJECTION RECON SOLN 5 MILLION UNIT piperacillintazobactam intravenous recon soln 3.375 gram, 4.5 gram QUINOLONES AVELOX IN NACL (ISO-OSMOTIC) ciprofloxacin intravenous solution 400 mg/40 ml ciprofloxacin oral suspension,microcap sule recon ciprofloxacin oral tablet ciprofloxacin (mixture)
Name ciprofloxacin in 5 % dextrose intravenous piggyback 200 mg/00 ml levofloxacin intravenous levofloxacin oral levofloxacin in d5w intravenous piggyback 500 mg/00 ml moxifloxacin ofloxacin oral SULFA'S / RELATED AGENTS sulfadiazine oral sulfamethoxazoletrimethoprim TETRACYCLINES demeclocycline doxycycline hyclate intravenous doxycycline hyclate oral doxycycline monohydrate oral capsule 50 mg, 75 mg doxycycline monohydrate oral suspension for reconstitution doxycycline monohydrate oral tablet 50 mg, 50 mg, 75 mg minocycline oral tetracycline Name URINARY TRACT AGENTS MACRODANTIN ORAL CAPSULE 25 MG methenamine hippurate nitrofurantoin oral nitrofurantoin macrocrystal oral capsule 50 mg nitrofurantoin monohyd/m-cryst PRIMSOL trimethoprim VANCOMYCIN vancomycin intravenous recon soln,000 mg, 0 gram, 500 mg vancomycin oral ANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGS ADJUNCTIVE AGENTS amifostine crystalline dexrazoxane intravenous recon soln 250 mg ELITEK INTRAVENOUS RECON SOLN.5 MG FUSILEV KEPIVANCE You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 4
Name leucovorin calcium injection recon soln 00 mg, 350 mg leucovorin calcium oral mesna MESNEX ORAL XGEVA ANTINEOPLASTIC / IMMUNOSUPPRESSANT DRUGS ABRAXANE AFINITOR ORAL TABLET 0 MG AFINITOR ORAL TABLET 2.5 MG, 5 MG, 7.5 MG AFINITOR DISPERZ ALIMTA INTRAVENOUS RECON SOLN 500 MG PA; MO; QL (60 per 30 days) PA; MO PA; MO anastrozole ARRANON ARZERRA INTRAVENOUS SOLUTION 00 MG/5 ML B/D PA; MO AVASTIN azacitidine AZASAN B/D PA; MO azathioprine B/D PA; MO bicalutamide BICNU Name bleomycin injection recon soln 30 unit BOSULIF ORAL TABLET 00 MG BOSULIF ORAL TABLET 500 MG BUSULFEX CAPRELSA ORAL TABLET 00 MG CAPRELSA ORAL TABLET 300 MG carboplatin intravenous solution CELLCEPT ORAL SUSPENSION FOR RECONSTITUTIO N CELLCEPT INTRAVENOUS PA; MO PA; MO; QL (30 per 30 days) ; LA ; LA; QL (30 per 30 days) B/D PA; MO B/D PA cisplatin cladribine CLOLAR COMETRIQ PA; MO cyclophosphamide oral capsule cyclophosphamide oral tablet cyclosporine intravenous B/D PA B/D PA; MO B/D PA cyclosporine oral B/D PA; MO cyclosporine modified B/D PA; MO cytarabine You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 5
Name cytarabine (pf) injection solution 2 gram/20 ml (00 mg/ml) dacarbazine intravenous recon soln 200 mg daunorubicin intravenous solution decitabine DOCEFREZ docetaxel intravenous solution 80 mg/4 ml (20 mg/ml) docetaxel intravenous solution 80 mg/8 ml (0 mg/ml) DOXIL doxorubicin intravenous solution 50 mg/25 ml DROXIA ELIGARD PA; MO EMCYT epirubicin intravenous solution 50 mg/25 ml ERBITUX INTRAVENOUS SOLUTION 00 MG/50 ML ERIVEDGE PA; MO; QL (30 per 30 days) ERWINAZE ETOPOPHOS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 6 Name etoposide intravenous exemestane FARESTON FASLODEX FIRMAGON KIT W DILUENT SYRINGE fludarabine intravenous recon soln fluorouracil intravenous solution 2.5 gram/50 ml flutamide FOLOTYN INTRAVENOUS SOLUTION 40 MG/2 ML (20 MG/ML) gemcitabine intravenous recon soln gram GENGRAF B/D PA; MO GILOTRIF ORAL TABLET 20 MG GILOTRIF ORAL TABLET 30 MG GILOTRIF ORAL TABLET 40 MG GLEEVEC ORAL TABLET 00 MG GLEEVEC ORAL TABLET 400 MG PA; MO; QL (60 per 30 days) PA; MO; QL (40 per 30 days) PA; MO; QL (30 per 30 days) PA; MO PA; MO; QL (60 per 30 days)
Name HALAVEN HERCEPTIN HEXALEN hydroxyurea idarubicin ifosfamide intravenous recon soln gram IMBRUVICA PA; MO; QL (20 per 30 days) INLYTA ORAL TABLET MG INLYTA ORAL TABLET 5 MG irinotecan intravenous solution 00 mg/5 ml PA; MO PA; MO; QL (20 per 30 days) ISTODAX IXEMPRA INTRAVENOUS RECON SOLN 45 MG JAKAFI ORAL TABLET 0 MG, 5 MG, 20 MG, 5 MG JAKAFI ORAL TABLET 25 MG PA; MO PA; MO; QL (60 per 30 days) JEVTANA KADCYLA INTRAVENOUS RECON SOLN 00 MG letrozole LEUKERAN Name leuprolide lomustine LUPRON DEPOT PA; MO LUPRON DEPOT (3 MONTH) LUPRON DEPOT (4 MONTH) LUPRON DEPOT (6 MONTH) LUPRON DEPOT- PED INTRAMUSCULA R KIT.25 MG, 5 MG PA; MO PA; MO PA; MO PA; MO LYSODREN MATULANE megestrol oral suspension 400 mg/0 ml (40 mg/ml) megestrol oral tablet MEKINIST ORAL TABLET 0.5 MG MEKINIST ORAL TABLET 2 MG melphalan PA; MO; QL (20 per 30 days) PA; MO; QL (30 per 30 days) mercaptopurine methotrexate sodium oral methotrexate sodium (pf) injection recon soln methotrexate sodium (pf) injection solution B/D PA; MO B/D PA B/D PA; MO You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 7
Name mitomycin intravenous recon soln 20 mg mitoxantrone MUSTARGEN mycophenolate mofetil mycophenolate sodium B/D PA; MO B/D PA; MO NEXAVAR PA; MO; LA NILANDRON NULOJIX B/D PA; MO octreotide acetate injection solution ONCASPAR oxaliplatin intravenous solution 00 mg/20 ml paclitaxel PERJETA POMALYST PROGRAF INTRAVENOUS RAPAMUNE ORAL SOLUTION RAPAMUNE ORAL TABLET MG, 2 MG B/D PA; MO B/D PA; MO B/D PA; MO REVLIMID PA; MO; LA RITUXAN PA; MO SANDOSTATIN LAR DEPOT SIGNIFOR PA; MO Name SIMULECT INTRAVENOUS RECON SOLN 20 MG B/D PA; MO sirolimus B/D PA; MO SOLTAMOX SPRYCEL ORAL TABLET 00 MG, 20 MG, 50 MG, 80 MG SPRYCEL ORAL TABLET 40 MG SPRYCEL ORAL TABLET 70 MG PA; MO PA; MO; QL (30 per 30 days) PA; MO; QL (60 per 30 days) STIVARGA PA; MO; QL (84 per 28 days) SUTENT ORAL CAPSULE 2.5 MG SUTENT ORAL CAPSULE 25 MG SUTENT ORAL CAPSULE 50 MG SYLVANT INTRAVENOUS RECON SOLN 00 MG PA; MO PA; MO; QL (60 per 30 days) PA; MO; QL (30 per 30 days) SYNRIBO TABLOID tacrolimus B/D PA; MO TAFINLAR ORAL CAPSULE 50 MG PA; MO; QL (80 per 30 days) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 8
Name TAFINLAR ORAL CAPSULE 75 MG PA; MO; QL (20 per 30 days) tamoxifen TARCEVA ORAL TABLET 00 MG, 25 MG TARCEVA ORAL TABLET 50 MG PA; MO PA; MO; QL (30 per 30 days) TARGRETIN TASIGNA ORAL CAPSULE 50 MG TASIGNA ORAL CAPSULE 200 MG PA; MO PA; MO; QL (2 per 28 days) THALOMID PA; MO TOPOSAR topotecan intravenous recon soln TORISEL TREANDA INTRAVENOUS RECON SOLN 00 MG TRELSTAR TRELSTAR DEPOT TRELSTAR LA tretinoin (chemotherapy) TRISENOX TYKERB PA; MO; LA; QL (80 per 30 days) Name VECTIBIX INTRAVENOUS SOLUTION 00 MG/5 ML (20 MG/ML) B/D PA; MO VELCADE vinblastine intravenous solution vincristine intravenous solution mg/ml vinorelbine intravenous solution 50 mg/5 ml VOTRIENT PA; MO; QL (20 per 30 days) XALKORI ORAL CAPSULE 200 MG XALKORI ORAL CAPSULE 250 MG PA; MO PA; MO; QL (60 per 30 days) XTANDI PA; MO; QL (20 per 30 days) YERVOY INTRAVENOUS SOLUTION 50 MG/0 ML (5 MG/ML) ZALTRAP INTRAVENOUS SOLUTION 00 MG/4 ML (25 MG/ML) ZANOSAR ZELBORAF PA; MO; QL (240 per 30 days) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 9
Name ZOLINZA ZORTRESS B/D PA; MO ZYKADIA PA; MO; QL (50 per 30 days) ZYTIGA PA; MO; QL (20 per 30 days) AUTONOMIC / CNS DRUGS, NEUROLOGY / PSYCH ANTICONVULSANTS APTIOM BANZEL carbamazepine CELONTIN clonazepam PA; MO diazepam rectal PA; MO DILANTIN divalproex EPITOL ethosuximide felbamate fosphenytoin injection solution 00 mg pe/2 ml FYCOMPA gabapentin oral capsule gabapentin oral solution 250 mg/5 ml gabapentin oral tablet Name GABITRIL ORAL TABLET 2 MG, 6 MG lamotrigine oral tablet lamotrigine oral tablet extended release 24hr lamotrigine oral tablet, chewable dispersible levetiracetam intravenous levetiracetam oral solution 00 mg/ml levetiracetam oral tablet levetiracetam oral tablet extended release 24 hr LYRICA PA; MO ONFI PA; MO oxcarbazepine PEGANONE phenobarbital phenytoin oral suspension 25 mg/5 ml phenytoin oral tablet,chewable phenytoin sodium intravenous solution phenytoin sodium extended POTIGA primidone You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 20
Name SABRIL ; LA TEGRETOL XR ORAL TABLET EXTENDED RELEASE 2 HR 00 MG tiagabine topiramate oral capsule, sprinkle topiramate oral tablet PA; MO PA; MO valproate sodium valproic acid valproic acid (as sodium salt) oral solution 250 mg/5 ml VIMPAT INTRAVENOUS VIMPAT ORAL zonisamide PA; MO ANTIPARKINSONISM AGENTS APOKYN ; LA AZILECT benztropine bromocriptine carbidopa carbidopa-levodopa carbidopa-levodopaentacapone entacapone NEUPRO pramipexole ropinirole selegiline hcl Name MIGRAINE / CLUSTER HEADACHE THERAPY dihydroergotamine injection ERGOMAR MIGERGOT naratriptan ; QL (8 per 28 days) rizatriptan ; QL (36 per 28 days) sumatriptan nasal spray,non-aerosol 20 mg/actuation sumatriptan nasal spray,non-aerosol 5 mg/actuation sumatriptan succinate oral sumatriptan succinate subcutaneous pen injector 6 mg/0.5 ml sumatriptan succinate subcutaneous solution ; QL (8 per 28 days) ; QL (36 per 28 days) ; QL (8 per 28 days) ; QL (6 per 28 days) ; QL (6 per 28 days) zolmitriptan ; QL (8 per 28 days) MISCELLANEOUS NEUROLOGICAL THERAPY AMPYRA PA; MO; LA COPAXONE SUBCUTANEOUS SYRINGE KIT PA; MO; QL (30 per 30 days) donepezil EXELON TRANSDERMAL ST; MO You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 2
Name galantamine GILENYA PA; MO NAMENDA PA; MO NAMENDA TITRATION PAK PA; MO NUEDEXTA rivastigmine tartrate TECFIDERA PA; MO TYSABRI PA; MO; LA XENAZINE PA; MO; LA MUSCLE RELAXANTS / ANTISPASMODIC THERAPY baclofen cyclobenzaprine PA; MO dantrolene GABLOFEN INTRATHECAL SOLUTION 0,000 MCG/20ML (500 MCG/ML), 40,000 MCG/20ML (2,000 MCG/ML) GABLOFEN INTRATHECAL SYRINGE 50 MCG/ML ( ML) LIORESAL INTRATHECAL SOLUTION 2,000 MCG/ML, 500 MCG/ML LIORESAL INTRATHECAL SOLUTION 50 MCG/ML MESTINON ORAL SYRUP B/D PA; MO B/D PA; MO B/D PA; MO B/D PA Name MESTINON TIMESPAN pyridostigmine bromide tizanidine NARCOTIC ANALGESICS acetaminophencodeine oral solution 300 mg-30 mg /2.5 ml acetaminophencodeine oral tablet 300-5 mg, 300-30 mg acetaminophencodeine oral tablet 300-60 mg buprenorphine injection syringe buprenorphine sublingual tablet, sublingual 2 mg buprenorphine sublingual tablet, sublingual 8 mg codeine sulfate oral tablet DURAMORPH (PF) INJECTION SOLUTION 0.5 MG/ML DURAMORPH (PF) INJECTION SOLUTION MG/ML ENDOCET ORAL TABLET 0-325 MG, 5-325 MG, 7.5-325 MG QL (4500 per 30 days) ; QL (360 ; QL (80 QL (267 per 30 days) ; QL (300 ; QL (75 ; QL (80 ; QL (4000 QL (2000 per 30 days) ; QL (360 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 22
Name ENDODAN ; QL (360 fentanyl citrate buccal lozenge on a handle,200 mcg fentanyl citrate buccal lozenge on a handle,600 mcg fentanyl citrate buccal lozenge on a handle 200 mcg fentanyl citrate buccal lozenge on a handle 400 mcg fentanyl citrate buccal lozenge on a handle 600 mcg fentanyl citrate buccal lozenge on a handle 800 mcg fentanyl patches transdermal patch 72 hour 00 mcg/hr fentanyl patches transdermal patch 72 hour 2 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr hydrocodoneacetaminophen oral solution 7.5-325 mg/5 ml hydrocodoneacetaminophen oral tablet 0-300 mg, 0-325 mg, 5-300 mg, 5-325 mg, 7.5-300 mg, 7.5-325 mg PA; MO; QL (39 per 30 days) PA; MO; QL (29 per 30 days) PA; MO; QL (20 per 30 days) PA; MO; QL (6 per 30 days) PA; MO; QL (77 per 30 days) PA; MO; QL (58 per 30 days) ; QL (9 per 30 days) ; QL (0 ; QL (5550 ; QL (360 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 23 Name hydrocodoneibuprofen oral tablet 7.5-200 mg hydromorphone oral liquid hydromorphone oral tablet hydromorphone oral tablet extended release 24 hr 2 mg, 6 mg, 8 mg hydromorphone (pf) injection solution 0 mg/ml ; QL (50 ; QL (300 ; QL (80 ; QL (60 ; QL (20 ibuprofen-oxycodone ; QL (28 levorphanol tartrate ; QL (20 LORCET (HYDROCODONE) QL (360 per 30 days) LORCET HD ; QL (360 LORCET PLUS QL (360 per 30 days) LORTAB 0-325 ; QL (360 LORTAB 5-325 ; QL (360 LORTAB 7.5-325 ; QL (360 methadone injection QL (60 per 30 days) methadone oral solution 0 mg/5 ml methadone oral solution 5 mg/5 ml methadone oral tablet 0 mg ; QL (600 ; QL (200 ; QL (20
Name methadone oral tablet 5 mg morphine intravenous syringe 2 mg/ml morphine intravenous syringe 4 mg/ml morphine oral capsule, er multiphase 24 hr 20 mg morphine oral capsule, er multiphase 24 hr 30 mg, 45 mg, 60 mg, 75 mg, 90 mg morphine oral capsule,extend.relea se pellets 0 mg, 20 mg, 30 mg, 50 mg, 60 mg morphine oral capsule,extend.relea se pellets 00 mg morphine oral capsule,extend.relea se pellets 80 mg morphine oral solution ; QL (240 QL (000 per 30 days) QL (500 per 30 days) ; QL (50 ; QL (60 ; QL (90 ; QL (60 ; QL (75 ; QL (900 morphine oral tablet ; QL (80 morphine oral tablet extended release 00 mg morphine oral tablet extended release 5 mg, 30 mg ; QL (60 ; QL (20 Name morphine oral tablet extended release 200 mg morphine oral tablet extended release 60 mg morphine concentrate oral solution oxycodone oral capsule oxycodone oral concentrate oxycodone oral solution oxycodone oral tablet 0 mg, 5 mg, 20 mg oxycodone oral tablet 30 mg oxycodone oral tablet 5 mg oxycodoneacetaminophen ; QL (30 ; QL (00 ; QL (300 ; QL (360 ; QL (80 ; QL (200 ; QL (80 ; QL (34 ; QL (360 ; QL (360 oxycodone-aspirin ; QL (360 oxymorphone oral tablet 0 mg oxymorphone oral tablet 5 mg oxymorphone oral tablet extended release 2 hr 0 mg, 5 mg, 20 mg, 5 mg, 7.5 mg oxymorphone oral tablet extended release 2 hr 30 mg ; QL (200 ; QL (80 ; QL (90 ; QL (67 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 24
Name oxymorphone oral tablet extended release 2 hr 40 mg ; QL (50 REPREXAIN ; QL (50 VICODIN ; QL (360 VICODIN ES ; QL (360 VICODIN HP ; QL (360 ZAMICET ; QL (5550 NON-NARCOTIC ANALGESICS butorphanol tartrate injection solution mg/ml butorphanol tartrate injection solution 2 mg/ml butorphanol tartrate nasal PA; MO; QL (90 per 30 days) ; QL (720 ; QL (360 ; QL (40 CELEBREX diclofenac potassium diclofenac sodium oral diclofenac sodium topical drops buprenorphinenaloxone diclofenacmisoprostol diflunisal etodolac fenoprofen oral tablet You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 25 Name flurbiprofen ibuprofen oral suspension ibuprofen oral tablet 400 mg, 600 mg, 800 mg ketoprofen meclofenamate oral mefenamic acid meloxicam oral suspension meloxicam oral tablet 5 mg meloxicam oral tablet 7.5 mg ; QL (30 nabumetone nalbuphine injection solution 0 mg/ml nalbuphine injection solution 20 mg/ml naloxone injection syringe mg/ml ; QL (200 ; QL (00 naltrexone naproxen naproxen sodium oral tablet 275 mg, 550 mg oxaprozin piroxicam sulindac oral tolmetin tramadol oral tablet ; QL (240
Name tramadol oral tablet extended release 24 hr 00 mg, 200 mg tramadol oral tablet, er multiphase 24 hr 300 mg tramadolacetaminophen ; QL (30 ; QL (30 ; QL (240 VOLTAREN GEL ST; MO ZUBSOLV PA; MO; QL (90 per 30 days) PSYCHOTHERAPEUTIC DRUGS ABILIFY INTRAMUSCULA R ABILIFY ORAL SOLUTION ABILIFY ORAL TABLET 0 MG ABILIFY ORAL TABLET 5 MG, 20 MG ABILIFY ORAL TABLET 2 MG ABILIFY ORAL TABLET 30 MG ABILIFY ORAL TABLET 5 MG ABILIFY DISCMELT ORAL TABLET,DISINTE GRATING 0 MG ABILIFY DISCMELT ORAL TABLET,DISINTE GRATING 5 MG ; QL (90 ; QL (60 ; QL (450 ; QL (30 ; QL (80 ; QL (90 ; QL (60 Name ABILIFY MAINTENA INTRAMUSCULA R SUSPENSION,EXT ENDED REL RECON 300 MG alprazolam oral tablet amitriptyline PA; MO amoxapine AMPHETAMINE SALT COMBO BRINTELLIX ORAL TABLET 0 MG BRINTELLIX ORAL TABLET 20 MG BRINTELLIX ORAL TABLET 5 MG bupropion hcl oral tablet bupropion hcl oral tablet extended release 00 mg bupropion hcl oral tablet extended release 50 mg bupropion hcl oral tablet extended release 200 mg bupropion hcl oral tablet extended release 24 hr 50 mg bupropion hcl oral tablet extended release 24 hr 300 mg ; QL (60 ; QL (30 ; QL (20 ; QL (20 ; QL (90 ; QL (60 ; QL (90 ; QL (60 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 26
Name buspirone chlorpromazine citalopram oral solution citalopram oral tablet 0 mg citalopram oral tablet 20 mg citalopram oral tablet 40 mg ; QL (20 ; QL (60 ; QL (30 clomipramine PA; MO clonidine hcl oral tablet extended release 2 hr clorazepate dipotassium clozapine oral tablet PA; MO desipramine oral dexmethylphenidate dextroamphetamine oral capsule, extended release dextroamphetamine oral tablet dextroamphetamineamphetamine diazepam oral solution 5 mg/5 ml PA; MO diazepam oral tablet PA; MO DIAZEPAM INTENSOL PA; MO doxepin oral PA; MO duloxetine oral capsule,delayed release(dr/ec) 20 mg ; QL (80 Name duloxetine oral capsule,delayed release(dr/ec) 30 mg duloxetine oral capsule,delayed release(dr/ec) 60 mg ; QL (20 ; QL (60 EMSAM ergoloid escitalopram oxalate oral solution escitalopram oxalate oral tablet 0 mg escitalopram oxalate oral tablet 20 mg escitalopram oxalate oral tablet 5 mg ; QL (60 ; QL (30 ; QL (20 eszopiclone ST; MO; QL (30 per 30 days) FANAPT ORAL TABLET MG FANAPT ORAL TABLET 0 MG, 8 MG FANAPT ORAL TABLET 2 MG FANAPT ORAL TABLET 2 MG FANAPT ORAL TABLET 4 MG FANAPT ORAL TABLET 6 MG FANAPT ORAL TABLETS,DOSE PACK ; QL (720 ; QL (90 ; QL (60 ; QL (360 ; QL (80 ; QL (20 QL (8 per 28 days) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 27
Name FAZACLO ORAL TABLET,DISINTE GRATING 50 MG, 200 MG FETZIMA ORAL CAPSULE,EXT REL 24HR DOSE PACK FETZIMA ORAL CAPSULE,EXTEN DED RELEASE 24 HR 20 MG FETZIMA ORAL CAPSULE,EXTEN DED RELEASE 24 HR 20 MG FETZIMA ORAL CAPSULE,EXTEN DED RELEASE 24 HR 40 MG FETZIMA ORAL CAPSULE,EXTEN DED RELEASE 24 HR 80 MG fluoxetine oral capsule 0 mg fluoxetine oral capsule 20 mg fluoxetine oral capsule 40 mg fluoxetine oral capsule,delayed release(dr/ec) fluoxetine oral solution fluoxetine oral tablet 0 mg fluoxetine oral tablet 20 mg ST; MO; QL (28 per 28 days) ST; MO; QL (30 per 30 days) ST; MO; QL (80 per 30 days) ST; MO; QL (90 per 30 days) ST; MO; QL (45 per 30 days) ; QL (240 ; QL (60 ; QL (4 per 28 days) ; QL (240 Name fluphenazine decanoate fluphenazine hcl fluvoxamine oral capsule,extended release 24hr 00 mg fluvoxamine oral capsule,extended release 24hr 50 mg fluvoxamine oral tablet 00 mg fluvoxamine oral tablet 25 mg fluvoxamine oral tablet 50 mg GEODON INTRAMUSCULA R ; QL (90 ; QL (60 ; QL (90 ; QL (360 ; QL (80 guanidine haloperidol haloperidol decanoate haloperidol lactate imipramine hcl PA; MO imipramine pamoate PA; MO INVEGA ORAL TABLET EXTENDED RELEASE 24HR.5 MG INVEGA ORAL TABLET EXTENDED RELEASE 24HR 3 MG ; QL (240 ; QL (20 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 28
Name INVEGA ORAL TABLET EXTENDED RELEASE 24HR 6 MG INVEGA ORAL TABLET EXTENDED RELEASE 24HR 9 MG INVEGA SUSTENNA LATUDA ORAL TABLET 20 MG LATUDA ORAL TABLET 20 MG LATUDA ORAL TABLET 40 MG LATUDA ORAL TABLET 60 MG, 80 MG ; QL (60 ; QL (4 ; QL (30 ; QL (240 ; QL (20 ; QL (60 lithium carbonate lithium citrate lorazepam oral tablet LORAZEPAM INTENSOL PA; MO PA; MO loxapine succinate maprotiline MARPLAN METADATE ER methamphetamine methylphenidate oral capsule, er biphasic 30-70 0 mg, 50 mg, 60 mg Name methylphenidate oral capsule,er biphasic 50-50 methylphenidate oral solution methylphenidate oral tablet methylphenidate oral tablet extended release methylphenidate oral tablet extended release 24hr mirtazapine modafinil PA; MO nefazodone nortriptyline olanzapine intramuscular olanzapine oral tablet 0 mg olanzapine oral tablet 5 mg, 20 mg olanzapine oral tablet 2.5 mg olanzapine oral tablet 5 mg olanzapine oral tablet 7.5 mg olanzapine oral tablet,disintegrating 0 mg olanzapine oral tablet,disintegrating 5 mg, 20 mg ; QL (60 ; QL (30 ; QL (240 ; QL (20 ; QL (8 ; QL (60 ; QL (30 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 29
Name olanzapine oral tablet,disintegrating 5 mg ; QL (20 ORAP oxazepam PA; MO paroxetine hcl oral tablet 0 mg paroxetine hcl oral tablet 20 mg paroxetine hcl oral tablet 30 mg paroxetine hcl oral tablet 40 mg paroxetine hcl oral tablet extended release 24 hr 2.5 mg paroxetine hcl oral tablet extended release 24 hr 25 mg paroxetine hcl oral tablet extended release 24 hr 37.5 mg PAXIL ORAL SUSPENSION ; QL (80 ; QL (90 ; QL (60 ; QL (45 ; QL (80 ; QL (90 ; QL (60 perphenazine olanzapinefluoxetine perphenazineamitriptyline PA; MO phenelzine PRISTIQ ORAL TABLET EXTENDED RELEASE 24 HR 00 MG ST; MO; QL (20 per 30 days) Name PRISTIQ ORAL TABLET EXTENDED RELEASE 24 HR 50 MG ST; MO; QL (240 per 30 days) PROCENTRA protriptyline quetiapine oral tablet 00 mg quetiapine oral tablet 200 mg quetiapine oral tablet 25 mg quetiapine oral tablet 300 mg quetiapine oral tablet 400 mg quetiapine oral tablet 50 mg RISPERDAL CONSTA risperidone oral solution risperidone oral tablet 0.25 mg risperidone oral tablet 0.5 mg risperidone oral tablet mg risperidone oral tablet 2 mg risperidone oral tablet 3 mg risperidone oral tablet 4 mg ; QL (240 ; QL (20 ; QL (902 ; QL (8 ; QL (60 ; QL (480 ; QL (480 ; QL (920 ; QL (960 ; QL (480 ; QL (240 ; QL (6 ; QL (20 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 30
Name risperidone oral tablet,disintegrating 0.25 mg risperidone oral tablet,disintegrating 0.5 mg risperidone oral tablet,disintegrating mg risperidone oral tablet,disintegrating 2 mg risperidone oral tablet,disintegrating 3 mg risperidone oral tablet,disintegrating 4 mg ; QL (920 ; QL (960 ; QL (480 ; QL (240 ; QL (6 ; QL (20 ROZEREM ; QL (30 SAPHRIS SUBLINGUAL TABLET, SUBLINGUAL 0 MG SAPHRIS SUBLINGUAL TABLET, SUBLINGUAL 5 MG SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET, SUBLINGUAL 0 MG ; QL (60 ; QL (20 ; QL (60 Name SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET, SUBLINGUAL 5 MG SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 50 MG SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 200 MG SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 300 MG SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 400 MG SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 50 MG sertraline oral concentrate sertraline oral tablet 00 mg sertraline oral tablet 25 mg sertraline oral tablet 50 mg ; QL (20 ; QL (6 ; QL (20 ; QL (8 ; QL (60 ; QL (480 ; QL (60 ; QL (240 ; QL (20 STRATTERA You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 3
Name SURMONTIL PA; MO temazepam PA; MO thioridazine thiothixene tranylcypromine trazodone trifluoperazine venlafaxine oral capsule,extended release 24hr 50 mg venlafaxine oral capsule,extended release 24hr 37.5 mg venlafaxine oral capsule,extended release 24hr 75 mg venlafaxine oral tablet 00 mg, 75 mg venlafaxine oral tablet 25 mg venlafaxine oral tablet 37.5 mg venlafaxine oral tablet 50 mg ; QL (60 ; QL (80 ; QL (90 ; QL (90 VERSACLOZ LA VIIBRYD ORAL TABLET 0 MG VIIBRYD ORAL TABLET 20 MG VIIBRYD ORAL TABLET 40 MG VIIBRYD ORAL TABLETS,DOSE PACK ; QL (270 ; QL (80 ; QL (50 ; QL (20 ; QL (60 ; QL (30 ; QL (30 XYREM ; LA Name zaleplon oral capsule 0 mg zaleplon oral capsule 5 mg ZENZEDI ORAL TABLET 0 MG, 5 MG ziprasidone hcl oral capsule 20 mg ziprasidone hcl oral capsule 40 mg ziprasidone hcl oral capsule 60 mg ziprasidone hcl oral capsule 80 mg ST; MO; QL (60 per 30 days) ST; MO; QL (30 per 30 days) ; QL (240 ; QL (20 ; QL (80 ; QL (60 zolpidem ST; MO; QL (30 per 30 days) CARDIOVASCULAR, HYPERTENSION / LIPIDS ANTIARRHYTHMIC AGENTS amiodarone intravenous solution amiodarone oral tablet 200 mg, 400 mg B/D PA; MO flecainide mexiletine PACERONE procainamide injection solution 00 mg/ml procainamide injection solution 500 mg/ml You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 32
Name propafenone quinidine gluconate quinidine sulfate SORINE ORAL TABLET 20 MG, 60 MG, 80 MG SORINE ORAL TABLET 240 MG sotalol oral tablet 60 mg, 240 mg, 80 mg SOTALOL AF ORAL TABLET 20 MG TIKOSYN ANTIHYPERTENSIVE THERAPY acebutolol oral AFEDITAB CR amiloride amlodipine atenolol benazepril betaxolol oral bisoprolol fumarate bumetanide You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 33 Name candesartan captopril amiloridehydrochlorothiazide amlodipinebenazepril atenololchlorthalidone benazeprilhydrochlorothiazide bisoprololhydrochlorothiazide candesartanhydrochlorothiazid captoprilhydrochlorothiazide CARTIA XT carvedilol chlorothiazide chlorothiazide sodium chlorthalidone clonidine ; QL (4 per 28 days) clonidine hcl oral tablet CLORPRES ORAL TABLET 0.-5 MG, 0.3-5 MG DEMSER DIBENZYLINE DILT-XR diltiazem hcl intravenous diltiazem hcl oral capsule, extended release 80 mg, 360 mg, 420 mg diltiazem hcl oral capsule,extended release 2 hr diltiazem hcl oral capsule,extended release 24hr 20 mg, 240 mg, 300 mg
Name diltiazem hcl oral tablet doxazosin oral tablet mg, 2 mg, 4 mg doxazosin oral tablet 8 mg ; QL (30 ; QL (60 DUTOPROL enalapril maleate eplerenone eprosartan felodipine fosinopril furosemide injection solution furosemide oral hydralazine hydrochlorothiazide indapamide irbesartan isradipine labetalol intravenous solution labetalol oral lisinopril losartan Name enalaprilhydrochlorothiazide fosinoprilhydrochlorothiazide irbesartanhydrochlorothiazide lisinoprilhydrochlorothiazide losartanhydrochlorothiazide MATZIM LA methyclothiazide methyldopa metolazone metoprolol succinate metoprolol tartrate intravenous solution metoprolol tartrate oral minoxidil oral moexipril nadolol metoprolol tahydrochlorothiaz moexiprilhydrochlorothiazide nadololbendroflumethiazide nicardipine NIFEDICAL XL nifedipine oral tablet extended release 24hr nimodipine nisoldipine perindopril erbumine pindolol prazosin propranolol intravenous propranolol oral You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 34
Name quinapril ramipril REMODULIN PA; MO; LA spironolactone TAZTIA XT telmisartan terazosin oral capsule mg, 2 mg, 5 mg terazosin oral capsule 0 mg ; QL (30 ; QL (60 timolol maleate oral torsemide intravenous solution 20 mg/2 ml (0 mg/ml) torsemide oral trandolapril propranololhydrochlorothiazid quinaprilhydrochlorothiazide spironolactonhydrochlorothiaz telmisartanamlodipine telmisartanhydrochlorothiazid triamterenehydrochlorothiazid valsartanhydrochlorothiazide verapamil intravenous solution verapamil oral Name CARDIAC GLYCOSIDES digoxin oral LANOXIN ORAL TABLET 87.5 MCG LANOXIN ORAL TABLET 62.5 MCG COAGULATION THERAPY AGGRENOX BRILINTA cilostazol clopidogrel dipyridamole oral EFFIENT ELIQUIS enoxaparin fondaparinux heparin (porcine) injection solution heparin (porcine) in 5 % dex intravenous parenteral solution 20,000 unit/500 ml (40 unit/ml), 25,000 unit/250 ml(00 unit/ml) heparin (porcine) in 5 % dex intravenous parenteral solution 25,000 unit/500 ml (50 unit/ml) heparin (porcine) in nacl (pf) intravenous parenteral solution,000 unit/500 ml JANTOVEN You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 35
Name pentoxifylline PROMACTA PA; MO; LA tranexamic acid intravenous warfarin XARELTO LIPID/CHOLESTEROL LOWERING AGENTS ADVICOR ORAL TABLET, ER MULTIPHASE 24 HR,000-20 MG, 750-20 MG ADVICOR ORAL TABLET, ER MULTIPHASE 24 HR,000-40 MG, 500-20 MG amlodipineatorvastatin ; QL (60 ; QL (30 ; QL (30 atorvastatin ; QL (30 CHOLESTYRAMI NE LIGHT ORAL POWDER IN PACKET colestipol oral granules colestipol oral tablet fenofibrate oral tablet fenofibrate micronized fenofibrate nanocrystallized fenofibric acid (choline) Name fluvastatin oral capsule 20 mg fluvastatin oral capsule 40 mg ; QL (30 ; QL (60 gemfibrozil oral JUXTAPID ; LA KYNAMRO ; LA lovastatin oral tablet 0 mg lovastatin oral tablet 20 mg, 40 mg niacin oral tablet extended release 24 hr omega-3 acid ethyl esters ; QL (30 ; QL (60 pravastatin ; QL (30 PREVALITE ORAL POWDER simvastatin ; QL (30 WELCHOL ZETIA MISCELLANEOUS CARDIOVASCULAR AGENTS RANEXA VECAMYL NITRATES isosorbide dinitrate isosorbide mononitrate NITRO-BID nitroglycerin intravenous B/D PA You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 36
Name nitroglycerin transdermal nitroglycerin translingual spray,non-aerosol NITROSTAT DERMATOLOGICALS/TOPICAL THERAPY ANTIPSORIATIC / ANTISEBORRHEIC acitretin calcipotriene calcitriol topical selenium sulfide topical suspension BURN THERAPY silver sulfadiazine SSD MISCELLANEOUS DERMATOLOGICALS 8-MOP ammonium lactate CARAC diclofenac sodium topical gel fluorouracil topical imiquimod methoxsalen rapid OXSORALEN PANRETIN podofilox PROTOPIC PA; MO Name PRUDOXIN REGRANEX ; QL (5 UVADEX ZYCLARA THERAPY FOR ACNE adapalene PA; MO AMNESTEEM AVITA TOPICAL CREAM PA; MO CLARAVIS clindamycin phosphate topical clindamycin-benzoyl peroxide topical gel ERY PADS erythromycin with ethanol topical gel erythromycin with ethanol topical solution calcipotrienebetamethasone erythromycinbenzoyl peroxide metronidazole topical cream metronidazole topical gel metronidazole topical lotion MYORISAN TAZORAC PA; MO tretinoin topical PA; MO ZENATANE TOPICAL ANESTHETICS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 37
Name lidocaine topical adhesive patch,medicated lidocaine topical ointment lidocaine (pf) injection solution 0 mg/ml ( %), 5 mg/ml (0.5 %) lidocaine hcl injection solution 20 mg/ml (2 %) lidocaine hcl mucous membrane gel lidocaine hcl mucous membrane jelly in applicator lidocaine hcl mucous membrane solution 2 % lidocaine hcl mucous membrane solution 4 % lidocaine-prilocaine topical cream PA; MO TOPICAL ANTIBACTERIALS gentamicin topical mafenide acetate mupirocin mupirocin calcium sulfacetamide sodium (acne) SULFAMYLON TOPICAL CREAM TOPICAL ANTIFUNGALS ciclopirox clotrimazole topical You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 38 Name econazole topical ketoconazole topical KETODAN KIT NYAMYC nystatin topical clotrimazolebetamethasone nystatintriamcinolone NYSTOP PEDI-DRI TOPICAL ANTIVIRALS acyclovir topical DENAVIR ZOVIRAX TOPICAL CREAM TOPICAL CORTICOSTEROIDS ALA-CORT alclometasone amcinonide APEXICON E betamethasone dipropionate betamethasone valerate betamethasone, augmented clobetasol topical foam clobetasol topical gel clobetasol topical lotion
Name clobetasol topical ointment clobetasol topical shampoo clobetasol topical solution clobetasol-emollient topical cream desonide desoximetasone diflorasone fluocinolone fluocinonide topical cream 0. % fluocinonide topical gel fluocinonide topical ointment fluocinonide topical solution FLUOCINONIDE-E fluticasone topical halobetasol propionate hydrocortisone topical cream %, 2.5 % hydrocortisone topical lotion 2.5 % hydrocortisone topical ointment %, 2.5 % hydrocortisone butyr-emollient Name hydrocortisone butyrate topical ointment hydrocortisone butyrate topical solution hydrocortisone valerate mometasone prednicarbate triamcinolone acetonide topical TRIDERM TOPICAL ENZYMES SANTYL TOPICAL SCABICIDES / PEDICULICIDES lindane malathion permethrin topical cream spinosad DIAGNOSTICS / MISCELLANEOUS AGENTS IRRIGATING SOLUTIONS lactated ringers irrigation neomycin-polymyxin b gu ringers irrigation MISCELLANEOUS AGENTS acamprosate ADAGEN You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 39
Name alendronate oral tablet 40 mg ; QL (30 anagrelide ARALAST NP INTRAVENOUS RECON SOLN 500 MG ; LA CARBAGLU ; LA cevimeline CHEMET CLINIMIX 4.25%/D5W SULFIT FREE CLINIMIX E 2.75%/D0W SUL FREE CLINIMIX E 2.75%/D5W SULF FREE d0 % & 0.45 % sodium chloride d2.5 %-0.45 % sodium chloride d5 % and 0.9 % sodium chloride d5 %-0.45 % sodium chloride dextrose 0 % & 0.2 % nacl dextrose 0 % in water (d0w) dextrose 5 % in water (d5w) intravenous parenteral solution dextrose 5 %- lactated ringers B/D PA Name dextrose 5%-0.2 % sod chloride dextrose 5%-0.3 % sod.chloride disulfiram etidronate disodium EXJADE ; LA FERRIPROX INCRELEX ; LA KIONEX ORAL POWDER levocarnitine intravenous levocarnitine oral tablet levocarnitine (with sugar) midodrine ORFADIN ; LA pilocarpine hcl oral PROLASTIN-C ; LA RAVICTI RENVELA ORAL TABLET riluzole sodium chloride irrigation sodium chloride 0.9 % intravenous parenteral solution sodium phenylbutyrate SODIUM POLYSTYRENE (SORB FREE) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 40
Name SYPRINE THIOLA water for irrigation, sterile zoledronic acidmannitol-water intravenous solution SMOKING DETERRENTS PA; MO BUPROBAN CHANTIX CHANTIX CONTINUING MONTH BOX CHANTIX CONTINUING MONTH PAK CHANTIX STARTING MONTH BOX CHANTIX STARTING MONTH PAK NICOTROL NICOTROL NS EAR, NOSE / THROAT MEDICATIONS MISCELLANEOUS AGENTS azelastine nasal ; QL (60 chlorhexidine gluconate mucous membrane ipratropium bromide nasal ; QL (30 PERIOGARD Name triamcinolone acetonide dental TYZINE NASAL DROPS 0.05 % MISCELLANEOUS OTIC PREPARATIONS ACETASOL HC acetic acid otic fluocinolone acetonide oil hydrocortisoneacetic acid ofloxacin otic OTIC STEROID / ANTIBIOTIC CIPRODEX neomycinpolymyxin-hc otic ENDOCRINE/DIABETES ADRENAL HORMONES A-HYDROCORT cortisone dexamethasone oral elixir dexamethasone oral tablet DEXAMETHASON E INTENSOL dexamethasone sodium phosphate injection fludrocortisone hydrocortisone oral methylprednisolone oral tablet B/D PA; MO You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 4
Name methylprednisolone oral tablets,dose pack methylprednisolone acetate methylprednisolone sodium succ injection recon soln 25 mg methylprednisolone sodium succ injection recon soln 40 mg MILLIPRED ORAL TABLET prednisolone sodium phosphate oral solution 5 mg/5 ml, 5 mg base/5 ml (6.7 mg/5 ml) prednisolone sodium phosphate oral solution 25 mg/5 ml (5 mg/ml) prednisone oral solution prednisone oral tablet PREDNISONE INTENSOL triamcinolone acetonide injection suspension 0 mg/ml triamcinolone acetonide injection suspension 40 mg/ml B/D PA; MO B/D PA; MO VERIPRED 20 ANTITHYROID AGENTS methimazole You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 42 Name propylthiouracil DIABETES THERAPY acarbose oral tablet 00 mg acarbose oral tablet 25 mg acarbose oral tablet 50 mg ALCOHOL PADS BYDUREON SUBCUTANEOUS SUSPENSION,EXT ENDED REL RECON BYETTA SUBCUTANEOUS PEN INJECTOR 0 MCG/DOSE(250 MCG/ML) 2.4 ML BYETTA SUBCUTANEOUS PEN INJECTOR 5 MCG/DOSE (250 MCG/ML).2 ML ; QL (90 ; QL (360 ; QL (80 PA; MO; QL (4 per 28 days) PA; MO; QL (2.4 per 30 days) PA; MO; QL (.2 per 30 days) CYCLOSET ; QL (80 gauze pads 2 x 2 glimepiride oral tablet mg glimepiride oral tablet 2 mg glimepiride oral tablet 4 mg glipizide oral tablet 0 mg glipizide oral tablet 5 mg ; QL (240 ; QL (20 ; QL (60 ; QL (20 ; QL (240
Name glipizide oral tablet extended release 24hr 0 mg glipizide oral tablet extended release 24hr 2.5 mg glipizide oral tablet extended release 24hr 5 mg glipizide-metformin oral tablet 2.5-250 mg glipizide-metformin oral tablet 2.5-500 mg, 5-500 mg GLUCAGEN GLUCAGEN HYPOKIT GLUCAGON EMERGENCY ; QL (60 ; QL (240 ; QL (20 ; QL (240 ; QL (20 HUMALOG HUMALOG KWIKPEN HUMALOG MIX 50-50 HUMALOG MIX 50-50 KWIKPEN HUMALOG MIX 75-25 HUMALOG MIX 75-25 KWIKPEN HUMULIN 70/30 HUMULIN 70/30 KWIKPEN HUMULIN 70/30 PEN HUMULIN N Name HUMULIN N KWIKPEN HUMULIN N PEN HUMULIN R HUMULIN R U-500 "CONCENTRATED " insulin pen needle insulin syringe (disp) u-00 0.3 ml insulin syringe (disp) u-00 ml insulin syringe (disp) u-00 /2 ml INVOKANA ; QL (30 JANUMET ; QL (60 JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 00-,000 MG, 50-500 MG JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 50-,000 MG ; QL (30 ; QL (60 JANUVIA ; QL (30 JENTADUETO ; QL (60 LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR FLEXPEN You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 43
Name LEVEMIR FLEXTOUCH metformin oral tablet,000 mg metformin oral tablet 500 mg metformin oral tablet 850 mg metformin oral tablet extended release 24 hr 500 mg metformin oral tablet extended release 24 hr 750 mg metformin oral tablet extended release 24hr,000 mg nateglinide oral tablet 20 mg nateglinide oral tablet 60 mg needles, insulin disp.,safety ; QL (75 ; QL (50 ; QL (90 ; QL (20 ; QL (75 ; QL (75 ; QL (90 ; QL (80 NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 NOVOLOG MIX 70-30 FLEXPEN NOVOLOG PENFILL pioglitazone ; QL (30 ; QL (30 Name pioglitazoneglimepiride pioglitazonemetformin ; QL (90 PROGLYCEM repaglinide oral tablet 0.5 mg repaglinide oral tablet mg repaglinide oral tablet 2 mg ; QL (960 ; QL (480 ; QL (240 RIOMET ; QL (765 SYMLINPEN 20 PA; MO; QL (8.9 per 30 days) SYMLINPEN 60 PA; MO; QL (0.5 per 30 days) tolazamide oral tablet 250 mg tolazamide oral tablet 500 mg ; QL (20 ; QL (60 tolbutamide ; QL (80 TRADJENTA ; QL (30 VGO 20 VGO 30 VGO 40 MISCELLANEOUS HORMONES ALDURAZYME ANADROL-50 PA; MO ANDROGEL PA; MO ANDROXY cabergoline ; QL (6 per 28 days) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 44
Name calcitonin (salmon) calcitriol intravenous calcitriol oral CEREZYME chorionic gonadotropin, human PA; MO danazol oral desmopressin injection desmopressin nasal spray,non-aerosol desmopressin oral doxercalciferol intravenous doxercalciferol oral ELAPRASE ELELYSO FABRAZYME INTRAVENOUS RECON SOLN 35 MG FORTICAL KUVAN ORAL TABLET,SOLUBL E ; LA LUMIZYME ; LA METHITEST MIACALCIN INJECTION MYALEPT PA; MO; LA MYOZYME NAGLAZYME ; LA NOVAREL PA; MO Name oxandrolone PA; MO pamidronate intravenous solution paricalcitol SAMSCA ORAL TABLET 5 MG SAMSCA ORAL TABLET 30 MG PA; MO; QL (30 per 30 days) PA; MO; QL (60 per 30 days) SENSIPAR SOMAVERT ; LA SYNAREL testosterone cypionate testosterone enanthate VPRIV ZAVESCA ; LA ZEMPLAR INTRAVENOUS zoledronic acid intravenous solution THYROID HORMONES levothyroxine oral LEVOXYL liothyronine intravenous liothyronine oral THYROLAR- THYROLAR-/2 THYROLAR-/4 THYROLAR-2 THYROLAR-3 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 45
Name UNITHROID ORAL TABLET 00 MCG, 2 MCG, 25 MCG, 50 MCG, 75 MCG, 200 MCG, 25 MCG, 300 MCG, 50 MCG, 75 MCG, 88 MCG GASTROENTEROLOGY ANTIDIARRHEALS / ANTISPASMODICS atropine injection syringe dicyclomine diphenoxylateatropine glycopyrrolate loperamide oral capsule MISCELLANEOUS GASTROINTESTINAL AGENTS ALOXI ; QL (0 AMITIZA balsalazide budesonide oral CANASA CESAMET B/D PA; MO CHENODAL PA; MO; LA COLOCORT COMPRO CONSTULOSE CORTIFOAM CREON Name cromolyn oral CYSTADANE DIPENTUM dronabinol B/D PA; MO EMEND INTRAVENOUS EMEND ORAL B/D PA; MO ENULOSE GAVILYTE-C GAVILYTE-G GAVILYTE-N GENERLAC granisetron intravenous solution mg/ml ( ml) granisetron oral B/D PA; MO granisetron (pf) intravenous solution 00 mcg/ml GRANISOL B/D PA; MO hydrocortisone rectal lactulose oral solution 0 gram/5 ml LIALDA LINZESS LOTRONEX meclizine oral tablet mesalamine with cleansing wipe metoclopramide hcl injection solution You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 46
Name metoclopramide hcl oral ondansetron B/D PA; MO ondansetron hcl oral solution ondansetron hcl oral tablet 24 mg ondansetron hcl oral tablet 4 mg, 8 mg ondansetron hcl (pf) injection solution peg 3350- electrolytes oral recon soln 236-22.74-6.74 gram B/D PA; MO B/D PA B/D PA; MO PENTASA polyethylene glycol 3350 oral powder prochlorperazine prochlorperazine edisylate injection solution 0 mg/2 ml (5 mg/ml) prochlorperazine maleate oral PROCTO-PAK PROCTOZONE-HC RECTIV RELISTOR REMICADE PA; MO SUCRAID sulfasalazine oral tablet SULFAZINE EC TRANSDERM- SCOP You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 47 Name TRILYTE WITH FLAVOR PACKETS UCERIS ursodiol VIOKACE ZENPEP ORAL CAPSULE,DELAY ED RELEASE(DR/EC) 0,000-34,000-55,000 UNIT, 5,000-5,000-82,000 UNIT, 20,000-68,000-09,000 UNIT, 25,000-85,000-36,000 UNIT, 3,000-0,000-6,000 UNIT ULCER THERAPY amoxicilclarithromylansopraz CARAFATE ORAL SUSPENSION ; QL (2 cimetidine esomeprazole sodium famotidine oral suspension famotidine oral tablet 20 mg, 40 mg famotidine (pf) famotidine (pf)-nacl (iso-os) lansoprazole oral capsule,delayed release(dr/ec) 5 mg ; QL (30
Name lansoprazole oral capsule,delayed release(dr/ec) 30 mg misoprostol nizatidine omeprazole oral capsule,delayed release(dr/ec) 0 mg, 20 mg omeprazole oral capsule,delayed release(dr/ec) 40 mg omeprazole-sodium bicarbonate oral capsule 20-. mggram omeprazole-sodium bicarbonate oral capsule 40-. mggram pantoprazole intravenous pantoprazole oral tablet,delayed release (dr/ec) 20 mg pantoprazole oral tablet,delayed release (dr/ec) 40 mg ; QL (30 ; QL (30 ; QL (30 rabeprazole ranitidine hcl injection solution 25 mg/ml ranitidine hcl oral capsule ranitidine hcl oral syrup You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 48 Name ranitidine hcl oral tablet 50 mg, 300 mg sucralfate oral tablet IMMUNOLOGY, VACCINES / BIOTECHNOLOGY BIOTECHNOLOGY DRUGS ACTIMMUNE ARCALYST PA; MO AVONEX INTRAMUSCULA R KIT AVONEX INTRAMUSCULA R PEN INJECTOR KIT AVONEX INTRAMUSCULA R SYRINGE AVONEX ADMINISTRATIO N PACK BETASERON SUBCUTANEOUS KIT PA; MO; QL (4 per 28 days) PA; MO; QL (4 per 28 days) PA; MO; QL (4 per 28 days) PA; MO; QL (4 per 28 days) PA; MO; QL (5 per 28 days) EGRIFTA PA; MO ILARIS (PF) PA; MO; LA INTRON A INJECTION RECON SOLN 0 MILLION UNIT ( ML) INTRON A INJECTION SOLUTION 6 MILLION UNIT/ML LEUKINE
Name MOZOBIL NEULASTA PA; MO; QL (2 NEUMEGA NEUPOGEN INJECTION SOLUTION 480 MCG/.6 ML NEUPOGEN INJECTION SYRINGE PA; MO PA; MO OMNITROPE PA; MO PEGASYS ; QL (4 per 28 days) PEGASYS CONVENIENCE PACK PEGASYS PROCLICK ; QL (4 per 28 days) ; QL (4 per 28 days) PEGINTRON ; QL (4 per 28 days) PEGINTRON REDIPEN ; QL (4 per 28 days) PROCRIT PA; MO PROLEUKIN REBIF (WITH ALBUMIN) REBIF REBIDOSE SUBCUTANEOUS PEN INJECTOR 22 MCG/0.5 ML, 44 MCG/0.5 ML REBIF REBIDOSE SUBCUTANEOUS PEN INJECTOR 8.8MCG/0.2ML-22 MCG/0.5ML (6) PA; MO; QL (6 per 28 days) PA; MO; QL (6 per 28 days) PA; MO; QL (2 per 28 days) Name REBIF TITRATION PACK PA; MO; QL (2 per 28 days) SAIZEN PA; MO SAIZEN CLICK.EASY PA; MO SYLATRON VACCINES / MISCELLANEOUS IMMUNOLOGICALS ACTHIB (PF) ADACEL(TDAP ADOLESN/ADULT )(PF) INTRAMUSCULA R SUSPENSION ATGAM B/D PA bcg vaccine, live (pf) BOOSTRIX TDAP BOTOX INJECTION RECON SOLN 00 UNIT CARIMUNE NF NANOFILTERED INTRAVENOUS RECON SOLN 3 GRAM CERVARIX VACCINE (PF) PA; MO PA COMVAX (PF) DAPTACEL (DTAP PEDIATRIC) (PF) ENGERIX-B (PF) INTRAMUSCULA R SYRINGE B/D PA; MO You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 49
Name ENGERIX-B PEDIATRIC (PF) INTRAMUSCULA R SUSPENSION ENGERIX-B PEDIATRIC (PF) INTRAMUSCULA R SYRINGE B/D PA; MO B/D PA fomepizole GAMASTAN S/D GAMUNEX-C INJECTION SOLUTION GRAM/0 ML (0 %) GARDASIL (PF) INTRAMUSCULA R SUSPENSION HAVRIX (PF) INTRAMUSCULA R SUSPENSION,440 ELISA UNIT/ML HAVRIX (PF) INTRAMUSCULA R SYRINGE 720 ELISA UNIT/0.5 ML IMOVAX RABIES VACCINE (PF) INFANRIX (DTAP) (PF) INTRAMUSCULA R SUSPENSION IPOL INJECTION SUSPENSION PA; MO IXIARO (PF) M-M-R II (PF) MENACTRA (PF) Name MENOMUNE - A/C/Y/W-35 (PF) MENVEO A-C-Y- W-35-DIP (PF) PEDVAX HIB (PF) PRIVIGEN PA; MO PROQUAD (PF) RABAVERT (PF) RAGWITEK RECOMBIVAX HB (PF) INTRAMUSCULA R SUSPENSION 0 MCG/ML, 40 MCG/ML ROTARIX ROTATEQ VACCINE tetanus toxoid,adsorbed (pf) tetanus-diphtheria toxoids-td TWINRIX (PF) INTRAMUSCULA R SUSPENSION TYPHIM VI INTRAMUSCULA R SOLUTION VAQTA (PF) INTRAMUSCULA R SUSPENSION 25 UNIT/0.5 ML B/D PA; MO VARIVAX (PF) YF-VAX (PF) ZOSTAVAX (PF) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 50
Name MUSCULOSKELETAL / RHEUMATOLOGY GOUT THERAPY allopurinol ALOPRIM colchicineprobenecid COLCRYS probenecid ULORIC ST; MO OSTEOPOROSIS THERAPY alendronate oral solution alendronate oral tablet 0 mg, 5 mg alendronate oral tablet 35 mg, 70 mg ; QL (286 ; QL (30 ; QL (4 per 28 days) FORTEO PA; MO; QL (2.4 per 28 days) ibandronate intravenous PA; MO ibandronate oral ; QL ( per 30 days) PROLIA PA; MO raloxifene risedronate ; QL ( per 30 days) OTHER RHEUMATOLOGICALS ACTEMRA PA; MO BENLYSTA INTRAVENOUS RECON SOLN 20 MG CUPRIMINE You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 5 Name DEPEN TITRATABS ENBREL SUBCUTANEOUS KIT ENBREL SUBCUTANEOUS SYRINGE 25 MG/0.5ML (0.5) ENBREL SUBCUTANEOUS SYRINGE 50 MG/ML (0.98 ML) ENBREL SURECLICK HUMIRA SUBCUTANEOUS KIT 20 MG/0.4 ML HUMIRA SUBCUTANEOUS KIT 40 MG/0.8 ML HUMIRA CROHN'S DIS START PCK PA; MO; QL (8 per 28 days) PA; MO; QL (8 per 28 days) PA; MO; QL (4 per 28 days) PA; MO; QL (4 per 28 days) PA; MO; QL (2 per 28 days) PA; MO; QL (3.2 per 28 days) PA; MO; QL (4.8 per 80 days) HUMIRA PEN PA; MO; QL (3.2 per 28 days) HUMIRA PSORIASIS STARTER PACK PA; MO; QL (3.2 per 80 days) leflunomide ; QL (30 ORENCIA PA; MO ORENCIA (WITH MALTOSE) PA; MO OTEZLA PA; MO OTEZLA STARTER PA; MO
Name RIDAURA OBSTETRICS / GYNECOLOGY ESTROGENS / PROGESTINS CAMILA DEPO-PROVERA INTRAMUSCULA R SOLUTION ERRIN ESTRACE VAGINAL estradiol oral estradiol transdermal estradiol valerate estradiolnorethindrone acet ; QL (4 per 28 days) estropipate JOLIVETTE LYZA medroxyprogesteron e intramuscular suspension medroxyprogesteron e oral MENEST MIMVEY MIMVEY LO NORA-BE norethindrone (contraceptive) norethindrone acetate progesterone micronized Name MISCELLANEOUS OB/GYN clindamycin phosphate vaginal metronidazole vaginal MICONAZOLE-3 VAGINAL SUPPOSITORY terconazole tranexamic acid oral VANDAZOLE XULANE ORAL CONTRACEPTIVES / RELATED AGENTS AMETHIA AMETHYST APRI ARANELLE (28) AVIANE BALZIVA (28) BRIELLYN CRYSELLE (28) CYCLAFEM /35 (28) CYCLAFEM 7/7/7 (28) drospirenone-ethinyl estradiol ELLA EMOQUETTE ENPRESSE GIANVI (28) GILDAGIA You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 52
Name INTROVALE JUNEL.5/30 (2) JUNEL /20 (2) JUNEL FE.5/30 (28) JUNEL FE /20 (28) KARIVA (28) KELNOR /35 (28) LARIN /20 (2) LARIN FE LEENA 28 LESSINA LEVONEST (28) levonorgestrelethinyl estrad oral tablets,dose pack,3 month LEVORA-28 LOMEDIA 24 FE LORYNA (28) LOW-OGESTREL (28) LUTERA (28) MARLISSA MICROGESTIN.5/30 (2) MICROGESTIN /20 (2) MICROGESTIN FE.5/30 (28) MICROGESTIN FE /20 (28) MONONESSA (28) NECON 0.5/35 (28) Name NECON /35 (28) NECON /50 (28) NECON 0/ (28) NECON 7/7/7 (28) NORTREL 0.5/35 (28) NORTREL /35 (2) NORTREL /35 (28) NORTREL 7/7/7 (28) OCELLA OGESTREL (28) ORSYTHIA PIMTREA (28) PIRMELLA ORAL TABLET -35 MG- MCG PORTIA PREVIFEM QUASENSE RECLIPSEN (28) SPRINTEC (28) SRONYX TRI-LEGEST FE TRI-PREVIFEM (28) TRI-SPRINTEC (28) TRINESSA (28) TRIVORA (28) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 53
Name VELIVET TRIPHASIC REGIMEN (28) VESTURA (28) VYFEMLA (28) ZENCHENT (28) ZENCHENT FE ZOVIA /35E (28) ZOVIA /50E (28) OXYTOCICS methylergonovine oral OPHTHALMOLOGY ANTIBIOTICS bacitracin ophthalmic bacitracinpolymyxin b ophthalmic ciprofloxacin ophthalmic erythromycin ophthalmic gatifloxacin GENTAK OPHTHALMIC OINTMENT gentamicin ophthalmic drops gentamicin ophthalmic ointment levofloxacin ophthalmic NATACYN Name neomycinbacitracinpolymyxin neomycinpolymyxingramicidin ofloxacin ophthalmic polymyxin b sulftrimethoprim tobramycin ANTIVIRALS trifluridine ZIRGAN BETA-BLOCKERS betaxolol ophthalmic carteolol levobunolol ophthalmic drops 0.5 % metipranolol timolol maleate ophthalmic CHOLINESTERASE INHIBITOR MIOTICS PHOSPHOLINE IODIDE DIRECT ACTING MIOTICS pilocarpine hcl ophthalmic MISCELLANEOUS OPHTHALMOLOGICS azelastine ophthalmic cromolyn ophthalmic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 54
Name CYSTARAN epinastine RESTASIS ; QL (60 NON-STEROIDAL ANTI- INFLAMMATORY AGENTS bromfenac diclofenac sodium ophthalmic flurbiprofen sodium ketorolac ophthalmic ORAL DRUGS FOR GLAUCOMA acetazolamide oral acetazolamide sodium methazolamide oral OTHER GLAUCOMA DRUGS dorzolamide dorzolamide-timolol latanoprost travoprost (benzalkonium) STEROID-ANTIBIOTIC COMBINATIONS neomycinbacitracin-poly-hc neomycinpolymyxin-dexameth neomycinpolymyxin-hc ophthalmic Name STEROIDS dexamethasone sodium phosphate ophthalmic FML S.O.P. PRED MILD prednisolone acetate prednisolone sodium phosphate ophthalmic STEROID-SULFONAMIDE COMBINATIONS BLEPHAMIDE BLEPHAMIDE S.O.P. tobramycindexamethasone sulfacetamideprednisolone SULFONAMIDES sulfacetamide sodium ophthalmic SYMPATHOMIMETICS ALPHAGAN P OPHTHALMIC DROPS 0. % apraclonidine brimonidine VASOCONSTRICTOR DECONGESTANTS naphazoline RESPIRATORY AND ALLERGY ANTIHISTAMINE / ANTIALLERGENIC AGENTS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 55
Name ADRENALIN INJECTION SOLUTION MG/ML (:,000) (ML) cetirizine oral solution mg/ml desloratadine ; QL (30 diphenhydramine hcl injection solution diphenhydramine hcl oral elixir PA; MO EPIPEN QL (4 per 30 days) EPIPEN 2-PAK ; QL (4 per 30 days) EPIPEN JR QL (4 per 30 days) EPIPEN JR 2-PAK ; QL (4 per 30 days) hydroxyzine hcl oral tablet levocetirizine oral solution levocetirizine oral tablet promethazine injection solution PULMONARY AGENTS acetylcysteine solution PA; MO ; QL (30 B/D PA; MO ADEMPAS PA; MO; LA Name albuterol sulfate inhalation solution for nebulization 0.63 mg/3 ml,.25 mg/3 ml, 2.5 mg /3 ml (0.083 %), 5 mg/ml B/D PA; MO albuterol sulfate oral aminophylline intravenous solution 250 mg/0 ml ARCAPTA NEOHALER ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 0 MCG (30 DOSES), 220 MCG (30 DOSES) ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 220 MCG (20 DOSES) ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 220 MCG (60 DOSES) ; QL (30 ; QL (30 ; QL (240 ; QL (60 ATROVENT HFA ; QL (25.8 budesonide inhalation B/D PA; MO budesonide nasal ; QL (7.2 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 56
Name CINRYZE PA; MO COMBIVENT RESPIMAT ; QL (8 per 30 days) cromolyn inhalation B/D PA; MO DALIRESP PA; MO DULERA PA; MO; QL (3 per 30 days) FIRAZYR PA; MO flunisolide ; QL (50 fluticasone nasal ; QL (6 ipratropium bromide inhalation ipratropiumalbuterol B/D PA; MO B/D PA; MO KALYDECO LETAIRIS PA; MO; LA levalbuterol hcl inhalation solution for nebulization 0.3 mg/3 ml, 0.63 mg/3 ml,.25 mg/0.5 ml B/D PA; MO metaproterenol montelukast OPSUMIT PA; MO; LA PERFOROMIST B/D PA; MO PROAIR HFA ; QL (7 PULMICORT INHALATION SUSPENSION FOR NEBULIZATION MG/2 ML B/D PA; MO PULMOZYME B/D PA; MO Name QVAR ; QL (7.4 REVATIO INTRAVENOUS SEREVENT DISKUS PA; MO ; QL (60 sildenafil PA; MO; QL (90 per 30 days) SPIRIVA WITH HANDIHALER SYMBICORT INHALATION HFA AEROSOL INHALER 60-4.5 MCG/ACTUATION SYMBICORT INHALATION HFA AEROSOL INHALER 80-4.5 MCG/ACTUATION ; QL (90 PA; MO; QL (0.2 per 30 days) PA; MO; QL (6.9 per 30 days) terbutaline oral terbutaline subcutaneous theophylline oral solution theophylline oral tablet extended release theophylline oral tablet extended release 2 hr TRACLEER PA; MO; LA triamcinolone acetonide nasal ; QL (6.5 TYVASO B/D PA; MO You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 57
Name XOLAIR PA; MO; LA; QL (6 per 28 days) zafirlukast UROLOGICALS ANTICHOLINERGICS / ANTISPASMODICS flavoxate oxybutynin chloride oral tolterodine trospium BENIGN PROSTATIC HYPERPLASIA(BPH) THERAPY alfuzosin finasteride oral tablet 5 mg tamsulosin CHOLINERGIC STIMULANTS bethanechol chloride MISCELLANEOUS UROLOGICALS ammonium chloride CYSTAGON ; LA ELMIRON potassium citrate oral tablet extended release 0 meq, 5 meq VITAMINS, HEMATINICS / ELECTROLYTES ELECTROLYTES calcium acetate oral capsule ELIPHOS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 58 Name KLOR-CON 0 KLOR-CON 8 KLOR-CON M5 KLOR-CON M20 lactated ringers intravenous magnesium sulfate injection syringe NORMOSOL-R IN 5 % DEXTROSE potassium chloridd5-0.45%nacl intravenous parenteral solution 0 meq/l, 30 meq/l, 40 meq/l potassium chloridd5-0.45%nacl intravenous parenteral solution 20 meq/l potassium chloride intravenous parenteral solution potassium chloride intravenous piggyback 0 meq/00 ml, 20 meq/00 ml, 40 meq/00 ml potassium chloride oral capsule, extended release potassium chloride oral tablet,er particles/crystals potassium chloride in 0.9%nacl
Name potassium chloride in 5 % dex intravenous parenteral solution 20 meq/l, 40 meq/l potassium chloride in lr-d5 intravenous parenteral solution 20 meq/l potassium chloride- 0.45 % nacl potassium chlorided5-0.2%nacl intravenous parenteral solution 20 meq/l potassium chlorided5-0.3%nacl potassium chlorided5-0.9%nacl ringers intravenous sodium chloride intravenous parenteral solution 2.5 meq/ml sodium chloride 0.45 % intravenous parenteral solution sodium chloride 3 % sodium chloride 5 % sodium lactate intravenous MISCELLANEOUS NUTRITION PRODUCTS AMINOSYN 8.5 %- ELECTROLYTES AMINOSYN II 0 % B/D PA B/D PA Name AMINOSYN II 5 % B/D PA AMINOSYN II 7 % B/D PA AMINOSYN II 8.5 % AMINOSYN II 8.5 %- ELECTROLYTES AMINOSYN M 3.5 % AMINOSYN-PF 0 % AMINOSYN-PF 7 % (SULFITE- FREE) CLINIMIX 5%/D5W SULFITE FREE CLINIMIX 5%/D25W SULFITE-FREE CLINIMIX 2.75%/D5W SULFIT FREE CLINIMIX 4.25%- D20W SULF-FREE CLINIMIX 4.25%- D25W SULF-FREE CLINIMIX 4.25%/D0W SULF FREE CLINIMIX 5%- D20W(SULFITE- FREE) CLINIMIX E 4.25%/D25W SUL FREE B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA B/D PA You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 59
Name CLINIMIX E 4.25%/D5W SULF FREE CLINIMIX E 5%/D5W SULFIT FREE CLINIMIX E 5%/D20W SULFIT FREE CLINIMIX E 5%/D25W SULFIT FREE HEPATAMINE 8% B/D PA HEPATASOL 8 % B/D PA INTRALIPID INTRAVENOUS EMULSION 20 % IONOSOL-B IN D5W IONOSOL-MB IN D5W ISOLYTE-P IN 5 % DEXTROSE ISOLYTE-S LIPOSYN III INTRAVENOUS EMULSION 0 %, 20 % NEPHRAMINE 5.4 % NORMOSOL-M IN 5 % DEXTROSE NORMOSOL-R PH 7.4 PLASMA-LYTE 48 PLASMA-LYTE A B/D PA; MO B/D PA B/D PA Name PLASMA-LYTE-56 IN 5 % DEXTROSE PREMASOL 0 % B/D PA PREMASOL 6 % B/D PA PROCALAMINE 3% B/D PA TRAVASOL 0 % B/D PA TROPHAMINE 0 % B/D PA TROPHAMINE 6% B/D PA VITAMINS / HEMATINICS PRENATAL VITAMIN sodium fluoride oral tablet You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 60
Index 8 8-MOP...37 A abacavir...8 abacavir-lamivudinezidovudine...8 ABELCET...8 ABILIFY...26 ABILIFY DISCMELT...26 ABILIFY MAINTENA...26 ABRAXANE...5 acamprosate...39 acarbose...42 acebutolol...33 acetaminophen-codeine...22 ACETASOL HC...4 acetazolamide...55 acetazolamide sodium...55 acetic acid...4 acetylcysteine...56 acitretin...37 ACTEMRA...5 ACTHIB (PF)...49 ACTIMMUNE...48 acyclovir...8, 38 acyclovir sodium...8 ADACEL(TDAP ADOLESN/ADULT)(PF) 49 ADAGEN...39 adapalene...37 adefovir...8 ADEMPAS...56 ADRENALIN...56 ADVICOR...36 AFEDITAB CR...33 AFINITOR...5 AFINITOR DISPERZ...5 AGGRENOX...35 A-HYDROCORT...4 ALA-CORT...38 ALBENZA... albuterol sulfate...56 alclometasone...38 ALCOHOL PADS...42 ALDURAZYME...44 alendronate...40, 5 alfuzosin...58 ALIMTA...5 ALINIA... allopurinol...5 ALOPRIM...5 ALOXI...46 ALPHAGAN P...55 alprazolam...26 amantadine hcl...8 AMBISOME...8 amcinonide...38 AMETHIA...52 AMETHYST...52 amifostine crystalline...4 amikacin... amiloride...33 amiloride-hydrochlorothiazide...33 aminophylline...56 AMINOSYN 8.5 %- ELECTROLYTES...59 AMINOSYN II 0 %...59 AMINOSYN II 5 %...59 AMINOSYN II 7 %...59 AMINOSYN II 8.5 %...59 AMINOSYN II 8.5 %- ELECTROLYTES...59 AMINOSYN M 3.5 %...59 AMINOSYN-PF 0 %...59 AMINOSYN-PF 7 % (SULFITE-FREE)...59 amiodarone...32 AMITIZA...46 amitriptyline...26 amlodipine...33 amlodipine-atorvastatin...36 amlodipine-benazepril...33 ammonium chloride...58 ammonium lactate...37 AMNESTEEM...37 amoxapine...26 amoxicil-clarithromy-lansopraz...47 amoxicillin...3 amoxicillin-pot clavulanate..3 AMPHETAMINE SALT COMBO...26 amphotericin b...8 ampicillin...3 ampicillin sodium...3 ampicillin-sulbactam...3 AMPYRA...2 ANADROL-50...44 anagrelide...40 anastrozole...5 ANDROGEL...44 ANDROXY...44 APEXICON E...38 APOKYN...2 apraclonidine...55 APRI...52 APTIOM...20 APTIVUS...8 ARALAST NP...40 ARANELLE (28)...52 ARCALYST...48 ARCAPTA NEOHALER...56 ARRANON...5 ARZERRA...5 ASMANEX TWISTHALER56 atenolol...33 atenolol-chlorthalidone...33 ATGAM...49 atorvastatin...36 atovaquone... atovaquone-proguanil... ATRIPLA...8 atropine...46 ATROVENT HFA...56 AUGMENTIN...3 AVASTIN...5 AVELOX IN NACL (ISO- OSMOTIC)...3 AVIANE...52 AVITA...37 AVONEX...48 AVONEX ADMINISTRATION PACK...48 azacitidine...5 AZASAN...5 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 6
azathioprine...5 azelastine...4, 54 AZILECT...2 azithromycin... aztreonam... B BACIIM... bacitracin..., 54 bacitracin-polymyxin b...54 baclofen...22 balsalazide...46 BALZIVA (28)...52 BANZEL...20 BARACLUDE...8 bcg vaccine, live (pf)...49 benazepril...33 benazepril-hydrochlorothiazide...33 BENLYSTA...5 benztropine...2 betamethasone dipropionate.38 betamethasone valerate...38 betamethasone, augmented...38 BETASERON...48 betaxolol...33, 54 bethanechol chloride...58 BETHKIS... bicalutamide...5 BICILLIN C-R...3 BICILLIN L-A...3 BICNU...5 bisoprolol fumarate...33 bisoprolol-hydrochlorothiazide...33 bleomycin...5 BLEPHAMIDE...55 BLEPHAMIDE S.O.P...55 BOOSTRIX TDAP...49 BOSULIF...5 BOTOX...49 BRIELLYN...52 BRILINTA...35 brimonidine...55 BRINTELLIX...26 bromfenac...55 bromocriptine...2 budesonide...46, 56 bumetanide...33 buprenorphine...22 buprenorphine-naloxone...25 BUPROBAN...4 bupropion hcl...26 buspirone...27 BUSULFEX...5 butorphanol tartrate...25 BYDUREON...42 BYETTA...42 C cabergoline...44 calcipotriene...37 calcipotriene-betamethasone 37 calcitonin (salmon)...45 calcitriol...37, 45 calcium acetate...58 CAMILA...52 CANASA...46 CANCIDAS...8 candesartan...33 candesartan-hydrochlorothiazid...33 CAPASTAT... CAPRELSA...5 captopril...33 captopril-hydrochlorothiazide...33 CARAC...37 CARAFATE...47 CARBAGLU...40 carbamazepine...20 carbidopa...2 carbidopa-levodopa...2 carbidopa-levodopaentacapone...2 carboplatin...5 CARIMUNE NF NANOFILTERED...49 carteolol...54 CARTIA XT...33 carvedilol...33 CAYSTON... cefaclor...0 cefadroxil...0 cefazolin...0 cefazolin in dextrose (iso-os)0 cefdinir...0 cefditoren pivoxil...0 cefepime...0 cefotaxime...0 cefotetan...0 cefoxitin...0 62 cefoxitin in dextrose, iso-osm...0 cefpodoxime...0 cefprozil...0 ceftazidime...0 ceftriaxone...0 cefuroxime axetil...0 cefuroxime sodium...0 CELEBREX...25 CELLCEPT...5 CELLCEPT INTRAVENOUS...5 CELONTIN...20 cephalexin...0 CEREZYME...45 CERVARIX VACCINE (PF)...49 CESAMET...46 cetirizine...56 cevimeline...40 CHANTIX...4 CHANTIX CONTINUING MONTH BOX...4 CHANTIX CONTINUING MONTH PAK...4 CHANTIX STARTING MONTH BOX...4 CHANTIX STARTING MONTH PAK...4 CHEMET...40 CHENODAL...46 chloramphenicol sod succinate... chlorhexidine gluconate...4 chloroquine phosphate... chlorothiazide...33 chlorothiazide sodium...33 chlorpromazine...27 chlorthalidone...33 CHOLESTYRAMINE LIGHT...36 chorionic gonadotropin, human...45 ciclopirox...38 cidofovir...8 cilostazol...35 cimetidine...47 CINRYZE...57 CIPRODEX...4 ciprofloxacin...3, 54 ciprofloxacin (mixture)...3
ciprofloxacin in 5 % dextrose..4 cisplatin...5 citalopram...27 cladribine...5 CLARAVIS...37 clarithromycin... clindamycin hcl... clindamycin in dextrose 5 % CLINDAMYCIN PEDIATRIC... clindamycin phosphate.., 37, 52 clindamycin-benzoyl peroxide...37 CLINIMIX 5%/D5W SULFITE FREE...59 CLINIMIX 5%/D25W SULFITE-FREE...59 CLINIMIX 2.75%/D5W SULFIT FREE...59 CLINIMIX 4.25%/D0W SULF FREE...59 CLINIMIX 4.25%/D5W SULFIT FREE...40 CLINIMIX 4.25%-D20W SULF-FREE...59 CLINIMIX 4.25%-D25W SULF-FREE...59 CLINIMIX 5%- D20W(SULFITE-FREE).59 CLINIMIX E 2.75%/D0W SUL FREE...40 CLINIMIX E 2.75%/D5W SULF FREE...40 CLINIMIX E 4.25%/D25W SUL FREE...59 CLINIMIX E 4.25%/D5W SULF FREE...60 CLINIMIX E 5%/D5W SULFIT FREE...60 CLINIMIX E 5%/D20W SULFIT FREE...60 CLINIMIX E 5%/D25W SULFIT FREE...60 clobetasol...38, 39 clobetasol-emollient...39 CLOLAR...5 clomipramine...27 clonazepam...20 clonidine...33 clonidine hcl...27, 33 clopidogrel...35 clorazepate dipotassium...27 CLORPRES...33 clotrimazole...8, 38 clotrimazole-betamethasone.38 clozapine...27 COARTEM... codeine sulfate...22 colchicine-probenecid...5 COLCRYS...5 colestipol...36 colistin (colistimethate na)... COLOCORT...46 COMBIVENT RESPIMAT.57 COMETRIQ...5 COMPLERA...8 COMPRO...46 COMVAX (PF)...49 CONSTULOSE...46 COPAXONE...2 CORTIFOAM...46 cortisone...4 CREON...46 CRIXIVAN...8 cromolyn...46, 54, 57 CRYSELLE (28)...52 CUBICIN... CUPRIMINE...5 CYCLAFEM /35 (28)...52 CYCLAFEM 7/7/7 (28)...52 cyclobenzaprine...22 cyclophosphamide...5 CYCLOSET...42 cyclosporine...5 cyclosporine modified...5 CYSTADANE...46 CYSTAGON...58 CYSTARAN...55 cytarabine...5 cytarabine (pf)...6 D d0 % & 0.45 % sodium chloride...40 d2.5 %-0.45 % sodium chloride...40 d5 % and 0.9 % sodium chloride...40 d5 %-0.45 % sodium chloride...40 dacarbazine...6 DALIRESP...57 danazol...45 dantrolene...22 dapsone...2 DAPTACEL (DTAP PEDIATRIC) (PF)...49 DARAPRIM...2 daunorubicin...6 decitabine...6 demeclocycline...4 DEMSER...33 DENAVIR...38 DEPEN TITRATABS...5 DEPO-PROVERA...52 desipramine...27 desloratadine...56 desmopressin...45 desonide...39 desoximetasone...39 dexamethasone...4 DEXAMETHASONE INTENSOL...4 dexamethasone sodium phosphate...4, 55 dexmethylphenidate...27 dexrazoxane...4 dextroamphetamine...27 dextroamphetamineamphetamine...27 dextrose 0 % & 0.2 % nacl.40 dextrose 0 % in water (d0w)...40 dextrose 5 % in water (d5w).40 dextrose 5 %-lactated ringers40 dextrose 5%-0.2 % sod chloride...40 dextrose 5%-0.3 % sod.chloride...40 diazepam...20, 27 DIAZEPAM INTENSOL...27 DIBENZYLINE...33 diclofenac potassium...25 diclofenac sodium...25, 37, 55 diclofenac-misoprostol...25 dicloxacillin...3 dicyclomine...46 didanosine...8 diflorasone...39 diflunisal...25 63
digoxin...35 dihydroergotamine...2 DILANTIN...20 diltiazem hcl...33, 34 DILT-XR...33 DIPENTUM...46 diphenhydramine hcl...56 diphenoxylate-atropine...46 dipyridamole...35 disulfiram...40 divalproex...20 DOCEFREZ...6 docetaxel...6 donepezil...2 DORIBAX...2 dorzolamide...55 dorzolamide-timolol...55 doxazosin...34 doxepin...27 doxercalciferol...45 DOXIL...6 doxorubicin...6 doxycycline hyclate...4 doxycycline monohydrate...4 dronabinol...46 drospirenone-ethinyl estradiol...52 DROXIA...6 DULERA...57 duloxetine...27 DURAMORPH (PF)...22 DUTOPROL...34 E E.E.S. 400... E.E.S. GRANULES... econazole...38 EDURANT...8 EFFIENT...35 EGRIFTA...48 ELAPRASE...45 ELELYSO...45 ELIGARD...6 ELIPHOS...58 ELIQUIS...35 ELITEK...4 ELLA...52 ELMIRON...58 EMCYT...6 EMEND...46 EMOQUETTE...52 EMSAM...27 EMTRIVA...8 enalapril maleate...34 enalapril-hydrochlorothiazide...34 ENBREL...5 ENBREL SURECLICK...5 ENDOCET...22 ENDODAN...23 ENGERIX-B (PF)...49 ENGERIX-B PEDIATRIC (PF)...50 enoxaparin...35 ENPRESSE...52 entacapone...2 ENULOSE...46 epinastine...55 EPIPEN...56 EPIPEN 2-PAK...56 EPIPEN JR...56 EPIPEN JR 2-PAK...56 epirubicin...6 EPITOL...20 EPIVIR...8 EPIVIR HBV...8 eplerenone...34 eprosartan...34 EPZICOM...8 ERBITUX...6 ergoloid...27 ERGOMAR...2 ERIVEDGE...6 ERRIN...52 ERWINAZE...6 ERY PADS...37 ERYPED 200... ERYPED 400... ERY-TAB... ERYTHROCIN... ERYTHROCIN (AS STEARATE)... erythromycin..., 54 erythromycin ethylsuccinate. erythromycin with ethanol...37 erythromycin-benzoyl peroxide...37 erythromycin-sulfisoxazole.. escitalopram oxalate...27 esomeprazole sodium...47 ESTRACE...52 estradiol...52 estradiol valerate...52 estradiol-norethindrone acet.52 estropipate...52 eszopiclone...27 ethambutol...2 ethosuximide...20 etidronate disodium...40 etodolac...25 ETOPOPHOS...6 etoposide...6 EXELON...2 exemestane...6 EXJADE...40 F FABRAZYME...45 famciclovir...8 famotidine...47 famotidine (pf)...47 famotidine (pf)-nacl (iso-os)47 FANAPT...27 FARESTON...6 FASLODEX...6 FAZACLO...28 felbamate...20 felodipine...34 fenofibrate...36 fenofibrate micronized...36 fenofibrate nanocrystallized.36 fenofibric acid (choline)...36 fenoprofen...25 fentanyl citrate...23 fentanyl patches...23 FERRIPROX...40 FETZIMA...28 finasteride...58 FIRAZYR...57 FIRMAGON KIT W DILUENT SYRINGE...6 flavoxate...58 flecainide...32 fluconazole...8 fluconazole in dextrose(iso-o) 8 flucytosine...8 fludarabine...6 fludrocortisone...4 flunisolide...57 fluocinolone...39 fluocinolone acetonide oil...4 fluocinonide...39 64
FLUOCINONIDE-E...39 fluorouracil...6, 37 fluoxetine...28 fluphenazine decanoate...28 fluphenazine hcl...28 flurbiprofen...25 flurbiprofen sodium...55 flutamide...6 fluticasone...39, 57 fluvastatin...36 fluvoxamine...28 FML S.O.P....55 FOLOTYN...6 fomepizole...50 fondaparinux...35 FORTEO...5 FORTICAL...45 foscarnet...8 fosinopril...34 fosinopril-hydrochlorothiazide...34 fosphenytoin...20 furosemide...34 FUSILEV...4 FUZEON...8 FYCOMPA...20 G gabapentin...20 GABITRIL...20 GABLOFEN...22 galantamine...22 GAMASTAN S/D...50 GAMUNEX-C...50 ganciclovir sodium...8 GARDASIL (PF)...50 gatifloxacin...54 gauze pads 2 x 2...42 GAVILYTE-C...46 GAVILYTE-G...46 GAVILYTE-N...46 gemcitabine...6 gemfibrozil...36 GENERLAC...46 GENGRAF...6 GENTAK...54 gentamicin...2, 38, 54 gentamicin in nacl (iso-osm) 2 gentamicin sulfate (pf)...2 GEODON...28 GIANVI (28)...52 GILDAGIA...52 GILENYA...22 GILOTRIF...6 GLEEVEC...6 glimepiride...42 glipizide...42, 43 glipizide-metformin...43 GLUCAGEN...43 GLUCAGEN HYPOKIT...43 GLUCAGON EMERGENCY...43 glycopyrrolate...46 granisetron...46 granisetron (pf)...46 GRANISOL...46 griseofulvin microsize...8 griseofulvin ultramicrosize...8 guanidine...28 H HALAVEN...7 halobetasol propionate...39 haloperidol...28 haloperidol decanoate...28 haloperidol lactate...28 HAVRIX (PF)...50 heparin (porcine)...35 heparin (porcine) in 5 % dex 35 heparin (porcine) in nacl (pf)35 HEPATAMINE 8%...60 HEPATASOL 8 %...60 HERCEPTIN...7 HEXALEN...7 HUMALOG...43 HUMALOG KWIKPEN...43 HUMALOG MIX 50-50...43 HUMALOG MIX 50-50 KWIKPEN...43 HUMALOG MIX 75-25...43 HUMALOG MIX 75-25 KWIKPEN...43 HUMIRA...5 HUMIRA CROHN'S DIS START PCK...5 HUMIRA PEN...5 HUMIRA PSORIASIS STARTER PACK...5 HUMULIN 70/30...43 HUMULIN 70/30 KWIKPEN...43 HUMULIN 70/30 PEN...43 HUMULIN N...43 HUMULIN N KWIKPEN...43 HUMULIN N PEN...43 HUMULIN R...43 HUMULIN R U-500...43 hydralazine...34 hydrochlorothiazide...34 hydrocodone-acetaminophen23 hydrocodone-ibuprofen...23 hydrocortisone...39, 4, 46 hydrocortisone butyrate...39 hydrocortisone butyr-emollient...39 hydrocortisone valerate...39 hydrocortisone-acetic acid...4 hydromorphone...23 hydromorphone (pf)...23 hydroxychloroquine...2 hydroxyurea...7 hydroxyzine hcl...56 I ibandronate...5 ibuprofen...25 ibuprofen-oxycodone...23 idarubicin...7 ifosfamide...7 ILARIS (PF)...48 IMBRUVICA...7 imipenem-cilastatin...2 imipramine hcl...28 imipramine pamoate...28 imiquimod...37 IMOVAX RABIES VACCINE (PF)...50 INCRELEX...40 indapamide...34 INFANRIX (DTAP) (PF)...50 INLYTA...7 insulin pen needle...43 insulin syringe (disp) u-00 0.3 ml...43 insulin syringe (disp) u-00 ml...43 insulin syringe (disp) u-00 /2 ml...43 INTELENCE...8, 9 INTRALIPID...60 INTRON A...48 INTROVALE...53 INVANZ...2 65
INVEGA...28, 29 INVEGA SUSTENNA...29 INVIRASE...9 INVOKANA...43 IONOSOL-B IN D5W...60 IONOSOL-MB IN D5W...60 IPOL...50 ipratropium bromide...4, 57 ipratropium-albuterol...57 irbesartan...34 irbesartan-hydrochlorothiazide...34 irinotecan...7 ISENTRESS...9 ISOLYTE-P IN 5 % DEXTROSE...60 ISOLYTE-S...60 isoniazid...2 isosorbide dinitrate...36 isosorbide mononitrate...36 isradipine...34 ISTODAX...7 itraconazole...8 IXEMPRA...7 IXIARO (PF)...50 J JAKAFI...7 JANTOVEN...35 JANUMET...43 JANUMET XR...43 JANUVIA...43 JENTADUETO...43 JEVTANA...7 JOLIVETTE...52 JUNEL.5/30 (2)...53 JUNEL /20 (2)...53 JUNEL FE.5/30 (28)...53 JUNEL FE /20 (28)...53 JUXTAPID...36 K KADCYLA...7 KALETRA...9 KALYDECO...57 KARIVA (28)...53 KELNOR /35 (28)...53 KEPIVANCE...4 ketoconazole...8, 38 KETODAN KIT...38 ketoprofen...25 ketorolac...55 KIONEX...40 KLOR-CON 0...58 KLOR-CON 8...58 KLOR-CON M5...58 KLOR-CON M20...58 KUVAN...45 KYNAMRO...36 L labetalol...34 lactated ringers...39, 58 lactulose...46 LAMISIL...8 lamivudine...9 lamivudine-zidovudine...9 lamotrigine...20 LANOXIN...35 lansoprazole...47, 48 LANTUS...43 LANTUS SOLOSTAR...43 LARIN /20 (2)...53 LARIN FE...53 latanoprost...55 LATUDA...29 LEENA 28...53 leflunomide...5 LESSINA...53 LETAIRIS...57 letrozole...7 leucovorin calcium...5 LEUKERAN...7 LEUKINE...48 leuprolide...7 levalbuterol hcl...57 LEVEMIR...43 LEVEMIR FLEXPEN...43 LEVEMIR FLEXTOUCH...44 levetiracetam...20 levobunolol...54 levocarnitine...40 levocarnitine (with sugar)...40 levocetirizine...56 levofloxacin...4, 54 levofloxacin in d5w...4 LEVONEST (28)...53 levonorgestrel-ethinyl estrad 53 LEVORA-28...53 levorphanol tartrate...23 levothyroxine...45 LEVOXYL...45 LEXIVA...9 LIALDA...46 lidocaine...38 lidocaine (pf)...38 lidocaine hcl...38 lidocaine-prilocaine...38 lindane...39 LINZESS...46 LIORESAL...22 liothyronine...45 LIPOSYN III...60 lisinopril...34 lisinopril-hydrochlorothiazide...34 lithium carbonate...29 lithium citrate...29 LOMEDIA 24 FE...53 lomustine...7 loperamide...46 lorazepam...29 LORAZEPAM INTENSOL.29 LORCET (HYDROCODONE)...23 LORCET HD...23 LORCET PLUS...23 LORTAB 0-325...23 LORTAB 5-325...23 LORTAB 7.5-325...23 LORYNA (28)...53 losartan...34 losartan-hydrochlorothiazide 34 LOTRONEX...46 lovastatin...36 LOW-OGESTREL (28)...53 loxapine succinate...29 LUMIZYME...45 LUPRON DEPOT...7 LUPRON DEPOT (3 MONTH)...7 LUPRON DEPOT (4 MONTH)...7 LUPRON DEPOT (6 MONTH)...7 LUPRON DEPOT-PED...7 LUTERA (28)...53 LYRICA...20 LYSODREN...7 LYZA...52 M MACRODANTIN...4 mafenide acetate...38 66
magnesium sulfate...58 malathion...39 maprotiline...29 MARLISSA...53 MARPLAN...29 MATULANE...7 MATZIM LA...34 meclizine...46 meclofenamate...25 medroxyprogesterone...52 mefenamic acid...25 mefloquine...2 megestrol...7 MEKINIST...7 meloxicam...25 melphalan...7 MENACTRA (PF)...50 MENEST...52 MENOMUNE - A/C/Y/W-35 (PF)...50 MENVEO A-C-Y-W-35-DIP (PF)...50 mercaptopurine...7 meropenem...2 mesalamine with cleansing wipe...46 mesna...5 MESNEX...5 MESTINON...22 MESTINON TIMESPAN...22 METADATE ER...29 metaproterenol...57 metformin...44 methadone...23, 24 methamphetamine...29 methazolamide...55 methenamine hippurate...4 methimazole...42 METHITEST...45 methotrexate sodium...7 methotrexate sodium (pf)...7 methoxsalen rapid...37 methyclothiazide...34 methyldopa...34 methylergonovine...54 methylphenidate...29 methylprednisolone...4, 42 methylprednisolone acetate..42 methylprednisolone sodium succ...42 metipranolol...54 metoclopramide hcl...46, 47 metolazone...34 metoprolol succinate...34 metoprolol ta-hydrochlorothiaz...34 metoprolol tartrate...34 metronidazole...2, 37, 52 metronidazole in nacl (iso-os)...2 mexiletine...32 MIACALCIN...45 MICONAZOLE-3...52 MICROGESTIN.5/30 (2) 53 MICROGESTIN /20 (2)...53 MICROGESTIN FE.5/30 (28)...53 MICROGESTIN FE /20 (28)...53 midodrine...40 MIGERGOT...2 MILLIPRED...42 MIMVEY...52 MIMVEY LO...52 minocycline...4 minoxidil...34 mirtazapine...29 misoprostol...48 mitomycin...8 mitoxantrone...8 M-M-R II (PF)...50 modafinil...29 MODERIBA...9 MODERIBA DOSE PACK...9 moexipril...34 moexipril-hydrochlorothiazide...34 mometasone...39 MONONESSA (28)...53 montelukast...57 morphine...24 morphine concentrate...24 moxifloxacin...4 MOZOBIL...49 mupirocin...38 mupirocin calcium...38 MUSTARGEN...8 MYALEPT...45 MYCAMINE...8 mycophenolate mofetil...8 mycophenolate sodium...8 MYORISAN...37 MYOZYME...45 N nabumetone...25 nadolol...34 nadolol-bendroflumethiazide34 nafcillin...3 nafcillin in dextrose iso-osm 3 NAGLAZYME...45 nalbuphine...25 naloxone...25 naltrexone...25 NAMENDA...22 NAMENDA TITRATION PAK...22 naphazoline...55 naproxen...25 naproxen sodium...25 naratriptan...2 NATACYN...54 nateglinide...44 NEBUPENT...2 NECON 0.5/35 (28)...53 NECON /35 (28)...53 NECON /50 (28)...53 NECON 0/ (28)...53 NECON 7/7/7 (28)...53 needles, insulin disp.,safety..44 nefazodone...29 neomycin...2 neomycin-bacitracin-poly-hc55 neomycin-bacitracinpolymyxin...54 neomycin-polymyxin b gu...39 neomycin-polymyxindexameth...55 neomycin-polymyxingramicidin...54 neomycin-polymyxin-hc.4, 55 NEPHRAMINE 5.4 %...60 NEULASTA...49 NEUMEGA...49 NEUPOGEN...49 NEUPRO...2 nevirapine...9 NEXAVAR...8 niacin...36 nicardipine...34 NICOTROL...4 67
NICOTROL NS...4 NIFEDICAL XL...34 nifedipine...34 NILANDRON...8 nimodipine...34 nisoldipine...34 NITRO-BID...36 nitrofurantoin...4 nitrofurantoin macrocrystal..4 nitrofurantoin monohyd/mcryst...4 nitroglycerin...36, 37 NITROSTAT...37 nizatidine...48 NORA-BE...52 norethindrone (contraceptive)...52 norethindrone acetate...52 NORMOSOL-M IN 5 % DEXTROSE...60 NORMOSOL-R IN 5 % DEXTROSE...58 NORMOSOL-R PH 7.4...60 NORTREL 0.5/35 (28)...53 NORTREL /35 (2)...53 NORTREL /35 (28)...53 NORTREL 7/7/7 (28)...53 nortriptyline...29 NORVIR...9 NOVAREL...45 NOVOLOG...44 NOVOLOG FLEXPEN...44 NOVOLOG MIX 70-30...44 NOVOLOG MIX 70-30 FLEXPEN...44 NOVOLOG PENFILL...44 NOXAFIL...8 NUEDEXTA...22 NULOJIX...8 NYAMYC...38 nystatin...8, 38 nystatin-triamcinolone...38 NYSTOP...38 O OCELLA...53 octreotide acetate...8 ofloxacin...4, 4, 54 OGESTREL (28)...53 olanzapine...29, 30 olanzapine-fluoxetine...30 OLYSIO...9 omega-3 acid ethyl esters...36 omeprazole...48 omeprazole-sodium bicarbonate...48 OMNITROPE...49 ONCASPAR...8 ondansetron...47 ondansetron hcl...47 ondansetron hcl (pf)...47 ONFI...20 OPSUMIT...57 ORAP...30 ORENCIA...5 ORENCIA (WITH MALTOSE)...5 ORFADIN...40 ORSYTHIA...53 OTEZLA...5 OTEZLA STARTER...5 oxacillin...3 oxacillin in dextrose(iso-osm)...3 oxaliplatin...8 oxandrolone...45 oxaprozin...25 oxazepam...30 oxcarbazepine...20 OXSORALEN...37 oxybutynin chloride...58 oxycodone...24 oxycodone-acetaminophen...24 oxycodone-aspirin...24 oxymorphone...24, 25 P PACERONE...32 paclitaxel...8 pamidronate...45 PANRETIN...37 pantoprazole...48 paricalcitol...45 paromomycin...2 paroxetine hcl...30 PASER...2 PAXIL...30 PEDI-DRI...38 PEDVAX HIB (PF)...50 peg 3350-electrolytes...47 PEGANONE...20 PEGASYS...49 PEGASYS CONVENIENCE PACK...49 PEGASYS PROCLICK...49 PEGINTRON...49 PEGINTRON REDIPEN...49 penicillin g potassium...3 penicillin g procaine...3 penicillin g sodium...3 penicillin v potassium...3 PENTAM...2 PENTASA...47 pentoxifylline...36 PERFOROMIST...57 perindopril erbumine...34 PERIOGARD...4 PERJETA...8 permethrin...39 perphenazine...30 perphenazine-amitriptyline...30 PFIZERPEN-G...3 phenelzine...30 phenobarbital...20 phenytoin...20 phenytoin sodium...20 phenytoin sodium extended..20 PHOSPHOLINE IODIDE...54 pilocarpine hcl...40, 54 PIMTREA (28)...53 pindolol...34 pioglitazone...44 pioglitazone-glimepiride...44 pioglitazone-metformin...44 piperacillin-tazobactam...3 PIRMELLA...53 piroxicam...25 PLASMA-LYTE 48...60 PLASMA-LYTE A...60 PLASMA-LYTE-56 IN 5 % DEXTROSE...60 podofilox...37 polyethylene glycol 3350...47 polymyxin b sulfate...2 polymyxin b sulf-trimethoprim...54 POMALYST...8 PORTIA...53 potassium chlorid-d5-0.45%nacl...58 potassium chloride...58 68
potassium chloride in 0.9%nacl...58 potassium chloride in 5 % dex...59 potassium chloride in lr-d5...59 potassium chloride-0.45 % nacl...59 potassium chloride-d5-0.2%nacl...59 potassium chloride-d5-0.3%nacl...59 potassium chloride-d5-0.9%nacl...59 potassium citrate...58 POTIGA...20 pramipexole...2 pravastatin...36 prazosin...34 PRED MILD...55 prednicarbate...39 prednisolone acetate...55 prednisolone sodium phosphate...42, 55 prednisone...42 PREDNISONE INTENSOL 42 PREMASOL 0 %...60 PREMASOL 6 %...60 PRENATAL VITAMIN...60 PREVALITE...36 PREVIFEM...53 PREZISTA...9 PRIFTIN...2 primaquine...2 primidone...20 PRIMSOL...4 PRISTIQ...30 PRIVIGEN...50 PROAIR HFA...57 probenecid...5 procainamide...32 PROCALAMINE 3%...60 PROCENTRA...30 prochlorperazine...47 prochlorperazine edisylate...47 prochlorperazine maleate...47 PROCRIT...49 PROCTO-PAK...47 PROCTOZONE-HC...47 progesterone micronized...52 PROGLYCEM...44 PROGRAF...8 PROLASTIN-C...40 PROLEUKIN...49 PROLIA...5 PROMACTA...36 promethazine...56 propafenone...33 propranolol...34 propranolol-hydrochlorothiazid...35 propylthiouracil...42 PROQUAD (PF)...50 PROTOPIC...37 protriptyline...30 PRUDOXIN...37 PULMICORT...57 PULMOZYME...57 pyrazinamide...2 pyridostigmine bromide...22 Q QUASENSE...53 quetiapine...30 quinapril...35 quinapril-hydrochlorothiazide...35 quinidine gluconate...33 quinidine sulfate...33 quinine sulfate...2 QVAR...57 R RABAVERT (PF)...50 rabeprazole...48 RAGWITEK...50 raloxifene...5 ramipril...35 RANEXA...36 ranitidine hcl...48 RAPAMUNE...8 RAVICTI...40 REBIF (WITH ALBUMIN).49 REBIF REBIDOSE...49 REBIF TITRATION PACK.49 RECLIPSEN (28)...53 RECOMBIVAX HB (PF)...50 RECTIV...47 REGRANEX...37 RELENZA DISKHALER...9 RELISTOR...47 REMICADE...47 REMODULIN...35 RENVELA...40 repaglinide...44 REPREXAIN...25 RESCRIPTOR...9 RESTASIS...55 RETROVIR...9 REVATIO...57 REVLIMID...8 REYATAZ...9 RIBAPAK DOSE PACK...9 RIBASPHERE...9 ribavirin...9 RIDAURA...52 rifabutin...2 rifampin...2 riluzole...40 rimantadine...9 ringers...39, 59 RIOMET...44 risedronate...5 RISPERDAL CONSTA...30 risperidone...30, 3 RITUXAN...8 rivastigmine tartrate...22 rizatriptan...2 ropinirole...2 ROTARIX...50 ROTATEQ VACCINE...50 ROZEREM...3 S SABRIL...2 SAIZEN...49 SAIZEN CLICK.EASY...49 SAMSCA...45 SANDOSTATIN LAR DEPOT...8 SANTYL...39 SAPHRIS...3 SAPHRIS (BLACK CHERRY)...3 selegiline hcl...2 selenium sulfide...37 SELZENTRY...9 SENSIPAR...45 SEREVENT DISKUS...57 SEROQUEL XR...3 sertraline...3 SIGNIFOR...8 sildenafil...57 silver sulfadiazine...37 69
SIMULECT...8 simvastatin...36 sirolimus...8 SIRTURO...2 sodium chloride...40, 59 sodium chloride 0.45 %...59 sodium chloride 0.9 %...40 sodium chloride 3 %...59 sodium chloride 5 %...59 sodium fluoride...60 sodium lactate...59 sodium phenylbutyrate...40 SODIUM POLYSTYRENE (SORB FREE)...40 SOLTAMOX...8 SOMAVERT...45 SORINE...33 sotalol...33 SOTALOL AF...33 SOVALDI...9 spinosad...39 SPIRIVA WITH HANDIHALER...57 spironolactone...35 spironolacton-hydrochlorothiaz...35 SPORANOX...8 SPRINTEC (28)...53 SPRYCEL...8 SRONYX...53 SSD...37 stavudine...9 STIVARGA...8 STRATTERA...3 streptomycin...2 STRIBILD...9 STROMECTOL...2 SUCRAID...47 sucralfate...48 sulfacetamide sodium...55 sulfacetamide sodium (acne) 38 sulfacetamide-prednisolone..55 sulfadiazine...4 sulfamethoxazole-trimethoprim...4 SULFAMYLON...38 sulfasalazine...47 SULFAZINE EC...47 sulindac...25 sumatriptan...2 sumatriptan succinate...2 SUPRAX...0, SURMONTIL...32 SUSTIVA...9 SUTENT...8 SYLATRON...49 SYLVANT...8 SYMBICORT...57 SYMLINPEN 20...44 SYMLINPEN 60...44 SYNAGIS...9 SYNAREL...45 SYNERCID...2 SYNRIBO...8 SYPRINE...4 T TABLOID...8 tacrolimus...8 TAFINLAR...8, 9 TAMIFLU...9 tamoxifen...9 tamsulosin...58 TARCEVA...9 TARGRETIN...9 TASIGNA...9 TAZORAC...37 TAZTIA XT...35 TECFIDERA...22 TEFLARO... TEGRETOL XR...2 telmisartan...35 telmisartan-amlodipine...35 telmisartan-hydrochlorothiazid...35 temazepam...32 terazosin...35 terbinafine...8 terbutaline...57 terconazole...52 testosterone cypionate...45 testosterone enanthate...45 tetanus toxoid,adsorbed (pf).50 tetanus-diphtheria toxoids-td 50 tetracycline...4 THALOMID...9 theophylline...57 THIOLA...4 thioridazine...32 thiothixene...32 THYROLAR-...45 THYROLAR-/2...45 THYROLAR-/4...45 THYROLAR-2...45 THYROLAR-3...45 tiagabine...2 TIKOSYN...33 timolol maleate...35, 54 tinidazole...2 TIVICAY...9 tizanidine...22 tobramycin...54 tobramycin in 0.225 % nacl..2 tobramycin in 0.9 % nacl...2 tobramycin sulfate...2 tobramycin-dexamethasone..55 tolazamide...44 tolbutamide...44 tolmetin...25 tolterodine...58 topiramate...2 TOPOSAR...9 topotecan...9 TORISEL...9 torsemide...35 TRACLEER...57 TRADJENTA...44 tramadol...25, 26 tramadol-acetaminophen...26 trandolapril...35 tranexamic acid...36, 52 TRANSDERM-SCOP...47 tranylcypromine...32 TRAVASOL 0 %...60 travoprost (benzalkonium)...55 trazodone...32 TREANDA...9 TRECATOR...2 TRELSTAR...9 TRELSTAR DEPOT...9 TRELSTAR LA...9 tretinoin...37 tretinoin (chemotherapy)...9 triamcinolone acetonide.39, 4, 42, 57 triamterene-hydrochlorothiazid...35 TRIDERM...39 trifluoperazine...32 trifluridine...54 TRI-LEGEST FE...53 70
TRILYTE WITH FLAVOR PACKETS...47 trimethoprim...4 TRINESSA (28)...53 TRI-PREVIFEM (28)...53 TRISENOX...9 TRI-SPRINTEC (28)...53 TRIVORA (28)...53 TROPHAMINE 0 %...60 TROPHAMINE 6%...60 trospium...58 TRUVADA...0 TWINRIX (PF)...50 TYGACIL...2 TYKERB...9 TYPHIM VI...50 TYSABRI...22 TYVASO...57 TYZEKA...0 TYZINE...4 U UCERIS...47 ULORIC...5 UNITHROID...46 ursodiol...47 UVADEX...37 V valacyclovir...0 VALCYTE...0 valproate sodium...2 valproic acid...2 valproic acid (as sodium salt)...2 valsartan-hydrochlorothiazide...35 vancomycin...4 VANDAZOLE...52 VAQTA (PF)...50 VARIVAX (PF)...50 VECAMYL...36 VECTIBIX...9 VELCADE...9 VELIVET TRIPHASIC REGIMEN (28)...54 venlafaxine...32 verapamil...35 VERIPRED 20...42 VERSACLOZ...32 VESTURA (28)...54 VGO 20...44 VGO 30...44 VGO 40...44 VICODIN...25 VICODIN ES...25 VICODIN HP...25 VICTRELIS...0 VIDEX 2 GRAM PEDIATRIC...0 VIIBRYD...32 VIMPAT...2 vinblastine...9 vincristine...9 vinorelbine...9 VIOKACE...47 VIRACEPT...0 VIRAMUNE XR...0 VIRAZOLE...0 VIREAD...0 VOLTAREN GEL...26 voriconazole...8 VOTRIENT...9 VPRIV...45 VYFEMLA (28)...54 W warfarin...36 water for irrigation, sterile...4 WELCHOL...36 X XALKORI...9 XARELTO...36 XENAZINE...22 XGEVA...5 XIFAXAN...2 XOLAIR...58 XTANDI...9 XULANE...52 XYREM...32 Y YERVOY...9 YF-VAX (PF)...50 Z zafirlukast...58 zaleplon...32 ZALTRAP...9 ZAMICET...25 ZANOSAR...9 ZAVESCA...45 ZELBORAF...9 ZEMPLAR...45 ZENATANE...37 ZENCHENT (28)...54 ZENCHENT FE...54 ZENPEP...47 ZENZEDI...32 ZETIA...36 ZIAGEN...0 zidovudine...0 ziprasidone hcl...32 ZIRGAN...54 zoledronic acid...45 zoledronic acid-mannitol-water...4 ZOLINZA...20 zolmitriptan...2 zolpidem...32 zonisamide...2 ZORTRESS...20 ZOSTAVAX (PF)...50 ZOVIA /35E (28)...54 ZOVIA /50E (28)...54 ZOVIRAX...38 ZUBSOLV...26 ZYCLARA...37 ZYKADIA...20 ZYTIGA...20 ZYVOX...3 7
Community HealthFirst MA Special Needs Plan (HMO SNP) 205 Pharmacy Directory This pharmacy directory was updated on 08/22/204. For more recent information or other questions, please contact Community Health Plan of Washington at -800-944-247 or for TTY users, Dial 7--, 7 days a week, 8am 8pm or visit www.healthfirst.chpw.org. Introduction This booklet provides a list of Community HealthFirst MA Special Needs Plan s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Community HealthFirst MA Special Needs Plan s formulary. When this pharmacy directory refers to we, us, or our, it means Community Health Plan of Washington. When it refers to plan or our plan, it means Community HealthFirst MA Special Needs Plan. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under our plan only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at nonnetwork pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of 0/2/204. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can get prescription drugs shipped to your home through our network mail order delivery program. For more information, please contact us or see the mail order section of this pharmacy directory. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us. 72
Can the list of network pharmacies change? Yes, our plan may add or remove pharmacies from our pharmacy directory. To get current information about Community HealthFirst MA Special Needs Plan network pharmacies in your area, please visit our web site at www.healthfirst.chpw.org or call Customer Service. How do I find a Community HealthFirst MA Special Needs Plan network pharmacy in my area? You can visit our web site at www.healthfirst.chpw.org or call Customer Service during the hours of 8:00 a.m. to 8:00 p.m., 7 days a week. Current members should call -800-942-0247 and prospective members should call -800-944-247 (TTY Relay: Dial 7--). How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show your Community HealthFirst MA Special Needs Plan Member ID card. If you do not have your ID card with you when you fill your prescription, you may have to pay the full cost of the prescription (rather than paying just your copay). If this happens, you can ask us to reimburse you for our share of the cost by submitting a claim to us. To find out how to submit a claim, look in your Evidence of Coverage or call our Customer Service. How do I fill a prescription through Community HealthFirst MA Special Needs Plan s mail-order pharmacy service? To get order forms and information about filling your prescriptions by mail, please call -888-823-968. Please note that you must use our mail-order service. Prescription drugs that you get through any other mail-order service are not covered. You can use our plan s mail-order service to fill prescriptions for any drug that is on the formulary list. Our plan s mail-order service requires you to order at least a 30-day supply of the drug and no more than a 90-day supply. You are not required to use mail-order service to obtain an extended supply of maintenance medications. Instead, you have the option of using a retail pharmacy in our network to obtain a supply of maintenance medications. Some retail pharmacies may agree to accept the mail-order reimbursement rate for an extended supply of medications for up to 90 days per dispensing, which may result in no out-of-pocket payment difference to you. Other retail pharmacies may not agree to accept the mail-order reimbursement rate for an extended supply of medication. In this case, you will be responsible for the difference in price. Please look in the pharmacy directory below for retail pharmacies in our network at which you can obtain an extended supply of maintenance medications or call our Customer Service for more information. After you ve sent your order, you should receive your prescription within 4 days. If for some reason your order cannot be delivered within 4 days, a mail-order representative may contact you. For more information about mail-order, visit Community HealthFirst s web site at www.healthfirst.chpw.org or call our Customer Service during the hours of 8:00 a.m. to 8:00 p.m., 7 days a week. Current members should call -800-942-0247 and prospective members should call -800-944-247 (TTY Relay: Dial 7--). Filling prescriptions outside the network Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available. Below are some circumstances when we would cover prescriptions filled at an out-of- network pharmacy. Before you fill your prescription in these situations, call Customer Service to see if there is a network pharmacy in your area where you can fill your prescription. If you must use an out-of-network pharmacy, you will generally have to 73 73
pay the full cost (rather than your normal share of the cost) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a claim form. You should submit a claim to us if you fill a prescription at an out-of-network pharmacy as any amount you pay will help you qualify for catastrophic coverage. To learn how to submit a paper claim, please refer to the paper claims process described next. You will be allowed a total of three fills at an out-of-network pharmacy within a plan year. If you fill a prescription out-of- network, you will receive a message on your monthly Explanation of Benefits (EOB) that will state Non-network pharmacy. If you request a fourth fill at an out-of-network pharmacy, your request for coverage will be denied. If you feel that the out-of-network claim should have been covered, contact our Customer Service during the hours of 8:00 a.m. to 8:00 p.m., 7 days a week. Current members should call -800-942-0247 and prospective members should call -800-944-247 (TTY Relay: Dial 7--). How do I submit a paper claim? When you go to a network pharmacy, your claim is automatically submitted to us by the pharmacy. However, if you go to an out-of-network pharmacy the pharmacy may not be able to submit the claim directly to us. When that happens, you will have to pay the full cost of your prescription. To submit a paper claim, you must send a copy of the receipt for the prescription drugs from the pharmacy where you bought them and a completed Prescription Claim Form. Please send the completed Prescription Claim Form and the receipts to the following address: Express Scripts Attn: Med D Accts. PO Box 2858 Clinton, IA 52733-2858 If you do not have a Prescription Claim Form visit our web site at www.healthfirst.chpw.org or call Customer Service. Community HealthFirst MA Special Needs Plan Retail Pharmacies Offering Extended Supplies Medications You are not required to use mail-order service to obtain an extended supply of maintenance medications. Instead, you have the option of using a retail pharmacy in our network to obtain an extended supply of maintenance medications. Some retail pharmacies may agree to accept the mail-order reimbursement rate for an extended supply of medications for up to 90 days per dispensing, which may result in no out-of-pocket payment difference to you. Other retail pharmacies may not agree to accept the mail-order reimbursement rate for an extended supply of medication. In this case, you will be responsible for the difference in price. In the pharmacy directory below, you will find identified those retail pharmacies in our network that offer extended supplies of maintenance medications. For more information For more detailed information about your Community HealthFirst prescription drug coverage, please review the Evidence of Coverage and Community HealthFirst s formulary. If you have questions about Community HealthFirst, please visit our web site at www.healthfirst.chpw.org or call Customer Service during the hours of 8:00 a.m. to 8:00 p.m., 7 days a week. Current members should call -800-942- 0247 and prospective members should call -800-944-247 (TTY Relay: Dial 7--). 74 74 of
Pharmacy Listing Table of Contents Retail Pharmacies page 82 Mail-Order Pharmacies page 4 Home Infusion Pharmacies page 42 Long Term Care Pharmacies page 44 Indian Health Service/Tribal/ Urban Indian Health Program Pharmacies page 50 75
ADAMS COUNTY...82 OTHELLO...82 RITZVILLE...82 ASOTIN COUNTY...82 CLARKSTON...82 BENTON COUNTY...82 BENTON CITY...82 KENNEWICK...82 PROSSER...83 RICHLAND...83 WEST RICHMOND...84 CHELAN COUNTY...84 CASHMERE...84 CHELAN...84 LEAVENWORTH...84 WENATCHEE...84 CLALLAM COUNTY...84 FORKS...84 PORT ANGELES...84 SEQUIM...85 CLARK COUNTY...85 BATTLE GROUND...85 CAMAS...85 ORCHARDS...86 VANCOUVER...86 WASHOUGAL...88 COLUMBIA COUNTY...88 DAYTON...88 COWLITZ COUNTY...88 CASTLE ROCK...88 KALAMA...88 KELSO...88 LONGVIEW...89 WOODLAND...89 DOUGLAS COUNTY...89 BRIDGEPORT...89 EAST WENATCHEE...89 WENATCHEE...89 76
FERRY COUNTY...90 REPUBLIC...90 FRANKLIN COUNTY...90 CONNELL...90 PASCO...90 GARFIELD COUNTY...90 POMEROY...90 GRANT COUNTY...90 EPHRATA...90 GRAND COULEE...9 MATTAWA...9 MOSES LAKE...9 QUINCY...9 GRAYS HARBOR COUNTY...9 ABERDEEN...9 ELMA...9 HOQUIAM...9 OCEAN SHORES...92 WESTPORT...92 ISLAND COUNTY...92 CAMANO ISLAND...92 CLINTON...92 COUPEVILLE...92 FREELAND...92 OAK HARBOR...92 JEFFERSON COUNTY...92 PORT HADLOCK...92 PORT TOWNSEND...92 KING COUNTY...93 AUBURN...93 BELLEVUE...93 BOTHELL...94 BURIEN...94 COVINGTON...95 DES MOINES...95 DUVALL...95 ENUMCLAW...95 FEDERAL WAY...96 ISSAQUAH...96 KENMORE...97 KENT...97 KIRKLAND...98 77
MAPLE VALLEY...99 MERCER ISLAND...99 NEWCASTLE...99 NORMANDY PARK...99 NORTH BEND...99 REDMOND...99 RENTON...00 SAMMAMISH...0 SEATAC...0 SEATTLE...0 SHORELINE...07 SNOQUALMIE...08 TUKWILA...08 VASHON...08 WOODINVILLE...08 KITSAP COUNTY...09 BAINBRIDGE ISLAND...09 BREMERTON...09 KINGSTON...0 PORT ORCHARD...0 POULSBO...0 SILVERDALE... KITTITAS COUNTY... CLE ELUM... ELLENSBURG... KLICKITAT COUNTY... WHITE SALMON... LEWIS... CENTRALIA... CHEHALIS...2 MORTON...2 WINLOCK...2 LINCOLN COUNTY...2 DAVENPORT...2 BELFAIR...2 SHELTON...2 OKANOGAN COUNTY...3 BREWSTER...3 OKANOGAN...3 OMAK...3 TONASKET...3 TWISP...3 78
PACIFIC COUNTY...3 LONG BEACH...3 OCEAN PARK...3 RAYMOND...3 SOUTH BEND...3 PEND OREILLE COUNTY...3 NEWPORT...3 PIERCE COUNTY...3 AUBURN...3 BONNEY LAKE...4 BUCKLEY...4 DUPONT...4 EDGEWOOD...4 FIRCREST...4 GIG HARBOR...4 GRAHAM...5 LAKEWOOD...5 MILTON...5 ORTING...6 PUYALLUP...6 SPANAWAY...7 SUMNER...7 TACOMA...7 UNIVERSITY PLACE...9 SAN JUAN COUNTY...20 EASTSOUND...20 FRIDAY HARBOR...20 LOPEZ ISLAND...20 SKAGIT COUNTY...20 ANACORTES...20 BURLINGTON...20 CONCRETE...20 LA CONNER...2 MOUNT VERNON...2 SEDRO WOOLLEY...2 SKAMANIA COUNTY...2 STEVENSON...2 SNOHOMISH COUNTY...2 ARLINGTON...2 BOTHELL...22 DARRINGTON...22 EDMONDS...22 EVERETT...23 79
GRANITE FALLS...25 LAKE STEVENS...25 LYNNWOOD...25 MARYSVILLE...26 MILL CREEK...26 MOUNTLAKE TERRACE...27 MUKILTEO...27 SNOHOMISH...27 STANWOOD...28 SULTAN...28 TULALIP...28 WOODINVILLE...28 SPOKANE COUNTY...28 AIRWAY HEIGHTS...28 CHENEY...28 DEER PARK...28 FAIRFIELD...28 LIBERTY LAKE...28 MEAD...29 MEDICAL LAKE...29 MILLWOOD...29 SPOKANE...29 SPOKANE VALLEY...32 VERADALE...33 STEVENS COUNTY...33 CHEWELAH...33 COLVILLE...33 KETTLE FALLS...33 NINE MILE FALLS...33 THURSTON COUNTY...33 LACEY...33 OLYMPIA...34 TENINO...34 TUMWATER...34 YELM...35 WAHKIAKUM COUNTY...35 CATHLAMET...35 WALLA WALLA...35 WHATCOM COUNTY...36 BELLINGHAM...36 BLAINE...37 EVERSON...37 LYNDEN...37 SUMAS...37 80
WHITMAN COUNTY...37 COLFAX...37 GARFIELD...37 PULLMAN...37 SAINT JOHN...38 TEKOA...38 YAKIMA COUNTY...38 GRANDVIEW...38 SELAH...38 SUNNYSIDE...38 TOPPENISH...38 UNION GAP...38 WAPATO...38 YAKIMA...38 8
Pharmacies noted with a * offer a 90 day supply. Retail Pharmacies ADAMS COUNTY OTHELLO OTHELLO FAMILY CLINIC 40 E MAIN ST OTHELLO, WA 99344 (509) 488-5256 WAL-MART * 860 E MAIN ST OTHELLO, WA 99344 (509) 488-9324 RITZVILLE RITZVILLE DRUG * 209 W MAIN AVE RITZVILLE, WA 9969 (509) 659-0250 ASOTIN COUNTY CLARKSTON BI-MART 5 3RD ST CLARKSTON, WA 99403 (509) 758-8230 CHAS-WASEM * 800 6TH ST CLARKSTON, WA 99403 (509) 758-2565 CLARKSTON HEIGHTS 29 5TH AVE CLARKSTON, WA 99403 (509) 758-3376 COSTCO * 30 FIFTH ST CLARKSTON, WA 99403 (509) 758-8897 OWL TRI-STATE 275 HIGHLAND AVE CLARKSTON, WA 99403 (509) 758-5533 SAVON 400 BRIDGE ST CLARKSTON, WA 99403 (509) 758-7475 WAL-MART * 306 5TH ST CLARKSTON, WA 99403 (509) 758-6660 WASEM'S DRUG * 800 6TH ST CLARKSTON, WA 99403 (509) 758-2565 BENTON COUNTY BENTON CITY LOGAR 55 9TH ST STE A BENTON CITY, WA 99320 (509) 588-8600 KENNEWICK ALBERTSON'S * 5204 W CLEARWATER KENNEWICK, WA 99336 (509) 735-83 COLUMBIA BASIN HEMATOLOGY * 7360 W DESCHUTES AVE KENNEWICK, WA 99336 (509) 783-044 COSTCO * 8505 W GAGE BLVD KENNEWICK, WA 99336 (509) 737-8877 FRED MEYER 28 W 0TH AVE KENNEWICK, WA 99336 (509) 735-8733 MEDICAL MALL 52 N YOUNG ST KENNEWICK, WA 99336 (509) 585-5250 82
90 N STEPTOE ST KENNEWICK, WA 99336 (509) 783-343 W 2825 KENNEWICK AVE KENNEWICK, WA 99336 (509) 783-2622 SHOPKO PHARMACY* 867 N COLUMBIA CENTER BLVD KENNEWICK, WA 99336 (509) 736-0505 TARGET 60 N COLUMBIA CENTER BLVD KENNEWICK, WA 99336 (509) 737-700 4000 W 27TH AVE KENNEWICK, WA 99337 (509) 582-778 2800 W CLEARWATER AVE KENNEWICK, WA 99336 (509) 783-542 WAL-MART * 2720 S QUILLAN ST KENNEWICK, WA 99337 (509) 586-574 YOKES 40 W 27TH AVE KENNEWICK, WA 99337 (509) 585-0846 PROSSER ELFERS-LYON 820 MEMORIAL ST STE 2 PROSSER, WA 99350 (509) 786-3200 RICHLAND ALBERTSON'S * 320 LEE BLVD RICHLAND, WA 99352 (509) 946-0656 ALBERTSON'S * 690 GAGE BLVD RICHLAND, WA 99352 (509) 627-533 DENSOW'S 0 WRIGHT AVE RICHLAND, WA 99354 (509) 943-64 FRED MEYER 0 WELLSIAN WAY RICHLAND, WA 99352 (509) 943-8358 MALLEYS COMPOUNDING 906 GEORGE WASHINGTON WAY RICHLAND, WA 99354 (509) 943-973 268 LEE BLVD RICHLAND, WA 99352 (509) 946-4684 549 GEORGE WASHINGTON WAY RICHLAND, WA 99352 (509) 946-5770 803 GEORGE WASHINGTON WAY RICHLAND, WA 99352 (509) 946-57 60 GEORGE WASHINGTON WAY RICHLAND, WA 99354 (509) 943-2605 800 SWIFT BLVD STE 60 RICHLAND, WA 99352 (509) 943-92 585 GAGE BLVD RICHLAND, WA 99352 (509) 628-3629 WAL-MART * 280 DUPORTAIL ST RICHLAND, WA 99352 (509) 628-370 YOKES * 455 ENGLEWOOD DR RICHLAND, WA 99352 (509) 49-3339 83
WEST RICHMOND YOKES 40 BOMBING RANGE RD WEST RICHMOND, WA 99353 (509) 967-8008 CHELAN COUNTY CASHMERE DOANE'S VALLEY 9 COTTAGE AVE CASHMERE, WA 9885 (509) 782-277 CHELAN LAKE CHELAN 223 E JOHNSON AVE CHELAN, WA 9886 (509) 682-275 06 W MANSON RD CHELAN, WA 9886 (509) 682-4087 WAL-MART * 08 APPLE BLOSSOM DR CHELAN, WA 9886 (509) 682-4634 LEAVENWORTH 6 RIVERBEND DR LEAVENWORTH, WA 98826 (509) 548-58 VILLAGE PHARMACY* 85 FRONT ST LEAVENWORTH, WA 98826 (509) 548-7622 WENATCHEE ALBERTSON'S * 28 N MILLER ST WENATCHEE, WA 9880 (509) 662-2942 CENTRAL WASHINGTON HOSP PHCY * 933 RED APPLE RD STE A WENATCHEE, WA 9880 (509) 667-3333 COLUMBIA VALLEY COMM H PHCY * 600 ORONDO AVE STE WENATCHEE, WA 9880 (509) 664-3508 380 N MILLER ST WENATCHEE, WA 9880 (509) 663-7805 50 N MILLER ST WENATCHEE, WA 9880 (509) 663-5575 050 N MILLER ST WENATCHEE, WA 9880 (509) 665-7539 WAL-MART * 2000 N WENATCHEE AVE WENATCHEE, WA 9880 (509) 664-3698 WENATCHEE CLINIC 820 N CHELAN AVE WENATCHEE, WA 9880 (509) 662-580 CLALLAM COUNTY FORKS CHINOOK PHARMACY S FORKS AVE FORKS, WA 9833 (360) 374-2294 PORT ANGELES ALBERTSON'S * 4 E LAURIDSEN BLVD PORT ANGELES, WA 98362 (360) 452-440 84
JIM'S 424 2ND ST E PORT ANGELES, WA 98362 (360) 452-4200 62 S LINCOLN ST PORT ANGELES, WA 98362 (360) 452-9784 940 E ST ST STE 0 PORT ANGELES, WA 98362 (360) 457-3456 0 E 3RD ST PORT ANGELES, WA 98362 (360) 457-0599 2709 E HIGHWAY 0 PORT ANGELES, WA 98362 (360) 457-7865 932 E FRONT ST PORT ANGELES, WA 98362 (360) 457-4456 WAL-MART * 34 E KOLONELS WAY PORT ANGELES, WA 98362 (360) 452-305 SEQUIM COSTCO * 955 W WASHINGTON ST SEQUIM, WA 98382 (360) 406-2032 QFC 990 E WASHINGTON ST BLDG B SEQUIM, WA 98382 (360) 683-56 520 W WASHINGTON ST SEQUIM, WA 98382 (360) 68-029 680 W WASHINGTON ST BLDG F SEQUIM, WA 98382 (360) 68-220 490 W WASHINGTON ST SEQUIM, WA 98382 (360) 68-208 CLARK COUNTY BATTLE GROUND ALBERTSON'S * 208 W MAIN ST BATTLE GROUND, WA 98604 (360) 687-4092 FRED MEYER 40 NW 2TH AVE BATTLE GROUND, WA 98604 (360) 666-533 904 W MAIN ST BATTLE GROUND, WA 98604 (360) 723-9046 808 W MAIN ST STE 0 BATTLE GROUND, WA 98604 (360) 687-536 WAL-MART * 20 SW 3TH AVE BATTLE GROUND, WA 98604 (360) 723-9007 CAMAS COSTCO * 960 SE ST ST CAMAS, WA 98607 (360) 258-6230 800 NE 3RD AVE CAMAS, WA 98607 (360) 834-6550 3328 NE 3RD AVE CAMAS, WA 98607 (360) 835-3303 85
ORCHARDS BI-MART PHARMACY 92 4TH PLAIN BLVD NE ORCHARDS, WA 98662 (360) 944-8368 VANCOUVER ALBERTSON'S * 4300 NE 20TH AVE VANCOUVER, WA 98686 (360) 576-4844 BI-MART PHARMACY 260 FALK RD VANCOUVER, WA 98668 (360) 695-7578 COSTCO * 6720 NE 84TH ST VANCOUVER, WA 98665 (360) 828-2289 FAMILY WELLNESS CENTER PC * 000 SE TECH CTR DR STE 20 VANCOUVER, WA 98683 (360) 260-2773 FRED MEYER 325 SE MILL PLAIN BLVD VANCOUVER, WA 98664 (360) 256-4406 FRED MEYER * 74 NE 7TH AVE VANCOUVER, WA 98662 (360) 896-3533 FRED MEYER 6600 SE MCGILLIVRAY BLVD VANCOUVER, WA 98683 (360) 260-3333 FRED MEYER * 7700 NE HIGHWAY 9 VANCOUVER, WA 98665 (360) 699-833 FRED MEYER 800 NE TENNEY RD VANCOUVER, WA 98685 (360) 57-2573 HI-SCHOOL PHARMACY 6926 NE FOURTH PLAIN BLVD VANCOUVER, WA 9866 (360) 693-8374 LEGACY SALMON CREEK APOTHECARY* 22 NE 39TH ST STE 30 VANCOUVER, WA 98686 (360) 487-3700 9 MILL PLAIN MEDICAL AND PHCY * 864 E MILL PLAIN BLVD VANCOUVER, WA 98664 (360) 253-8993 OLYMPIC DRUG * 3898 NE 28TH ST VANCOUVER, WA 98682 (360) 896-8932 PACIFIC NW SPECIALTY 380 MAIN ST STE A VANCOUVER, WA 98663 (360) 448-7890 PEACE HEALTH SOUTHWEST PHCY * 420 MOTHER JOSEPH PL VANCOUVER, WA 98664 (360) 54-2294 PHSW PHARMACY AT MEDICAL CTR * 420 NE MOTHER JOSEPH PL VANCOUVER, WA 98664 (360) 54-2294 QFC 3505 SE 92ND AVE VANCOUVER, WA 98683 (360) 253-3043 86
2800 NE 62ND AVE VANCOUVER, WA 98682 (360) 253-563 35 SE 3RD WAY VANCOUVER, WA 98684 (360) 885-0839 67 NE 63RD ST VANCOUVER, WA 9866 (360) 992-5686 265 NE 2TH AVE VANCOUVER, WA 98684 (360) 449-5205 670 E MILL PLAIN BLVD VANCOUVER, WA 9866 (360) 992-5726 696 NE 76TH ST VANCOUVER, WA 98662 (360) 944-2665 3707 MAIN ST VANCOUVER, WA 98663 (360) 993-8604 379 SE MILL PLAIN BLVD VANCOUVER, WA 98684 (360) 89-4254 3023 NE HIGHWAY 99 VANCOUVER, WA 98686 (360) 566-7986 408 NE 8ST ST VANCOUVER, WA 98665 (360) 574-8824 TARGET 880 NE HAZEL DELL AVE VANCOUVER, WA 98665 (360) 73-0005 TARGET 6200 SE MILL PLAIN BLVD VANCOUVER, WA 98684 (360) 449-6425 THE VANCOUVER CLINIC * 50 SE 72ND AVE VANCOUVER, WA 98684 (360) 397-3602 THE VANCOUVER CLINIC PHCY * 2525 NE 39TH ST VANCOUVER, WA 98686 (360) 397-3880 VANCOUVER CLINIC 700 NE 87TH AVE VANCOUVER, WA 98664 (360) 397-334 85 NE 62ND AVE VANCOUVER, WA 98682 (360) 597-023 605 NE 4TH AVE VANCOUVER, WA 98662 (360) 254-3848 2903 NE ANDERSON RD VANCOUVER, WA 9866 (360) 256-503 3503 SE MILL PLAIN BLVD VANCOUVER, WA 98684 (360) 256-9875 87
252 MAIN ST VANCOUVER, WA 98660 (360) 693-2524 3009 NE HIGHWAY 99 VANCOUVER, WA 98686 (360) 574-094 974 E MILL PLAIN BLVD VANCOUVER, WA 98664 (360) 253-7254 900 NE 62ND AVE BLDG C VANCOUVER, WA 98684 (360) 89-809 6708 NE 63RD ST VANCOUVER, WA 9866 (360) 696-0759 982 NE HIGHWAY 99 VANCOUVER, WA 98665 (360) 576-4902 WAL-MART * 430 SE 92ND AVE VANCOUVER, WA 98683 (360) 256-636 WAL-MART * 220 GRAND BLVD VANCOUVER, WA 9866 (360) 258-207 WAL-MART * 7809 NE VANCOUVER PLAZA DR VANCOUVER, WA 98662 (360) 253-4038 WAL-MART * 22E NE 04TH AVE VANCOUVER, WA 98664 (360) 885-026 WAL-MART * 9000 NE HIGHWAY 99 VANCOUVER, WA 98665 (360) 57-2207 WASHOUGAL BI-MART PHARMACY 3003 ADDY ST WASHOUGAL, WA 9867 (360) 835-068 3307 EVERGREEN BLVD STE 4 WASHOUGAL, WA 9867 (360) 335-9255 * 3307 EVERGREEN WAY STE 5 WASHOUGAL, WA 9867 (360) 335-2006 COLUMBIA COUNTY DAYTON ELK DRUG 76 E MAIN ST DAYTON, WA 99328 (509) 382-2536 COWLITZ COUNTY CASTLE ROCK CASTLE ROCK 7 ST AVE SW CASTLE ROCK, WA 986 (360) 274-82 KALAMA GODFREYS 270 N ST ST KALAMA, WA 98625 (360) 673-2600 KELSO L J'S FURNESS DRUG* 4 S PACIFIC AVE KELSO, WA 98626 (360) 425-3280 88
230 KELSO DR KELSO, WA 98626 (360) 577-2693 4 THREE RIVERS DR KELSO, WA 98626 (360) 636-5430 TARGET 205 THREE RIVERS DR KELSO, WA 98626 (360) 578-7387 LONGVIEW FRED MEYER 384 OCEAN BEACH WAY LONGVIEW, WA 98632 (360) 425-6222 PEACEHEALTH ST JOHN MED CTR * 65 DELAWARE ST LONGVIEW, WA 98632 (360) 44-745 2930 OCEAN BEACH HWY LONGVIEW, WA 98632 (360) 575-6246 227 5TH AVE LONGVIEW, WA 98632 (360) 575-6606 2939 OCEAN BEACH HWY LONGVIEW, WA 98632 (360) 232-02 WAL-MART * 375 OCEAN BEACH HWY LONGVIEW, WA 98632 (360) 355-3082 WAL-MART * 540 7TH AVE LONGVIEW, WA 98632 (360) 44-9602 WOODLAND HI-SCHOOL 365 LEWIS RIVER RD WOODLAND, WA 98674 (360) 225-9475 725 PACIFIC AVE WOODLAND, WA 98674 (360) 225-4375 WAL-MART * 486 DIKE ACCESS RD WOODLAND, WA 98674 (360) 84-938 DOUGLAS COUNTY BRIDGEPORT GROSS DRUG * 2520 FOSTER CREEK AVE BRIDGEPORT, WA 9883 (509) 686-59 EAST WENATCHEE BI-MART 780 GRANT RD EAST WENATCHEE, WA 98802 (509) 884-4022 E WENATCHEE FOOD PAVILION PHCY * 35 VALLEY MALL PKWY EAST WENATCHEE, WA 98802 (360) 74-9797 50 GRANT RD EAST WENATCHEE, WA 98802 (509) 884-0678 WENATCHEE 470 GRANT RD WENATCHEE, WA 98802 (509) 886-7047 89
COSTCO * 375 HIGHLINE DR S WENATCHEE, WA 98802 (509) 886-0754 FRED MEYER GRANT BLVD WENATCHEE, WA 98802 (509) 88-2833 FERRY COUNTY REPUBLIC REPUBLIC DRUG STORE 6 N CLARK AVE REPUBLIC, WA 9966 (509) 775-335 FRANKLIN COUNTY CONNELL CONNELL FAMILY CLINIC 05 COLUMBIA AVE CONNELL, WA 99326 (509) 488-5256 PASCO FIESTA 5 S 0TH AVE PASCO, WA 9930 (509) 545-0596 LOURDES WEST PASCO 7425 WRIGLEY DR STE 04 PASCO, WA 9930 (509) 546-8388 MEDICINE SHOPPE 2 W COURT ST PASCO, WA 9930 (509) 547-7537 25 N 4TH AVE PASCO, WA 9930 (509) 547-223 308 N 20TH AVE PASCO, WA 9930 (509) 545-958 TCCH 55 W COURT ST PASCO, WA 9930 (509) 547-2204 200 N 4TH AVE STE 00 PASCO, WA 9930 (509) 547-220 2005 W COURT ST PASCO, WA 9930 (509) 545-439 5506 RD 68 PASCO, WA 9930 (509) 547-789 WAL-MART * 4820 N ROAD 68 PASCO, WA 9930 (509) 543-7947 YOKES 4905 N ROAD 68 PASCO, WA 9930 (509) 545-4884 GARFIELD COUNTY POMEROY POMEROY 764 MAIN STREET POMEROY, WA 99347 (509) 843-82 GRANT COUNTY EPHRATA 250 BASIN ST SW EPHRATA, WA 98823 (509) 754-353 50 BASIN ST SW EPHRATA, WA 98823 (509) 754-3567 WAL-MART * 399 SE BLVD EPHRATA, WA 98823 (509) 754-8847 90
GRAND COULEE 0 GRAND COULEE HWY GRAND COULEE, WA 9933 (509) 633-0463 MATTAWA WFHC PHARMACY 60 GOVERNMENT WAY MATTAWA, WA 99349 (509) 488-5256 MOSES LAKE PIONEER MED CENTER 550 S PIONEER WAY STE 05 MOSES LAKE, WA 98837 (509) 765-889 500 S PIONEER WAY MOSES LAKE, WA 98837 (509) 765-29 60 S PIONEER WAY MOSES LAKE, WA 98837 (509) 764-472 SOUTHGATE 2709 W BROADWAY AVE MOSES LAKE, WA 98837 (509) 765-9332 200 E BROADWAY AVE MOSES LAKE, WA 98837 (509) 765-27 WAL-MART * 005 N STRATFORD RD MOSES LAKE, WA 98837 (509) 766-068 QUINCY SHOPKO PHARMACY* 0 F ST QUINCY, WA 98848 (509) 787-4437 GRAYS HARBOR COUNTY ABERDEEN ABERDEEN HEALTH MART 82 SUMNER AVE STE H ABERDEEN, WA 98520 (360) 533-525 CITY CENTER DRUG * 08 E WISHKAH ST ABERDEEN, WA 98520 (360) 532-582 30 E WISHKAH ST ABERDEEN, WA 98520 (360) 533-6320 22 W HERON ST ABERDEEN, WA 98520 (360) 532-8743 SWANSON OWL 7 N BOONE ST ABERDEEN, WA 98520 (360) 533-3294 WAL-MART * 909 E WISHKAH ST ABERDEEN, WA 98520 (360) 532-7875 ELMA ELMA HEALTH MART 22 W MAIN ST ELMA, WA 9854 (360) 482-2442 HOQUIAM CROWN DRUG * 2544 SIMPSON AVE HOQUIAM, WA 98550 (360) 533-096 HARBOR DRUG * 36 8TH ST HOQUIAM, WA 98550 (360) 532-306 330 SIMPSON AVE HOQUIAM, WA 98550 (360) 533-553 9
OCEAN SHORES OCEAN SHORES 72 W CHANCE A LA MER NW OCEAN SHORES, WA 98569 (360) 289-4647 WESTPORT ALBERTSON'S * TWIN HARBOR DRUG* 450 SW ERIE ST 733 N MONTESANO OAK HARBOR, WA ST 98277 WESTPORT, WA 98595 (360) 279-8829 (360) 268-0505 ISLAND DRUG * ISLAND COUNTY 230 SE PIONEER WAY OAK HARBOR, WA CAMANO ISLAND 98277 (360) 675-6688 MARKS CAMANO KMART 370 NE CAMANO DR 3265 SR 20 STE 6 OAK HARBOR, WA CAMANO ISLAND, WA 98277 98282 (360) 679-5546 (360) 387-5757 CLINTON ISLAND DRUG * 042 STATE ROUTE 525 CLINTON, WA 98236 (360) 34-3885 COUPEVILLE LINDS COUPVILLE 40 N MAIN ST COUPEVILLE, WA 98239 (360) 678-400 FREELAND LIND'S FREELAND 609 E MAIN ST FREELAND, WA 98249 (360) 33-4700 OAK HARBOR 3645 SR 20 OAK HARBOR, WA 98277 (360) 679-3522 SAAR'S MARKETPLACE FOOD * 3299 STATE RTE 20 OAK HARBOR, WA 98277 (360) 675-45 3490 STATE RTE 20 OAK HARBOR, WA 98277 (360) 675-3497 WAL-MART * 250 SW ERIE ST OAK HARBOR, WA 98277 (360) 279-067 JEFFERSON COUNTY PORT HADLOCK QFC 890 IRONDALE RD PORT HADLOCK, WA 98339 (360) 385-900 TRI-AREA PHARMACY* 65 OAK BAY RD PORT HADLOCK, WA 98339 (360) 379-9800 PORT TOWNSEND DONS 5 WATER ST PORT TOWNSEND, WA 98368 (360) 385-0969 442 W SIMS WAY PORT TOWNSEND, WA 98368 (360) 385-2860 92
KING COUNTY AUBURN FRANCISCAN PHARMACY AUBURN* 205 0TH ST NE AUBURN, WA 98002 (253) 35-5230 FRED MEYER 80 AUBURN WAY N AUBURN, WA 98002 (253) 93-5584 HEALTHPOINT AUBURN PHARMACY* 26 AUBURN AVE STE 04 AUBURN, WA 98002 (253) 804-359 PECKENPAUGH DRUG * 23 E MAIN ST AUBURN, WA 98002 (253) 833-8020 23 AUBURN WAY N AUBURN, WA 98002 (253) 939-5355 509 AUBURN WAY S AUBURN, WA 98002 (253) 939-939 0 AUBURN WAY S AUBURN, WA 98002 (253) 735-4404 SAM'S CLUB * 0 SUPERMALL WAY STE 275 AUBURN, WA 9800 (253) 333-89 TOP FOOD AND DRUG* 702 AUBURN WAY N AUBURN, WA 98002 (253) 804-966 400 HARVEY RD AUBURN, WA 98002 (253) 394-0022 70 AUBURN WAY S AUBURN, WA 98002 (253) 394-0029 WAL-MART * 762 OUTLET COLLECTION DR SW AUBURN, WA 9800 (253) 735-0708 BELLEVUE BARTELL DRUGS * 3620 FACTORIA BLVD SE BELLEVUE, WA 98006 (425) 644-7529 BARTELL DRUGS * 06 NE 8TH ST BELLEVUE, WA 98004 (425) 454-2468 BARTELL DRUGS * 99 NE 8TH ST BELLEVUE, WA 98005 (425) 454-046 BARTELL DRUGS * 653 56TH AVE NE BELLEVUE, WA 98007 (425) 64-927 BELLEGROVE 200 2TH AVE NE STE A00 BELLEVUE, WA 98004 (425) 455-223 EVERGREEN INTEGRATIVE MEDICINE * 520 NE 20TH ST BELLEVUE, WA 98004 (425) 646-4747 FRED MEYER 204 48TH NE BELLEVUE, WA 98007 (425) 865-8593 LAKEMONT 4935 LAKEMONT BLVD SE BELLEVUE, WA 98006 (425) 644-6080 MEDIART FAMILY CLINIC * 530 40TH AVE NE STE 0 BELLEVUE, WA 98005 (425) 233-8254 MEDICAL ARTS ASSOCIATES PS * 380 2TH AVE NE STE 00 BELLEVUE, WA 98004 (425) 454-89 93
MICHAEL K WOO ND * 4205 48TH AVE NE STE 03 BELLEVUE, WA 98007 (425) 822-0602 O'HANA WELLNESS CENTER * 230 30TH AVE NE STE 03 BELLEVUE, WA 98005 (425) 88-230 PHARMACY PLUS * 299 56TH AVE NE STE 40 BELLEVUE, WA 98007 (425) 644-8887 QFC 2636 BELLEVUE WAY NE BELLEVUE, WA 98004 (425) 576-9222 QFC 50 45TH PL SE BELLEVUE, WA 98007 (425) 653-243 QFC 3550 FACTORIA BLVD SE BELLEVUE, WA 98006 (425) 378-0202 500 SE 38TH ST BELLEVUE, WA 98006 (425) 746-4028 20 06TH AVE NE BELLEVUE, WA 98004 (425) 454-653 3905 FACTORIA MALL SE BELLEVUE, WA 98006 (425) 644-2925 645 40TH AVE NE BELLEVUE, WA 98005 (425) 643-778 300 BELLEVUE WAY BELLEVUE, WA 98004 (425) 749-3889 SEATTLE CHILDRENS HOSPITAL * 500 6TH AVE NE BELLEVUE, WA 98004 (206) 884-920 647 40TH AVE NE BELLEVUE, WA 98005 (425) 603-438 35 6TH AVE NE STE 05 BELLEVUE, WA 98004 (425) 453-30 5585 NE 24TH ST BELLEVUE, WA 98007 (425) 643-828 WAL-MART * 5063 MAIN ST BELLEVUE, WA 98007 (425) 643-9402 WAL-MART * 2620 SE 4ST PL BELLEVUE, WA 98006 (425) 643-9034 WASHINGTON CTR FOR PAIN MGMT * 900 6TH AVE NE STE 20 BELLEVUE, WA 98004 (425) 774-538 BOTHELL HEALTHPOINT BOTHELL PHARMACY* 044 BEARDSLEE BLVD BOTHELL, WA 980 (425) 486-0658 QFC 892 BOTHELL WAY NE BOTHELL, WA 980 (425) 487-303 907 BOTHELL WAY NE BOTHELL, WA 980 (425) 489-84 BURIEN ALBERTSON'S * 2725 ST AVE S BURIEN, WA 9868 (206) 242-7942 BARTELL DRUGS * 490 4TH AVE SW BURIEN, WA 9866 (206) 242-202 94
0 SW 48TH ST BURIEN, WA 9866 (206) 835-066 THREE MOON CLINIC* 800 SW 52ND ST STE A BURIEN, WA 9866 (206) 838-3878 4656 AMBAUM BLVD SW BURIEN, WA 9866 (206) 90-86 COVINGTON COSTCO * 27520 COVINGTON WAY SE COVINGTON, WA 98042 (253) 796-0 COVINGTON MULTICARE CLINIC * 7700 SE 272ND ST STE 00 COVINGTON, WA 98042 (253) 372-7220 725 SE 272ND ST COVINGTON, WA 98042 (253) 630-9880 WAL-MART * 7432 SE 270TH PL COVINGTON, WA 98042 (253) 630-8682 DES MOINES BARTELL DRUGS * 27055 PACIFIC HWY S DES MOINES, WA 9898 (253) 839-693 NATUROPATHIC MEDICINE * 2205 MARINE VIEW DR S DES MOINES, WA 9898 (206) 878-2628 240 PACIFIC HWY S DES MOINES, WA 9898 (206) 824-4784 23003 PACIFIC HWY S DES MOINES, WA 9898 (206) 870-832 DUVALL DUVALL FAMILY DRUGS * 5602 MAIN ST NE DUVALL, WA 9809 (425) 788-2644 4020 MAIN ST NE DUVALL, WA 9809 (425) 844-99 ENUMCLAW JIM'S 2820 GRIFFIN AVE STE 02 ENUMCLAW, WA 98022 (360) 825-6523 PLATEAU COMMUNITY 302 GRIFFIN AVE ENUMCLAW, WA 98022 (360) 825-2442 QFC 009 MONROE ST ENUMCLAW, WA 98022 (360) 825-9360 232 ROOSEVELT AVE ENUMCLAW, WA 98022 (360) 825-2558 52 ROOSEVELT AVE E ENUMCLAW, WA 98022 (360) 802-534 350 2ND ST ENUMCLAW, WA 98022 (360) 825-5739 95
FEDERAL WAY ALBERTSON'S * 3009 PACIFIC HWY S FEDERAL WAY, WA 98003 (253) 946-4033 COSTCO * 3500 ENCHANTED PKWY S FEDERAL WAY, WA 98003 (253) 874-443 FEDERAL WAY 3350 ST WAY S FEDERAL WAY, WA 98003 (253) 874-650 FRANCISCAN PHARMACY FIRST AVE * 30809 ST AVE S FEDERAL WAY, WA 98003 (253) 529-8888 FRED MEYER 33702 2ST AVE SW FEDERAL WAY, WA 98023 (253) 952-033 HEALTHPOINT FEDERAL WAY PHCY* 3343 3TH PL S FEDERAL WAY, WA 98003 (253) 85-8045 HIGHLAND 3260 PACIFIC HWY S STE 0 FEDERAL WAY, WA 98003 (253) 839-399 ONURI 33507 9TH AVE S STE B STE 2 FEDERAL WAY, WA 98003 (253) 79-8554 23 SW 336TH ST FEDERAL WAY, WA 98023 (253) 952-2803 3205 PACIFIC HWY S FEDERAL WAY, WA 98003 (253) 945-60 207 S 320TH ST FEDERAL WAY, WA 98003 (253) 946-505 TARGET 220 S COMMONS FEDERAL WAY, WA 98003 (253) 733-752 2887 MILITARY RD S FEDERAL WAY, WA 98003 (253) 839-027 34008 HOYT RD SW FEDERAL WAY, WA 98023 (253) 838-5963 WAL-MART * 34520 6TH AVE S FEDERAL WAY, WA 98003 (253) 835-4976 WAL-MART * 900 S 34TH ST FEDERAL WAY, WA 98003 (253) 94-3555 ISSAQUAH BARTELL DRUGS * 5700 E LAKE SAMMAMISH PKWY ISSAQUAH, WA 98029 (425) 39-6408 COSTCO * 80 0TH AVE NW ISSAQUAH, WA 98027 (425) 33-9200 FRED MEYER 600 E LAKE SAMMAMISH PKWY ISSAQUAH, WA 98029 (425) 46-33 MEDICAL CENTER 450 NW GILMAN BLVD STE 07 ISSAQUAH, WA 98027 (425) 392-8650 96
QFC 4560 KLAHANIE DR SE ISSAQUAH, WA 98027 (425) 392-855 065 NW GILMAN BLVD ISSAQUAH, WA 98027 (425) 392-2865 45 HIGHLANDS DR NE ISSAQUAH, WA 98029 (425) 392-48 735 NW GILMAN BLVD ISSAQUAH, WA 98027 (425) 507-042 SWEDISH ISSAQUAH RETAIL PHCY * 75 NE BLAKELY DR ISSAQUAH, WA 98029 (425) 33-5200 TARGET 755 NW GILMAN BLVD ISSAQUAH, WA 98027 (425) 507-020 6300 E LAKE SAMMAMISH PKWY ISSAQUAH, WA 98029 (425) 369-0265 KENMORE OSTROM DRUG AND GIFT * 644 NE BOTHELL WAY KENMORE, WA 98028 (425) 486-77 8022 NE 68TH AVE KENMORE, WA 98028 (425) 424-2320 6850 NE BOTHELL WAY KENMORE, WA 98028 (425) 486-66 KENT A AND H PHARMACEUTICAL SVCS 60 W MEEKER ST STE 20 KENT, WA 98032 (253) 852-23 BARTELL DRUGS * 2946 SE KENT KANGLEY RD KENT, WA 98030 (253) 63-6874 FRED MEYER 25250 PACIFIC HWY S KENT, WA 9803 (253) 94-2905 FRED MEYER 6735 SE 272ND ST KENT, WA 98402 (253) 639-7433 FRED MEYER 020 SE 240TH ST KENT, WA 9803 (253) 859-5533 HEALTHPOINT KENT 403 E MEEKER ST STE 300 KENT, WA 98030 (253) 372-366 PROPAC PHARMACY* 702 S 220TH ST KENT, WA 98032 (855)535-783 26200 PACIFIC HWY S KENT, WA 98032 (253) 94-4660 0407 SE 256TH ST KENT, WA 98030 (253) 854-5343 05 WASHINGTON AVE N KENT, WA 98032 (253) 373-056 705 272ND SE KENT, WA 98042 (253) 63-2450 97
20830 08TH AVE SE KENT, WA 9803 (253) 852-939 30 SE KENT KANGLEY HWY KENT, WA 9803 (253) 638-083 20 WASHINGTON AVE S KENT, WA 98032 (253) 852-55 TARGET 2630 04TH AVE SE KENT, WA 9803 (253) 58-90 TOP FOOD AND DRUG* 2605 04TH AVE SE KENT, WA 98030 (253) 850-6480 UNITED CARE 8230 E VALLEY HWY STE 88 KENT, WA 98032 (206) 37-7697 UNITED CARE PHARMACY 8230 E VALLEY HWY KENT, WA 98032 (425) 656-2900 25605 04TH AVE SE KENT, WA 98030 (253) 83-6968 272 32ND AVE SE KENT, WA 98042 (253) 638-3324 KIRKLAND ASSURED PHARMACY* 207 24TH AVE NE KIRKLAND, WA 98034 (425) 820-030 BARTELL DRUGS * 669 32ND AVE NE KIRKLAND, WA 98033 (425) 88-5678 BARTELL DRUGS * 4442 24TH AVE NE KIRKLAND, WA 98034 (425) 82-7899 BARTELL DRUGS * 430 JUANITA DR NE KIRKLAND, WA 98034 (425) 82-6275 BARTELL DRUGS * 0625 NE 68TH ST KIRKLAND, WA 98033 (425) 822-224 COSTCO * 8629 20TH AVE NE KIRKLAND, WA 98033 (425) 822-044 EVERGREEN 29 20TH AVE NE KIRKLAND, WA 98034 (425) 82-8888 EVERGREEN PROF CTR 2303 NE 30TH LN STE 20 KIRKLAND, WA 98034 (425) 899-2790 FRED MEYER 222 20TH AVE NE KIRKLAND, WA 98034 (425) 820-3233 INTEGRATIVE FOOT AND ANKLE CTR * 3030 2ST WAY NE STE 204 KIRKLAND, WA 98034 (425) 822-7426 PACMED CLINIC PHARMACY 290 TOTEM LAKE BLVD NE KIRKLAND, WA 98034 (425) 84-5003 QFC 2 PARK PL KIRKLAND, WA 98033 (425) 822-423 QFC 224 NE 24TH ST KIRKLAND, WA 98034 (425) 820-0440 98
9820 NE 32ND ST KIRKLAND, WA 98034 (425) 823-4466 2530 TOTEM LAKE BLVD KIRKLAND, WA 98034 (425) 82-500 4444 24TH AVE NE KIRKLAND, WA 98033 (425) 82-7455 0020 NE 37TH AVE KIRKLAND, WA 98033 (425) 82-0708 259 85TH ST NE KIRKLAND, WA 98033 (425) 822-9235 607 98TH AVE NE KIRKLAND, WA 98034 (425) 825-884 2405 NE 85TH ST KIRKLAND, WA 98033 (425) 822-9202 MAPLE VALLEY BARTELL DRUGS * 227 SE 237TH ST MAPLE VALLEY, WA 98038 (425) 432-234 FRED MEYER 26520 MAPLE VALLEY BLACK MAPLE VALLEY, WA 98038 (425) 433-2333 26705 BLACK DIAMOND RD SE MAPLE VALLEY, WA 98038 (425) 578-943 MERCER ISLAND ALBERTSON'S * 2755 77TH AVE SE MERCER ISLAND, WA 98040 (206) 232-2222 3023 SE 78TH AVE MERCER ISLAND, WA 98040 (206) 236-0776 844 SE 68TH ST MERCER ISLAND, WA 98040 (206) 232-3000 7707 SE 27TH ST STE 00 MERCER ISLAND, WA 98040 (206) 232-97 NEWCASTLE BARTELL DRUGS * 6939 COAL CREEK PKWY SE NEWCASTLE, WA 98059 (425) 644-446 NORMANDY PARK ACCESS 7833 ST AVE S STE C NORMANDY PARK, WA 9848 (206) 246-0040 NORTH BEND BARTELL DRUGS * 248 BENDIGO BLVD S NORTH BEND, WA 98045 (425) 888-308 QFC 460 E NORTHBEND WAY NORTH BEND, WA 98045 (425) 888-2357 460 SW MOUNT BLVD NORTH BEND, WA 98045 (425) 83-226 REDMOND ALBERTSON'S * 3925 236TH AVE NE REDMOND, WA 98053 (425) 836-8706 99
ALPINE INTEGRATED MEDICINE * 22635 NE MARKETPLACE DR REDMOND, WA 98053 (425) 949-596 BARTELL DRUGS * 8862 6ST AVE NE REDMOND, WA 98052 (425) 883-9532 BARTELL DRUGS * 7370 70TH AVE NE REDMOND, WA 98052 (425) 895-8242 FRED MEYER 7667 NE 76TH ST REDMOND, WA 98052 (425) 556-8033 PHARMACA INTEGRATIVE 5840 REDMOND WAY REDMOND, WA 98052 (425) 885-2323 QFC 8867 6ST AVE NE REDMOND, WA 98052 (425) 869-7474 4880 NE 24TH ST REDMOND, WA 98052 (425) 883-0900 7220 REDMOND WAY REDMOND, WA 98052 (425) 883-56 630 228TH AVE NE REDMOND, WA 98074 (425) 868-68 TARGET 7700 NE 76TH ST REDMOND, WA 98052 (425) 202-000 RENTON ALBERTSON'S * 425 SE PETROVITSKY RD RENTON, WA 98058 (425) 235-7772 BARTELL DRUGS * 4700 NE 4TH ST RENTON, WA 98059 (425) 793-05 BARTELL DRUGS * 7254 40TH SE RENTON, WA 98058 (425) 226-7000 FRED MEYER 780 08TH AVE SE RENTON, WA 98055 (425) 235-5383 FRED MEYER 365 RENTON CENTER WAY SW RENTON, WA 98055 (425) 204-5233 HEALTHPOINT CENTRAL FILL PHCY * 947 POWELL AVE SW RENTON, WA 98057 (877)233-0246 JOLLY'S PHARMACY 42 SW 43RD ST STE 20 RENTON, WA 98057 (425) 25-6335 LAURA J HIEB ND * 304 MAIN AVE S STE 20 RENTON, WA 98057 (425) 282-5304 PACMED CLINIC PHARMACY 60 S CARR RD STE 00 RENTON, WA 98055 (425) 227-322 PAIN ASSOCIATES OF WASHINGTON * 4300 TALBOT RD S STE 200 RENTON, WA 98055 (425) 27-255 READY MEDS 42 SW 43RD ST STE 20 RENTON, WA 98057 (425) 25-6335 36 NE SUNSET BLVD RENTON, WA 98056 (425) 793-0787 00
60 S GRADY WAY STE P RENTON, WA 98055 (425) 226-4390 4300 4TH ST NE RENTON, WA 98059 (425) 235-625 200 S 3RD ST RENTON, WA 98055 (425) 226-0325 69 COAL CREEK PKWY SE RENTON, WA 98056 (425) 644-2726 SAM'S CLUB * 90 S GRADY WAY RENTON, WA 98057 (425) 793-7937 SUNSET PLAZA 388 NE SUNSET BLVD RENTON, WA 98056 (425) 27-6066 TARGET 25 LANDING WAY RENTON, WA 98055 (425) 207-0078 THE PRESCRIPTION PAD 395 TALBOT RD S RENTON, WA 98055 (425) 656-4050 THE PRESCRIPTION PAD 400 S 43RD ST RENTON, WA 98055 (425) 97-6226 405 NE 4TH ST RENTON, WA 98059 (425) 207-278 275 RAINER AVE S RENTON, WA 98055 (425) 277-022 30 NE SUNSET BLVD RENTON, WA 98056 (425) 207-0053 WAL-MART * 743 RAINIER AVE S RENTON, WA 98057 (425) 227-9307 SAMMAMISH BARTELL DRUGS * 526 228TH AVE NE SAMMAMISH, WA 98074 (425) 868-2 3066 ISSAQUAH PINE LAKE SAMMAMISH, WA 98075 (425) 39-582 SEATAC 40 S 64TH ST SEATAC, WA 9888 (206) 248-0300 SEATTLE AFH PHARAMCY * 07 E UNION ST SEATTLE, WA 9822 (206) 568-2486 AHP 20 CHERRY ST STE 24 SEATTLE, WA 9804 (206) 624-39 BALLARD PLAZA 80 NW MARKET ST STE 04 SEATTLE, WA 9807 (206) 782-7200 BARTELL DRUGS * 600 ST AVE N SEATTLE, WA 9809 (206) 284-354 BARTELL DRUGS * 20 N 85TH ST SEATTLE, WA 9803 (206) 784-7600 0
BARTELL DRUGS * 9600 5TH AVE SW SEATTLE, WA 9806 (206) 763-2727 BARTELL DRUGS * 308 NE 25TH ST SEATTLE, WA 9825 (206) 362-7572 BARTELL DRUGS * 4706 42ND AVE SW SEATTLE, WA 986 (206) 932-8045 BARTELL DRUGS * 2345 42ND AVE SW SEATTLE, WA 986 (206) 932-7437 BARTELL DRUGS * 265 PACIFIC HWY S SEATTLE, WA 9898 (206) 878-4628 BARTELL DRUGS * 4344 UNIVERSITY WAY NE SEATTLE, WA 9805 (206) 632-353 BARTELL DRUGS * 2222 32ND AVE W SEATTLE, WA 9899 (206) 282-2880 BARTELL DRUGS * 404 3RD AVE SEATTLE, WA 980 (206) 624-40 BARTELL DRUGS * 2700 NE UNIVERSITY VILLAGE ST SEATTLE, WA 9805 (206) 525-0705 BARTELL DRUGS * 407 BROADWAY AVE SEATTLE, WA 9822 (206) 726-3495 BARTELL DRUGS * 5605 22ND AVE NW SEATTLE, WA 9807 (206) 783-3050 BARTELL DRUGS * 0 MADISON ST SEATTLE, WA 9804 (206) 340-7 BARTELL DRUGS * 640 2TH AVE NE SEATTLE, WA 985 (206) 525-3754 BARTELL DRUGS * 820 N 45TH ST SEATTLE, WA 9803 (206) 632-333 BARTELL DRUGS * 90 4TH AVE SEATTLE, WA 9834 (206) 624-8394 BARTELL DRUGS * 929 QUEEN ANNE AVE N SEATTLE, WA 9809 (206) 285-737 BARTELL DRUGS * 2345 RAINIER AVE S SEATTLE, WA 9844 (206) 325-5725 BARTELL DRUGS * 00 MERCER ST SEATTLE, WA 9809 (206) 223-04 BARTELL DRUGS * 500 NW MARKET ST STE 0 SEATTLE, WA 9807 (206) 783-482 BOB JOHNSONS 407 NW 85TH ST SEATTLE, WA 987 (206) 782-5822 BUCK PAVILION MASON CLINIC 00 9TH AVE SEATTLE, WA 980 (206) 223-6877 CABRINI MEDICAL TOWER PHCY * 90 BOREN AVE SEATTLE, WA 9804 (206) 682-0 CHESTERFIELD 720 7TH AVE STE 00 SEATTLE, WA 9804 (206) 838-6070 COLUMBIA 474 RAINIER AVE S SEATTLE, WA 988 (206) 723-5233 COMMUNITY * 00 BROADWAY STE 02 SEATTLE, WA 9822 (206) 324-2335 02
COSTCO * 75 N 205TH ST SEATTLE, WA 9833 (206) 542-0497 COSTCO * 440 4TH AVE S SEATTLE, WA 9834 (206) 682-6244 COUNTRY DOCTOR COMMUNITY CLN * 500 9TH AVE E SEATTLE, WA 982 (206) 299-620 DES MOINES DRUG 627 227TH ST S SEATTLE, WA 9898 (206) 878-2345 DONG NAI 620 S JACKSON ST SEATTLE, WA 9804 (206) 624-4238 DOWNTOWN PUBLIC HLTH CNTR PHCY 224 4TH AVE SEATTLE, WA 982 (206) 296-4637 FRED MEYER 3000 LAKE CITY WAY NE SEATTLE, WA 9825 (206) 440-249 FRED MEYER 00 NW 85TH ST SEATTLE, WA 987 (206) 783-2272 FRED MEYER 8325 AURORA AVE N SEATTLE, WA 9833 (206) 546-0753 FRED MEYER 4300 ST AVE S SEATTLE, WA 9868 (206) 433-6446 FRED MEYER 95 NW 45TH ST SEATTLE, WA 9807 (206) 297-4333 HARBORVIEW MEDICAL CENTER * 325 9TH AVE SEATTLE, WA 9804 (206) 744-329 HOLLY PARK 385 S OTHELLOS ST SEATTLE, WA 988 (206) 788-3562 INTERNATIONAL COMM HLTH SVCS * 720 8TH AVE S STE 00 SEATTLE, WA 9804 (206) 788-3770 KATTERMAN'S SAND POINT PHCY * 5400 SAND POINT WAY NE SEATTLE, WA 9805 (206) 524-22 KELLEY ROSS LTC PHARMACY 2324 EASTLAKE AVE E SEATTLE, WA 9802 (206) 838-4590 KELLEY-ROSS 904 7TH AVE STE 03 SEATTLE, WA 9804 (206) 324-6990 KING PLAZA 70 MLK JR WAY S STE 0B SEATTLE, WA 988 (206) 72-5009 LAFFERRY'S 532 7TH AVE NW SEATTLE, WA 9807 (206) 783-533 LINDEMAN PAVILION 20 TERRY AVE STE X2-PN SEATTLE, WA 980 (206) 625-7202 LOWRY'S PRESCRIPTIONS * 0330 MERIDIAN AVE N SEATTLE, WA 9833 (206) 368-6060 LUKE'S 6 MAYNARD AVE S SEATTLE, WA 9804 (206) 62-8883 03
MAPLE LEAF 8830 ROOSEVELT WAY NE SEATTLE, WA 985 (206) 729-754 MERIDIAN PHARMACY* 0 MERIDIAN AVE N SEATTLE, WA 9833 (206) 403-37 NATURAL HEALTHCARE NORTHWEST * 509 OLIVE WAY STE 35 SEATTLE, WA 980 (206) 382-9977 NAVOS * 2600 SW HOLDEN ST SEATTLE, WA 9826 (206) 933-729 NEIGHBORCARE HEALTH * 4400 37TH AVE S SEATTLE, WA 988 (206) 46-6957 NEIGHBORCARE HEALTH * 930 POST ALY SEATTLE, WA 980 (206) 728-443 NEIGHBORCARE HEALTH * 629 N 45TH ST SEATTLE, WA 9803 (206) 548-2964 NGUYENS PHARMACY AND GIFTS * 220 RAINIER AVE S SEATTLE, WA 9844 (206) 323-9525 NGUYENS PHARMACY AND GIFTS * 22 S MAIN ST STE 03 SEATTLE, WA 9844 (206) 323-6003 NORTH PUBLIC HEALTH CTR PHCY 050 MERIDIAN AVE N SEATTLE, WA 9833 (206) 296-4908 NORTHWEST KIDNEY CENTER PHCY * 700 BROADWAY SEATTLE, WA 9822 (206) 343-4870 NORTHWEST PRESCRIPTION * 536 N 5TH ST STE 00 SEATTLE, WA 9833 (206) 365-2255 NW NATUROPATHY AND ACUPUNCTURE * 6300 9TH AVE NE STE 30 SEATTLE, WA 985 (206) 524-0863 PACIFIC DRUGS * 822 ST AVE SEATTLE, WA 9804 (206) 624-454 PACMED CLINIC PHARMACY 046 5TH AVE NE SEATTLE, WA 9825 (206) 57-6635 PACMED CLINIC PHARMACY 200 2TH AVE S SEATTLE, WA 9844 (206) 62-409 PACMED CLINIC PHARMACY 0 MADISON STE 306 SEATTLE, WA 9804 (206) 505-397 PARK'S 40 NE RAVENNA BLVD STE A SEATTLE, WA 985 (206) 527-300 PHARMACA INTEGRATIVE 4707 CALIFORNIA AVE SW SEATTLE, WA 986 (206) 932-4225 PHARMACA INTEGRATIVE PHCY * 430 EAST MADISON SEATTLE, WA 982 (206) 324-88 PHARMACARE SPECIALTY PHCY * 00 MADISON ST SEATTLE, WA 9804 (206) 38-259 04
PLANNED PARENTHOOD OF GRT NW PHCY * 200 E MADISON ST SEATTLE, WA 9822 (206) 963-2686 QFC 47 BROADWAY E SEATTLE, WA 9802 (206) 328-6960 QFC 9999 HOLMAN RD NW SEATTLE, WA 987 (206) 782-400 QFC 53 NE 45TH ST SEATTLE, WA 9855 (206) 366-4672 QFC 500 MERCER ST SEATTLE, WA 9809 (260)352-4030 QFC 2746 NE 45TH ST SEATTLE, WA 9805 (206) 729-3080 QFC 00 ROOSEVELT WAY NE SEATTLE, WA 9825 (206) 36-088 QFC 600 RICHMOND BEACH RD SEATTLE, WA 9877 (206) 542-5469 QFC 4550 42ND AVE SW SEATTLE, WA 986 (206) 923-639 QUE ARESTE ND * 605 2TH AVE STE 6 SEATTLE, WA 9822 (206) 328-2926 320 N AURORA AVE SEATTLE, WA 9833 (206) 364-7676 2603 THIRD AVE SEATTLE, WA 982 (206) 44-8790 655 NW RICHMOND BEACH RD SEATTLE, WA 9877 (206) 542-9688 2600 SW BARTON ST STE D SEATTLE, WA 9826 (206) 938-4253 527 CALIFORNIA AVE SW SEATTLE, WA 9836 (206) 937-29 300 MADISON ST SEATTLE, WA 9804 (206) 322-936 77 BOTHELL WAY NE STE 5 SEATTLE, WA 9855 (206) 363-6364 9200 RAINIER AVE S SEATTLE, WA 988 (206) 760-076 20 BROADWAY E SEATTLE, WA 9802 (206) 324-7 8500 35TH AVE NE SEATTLE, WA 985 (206) 527-8373 802 3RD AVE SEATTLE, WA 9804 (206) 623-0577 RXTRA CARE PHCY VIEW RIDGE * 737 35TH AVE NE SEATTLE, WA 985 (206) 47-8066 200 QUEEN ANNE AVE N SEATTLE, WA 9809 (206) 284-4226 56 ST AVE W SEATTLE, WA 989 (206) 494-700 05
7300 NE ROOSEVELT WAY SEATTLE, WA 985 (206) 524-649 3820 RAINIER AVE S SEATTLE, WA 988 (206) 725-9887 7340 35TH AVE NE SEATTLE, WA 985 (206) 494-255 3020 NE 45TH ST SEATTLE, WA 9805 (206) 524-993 9620 28TH AVE SW SEATTLE, WA 9826 (206) 923-90 5332 AURORA AVE N SEATTLE, WA 9833 (206) 362-4940 40 E JOHN ST SEATTLE, WA 982 (206) 323-4935 423 NW MARKET ST SEATTLE, WA 9807 (206) 782-8688 38 SW 48TH ST SEATTLE, WA 9866 (206) 243-2796 9262 RAINIER AVE S SEATTLE, WA 988 (206) 494-30 7202 5TH AVE NE SEATTLE, WA 9855 (206) 364-468 8340 5TH AVE NW SEATTLE, WA 987 (206) 782-7480 2622 CALIFORNIA AVE SW SEATTLE, WA 986 (206) 937-222 220 E MADISON ST SEATTLE, WA 982 (206) 494-520 8704 GREENWOOD AVE N SEATTLE, WA 9803 (206) 494-0440 SAM'S CLUB * 3550 AURORA AVE N SEATTLE, WA 9833 (206) 36-594 SEA MAR CHC PHARMACY 8800 4TH AVE S SEATTLE, WA 9808 (206) 762-3397 SEATTLE CANCER CARE ALLIANCE * 825 EASTLAKE AVE E SEATTLE, WA 9809 (206) 288-375 SEATTLE CHILDREN'S 4800 SAND POINT WAY NE SEATTLE, WA 9805 (206) 987-238 SEATTLEMEDS 305 MADISON ST SEATTLE, WA 9804 (206) 382-2087 SIMON WELLNESS * 6300 9TH AVE NE STE 30 SEATTLE, WA 985 (206) 524-0863 06
SWEDISH FIRST HILL 747 BROADWAY SEATTLE, WA 9822 (206) 386-3784 SWEDISH ORTHOPEDIC INST PHCY * 60 BROADWAY SEATTLE, WA 9822 (206) 25-90 SWEDISH PHARMACY CHERRY HILL * 550 7TH AVE STE 80 SEATTLE, WA 9822 (206) 320-2699 TARGET 302 NE NORTHGATE WAY SEATTLE, WA 9825 (206) 494-0898 UNION CENTER 2324 EASTLAKE AVE E STE 405 SEATTLE, WA 9802 (206) 44-974 UWMC AMBULATORY 959 NE PACIFIC ST SEATTLE, WA 9895 (206) 598-4363 VITAL THERAPEUTICS* 836 WESTLAKE AVE N STE 20 SEATTLE, WA 9809 (206) 729-600 222 PIKE ST SEATTLE, WA 980 (206) 903-8392 4352 LAKE CITY WAY NE SEATTLE, WA 9825 (206) 36-9753 9456 6TH AVE SW SEATTLE, WA 9806 (206) 767-2294 442 RAINIER AVE S SEATTLE, WA 988 (206) 760-7880 859 NE NORTHGATE WAY SEATTLE, WA 9825 (206) 47-0520 870 GREENWOOD AVE N SEATTLE, WA 9803 (206) 706-940 8500 5TH AVE NW STE A SEATTLE, WA 987 (206) 706-520 2400 S JACKSON ST SEATTLE, WA 9844 (206) 329-6850 6330 35TH AVE SW SEATTLE, WA 9826 (206) 938-2759 5409 5TH AVE NW SEATTLE, WA 9807 (206) 78-0056 566 DENNY WAY SEATTLE, WA 9809 (206) 204-982 4468 STONE WAY N SEATTLE, WA 9803 (206) 547-226 205 NE 50TH ST SEATTLE, WA 9805 (206) 204-045 53 BROADWAY BLVD SEATTLE, WA 9822 (206) 204-0599 WHITE CENTER 960 6TH AVE SW SEATTLE, WA 9806 (206) 763-2500 SHORELINE BARTELL DRUGS * 8420 AURORA AVE N SHORELINE, WA 9833 (206) 542-2948 07
20330 BALLINGER WAY NE SHORELINE, WA 9855 (206) 368-0034 SHORELINE NATURAL MEDICINE * 646 NW RICHMOND BEACH RD SHORELINE, WA 9877 (206) 542-8687 TOP FOOD AND DRUG* 20 N 75TH ST SHORELINE, WA 9833 (206) 533-286 450 AURORA AVE N SHORELINE, WA 9833 (206) 36-8826 7524 AURORA AVE N SHORELINE, WA 9833 (206) 542-4964 758 5TH AVE NE SHORELINE, WA 9855 (206) 36-7474 SNOQUALMIE SNOQUALMIE VILLAGE PHARMACY* 7730 CENTER BLVD SE SNOQUALMIE, WA 98065 (425) 396-7474 THE FALLS PHCY UNITED DRUGS * 82 RAILROAD AVE SE SNOQUALMIE, WA 98065 (425) 888-6858 TUKWILA BARTELL DRUGS * 4277 PACIFIC HWY S TUKWILA, WA 9868 (206) 43-9652 COSTCO * 400 COSTCO DR TUKWILA, WA 9888 (206) 575-847 PARAMOUNT 7200 S 80TH ST STE 04 TUKWILA, WA 9888 (425) 25-660 TARGET 30 STRANDER BLVD TUKWILA, WA 9888 (206) 575-0682 376 S 44TH ST TUKWILA, WA 9868 (206) 204-284 VASHON VASHON PHARMACY 767 VASHON HWY SW VASHON, WA 98070 (206) 463-98 WOODINVILLE 4035 NE WOODINVILLE DUVALL WOODINVILLE, WA 98072 (425) 485-6468 950 WOODINVILLE DUVALL RD WOODINVILLE, WA 98077 (425) 788-6658 TARGET 3950 NE 78TH PL WOODINVILLE, WA 98072 (425) 492-820 THE NATURAL PATH TO HEALING * 560 NE WOODINVILLE DUVALL WOODINVILLE, WA 98072 (425) 489-5900 08
TOP FOOD AND DRUG* 764 GARDEN WAY NE WOODINVILLE, WA 98072 (425) 398-670 TREE OF HEALTH INTEGRATIVE * 73 35TH AVE NE STE A250 WOODINVILLE, WA 98072 (425) 408-0040 7520 AVONDALE RD NE WOODINVILLE, WA 98077 (425) 844-0302 WOODINVILLE MED CTR PHCY * 700 40TH AVE NE UNIT E0 WOODINVILLE, WA 98072 (425) 485-2900 KITSAP COUNTY BAINBRIDGE ISLAND 30 HIGH SCHOOL RD NE BAINBRIDGE ISLAND, WA 980 (206) 842-4065 253 HIGH SCHOOL RD NE BAINBRIDGE ISLAND, WA 980 (206) 842-027 WINSLOW DRUG * 290 WINSLOW WAY E BAINBRIDGE ISLAND, WA 980 (206) 842-2652 BREMERTON ALBERTSON'S * 2900 WHEATON WAY BREMERTON, WA 9830 (360) 377-0933 APOTHECARY SHOPPE * 2500 CHERRY AVE STE 0 BREMERTON, WA 9830 (360) 479-4900 FRED MEYER 5050 STATE HIGHWAY 303 NE BREMERTON, WA 983 (360) 792-2833 PENINSULA COMMUNITY HEALTH SVS * 2508 WHEATON WAY BREMERTON, WA 9830 (360) 66-33 PENINSULA COMMUNITY HLTH SRVS * 66 6TH ST BREMERTON, WA 98337 (360) 475-373 4220 WHEATON WAY BREMERTON, WA 9830 (360) 479-3450 900 CALLOW AVE BREMERTON, WA 9832 (360) 792-9262 40 NE MCWILLIAMS RD BREMERTON, WA 983 (360) 373-7226 3929 KITSAP WAY BREMERTON, WA 9832 (360) 97-04 6432 STATE HWY 303 NE BREMERTON, WA 983 (360) 307-874 09
3333 WHEATON WAY BREMERTON, WA 9830 (360) 782-0907 WAL-MART * 6797 STATE HWY 303 NE BREMERTON, WA 983 (360) 698-3446 KINGSTON ALBERTSON'S * 896 NE STATE HIGHWAY 04 KINGSTON, WA 98346 (360) 297-8 27000 MILLER BAY RD NE KINGSTON, WA 98346 (360) 297-5200 PORT ORCHARD ALBERTSON'S * 390 SW SEDGEWICK RD PORT ORCHARD, WA 98367 (360) 876-2698 ALBERTSON'S * 434 OLNEY ST SE PORT ORCHARD, WA 98366 (360) 895-063 FRED MEYER 900 SE SEDGWICK RD PORT ORCHARD, WA 98366 (360) 874-773 PENINSULA COMMUNITY HLTH SVCS * 320 S KITSAP BLVD PORT ORCHARD, WA 98366 (360) 874-5583 3282 BETHEL RD SE PORT ORCHARD, WA 98366 (360) 876-0969 3355 BETHEL RD SE PORT ORCHARD, WA 98366 (360) 876-6064 SOUTH PARK 743 VILLAGE LN SE PORT ORCHARD, WA 98366 (360) 87-020 3099 BETHEL RD SE PORT ORCHARD, WA 98366 (360) 876-522 WAL-MART * 3497 BETHEL RD SE PORT ORCHARD, WA 98366 (360) 874-9063 POULSBO KITSAP 2048 0TH AVE NE POULSBO, WA 98370 (360) 779-5335 PENINSULA COMM HTLH SVCS PHCY * 997 7TH AVE NE POULSBO, WA 98370 (360) 697-7636 POULSBO COMPOUNDING 325 NE HOSTMARK ST POULSBO, WA 98370 (360) 779-2737 9475 NE 7TH AVE POULSBO, WA 98370 (360) 697-2209 9245 0TH AVE NE POULSBO, WA 98370 (360) 394-589 WAL-MART * 2200 OLHAVA WAY NW POULSBO, WA 98370 (360) 697-209 0
SILVERDALE ALBERTSON'S * 2222 NW BUCKLIN HILL RD SILVERDALE, WA 98383 (360) 692-8596 COSTCO * 0000 MICKELBERRY RD NW SILVERDALE, WA 98383 (360) 308-26 NATURAL OPTIONS HEALTH CLINIC * 948 BAYSHORE DR NW SILVERDALE, WA 98383 (360) 698-44 2860 NW BUCKLIN HILL RD SILVERDALE, WA 98383 (360) 692-340 TARGET 320 NW RANDALL WAY SILVERDALE, WA 98383 (360) 536-600 9709 SILVERDALE WAY NW SILVERDALE, WA 98383 (360) 692-7536 KITTITAS COUNTY CLE ELUM CAVALLINI'S 06 E ST ST CLE ELUM, WA 98922 (509) 674-257 CLE ELUM DRUG * 29 E ST ST CLE ELUM, WA 98922 (509) 674-255 ELLENSBURG BI-MART 608 E MOUNTAIN VIEW AVE ELLENSBURG, WA 98926 (509) 925-6996 ELLENSBURG DOWNTOWN HM PHCY * 44 N PEARL ST ELLENSBURG, WA 98926 (509) 925-54 ELLENSBURG 52 E MOUNTAIN VIEW AVE ELLENSBURG, WA 98926 (509) 962-430 700 S MAIN ST ELLENSBURG, WA 98926 (509) 925-4232 400 NORTH RUBY ST ELLENSBURG, WA 98926 (509) 962-5096 SUPER ONE 200 E MOUNTAIN VIEW AVE ELLENSBURG, WA 98926 (509) 962-7777 KLICKITAT COUNTY WHITE SALMON HI-SCHOOL 250 E JEWETT BLVD WHITE SALMON, WA 98672 (509) 493-4842 LEWIS CENTRALIA HALLS DRUG CENTER* 505 S TOWER AVE STE 2 CENTRALIA, WA 9853 (360) 736-5000 PROVIDENCE CENTRALIA HOSPITAL 94 S SCHEUBER RD CENTRALIA, WA 9853 (360) 807-7997
200 HARRISON AVE CENTRALIA, WA 9853 (360) 807-204 29 HARRISON AVE CENTRALIA, WA 9853 (360) 330-5229 CHEHALIS KMART 20 NW LOUISIANA AVE CHEHALIS, WA 98532 (360) 748-968 55 S MARKET BLVD CHEHALIS, WA 98532 (360) 748-880 00 S MARKET BLVD CHEHALIS, WA 98532 (360) 740-6750 60 NW LOUISIANA AVE CHEHALIS, WA 98532 (360) 740-876 WAL-MART * 60 NW LOUISIANA AVE CHEHALIS, WA 98532 (360) 748-0858 MORTON COLTON 377 S 2ND ST MORTON, WA 98356 (360) 496-5902 WINLOCK CEDAR VILLAGE 206 E WALNUT ST WINLOCK, WA 98596 (360) 785-47 LINCOLN COUNTY DAVENPORT DAVENPORT GOOD NEIGHBOR PHCY * 525 MORGAN ST DAVENPORT, WA 9922 (509) 725-5 LINCOLN COUNTY HLTH MRT PHCY * 62RGAN ST DAVENPORT, WA 9922 (509) 725-330 MASON COUNTY BELFAIR QFC 20 NE STATE ROUTE 300 BELFAIR, WA 98528 (360) 275-967 23940 NE STATE ROUTE 3 BELFAIR, WA 98528 (360) 275-8964 2396 NE STATE ROUTE 3 BELFAIR, WA 98528 (360) 275-0953 SHELTON FRED MEYER 30 E WALLACE KNEELAND BLVD SHELTON, WA 98584 (360) 432-5373 MEDICINE SHOPPE 207 PROFESSIONAL WAY SHELTON, WA 98584 (360) 426-4272 NEIL'S 52 W FRANKLIN ST SHELTON, WA 98584 (360) 426-3328 600 FRANKLIN ST SHELTON, WA 98584 (360) 426-078 WAL-MART * 00 E WALLACE KNEELAND BLVD SHELTON, WA 98584 (360) 427-07 2
OKANOGAN COUNTY BREWSTER BREWSTER HEALTH MART DRUG * 8 STATE HWY 97 NINTH BREWSTER, WA 9882 (509) 689-242 FAMILY HEALTH CENTERS * 525 W JAY ST BREWSTER, WA 9882 (509) 689-4406 OKANOGAN DOUGLAS HOSPITAL PHCY * 507 HOSPITAL WAY BREWSTER, WA 9882 (509) 689-257 OKANOGAN OKANOGAN VALLEY 236 2ND AVE N OKANOGAN, WA 98840 (509) 422-9958 OMAK OMAK 903 ENGH RD STE A OMAK, WA 9884 (509) 422-500 609 OMACHE DR OMAK, WA 9884 (509) 826-2806 WAL-MART * 902 ENGH RD OMAK, WA 9884 (509) 826-646 TONASKET ROY'S HEALTH MART 38 S WHITCOMB AVE TONASKET, WA 98855 (509) 486-249 TWISP ULRICH VALLEY HEALTH MART PHCY 423 E METHOW VALLEY HWY TWISP, WA 98856 (509) 997-29 PACIFIC COUNTY LONG BEACH LONG BEACH 0 BOLSTAD AVE E LONG BEACH, WA 9863 (360) 642-3200 OCEAN PARK OCEAN PARK 50 BAY AVE OCEAN PARK, WA 98640 (360) 665-58 RAYMOND SAGENS 55 COMMERCIAL ST RAYMOND, WA 98577 (360) 942-2634 SOUTH BEND SOUTH BEND 0 WILLAPA AVE SOUTH BEND, WA 98586 (360) 875-5757 PEND OREILLE COUNTY NEWPORT 2 W WALNUT ST NEWPORT, WA 9956 (509) 447-3972 SEEBER'S HEALTH MART * 336 S WASHINGTON AVE NEWPORT, WA 9956 (509) 447-2484 PIERCE COUNTY AUBURN HAGGEN FOOD AND 406 LAKE TAPPS PKWY E AUBURN, WA 98092 (253) 876-76 3 3
502 LAKE TAPPS PKWY SE AUBURN, WA 98092 (253) 394-009 BONNEY LAKE FRANCISCAN PHCY BONNEY LAKE * 9230 SKY ISLAND DR E BONNEY LAKE, WA 9839 (253) 426-6209 FRED MEYER 2090 STATE ROUTE 40 E BONNEY LAKE, WA 9839 (253) 89-7333 MULTICARE BONNEY LAKE 0004 204TH AVE E STE 200 BONNEY LAKE, WA 9839 (253) 447-3355 2302 STATE RTE 40 E BONNEY LAKE, WA 9839 (253) 862-2822 RXPRESS PHARMACY* 2509 SR 40 E STE 4 BONNEY LAKE, WA 9839 (253) 862-5000 TARGET 9400 92ND AVE E BONNEY LAKE, WA 9839 (253) 862-640 WAL-MART * 9205 SR 40 E BONNEY LAKE, WA 9839 (253) 826-95 BUCKLEY CHUCK'S DRUGS * 787 MAIN ST BUCKLEY, WA 9832 (360) 829-045 DUPONT DUPONT 545 WILMINGTON DR STE 60 DUPONT, WA 98327 (253) 964-3400 EDGEWOOD 729 MERIDIAN AVE E EDGEWOOD, WA 9837 (253) 927-3380 FIRCREST FIRCREST 07 REGENTS BLVD FIRECREST, WA 98466 (253) 830-5242 GIG HARBOR ALBERTSON'S * 330 5ST AVE NW GIG HARBOR, WA 98332 (253) 853-4755 BARTELL DRUGS * 5500 OLYMPIC DR NW GIG HARBOR, WA 98335 (253) 858-7455 COSTCO * 0990 HARBOR HILL DR GIG HARBOR, WA 98335 (253) 853-8609 COSTLESS SENIOR SERVICES * 426 92ND AVE NW STE B GIG HARBOR, WA 98329 (253) 857-7677 FRANCISCAN PHCY ST ANTHONY * 5 CANTERWOOD BLVD NW GIG HARBOR, WA 98332 (253) 530-2653 MT RAINIER CLINIC WHOLISTIC * 672 KIMBALL DR STE 00 GIG HARBOR, WA 98335 (253) 853-8853 4
MULTICARE GIG HARBOR PHARMACY* 4545 POINT FOSDICK DR NW GIG HARBOR, WA 98335 (253) 530-8030 OLYMPIC PHCY AND HEALTH CARE * 4700 PT FOSDICK DR NW GIG HARBOR, WA 98335 (253) 858-994 PURDY COST LESS PRESCRIPTIONS * 428 92ND AVE NW GIG HARBOR, WA 98329 (253) 857-7797 488 POINT FOSDICK DR NW GIG HARBOR, WA 98335 (253) 85-6939 483 POINT FOSDICK DR NW GIG HARBOR, WA 98335 (253) 85-6870 TARGET 400 5ST AVE NW GIG HARBOR, WA 98335 (253) 858-7799 4840 BORGEN BLVD GIG HARBOR, WA 98332 (253) 853-9340 GRAHAM 2220 MERIDIAN AVE E GRAHAM, WA 98338 (253) 846-9455 005 224TH ST E GRAHAM, WA 98338 (253) 847-7634 LAKEWOOD FRANCISCAN PHARMACY ST CLARE * 35 BRIDGEPORT WAY SW LAKEWOOD, WA 98499 (253) 985-6290 GOOD 874 S TACOMA WAY LAKEWOOD, WA 98499 (253) 584-964 INTERNATIONAL 228 BRIDGEPORT SW LAKEWOOD, WA 98499 (253) 302-4553 LAKEWOOD 8720 S TACOMA WAY STE 03 LAKEWOOD, WA 98499 (253) 58-3426 5700 00TH ST SW STE 00 LAKEWOOD, WA 98499 (253) 588-3666 8224 STEILACOOM BLVD SW LAKEWOOD, WA 98498 (253) 58-0494 WAL-MART * 700 BRIDGEPORT WAY W LAKEWOOD, WA 98499 (253) 52-0960 MILTON ALBERTSON'S * 2800 MILTON WAY STE 0 MILTON, WA 98354 (253) 952-8436 900 MERIDIAN E MILTON, WA 98354 (253) 952-2680 5
900 MERIDIAN E MILTON, WA 98354 (253) 952-0390 ORTING COPE'S 34 WASHINGTON AVE S ORTING, WA 98360 (360) 893-27 25 WHITESELL ST NW ORTING, WA 98360 (360) 893-0843 PUYALLUP ALBERTSON'S * 02 CANYON RD E PUYALLUP, WA 98373 (253) 537-3808 BEALL'S 0 W MEEKER PUYALLUP, WA 9837 (253) 845-8444 COSTCO * 20 39TH AVE SW PUYALLUP, WA 98373 (253) 445-7542 FRANCISCAN 524 CANYON RD E STE 0 PUYALLUP, WA 98375 (253) 539-6030 FRED MEYER 00 N MERIDIAN STE 2 PUYALLUP, WA 9837 (253) 840-883 GOOD SAMARITAN BEHAVIORAL HLTH * 325 E PIONEER AVE PUYALLUP, WA 98372 (253) 697-8333 KIRK'S 3909 0TH ST SE STE 2 PUYALLUP, WA 98374 (253) 848-20 KIRK'S 22 SUNRISE BLVD E PUYALLUP, WA 98374 (253) 770-3408 MULTICARE GOOD SAMARITAN PHCY * 450 5TH ST SE STE 200 PUYALLUP, WA 98372 (253) 697-3494 PARTNER ONCOLOGY* 59 3RD ST SE STE 260 PUYALLUP, WA 98372 (253) 770-700 9502 76TH ST E PUYALLUP, WA 98375 (253) 846-5386 220 E CANYON RD PUYALLUP, WA 98373 (253) 537-307 323 E MAIN AVE PUYALLUP, WA 98372 (253) 848-3564 28 MERIDIAN ST E PUYALLUP, WA 98373 (253) 770-4700 3308 MERIDAN ST E PUYALLUP, WA 98373 (253) 435-742 50 CANYON RD E PUYALLUP, WA 98373 (253) 536-5296 566 76TH ST E PUYALLUP, WA 98375 (253) 44-74 6 S MERIDIAN PUYALLUP, WA 9837 (253) 84-534 TARGET 330 S MERIDIAN PUYALLUP, WA 98373 (253) 864-467 6
TARGET 0302 56TH ST E PUYALLUP, WA 98374 (253) 604-067 TOP FOOD & DRUG * 20 37TH AVE SE PUYALLUP, WA 98374 (253) 770-7720 78 MERIDIAN E PUYALLUP, WA 98373 (253) 770-6484 4308 MERIDIAN E PUYALLUP, WA 98375 (253) 604-05 509 CANYON RD E PUYALLUP, WA 98373 (253) 539-465 WAL-MART * 6502 MERIDIAN E PUYALLUP, WA 98375 (253) 446-754 WAL-MART * 30 3ST AVE SE PUYALLUP, WA 98374 (253) 770-9889 SPANAWAY FRED MEYER 22303 MOUNTAIN HWY E SPANAWAY, WA 98387 (253) 875-4033 223 E MOUNTAIN HWY SPANAWAY, WA 98387 (253) 846-0542 WAL-MART * 20307 MOUNTAIN HWY E SPANAWAY, WA 98387 (253) 846-6260 SUMNER FRED MEYER 20 VALLEY AVE SUMNER, WA 98390 (253) 826-8433 NICHOLSON'S SUMNER 90 ALDER AVE SUMNER, WA 98390 (253) 863-84 230 HIGHWAY 40 SUMNER, WA 98390 (253) 862-2533 TACOMA ALBERTSON'S * 04 MILITARY RD S TACOMA, WA 98444 (253) 538-26 ALLENMORE OUTPATIENT 90 S UNION AVE TACOMA, WA 98405 (253) 459-6746 BARTELL DRUGS * 360 6TH AVE TACOMA, WA 98406 (253) 76-248 CHUNG 922 SOUTH TACOMA WAY TACOMA, WA 98499 (253) 584-2484 COMM HEALTH CARE HILLTOP PHCY * 202 MARTIN LUTHER KING JR TACOMA, WA 98405 (253) 44-4779 COMMUNITY HEALTHCARE 225 PACIFIC AVE S TACOMA, WA 98444 (253) 536-6257 COMMUNITY HEALTHCARE 708 E 44TH ST TACOMA, WA 98404 (253) 284-2226 COST LESS PRESCRIPTIONS * 543 PACIFIC AVE TACOMA, WA 98408 (253) 474-9493 COST PHARMACY- FIRCREST * 09 REGENTS BLVD TACOMA, WA 98466 (253) 564-5200 7
COSTCO * 229 S 37TH ST TACOMA, WA 98409 (253) 67-6002 FRANCISCAN PHARMACY ST JOSEPH * 708 YAKIMA AVE STE 20 TACOMA, WA 98405 (253) 426-6920 FRANCISCAN PHARMACY TACOMA* 608 S J ST TACOMA, WA 98405 (253) 274-7650 FRED MEYER 690 S 9TH ST TACOMA, WA 98466 (253) 534-3033 FRED MEYER 7250 PACIFIC AVE TACOMA, WA 98408 (253) 475-994 FRED MEYER 4505 S 9TH ST TACOMA, WA 98405 (253) 756-9322 KMART 44 E 72ND ST TACOMA, WA 98404 (253) 537-6668 LINCOLN PHARMACY* 82 S 38TH ST TACOMA, WA 9848 (253) 473-55 MAI LINH PHARMACY* 2 S TH ST TACOMA, WA 98405 (253) 383-2576 MARY BRIDGE RETAIL CLINIC PHCY * 3 S L ST TACOMA, WA 98405 (253) 403-4 MEGA 902 96TH ST S STE A TACOMA, WA 98444 (253) 302-478 MULTICARE CLINIC 52 MLK JR WAY TACOMA, WA 98405 (253) 403-4920 MULTICARE MEDICAL CENTER PHCY * 35 MLK JR WAY TACOMA, WA 98405 (253) 403-2403 MULTICARE WESTGATE 2209 N PEARL ST STE 00 TACOMA, WA 98406 (253) 459-744 NATURAL HEALTH AND EDU SVCS * 20 N I ST STE C TACOMA, WA 98403 (253) 503-8792 PARKLAND MARKETPLACE 3322 PACIFIC AVE S TACOMA, WA 98444 (253) 53-37 PUGET SOUND 2 6TH AVE STE 0 TACOMA, WA 98405 (253) 572-080 RANKOS STADIUM 0 N TACOMA AVE TACOMA, WA 98403 (253) 383-24 850 S MILDRED ST TACOMA, WA 98465 (253) 460-9599 92 N PEARL ST TACOMA, WA 98406 (253) 879-040 580 PACIFIC AVE S TACOMA, WA 98444 (253) 53-7427 3840 W BRIDGEPORT WAY TACOMA, WA 98466 (253) 564-2255 704 PACIFIC AVE TACOMA, WA 98408 (253) 474-05 8
RUMED 3602 CENTER ST # 4 TACOMA, WA 98409 (253) 627-222 2637 N PEARL ST TACOMA, WA 98407 (253) 759-927 2 S M ST TACOMA, WA 98405 (253) 572-7753 302 38TH ST S TACOMA, WA 9848 (253) 47-55 624 72ND ST E TACOMA, WA 98404 (253) 537-2435 24 N PROCTOR ST TACOMA, WA 98406 (253) 759-9889 707 S 56TH ST TACOMA, WA 98408 (253) 47-730 620 6TH AVE TACOMA, WA 98406 (253) 566-927 0223 GRAVELLY LAKE DR SW TACOMA, WA 98499 (253) 58-78 TACOMA MEDICAL CENTER 206 S TH ST STE TACOMA, WA 98405 (253) 383-5359 TARGET 0509 GRAVELLY LAKE DR SW TACOMA, WA 98499 (253) 44-232 TARGET 3320 S 23RD ST TACOMA, WA 98405 (253) 44-0303 TOP FOOD AND DRUG* 330 S 23RD ST TACOMA, WA 98405 (253) 59-30 5225 PACIFIC AVE S TACOMA, WA 98444 (253) 538-696 5602 PACIFIC AVE TACOMA, WA 98408 (253) 203-0074 3737 PACIFIC AVE TACOMA, WA 9848 (253) 473-525 9505 BRIDGEPORT WAY SW TACOMA, WA 98499 (253) 582-2230 435 6TH AVE TACOMA, WA 98406 (253) 756-559 205 PACIFIC AVE S TACOMA, WA 98444 (253) 535-9302 8405 PACIFIC AVE TACOMA, WA 98444 (253) 536-3778 3540 N PEARL ST TACOMA, WA 98407 (253) 759-2378 2024 6TH AVE TACOMA, WA 98403 (253) 272-23 WAL-MART * 965 S UNION AVE TACOMA, WA 98405 (253) 627-4094 UNIVERSITY PLACE BARTELL DRUGS * 2700 BRIDGEPORT WAY STE D UNIVERSITY PLACE, WA 98466 (253) 460-879 9
FRANCISCAN HOSPICE LTC PHCY * 290 BRIDGEPORT WAY W UNIVERSITY PLACE, WA 98466 (253) 534-7033 FRED MEYER 6305 BRIDGEPORT WAY W UNIVERSITY PLACE, WA 98467 (253) 460-4033 745 CIRQUE DR W UNIVERSITY PLACE, WA 98467 (253) 564-7569 2650 BRIDGEPORT WAY W UNIVERSITY PLACE, WA 98466 (253) 564-035 SAN JUAN COUNTY EASTSOUND RAYS 5 TEMPLIN CTR EASTSOUND, WA 98245 (360) 376-2230 FRIDAY HARBOR FRIDAY HARBOR DRUG * 20 SPRING ST W FRIDAY HARBOR, WA 98250 (360) 378-442 LOPEZ ISLAND LOPEZ ISLAND PHARMACY 352 LOPEZ RD LOPEZ ISLAND, WA 9826 (360) 468-266 SKAGIT COUNTY ANACORTES FAMILY 23 24TH ST STE 400 ANACORTES, WA 9822 (360) 293-224 57 COMMERCIAL AVE ANACORTES, WA 9822 (360) 293-29 9 TH ST ANACORTES, WA 9822 (360) 293-448 909 7TH ST ANACORTES, WA 9822 (360) 299-286 BURLINGTON COSTCO * 725 S BURLINGTON BLVD BURLINGTON, WA 98233 (360) 757-5702 FRED MEYER 920 S BURLINGTON BLVD BURLINGTON, WA 98233 (360) 757-933 HAGGEN FOOD AND DRUG * 757 HAGGEN DR BURLINGTON, WA 98233 (360) 84-56 623 S BURLINGTON BLVD BURLINGTON, WA 98233 (360) 707-274 CONCRETE EAST VALLEY 7438 S D AVE STE C CONCRETE, WA 98237 (360) 853-809 20
LA CONNER LA CONNER DRUG * 708 E MORRIS ST LA CONNER, WA 98257 (360) 466-324 MOUNT VERNON HAGGEN FOOD AND 260 E DIVISION ST MOUNT VERNON, WA 98274 (360) 848-6930 HILLTOP 223 E DIVISION ST MOUNT VERNON, WA 98274 (360) 428-70 35 E COLLEGE WAY MOUNT VERNON, WA 98273 (360) 424-0467 SEA MAR CHC 400 N LAVENTURE MOUNT VERNON, WA 98273 (360) 542-8800 SKAGIT REGIONAL CLINICS PHCY * 40 E KINCAID ST MOUNT VERNON, WA 98274 (360) 428-6465 SKAGIT VALLEY HOSP 45 E KINCAID ST MOUNT VERNON, WA 98274 (360) 428-2425 SKAGIT VALLEY HOSPITAL OP PHCY * 45 E KINCAID ST MOUNT VERNON, WA 98274 (360) 428-8238 SRC RIVERBEND 2320 FREEWAY DR MOUNT VERNON, WA 98273 (360) 84-6840 WAL-MART * 230 FREEWAY DR MOUNT VERNON, WA 98273 (360) 428-39 SEDRO WOOLLEY 85ORE ST SEDRO WOOLLEY, WA 98284 (360) 856-253 SKAGIT REGIONAL CLINICS PHCY * 990 HOSPITAL DR STE 20 SEDRO WOOLLEY, WA 98284 (360) 854-2760 320 HARRISON ST SEDRO WOOLLEY, WA 98284 (360) 855-0735 HOAGLAND PHARMACY SOUTH * 640 SR HWY 20 SERDO WOOLLEY, WA 98284 (360) 503-676 SKAMANIA COUNTY STEVENSON WIND RIVER 280 SW 2ND ST STEVENSON, WA 98648 (509) 427-5480 SNOHOMISH COUNTY ARLINGTON ARLINGTON CHC 326 S STILLAGUAMISH AVE ARLINGTON, WA 98223 (360) 572-5454 ARLINGTON 540 N WEST AVE ARLINGTON, WA 98223 (360) 435-577 2
HAGGEN FOOD & 205 74TH AVE NE ARLINGTON, WA 98223 (360) 403-386 7226 SMOKEY POINT BLVD ARLINGTON, WA 98223 (360) 657-440 3532 72ND ST NE ARLINGTON, WA 98223 (360) 65-694 SMOKEY POINT 3823 72ND ST NE ARLINGTON, WA 98223 (360) 653-2500 WAL-MART * 400 72ND ST NE ARLINGTON, WA 98223 (360) 386-4539 BOTHELL BARTELL DRUGS * 22833 BOTHELL HWY BOTHELL, WA 9802 (425) 48-780 BARTELL DRUGS * 800 BOTHELL EVERETT HWY BOTHELL, WA 9802 (425) 402-6485 FRED MEYER 2045 BOTHELL EVERETT HWY BOTHELL, WA 9802 (425) 398-7033 PACIFIC MEDICAL CENTER PHCY 909 24TH ST SE STE 300 BOTHELL, WA 9802 (425) 42-6350 2263 SE BOTHELL WAY BOTHELL, WA 9802 (425) 48-8667 24040 BOTHELL EVERETT HWY BOTHELL, WA 9802 (425) 482-2829 207 BOTHELL EVERETT HWY BOTHELL, WA 9802 (425) 486-4473 2082 BOTHELL EVERETT HWY BOTHELL, WA 9802 (425) 398-0204 DARRINGTON DARRINGTON 200 SEEMANN ST DARRINGTON, WA 9824 (360) 436-200 EDMONDS BARTELL DRUGS * 23028 00TH AVE W EDMONDS, WA 98020 (425) 670-2860 EDMONDS 270 76TH AVE W STE 04A EDMONDS, WA 98026 (425) 563-638 EDMONDS 763 22TH ST SW STE 00 EDMONDS, WA 98026 (425) 977-4880 EDMONDS WELLNESS CLINIC * 7935 26TH ST SW STE E EDMONDS, WA 98026 (425) 672-23 FAMILY 735 22TH ST SW STE 00 EDMONDS, WA 98026 (425) 778-7778 22
HIGHLAND 2268 HIGHWAY 99 STE 09 EDMONDS, WA 98026 (425) 673-8533 PAVILION PHARMACY* 7320 26TH ST SW STE 00 EDMONDS, WA 98026 (425) 673-3700 QFC 22828 00TH AVE W EDMONDS, WA 98020 (425) 778-244 2255 HIGHWAY 99 EDMONDS, WA 98026 (425) 670-2667 23632 HIGHWAY 99 EDMONDS, WA 98026 (425) 775-030 THE COMPOUNDING APOTHECARY * 300 ADMIRAL WAY STE 07 EDMONDS, WA 98020 (425) 672-9888 TOP FOOD AND DRUG* 2900 HIGHWAY 99 EDMONDS, WA 98026 (425) 672-520 9797 EDMONDS WAY EDMONDS, WA 98020 (425) 672-007 EVERETT 2TH STREET CHC 09 2TH ST SW EVERETT, WA 98204 (425) 55-652 ALBERTSON'S * 520 28TH ST SW EVERETT, WA 98204 (425) 347-007 ALBERTSON'S * 6727 EVERGREEN WAY EVERETT, WA 98203 (425) 353-7539 BARTELL DRUGS * 020 9TH AVE SE EVERETT, WA 98208 (425) 337-797 BARTELL DRUGS * 825 BROADWAY EVERETT, WA 9820 (425) 303-2584 BARTELL DRUGS * 5006 32ND ST SE STE A EVERETT, WA 98208 (425) 357-662 BARTELL DRUGS * 3909 HOYT AVE EVERETT, WA 9820 (425) 37-3620 BROADWAY CHC 40 BROADWAY EVERETT, WA 9820 (425) 789-2050 COSTCO * 0200 9TH AVE SE EVERETT, WA 98208 (425) 379-7487 EVERETT FOOT CLINIC * 340 RUCKER AVE EVERETT, WA 9820 (425) 259-3757 FRED MEYER 2906 BOTHWELL EVERETT, WA 98208 (425) 357-2033 HAGGEN FOOD AND 895 MARKET PLACE DR EVERETT, WA 98205 (425) 377-70 JODI BERGS INTGRTVE FMLY HLTH* 3903 COLBY AVE EVERETT, WA 9820 (425) 258-2325 MCQUINN NATUROPATHIC * 2808 HOYT AVE STE 20 EVERETT, WA 9820 (425) 293-007 23
MEDICAL CENTER 32 COLBY C WING ST FL EVERETT, WA 9820 (425) 26-3559 MOLINA HEALTHCARE * 5 SW EVERETT MALL WAY EVERETT, WA 98204 (952)653-2568 PHYSICAL REHABILITATION * 99 28TH ST SW EVERETT, WA 98204 (425) 347-864 PROVIDENCE MILL CREEK PHCY * 2800 BOTHELL EVERETT HWY EVERETT, WA 98208 (425) 36-5454 QFC 499 EVERGREEN WAY EVERETT, WA 98203 (425) 259-3444 QFC 265 BROADWAY EVERETT, WA 9820 (425) 259-6262 4920A EVERGREEN WAY EVERETT, WA 98203 (425) 252-409 003 EVERGREEN WAY EVERETT, WA 98204 (425) 347-280 5802 34TH PL SE EVERETT, WA 98208 (425) 332-679 760 EVERGREEN WAY EVERETT, WA 98203 (425) 355-9303 428 RUCKER AVE EVERETT, WA 9820 (425) 252-9 03 9TH AVE SE EVERETT, WA 98204 (425) 337-0684 75 BROADWAY AVE EVERETT, WA 9820 (425) 339-9448 SEVAN 620 SE EVERETT MALL WAY EVERETT, WA 98208 (425) 348-5353 SHIRAZ SPECIALTY 205 E CASINO RD STE B6 EVERETT, WA 98208 (425) 356-3276 SOUND HOLISTIC HEALTH * 2804 GRAND AVE STE 300 EVERETT, WA 9820 (425) 258-4633 TARGET 405 SE EVERETT MALL WAY EVERETT, WA 98208 (425) 353-7967 6807 EVERGREEN WAY EVERETT, WA 98203 (425) 438-9380 30 BOTHELL EVERETT HWY EVERETT, WA 98208 (425) 379-7274 26 4TH AVE W EVERETT, WA 98204 (425) 355-9940 2205 BROADWAY EVERETT, WA 9820 (425) 252-523 WAL-MART * 400 HIGHWAY 99 EVERETT, WA 98204 (425) 923-75 24
GRANITE FALLS PHARM-A-SAVE 207 E STANLEY ST GRANITE FALLS, WA 98252 (360) 69-7778 608 W STANLEY ST GRANITE FALLS, WA 98252 (360) 69-4659 LAKE STEVENS BARTELL DRUGS * 62 HIGHWAY 9 LAKE STEVENS, WA 98258 (425) 334-4028 303 9ST AVE NE LAKE STEVENS, WA 98258 (425) 335-453 TARGET 960 MARKET PL LAKE STEVENS, WA 98258 (425) 397-8944 78 9ST AVE NE LAKE STEVENS, WA 98258 (425) 334-523 LYNNWOOD ALBERTSON'S * 9500 HIGHWAY 99 LYNNWOOD, WA 98036 (425) 670-9723 ALBERTSON'S * 28 BEVERLY PARK RD LYNNWOOD, WA 98087 (425) 347-345 BARTELL DRUGS * 3625 48TH ST SW STE B LYNNWOOD, WA 98087 (425) 742-20 BETHEL 744 HIGHWAY 99 STE 00 LYNNWOOD, WA 98037 (425) 74-0075 FRED MEYER 2902 64TH ST SW LYNNWOOD, WA 98037 (425) 787-4933 FRED MEYER 465 96TH ST SW LYNNWOOD, WA 98036 (425) 670-0233 LYNNWOOD CHC 4 94TH ST SW LYNNWOOD, WA 98036 (425) 835-5202 PHARMACY CARE * 4629 68TH ST SW STE A LYNNWOOD, WA 98037 (425) 743-22 7500 96TH ST SW STE A LYNNWOOD, WA 98036 (425) 774-6669 8600B 33RD AVE W LYNNWOOD, WA 98037 (425) 77-9427 4826 HIGHWAY 99 LYNNWOOD, WA 98087 (425) 743-6808 975 HIGHWAY 99 LYNNWOOD, WA 98036 (425) 778-4862 25
TARGET 8305 ALDERWOOD MALL PKWY LYNNWOOD, WA 98037 (425) 673-395 20725 HIGHWAY 99 LYNNWOOD, WA 98036 (425) 72-052 6423 LARCH WAY LYNNWOOD, WA 98037 (425) 74-8283 6824 HWY 99 LYNNWOOD, WA 98037 (425) 74-4302 WAL-MART * 400 64TH ST SW LYNNWOOD, WA 98087 (425) 74-3646 WAL-MART * 7222 HIGHWAY 99 LYNNWOOD, WA 98037 (425) 74-284 MARYSVILLE ALBERTSON'S * 30 MARYSVILLE MALL # 60 MARYSVILLE, WA 98270 (360) 659-8952 BARTELL DRUGS * 4420 76TH ST NE MARYSVILLE, WA 98270 (360) 65-740 COSTCO * 666 TWIN LAKES AVE MARYSVILLE, WA 9827 (360) 652-4539 FRED MEYER 9925 STATE AVE MARYSVILLE, WA 98270 (360) 653-0733 HAGGEN FOOD & 37 88TH ST NE MARYSVILLE, WA 98270 (360) 530-776 HILTON 220 STATE AVE MARYSVILLE, WA 98270 (360) 659-3222 25 MARYSVILLE MALL MARYSVILLE, WA 98270 (360) 659-0492 258 STATE AVE MARYSVILLE, WA 98270 (360) 659-2882 TARGET 688 TWIN LAKES AVE MARYSVILLE, WA 9827 (360) 386-402 404 STATE AVE MARYSVILLE, WA 98270 (360) 658-5375 WAL-MART * 873 64TH ST NE MARYSVILLE, WA 98270 (360) 386-30 MILL CREEK ALBERTSON'S * 3322 32ND ST SE MILL CREEK, WA 9802 (425) 338-89 MILL CREEK 025 53RD ST SE STE 04 MILL CREEK, WA 9802 (425) 48-7575 PURITY INTEGRATIVE HEALTH CTR * 58 MAIN ST STE 500 MILL CREEK, WA 9802 (425) 337-7029 26
QFC 926 64TH ST SE MILL CREEK, WA 9802 (425) 743-4806 6222 BOTHELL EVERETT HWY MILL CREEK, WA 9802 (425) 74-8649 3202 32ND ST SE MILL CREEK, WA 9802 (425) 379-705 334 BOTHELL EVERETT HWY MILL CREEK, WA 9802 (425) 337-4805 FRED MEYER 8805 STATE ROUTE 2 MONROE, WA 98272 (360) 805-833 PHARM A SAVE MONROE * 7788 47TH ST SE MONROE, WA 98272 (360) 794-464 PROVIDENCE PHARMACY MONROE* 9200 N KELSEY ST MONROE, WA 98272 (360) 794-5555 8906 STATE ROUTE 2 MONROE, WA 98272 (360) 794-0943 965 HIGHWAY 2 MONROE, WA 98272 (360) 794-9644 MOUNTLAKE TERRACE ALBERTSON'S * 430 22TH ST SW MOUNTLAKE TERRACE, WA 98043 (425) 775-50 BARTELL DRUGS * 22803 44TH AVE W MOUNTLAKE TERRACE, WA 98043 (425) 77-3738 MUKILTEO 700 MUKILTEO SPEEDWAY MUKILTEO, WA 98275 (425) 54-0620 0200 MUKILTEO SPEEDWAY MUKILTEO, WA 98275 (425) 35-923 SNOHOMISH ALBERTSON'S * 7520 STATE ROUTE 9 SE SNOHOMISH, WA 98296 (360) 668-407 BARTELL DRUGS * 5 3TH ST SNOHOMISH, WA 98290 (360) 568-0548 FRED MEYER 280 BICKFORD AVE SNOHOMISH, WA 98290 (360) 563-3733 KUSLER'S 700 AVENUE D SNOHOMISH, WA 98290 (360) 568-7787 205 PINE ST SNOHOMISH, WA 98290 (360) 563-0223 TOP FOOD AND DRUG* 30 AVENUE D SNOHOMISH, WA 98290 (360) 568-554 27
STANWOOD BARTELL DRUGS * 7205 267TH ST NW STANWOOD, WA 98292 (360) 939-0572 HAGGEN FOOD & 26603 72ND AVE NW STANWOOD, WA 98292 (360) 629-5520 2687 88TH DR NW STANWOOD, WA 98292 (360) 629-959 SULTAN SULTAN PHARMACY AND NAT CARE * 505 W STEVENS AVE SULTAN, WA 98294 (360) 793-883 TULALIP 3733 6TH ST NE TULALIP, WA 9827 (360) 653-578 WAL-MART * 8924 QUILCEDA BLVD TULALIP, WA 9827 (360) 657-223 WOODINVILLE COSTCO * 24008 SNO WOOD RD WOODINVILLE, WA 98072 (425) 806-7728 SPOKANE COUNTY AIRWAY HEIGHTS YOKES 2825 W SUNSET HWY AIRWAY HEIGHTS, WA 9900 (509) 244-5822 CHENEY BI-MART 222 ST ST CHENEY, WA 99004 (509) 235-4705 CHENEY OWL HEALTH MART PHCY * 20 F ST CHENEY, WA 99004 (509) 235-844 270 ST ST CHENEY, WA 99004 (509) 235-6030 DEER PARK BI-MART 42 S MAIN AVE DEER PARK, WA 99006 (509) 276-906 CHAS 40 S MAIN ST DEER PARK, WA 99006 (509) 434-0293 MEDICINE SHOPPE E H ST STE A DEER PARK, WA 99006 (509) 276-508 YOKES 80 S MAIN ST DEER PARK, WA 99006 (509) 276-2939 FAIRFIELD FAIRFIELD OWL 208 MAIN ST FAIRFIELD, WA 9902 (509) 283-4299 LIBERTY LAKE ALBERTSON'S * 304 N LIBERTY LAKE RD LIBERTY LAKE, WA 9909 (509) 89-6967 MEDICINE MAN LIBERTY LAKE * 2380 E APPLEWAY AVE LIBERTY LAKE, WA 9909 (509) 255-76 28
233 N LIBERTY LAKE RD LIBERTY LAKE, WA 9909 (509) 893-202 WELL LIFE LIBERTY LAKE * 2380 E APPLEWAY AVE LIBERTY LAKE, WA 9909 (509) 755-3333 MEAD YOKES 4202 N MARKET ST MEAD, WA 9902 (509) 242-020 MEDICAL LAKE MEDICAL LAKE OWL 23 E LAKE ST MEDICAL LAKE, WA 99022 (509) 299-53 MILLWOOD 2702 N ARGONNE RD MILLWOOD, WA 9922 (509) 892-637 SPOKANE ST AVENUE 6 E ST AVE SPOKANE, WA 99202 (509) 624-307 ALBERTSON'S * 6520 N NEVADA ST SPOKANE, WA 99208 (509) 489-5287 ALBERTSON'S * 900 N INDIAN TRAIL RD SPOKANE, WA 99208 (509) 465-8590 ALBERTSON'S * 300 E 57TH AVE SPOKANE, WA 99223 (509) 443-6502 ALBERTSON'S * 232 N DIVISION ST SPOKANE, WA 9928 (509) 466-0357 ALBERTSON'S * 50 W 37TH AVE SPOKANE, WA 99203 (509) 455-4437 BATES PHARMACEUTICAL SVCS * 3704 N NEVADA STE B SPOKANE, WA 99207 (509) 489-4500 BATES 3704 N NEVADA ST SPOKANE, WA 99207 (509) 489-4500 CHAS * 399 N MAPLE ST SPOKANE, WA 99205 (509) 343-6 CHAS DENNY MURPHY 00 W 2ND AVE SPOKANE, WA 9920 (509) 835-205 CHAS 592 N MARKET ST SPOKANE, WA 99208 (509) 343-6 CHAS-NHOS * 803 W MAXWELL AVE SPOKANE, WA 9920 (509) 444-8888 COSTCO * 769 N DIVISION ST SPOKANE, WA 99208 (509) 466-335 DEACONESS OUTPATIENT 800 W 5TH AVE SPOKANE, WA 99204 (509) 473-3784 EVERGREEN NATUROPATHIC * 35 W 9TH AVE STE 05 SPOKANE, WA 99204 (509) 755-500 FIFTH AND BROWNE 04 W 5TH AVE STE 80E SPOKANE, WA 99204 (509) 838-47 29
FRED MEYER 400 SO THOR ST SPOKANE, WA 99202 (509) 532-4033 FRED MEYER 220 N DIVISION ST SPOKANE, WA 99208 (509) 465-4433 HART AND DILATUSH 60 W RIVERSIDE STE 40 SPOKANE, WA 9920 (509) 624-2 KMART 40 E SPRAGUE AVE SPOKANE, WA 99202 (509) 534-7367 LIDGERWOOD OWL HM 590 N LIDGERWOOD ST SPOKANE, WA 99208 (509) 483-3566 MEDICAL ONCOLOGY ASSOCIATES PS * 600 N MAYFAIR ST SPOKANE, WA 99208 (509) 462-2273 MEDICINE SHOPPE 327 W NORTHWEST BLVD SPOKANE, WA 99205 (509) 327-504 NORTHWEST HEALTH SYSTEMS * 288 N SULLIVAN RD BLDG 2E SPOKANE, WA 9926 (509) 744-989 PAYLESS DRUG LTC PHARMACY 224 E WESTVIEW CT SPOKANE, WA 9928 (800)330-3665 PROVIDENCO SACRED 0 W 8TH AVE SPOKANE, WA 99204 (509) 474-3088 443 N ARGONNE RD SPOKANE, WA 9922 (509) 928-92 920 N DIVISION ST SPOKANE, WA 9928 (509) 464-4480 5520 N DIVISION ST SPOKANE, WA 99208 (509) 489-600 225 A WEST WELLESLEY AVE SPOKANE, WA 99205 (509) 328-7887 80 E 29TH AVE SPOKANE, WA 99203 (509) 838-3508 454 REGAL ST S SPOKANE, WA 99223 (509) 448-9063 2929 E 29TH AVE SPOKANE, WA 99223 (509) 535-9056 2420 N DIVISION ST SPOKANE, WA 9928 (509) 466-946 9007 N INDIAN TRAIL RD SPOKANE, WA 99208 (509) 464-279 RIVERPOINT 528 E SPOKANE FALLS BLVD SPOKANE, WA 99202 (509) 343-6252 RIVERSTONE FAMILY HEALTH PHCY * 400 N COOK ST SPOKANE, WA 99207 (866)983-9279 ROSAUERS 907 W 4TH SPOKANE, WA 99204 (509) 624-237 ROSAUERS 724 W FRANCIS SPOKANE, WA 99205 (509) 325-343 30
ROSAUERS 260 E 29TH AVE SPOKANE, WA 99223 (509) 535-3623 ROSAUERS 068 E SPRAGUE AVE SPOKANE, WA 99206 (509) 924-5560 ROSAUERS 808 W 3RD AVE SPOKANE, WA 99204 (509) 624-026 ROSAUERS 944 N DIVISION SPOKANE, WA 9928 (509) 467-6806 2509 29TH AVE E SPOKANE, WA 99223 (509) 532-982 399 N MARKET ST SPOKANE, WA 99207 (509) 482-3480 902 W FRANCIS AVE SPOKANE, WA 99205 (509) 327-64 W 66 NORTHWEST BLVD SPOKANE, WA 99205 (509) 327-500 44 N ARGONNE RD SPOKANE, WA 9922 (509) 92-8032 000 N NEWPORT HWY SPOKANE, WA 9928 (509) 465-3676 E 933 MISSION AVE SPOKANE, WA 99202 (509) 482-2089 SHOPKO PHARMACY* (509) 455-3736 E 344 SPRAGUE AVE SPOKANE, WA 9926 (509) 924-744 SHOPKO PHARMACY* 455 S REGAL ST SPOKANE, WA 99223 (509) 448-9585 SIXTH AVE MEDICAL 508 W 6TH AVE SPOKANE, WA 99204 (509) 455-9345 SPOKANE FALLS FAMILY CLIN PHCY * 20 W MISSION AVE SPOKANE, WA 9920 (866)983-9279 TARGET 9770 N NEWPORT HWY SPOKANE, WA 9928 (509) 466-7226 90 W 5TH AVE STE 270 SPOKANE, WA 99204 (509) 624-3350 235 HIGHWAY 395 SHOPKO PHARMACY* SPOKANE, WA 9928 N 9520 NEWPORT (509) 466-746 HWY SPOKANE, WA 9928 (509) 466-744 2830 S GRAND BLVD SPOKANE, WA 99203 2 E EMPIRE AVE SPOKANE, WA 99207 (509) 325-078 400 E 5TH AVE STE 02 SPOKANE, WA 99202 (509) 838-075 3
7905 N DIVISION ST SPOKANE, WA 99208 (509) 467-836 205 E WELLESLEY AVE SPOKANE, WA 99207 (509) 483-0342 708 W NORTHWEST BLVD SPOKANE, WA 99205 (509) 323-0309 WAL-MART * 922 N COLTON ST SPOKANE, WA 9928 (509) 464-2736 WAL-MART * 230 WEST WELLESLEY AVE SPOKANE, WA 99205 (509) 327-205 WELL LIFE LATAH 4235 S CHENEY SPOKANE RD SPOKANE, WA 99224 (509) 838-0896 YOKES 20 E NORTH FOOTHILLS DR SPOKANE, WA 99207 (509) 325-6933 YOKES 332 W INDIAN TRAIL RD SPOKANE, WA 99208 (509) 325-8720 SPOKANE VALLEY ALBERTSON'S * 885 E TRENT AVE SPOKANE VALLEY, WA 9922 (509) 924-9052 ALBERTSON'S * 3606 E 32ND AVE SPOKANE VALLEY, WA 9926 (509) 892-3659 CHAS 924 S PINES RD SPOKANE VALLEY, WA 99206 (509) 343-6 FRED MEYER 5609 E SPRAGUE AVE SPOKANE VALLEY, WA 99037 (509) 92-5383 MEDICINE SHOPPE 244 E SPRAGUE AVE SPOKANE VALLEY, WA 9926 (509) 924-222 25 E SPRAGUE AVE SPOKANE VALLEY, WA 99206 (509) 924-4922 RITE AID PHARMACY* 6528 DESMET CT SPOKANE VALLEY, WA 9925 (509) 926-6400 4020 E SPRAGUE AVE SPOKANE VALLEY, WA 9926 (509) 89-639 TRADING COMPANY 304 E SPRAGUE AVE SPOKANE VALLEY, WA 9926 (509) 926-2200 VALLEY MISSION HOMECARE PHCY * 2509 E MISSION AVE STE 03 SPOKANE VALLEY, WA 9926 (509) 928-6400 232 E SPRAGUE AVE SPOKANE VALLEY, WA 9926 (509) 92-0659 WAL-MART * 5025 E SPRAGUE AVE SPOKANE VALLEY, WA 9922 (509) 534-037 32
YOKES 9329 E MONTGOMERY AVE SPOKANE VALLEY, WA 99206 (509) 343-3379 VERADALE 550 E SPRAGUE AVE VERADALE, WA 99037 (509) 89-0735 STEVENS COUNTY CHEWELAH AKERS UNITED DRUG* 406 PARK ST N CHEWELAH, WA 9909 (509) 935-844 VALLEY HEALTH MART DRUG * 02 E MAIN AVE CHEWELAH, WA 9909 (509) 935-86 COLVILLE PROVIDENCE HEALTH SERVICES WA * 200 E COLUMBIA AVE COLVILLE, WA 994 (509) 684-7727 39 N MAIN ST COLVILLE, WA 994 (509) 684-848 SUPER ONE 250 NORTH HIGHWAY COLVILLE, WA 994 (509) 684-35 WAL-MART * 80 N HIGHWAY ST COLVILLE, WA 994 (509) 684-2973 KETTLE FALLS KETTLE FALLS HEALTH MART PHCY 280 E 3RD AVE KETTLE FALLS, WA 994 (509) 738-2223 NINE MILE FALLS LAKE SPOKANE 599 HIGHWAY 29 STE 5 NINE MILE FALLS, WA 99026 (509) 443-478 THURSTON COUNTY LACEY COSTCO * 470 MARVIN RD NE LACEY, WA 9856 (360) 42-3488 * FRED MEYER 700 SLEATER-KINNEY RD SE LACEY, WA 98503 (360) 438-6483 HAWKS PRAIRIE HEALTH MART PHCY * 2539 MARVIN RD NE LACEY, WA 9856 (360) 438-3072 METMEDS 5707 LACEY BLVD SE LACEY, WA 98503 (360) 459-540 QFC 4775 WHITMAN LN SE LACEY, WA 98509 (360) 438-634 69 SLEATER KINNEY RD SE LACEY, WA 98503 (360) 49-4 4776 WHITMAN LN SE LACEY, WA 9853 (360) 42-5962 243 MARVIN RD NE LACEY, WA 9856 (360) 252-2235 6200 PACIFIC AVE SE LACEY, WA 98503 (360) 486-340 33
SHOPKO PHARMACY* 5500 MARTIN WAY LACEY, WA 98506 (425) 456-4057 TARGET 665 SLEATER KINNEY RD SE LACEY, WA 98503 (360) 486-8927 4540 LACEY BLVD SE LACEY, WA 98503 (360) 438-2353 8333 MARTIN WAY E LACEY, WA 9856 (360) 455-0029 WAL-MART * 40 GALAXY DR NE LACEY, WA 98503 (360) 456-7862 OLYMPIA ALBERTSON'S * 3520 PACIFIC AVE SE OLYMPIA, WA 9850 (360) 49-0330 MEDICAL CENTER 3525 ENSIGN RD NE OLYMPIA, WA 98506 (360) 49-752 PROVIDENCE MOTHER JOSEPH CTR * 3333 ENSIGN RD NE OLYMPIA, WA 98506 (360) 493-4572 RALPH'S THRIFTWAY 908 4TH AVE E OLYMPIA, WA 98506 (360) 352-4426 8230 MARTIN WAY E OLYMPIA, WA 9856 (360) 456-0444 305 COOPER POINT RD NW OLYMPIA, WA 98502 (360) 754-804 4280 MARTIN WAY E OLYMPIA, WA 9856 (360) 456-0709 325 HARRISON AVE NW OLYMPIA, WA 98502 (360) 956-3827 520 CLEVELAND AVE OLYMPIA, WA 9850 (360) 943-7600 SEA MAR COMMUNITY HEALTH CTRS * 3030 LIMITED LN NW OLYMPIA, WA 98502 (360) 704-7575 TOP FOOD AND DRUG* 33 COOPER POINT RD SW OLYMPIA, WA 98502 (360) 754-504 VISTA ONCOLOGY * 420 MCPHEE RD SW OLYMPIA, WA 98502 (360) 352-2900 VISTA ONCOLOGY * 4 LILLY RD NE OLYMPIA, WA 98506 (360) 43-8880 50 COOPER POINT RD SW OLYMPIA, WA 98502 (360) 570-8008 YAUGER PARK 400 YAUGER WAY SW STE B OLYMPIA, WA 98502 (360) 357-337 TENINO HEDDEN'S 96 W SUSSEX AVE TENINO, WA 98589 (360) 264-2575 TUMWATER ALBERTSON'S * 705 TROSPER RD SW TUMWATER, WA 9852 (360) 705-3679 34
COSTCO * 5500 LITTLEROCK RD SW TUMWATER, WA 9852 (360) 357-7290 FRED MEYER 555 TROSPER RD SW TUMWATER, WA 9850 (360) 753-7933 MARTIN'S SOUTHGATE DRUG * 520 CAPITOL BLVD S TUMWATER, WA 9850 (360) 943-4043 702 TROSPER RD SW TUMWATER, WA 9852 (360) 943-578 WAL-MART * 5600 LITTLEROCK RD SW TUMWATER, WA 9852 (360) 350-6030 YELM 909 E YELM AVE YELM, WA 98597 (360) 458-90 09 YELM AVE E YELM, WA 98597 (360) 458-8835 TIM'S 06 ST ST S YELM, WA 98597 (360) 458-8467 WAL-MART * 700 STATE ROUTE 507 SE YELM, WA 98597 (360) 400-8062 WAHKIAKUM COUNTY CATHLAMET CATHLAMET 74 MAIN ST CATHLAMET, WA 9862 (360) 795-369 WALLA WALLA COUNTY WALLA WALLA ADVENTIST HEALTH COMMUNITY * S 2ND AVE WALLA WALLA, WA 99362 (509) 527-8333 ALBERTSON'S * 450 N WILBUR AVE WALLA WALLA, WA 99362 (509) 529-3706 BI-MART 649 PLAZA WAY WALLA WALLA, WA 99362 (509) 529-9350 FAMILY MED CTR 20 W ROSE ST WALLA WALLA, WA 99362 (866)983-9279 PROVIDENCE ST MARY 40 W POPLAR ST WALLA WALLA, WA 99362 (509) 529-894 2028 E ISAACS AVE WALLA WALLA, WA 99362 (509) 529-97 600 PLAZA WAY WALLA WALLA, WA 99362 (509) 522-4672 25 E ROSE ST WALLA WALLA, WA 99362 (509) 522-0227 SHOPKO PHARMACY* 65 W ROSE ST WALLA WALLA, WA 99362 (509) 525-9207 TALLMANS 4 W MAIN ST WALLA WALLA, WA 99362 (509) 525-00 35
633 W TIETAN ST WALLA WALLA, WA 99362 (509) 529-570 WHATCOM COUNTY BELLINGHAM COSTCO * 4299 GUIDE MERIDIAN ST BELLINGHAM, WA 98226 (360) 738-785 CUSTOM PRESCRIPTION SHOPPE * 33 E MAPLE ST STE 0 BELLINGHAM, WA 98225 (360) 685-4242 FAIRHAVEN 5 HARRIS AVE BELLINGHAM, WA 98225 (360) 734-3340 FRED MEYER 225 W BAKERVIEW RD BELLINGHAM, WA 98226 (360) 788-2933 FRED MEYER 800 LAKEWAY DR BELLINGHAM, WA 98226 (360) 676-05 HAGGEN FOOD AND 284 MERIDIAN ST BELLINGHAM, WA 98225 (360) 67-3305 HAGGEN FOOD AND 2900 WOBURN ST BELLINGHAM, WA 98226 (360) 75-5320 HAGGEN PHARMACY* 4545 CORDATA PKWY BELLINGHAM, WA 98226 (360) 676-7373 HOAGLAND PHARMACY LTC 44 MEADOR AVE STE H02 BELLINGHAM, WA 98229 (360) 734-543 HOAGLAND'S PHARMACY* 2330 YEW ST BELLINGHAM, WA 98229 (360) 734-543 INTERFAITH 28 UNITY ST BELLINGHAM, WA 98225 (360) 752-7406 3227 NORTHWEST AVE BELLINGHAM, WA 98225 (360) 647-275 225 E SUNSET DR STE 0 BELLINGHAM, WA 98226 (360) 67-504 220 36TH ST BELLINGHAM, WA 98225 (360) 734-8254 400 CORNWALL AVE BELLINGHAM, WA 98225 (360) 733-980 222 TELEGRAPH RD BELLINGHAM, WA 98226 (360) 676-8570 225 E SUNSET DR STE 55 BELLINGHAM, WA 98226 (360) 650-537 36
TARGET 30 BELLIS FAIR PKWY BELLINGHAM, WA 98226 (360) 734-0220 4090 GUIDE MERIDIAN BELLINGHAM, WA 98226 (360) 734-0229 070 E SUNSET DR BELLINGHAM, WA 98226 (360) 647-273 WAL-MART * 4420 MERIDIAN ST BELLINGHAM, WA 98226 (360) 647-6 BLAINE THRIFTY PAYLESS INC * 95 BOBLETT ST BLAINE, WA 98230 (360) 332-66 EVERSON VALLEY DRUG * 208 E MAIN ST EVERSON, WA 98247 (360) 966-348 575 4TH AVE FERNDALE, WA 98248 (360) 384-55 90 MAIN ST FERNDALE, WA 98248 (360) 384-7658 LYNDEN FAIRWAY DRUG * 758 FRONT ST STE 06 LYNDEN, WA 98264 (360) 354-226 8090 GUIDE MERIDIAN RD LYNDEN, WA 98264 (360) 354-4284 807 GUIDE MERIDAN RD LYNDEN, WA 98264 (360) 38-0698 SUMAS SUMAS DRUG * 35 CHERRY ST SUMAS, WA 98295 (360) 988-268 WHITMAN COUNTY COLFAX TICK KLOCK DRUGS * 09 S MAIN ST COLFAX, WA 99 (509) 397-2 GARFIELD GARFIELD PHARMACY 207 N 3RD STE 2 GARFIELD, WA 9930 (509) 635-000 PULLMAN 630 GRAND AVE S PULLMAN, WA 9963 (509) 334-7222 430 SE BISHOP BLVD PULLMAN, WA 9963 (509) 334-089 SHOPKO PHARMACY* S 450 GRAND AVE PULLMAN, WA 9963 (509) 332-0503 SID'S 825 SE BISHOP BLVD STE 30 PULLMAN, WA 9963 (509) 332-4608 SIDS PROFESSIONAL 825 S E BISHOP STE 30 B PULLMAN, WA 9963 (509) 334-6506 WAL-MART * 695 SE BISHOP BLVD PULLMAN, WA 9963 (509) 334-298 37
WSU HEALTH AND WELLNESS SVC * 25 SE WASHINGTON ST PULLMAN, WA 9963 (509) 335-5742 SAINT JOHN ST JOHN PHARMACY* 8 E FRONT ST SAINT JOHN, WA 997 (509) 648-3430 TEKOA TEKOA 24 N CROSBY TEKOA, WA 99033 (509) 284-4205 YAKIMA COUNTY GRANDVIEW YAKIMA VALLY FARM WORKERS * 000 WALLACE WAY GRANDVIEW, WA 98930 (866)983-9279 SELAH HOWARD'S DRUG * 9 E 3RD AVE SELAH, WA 98942 (509) 697-625 SELAH SAVE ON FOODS 800 N PARK CTR SELAH, WA 98942 (360) 74-9797 SUNNYSIDE BI-MART 0 W SOUTH HILL RD SUNNYSIDE, WA 98944 (509) 839-0766 200 YAKIMA VALLEY HWY STE C SUNNYSIDE, WA 98944 (509) 839-27 63 N 6TH ST SUNNYSIDE, WA 98944 (509) 839-203 WAL-MART * 2675 E LINCOLN AVE SUNNYSIDE, WA 98944 (509) 839-7030 YAKIMA NEIGHBORHOOD HEALTH * 67 SCOON RD SUNNYSIDE, WA 98944 (509) 837-8989 TOPPENISH GIBBONS PHARMACY* 7 S TOPPENISH AVE TOPPENISH, WA 98948 (509) 865-2722 7 W FIRST ST TOPPENISH, WA 98948 (509) 865-4700 YAKIMA VLY FARM WRKRS CLINIC * 58 W ST AVE TOPPENISH, WA 98948 (509) 865-3355 UNION GAP COSTCO * 230 LONGFIBRE RD UNION GAP, WA 98903 (509) 454-5249 259 MAIN ST UNION GAP, WA 98903 (509) 453-3603 SHOPKO PHARMACY* 2530 RUDKIN RD UNION GAP, WA 98903 (509) 248-9567 WAPATO HORIZON PHARMACY* 633 W ST ST WAPATO, WA 9895 (509) 584-0300 YAKIMA ALBERTSON'S * 60 W LINCOLN AVE YAKIMA, WA 98902 (509) 452-6567 38
ALBERTSON'S * 40 S 40TH ST YAKIMA, WA 98908 (509) 965-2336 BI-MART 207 N 40TH AVE YAKIMA, WA 98908 (509) 457-628 BI-MART 309 S 5TH AVE YAKIMA, WA 98902 (509) 452-6648 CENTRAL WA FAMILY MEDICINE * 806 W LINCOLN AVE YAKIMA, WA 98902 (509) 494-6702 FRED MEYER 206 N 40TH AVE YAKIMA, WA 98908 (509) 576-6833 KMART 2304 E NOB HILL BLVD YAKIMA, WA 9890 (509) 575-7552 MEMORIAL 402 S 2TH AVE YAKIMA, WA 98902 (509) 573-3808 NORTH STAR LODGE 808 N 39TH AVE YAKIMA, WA 98902 (509) 574-3404 5606 SUMMITVIEW AVE YAKIMA, WA 98908 (509) 965-2037 2204 W NOB HILL BLVD STE B YAKIMA, WA 98902 (509) 453-444 2 N 9TH AVE YAKIMA, WA 98902 (509) 452-2600 ROSAUERS 40 S 72 AVE YAKIMA, WA 98908 (509) 972-0284 205 N 5TH AVE YAKIMA, WA 98902 (509) 457-8869 905 E MEAD AVE YAKIMA, WA 98903 (509) 248-8782 5702 SUMMITVIEW AVE YAKIMA, WA 98908 (509) 965-3870 SHOPKO PHARMACY* 580 SUMMITVIEW AVE YAKIMA, WA 98908 (509) 965-6393 TERRACE VILLAGE HM 4040 TERRACE HEIGHTS DR YAKIMA, WA 9890 (509) 248-33 TIETON VILLAGE DRUG * 3708 TIETON DR YAKIMA, WA 98902 (509) 966-6850 60 W YAKIMA AVE YAKIMA, WA 98902 (509) 469-0246 400 SUMMITVIEW AVE STE YAKIMA, WA 98908 (509) 972-2986 WAL-MART * 600 E CHESTNUT AVE YAKIMA, WA 9890 (509) 248-3855 WAL-MART * 6600 W NOB HILL BLVD YAKIMA, WA 98908 (509) 966-384 39
WASHINGTON HEMATOLOGY ONCOLOGY * 39 CASTLEVALE RD STE 20 YAKIMA, WA 98902 (509) 454-9499 WRAY'S CHALET THRIFTWAY * 5605 SUMMITVIEW AVE YAKIMA, WA 98908 (509) 966-0530 WRAY'S THRIFTWAY * 7200 W NOB HILL BLVD YAKIMA, WA 98908 (509) 965-0202 YAKIMA NEIGHBORHOOD 2 S 8TH ST YAKIMA, WA 9890 (509) 853-2354 YAKIMA VALLEY FARM WKRS CLINIC * 602 E NOB HILL BLVD YAKIMA, WA 9890 (866)983-9279 40
Mail Order Pharmacies You can get prescription drugs shipped to your home through our network mail order delivery program. Typically you should expect to receive your prescription drugs within 4 days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at -800-942-0247 (TTY Relay: Dial 7-- ) from 8:00 a.m. to 8:00 p.m., 7 days a week. To get more information about the mail order pharmacy, please call our Customer Service department at -800-942-0247 (TTY Relay: Dial 7--) from 8:00 a.m. to 8:00 p.m., 7 days a week. Mail Order Pharmacies: Express Scripts PO Box 66566 St. Louis, MO 6366-6566 4
Home Infusion Pharmacies To get more information about the home infusion pharmacies, please call our Customer Service department at -800-942-0247 (TTY Relay: Dial 7--) from 8:00 a.m. to 8:00 p.m., 7 days a week. 42
Home Infusion Pharmacies BENTON COUNTY Kennewick OPTION CARE 7325 DESCHUTES AVE STE C KENNEWICK, WA 99336 (509) 783-2273 KING COUNTY KENT ACCREDO HEALTH GROUP 22408 68TH AVE S KENT, WA 98032 (253) 872-22 REDMOND CORAM SPECIALTY INFUSION SVCS 4935 NE 87TH ST STE 0 REDMOND, WA 98052 (425) 883-3525 SEATTLE OPTION CARE 3035 GATEWAY DR STE 3 SEATTLE, WA 9868 (800)277-5805 SNOHOMISH COUNTY EVERETT OPTION CARE 820 EVERGREEN WAY EVERETT, WA 98203 (800)737-063 SPOKANE COUNTY SPOKANE CORAM SPECIALTY INFUSION SVCS 520 E NORTH FOOTHILLS DR SPOKANE, WA 99207 (509) 482-4266 WALGREENS INFUSION SERVICES 328 N ASH ST SPOKANE, WA 9920 (509) 326-0306 LIFECARE SOLUTIONS 703 E SPRAGUE AVE STE 3 SPOKANE VALLEY, WA 99206 (509) 92-6560 WHATCOM COUNTY BELLINGHAM INFUSION SOLUTIONS 34 PRINCE AVE STE B BELLINGHAM, WA 98226 (360) 933-4892 OPTION CARE 477 W HORTON RD BELLINGHAM, WA 98226 (800)755-0484 43
Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Community HealthFirst through the facility s long-term care pharmacy or another network long-term care pharmacy. To get more information about the long term care pharmacies, please call our Customer Service department at -800-942-0247 (TTY Relay: Dial 7--) from 8:00 a.m. to 8:00 p.m., 7 days a week. 44
Long Term Care Pharmacies ASOTIN COUNTY CLARKSTON WASEM'S DRUG * 800 6TH ST CLARKSTON, WA 99403 (509) 758-2565 CLARK COUNTY CAMAS SURECARE RX 3400 SE 96TH AVE STE 00 CAMAS, WA 98607 (800)330-967 VANCOUVER CHS PHARMACY 6600 NE 2TH CT STE 03 VANCOUVER, WA 98662 (360) 694-7377 HI-SCHOOL PHARMACY 6926 NE FOURTH PLAIN BLVD VANCOUVER, WA 9866 (360) 693-8374 PROPAC PHARMACY 2606 NE 95TH ST VANCOUVER, WA 98682 (360) 260-756 COLUMBIA COUNTY DAYTON ELK DRUG 76 E MAIN ST DAYTON, WA 99328 (509) 382-2536 COWLITZ COUNTY CASTLE ROCK CASTLE ROCK 7 ST AVE SW CASTLE ROCK, WA 986 (360) 274-82 GARFIELD COUNTY POMEROY POMEROY 764 MAIN STREET POMEROY, WA 99347 (509) 843-82 GRAYS HARBOR COUNTY MONTESANO VALU DRUG * 20 E PIONEER AVE MONTESANO, WA 98563 (360) 249-4444 ISLAND COUNTY CLINTON ISLAND DRUG * 042 STATE ROUTE 525 CLINTON, WA 98236 (360) 34-3885 OAK HARBOR ISLAND DRUG * 230 SE PIONEER WAY OAK HARBOR, WA 98277 (360) 675-6688 ISLAND DRUG LTC 3270 STATE ROUTE 20 STE B OAK HARBOR, WA 98277 (360) 675-6688 KING COUNTY AUBURN GENOA HEALTHCARE 4508 AUBURN WAY N STE A04 AUBURN, WA 98002 (253) 373-9944 QOL MEDS 2704 I ST NE AUBURN, WA 98002 (253) 288-2 45
BELLEVUE BELLEGROVE 200 2TH AVE NE STE A00 BELLEVUE, WA 98004 (425) 455-223 BURIEN GENOA HEALTHCARE 20 SW 36TH ST RM 0 BURIEN, WA 9866 (206) 242-4446 KENT A AND H PHARMACEUTICAL SVCS 60 W MEEKER ST STE 20 KENT, WA 98032 (253) 852-23 PROPAC PHARMACY* 702 S 220TH ST KENT, WA 98032 (855)535-783 UNITED CARE PHARMACY 8230 E VALLEY HWY KENT, WA 98032 (425) 656-2900 KIRKLAND EVERGREEN PHARMACEUTICAL 2220 3TH AVE NE KIRKLAND, WA 98034 (425) 84-925 REDMOND CONSONUS PHARMACY SERVICES 4729 NE 87TH ST REDMOND, WA 98052 (866)698-520 RENTON JOLLY'S PHARMACY 42 SW 43RD ST STE 20 RENTON, WA 98057 (425) 25-6335 PROVIDENCE INFUSION PHCY SVS 220 LIND AVE SW STE 30 RENTON, WA 98057 (425) 687-4429 SEATTLE BOB JOHNSONS 407 NW 85TH ST SEATTLE, WA 987 (206) 782-5822 GENOA HEALTHCARE 600 E OLIVE ST BLDG D SEATTLE, WA 9822 (425) 835-70 KELLEY ROSS LTC PHARMACY 2324 EASTLAKE AVE E SEATTLE, WA 9802 (206) 838-4590 LOWRY'S PRESCRIPTIONS * 0330 MERIDIAN AVE N SEATTLE, WA 9833 (206) 368-6060 NORTHWEST MEDICATION MGMT 420 STONE WAY N SEATTLE, WA 9803 (206) 547-765 OTTERSENS PHARMACEUTICAL 3023 GREENWOOD AVE N SEATTLE, WA 9833 (206) 365-4048 PREMIER LTC PHARMACY 68 S LANE ST STE 204 SEATTLE, WA 9844 (206) 323-0868 SURECARE RX 605 S 93RD ST STE B SEATTLE, WA 9808 (206) 767-04 FIRCREST SCHOOL PHARMACY 5230 5TH AVE NE SHORELINE, WA 9855 (206) 36-3568 46
KITSAP COUNTY BREMERTON GENOA HEALTHCARE 5455 ALMIRA DR NE STE 329 BREMERTON, WA 983 (360) 45-6700 PORT ORCHARD STATE OF WA VETERANS HOME 4 BEACH DR E PORT ORCHARD, WA 98366 (360) 895-4700 LEWIS COUNTY CENTRALIA HALLS LONG TERM CARE PHCY 505 S TOWER AVE STE 2B CENTRALIA, WA 9853 (360) 736-5000 PIERCE COUNTY BUCKLEY RAINIER SCHOOL 220 RYAN RD BUCKLEY, WA 9832 (360) 829-3004 GIG HARBOR COSTLESS SENIOR SERVICES * 426 92ND AVE NW STE B GIG HARBOR, WA 98329 (253) 857-7677 LAKEWOOD BRIDGEPORT PHARMACY SERVICES 7424 BRIDGEPORT WAY W LAKEWOOD, WA 98499 (253) 582-2282 GENOA HEALTHCARE 9330 59TH AVE SW STE 79 LAKEWOOD, WA 98499 (253) 620-532 INTERNATIONAL PHARMACY LTC 228 BRIDGEPORT WAY SW LAKEWOOD, WA 98499 (253) 302-4559 TACOMA LINCOLN PHARMACY 82B S 38TH ST TACOMA, WA 9848 (253) 473-55 MEGA 902 96TH ST S STE A TACOMA, WA 98444 (253) 302-478 WESTERN STATE HOSP PHARMACY 960 STEILACOOM BLVD SW TACOMA, WA 98498 (253) 756-252 UNIVERSITY PLACE FRANCISCAN HOSPICE LTC PHCY * 290 BRIDGEPORT WAY W UNIVERSITY PLACE, WA 98466 (253) 534-7033 SKAGIT COUNTY LA CONNER LA CONNER DRUG * 708 E MORRIS ST LA CONNER, WA 98257 (360) 466-324 SNOHOMISH COUNTY EDMONDS EDMONDS PHCY STEVENS HLTH CTR 270 76TH AVE W STE 04B EDMONDS, WA 98026 (425) 563-638 47
PAVILION HOMECARE PHARMACY 7320 26TH ST SW STE 00B EDMONDS, WA 98026 (425) 673-3700 EVERETT GENOA HEALTHCARE 3322 BROADWAY STE 230 EVERETT, WA 9820 (425) 789-3050 PAYLESS DRUG LTC PHARMACY SE EVERETT MALL WAY EVERETT, WA 98203 (425) 257-9645 SHIRAZ SPECIALTY PHARMACY 205 E CASINO RD STE B6 EVERETT, WA 98208 (425) 356-3276 MOUNTLAKE TERRACE MERCURY PHARMACY SERVICES 278 66TH AVE W MOUNTLAKE TERRACE, WA 98043 (425) 673-5200 SPOKANE COUNTY MEDICAL LAKE EASTERN STATE HOSPITAL 800 MAPLE MEDICAL LAKE, WA 99022 (509) 565-4598 LAKELAND VILLAGE SOUTH 2320 SALNAVE RD MEDICAL LAKE, WA 99022 (509) 299-930 SPOKANE ST AVENUE 6 E ST AVE SPOKANE, WA 99202 (509) 624-307 BATES PHARMACEUTICAL SVCS * 3704 N NEVADA STE B SPOKANE, WA 99207 (509) 489-4500 EVERGREEN PHARMACEUTICAL 350 E 3RD AVE SPOKANE, WA 99202 (509) 838-4826 NORTHWEST HEALTH SYSTEMS 07 S DIVISION ST STE 209 SPOKANE, WA 99202 (508)744-989 NORTHWEST HEALTH SYSTEMS * 288 N SULLIVAN RD BLDG 2E SPOKANE, WA 9926 (509) 744-989 PROVIDENCO SACRED 0 W 8TH AVE SPOKANE, WA 99204 (509) 474-3088 RELIANT RX 20 N PINE ST STE 56 SPOKANE, WA 99202 (509) 343-3400 SPOKANE VALLEY PHARMERICA 24 N PINES RD STE 4 SPOKANE VALLEY, WA 99206 (509) 893-0 STEVENS COUNTY COLVILLE PROVIDENCE HEALTH SERVICES WA * 200 E COLUMBIA AVE COLVILLE, WA 994 (509) 684-7727 48
THURSTON COUNTY LACEY KIRK'S CHS PHARMACY 649 MARTIN WAY E LACEY, WA 9856 (360) 493-864 PUGET PHARMACY SERVICES 75 CIRCLE LN SE LACEY, WA 98503 (360) 456-5389 OLYMPIA NORTHWEST SPECIALTY PHARMACY 908 4TH AVE E STE OLYMPIA, WA 98506 (360) 596-008 PROVIDENCE MOTHER JOSEPH CTR * 3333 ENSIGN RD NE OLYMPIA, WA 98506 (360) 493-4572 WHATCOM COUNTY BELLINGHAM CUSTOM PRESCRIPTION SHOPPE * 33 E MAPLE ST STE 0 BELLINGHAM, WA 98225 B (360) 685-4242 HOAGLAND PHARMACY LTC 44 MEADOR AVE STE H02 BELLINGHAM, WA 98229 (360) 734-543 WHITMAN COUNTY PULLMAN SID'S LTC PHARMACY 825 SE BISHOP BLVD STE 30 B PULLMAN, WA 9963 (509) 334-6506 YAKIMA COUNTY SELAH YAKIMA VALLEY SCHOOL 609 SPEYERS RD SELAH, WA 98942 (509) 698-345 TOPPENISH GIBBONS PHARMACY* 7 S TOPPENISH AVE TOPPENISH, WA 98948 (509) 865-2722 YAKIMA CONSULTING AND PHARMACY SVCS 22 S 40TH AVE YAKIMA, WA 98908 (509) 575-0272 GENOA HEALTHCARE 402 S 4TH AVE YAKIMA, WA 98902 (509) 248-553 RIVER VILLAGE PHARMACY 3708 TIETON DR YAKIMA, WA 98902 (509) 469-398 YAKIMA VLY MEMORIAL HOSP PHCY 28 TIETON DR YAKIMA, WA 98902 (509) 575-8036 49
Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies/ Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through Community HealthFirst s pharmacy network. Those other than Native Americans and Alaska Natives may be able to access these pharmacies under limited circumstances (i.e., emergencies). To get more information about the I/T/U Indian Health Program, please call our Customer Service department at -800-942-0247 (TTY Relay: Dial 7--) from 8:00 a.m. to 8:00 p.m., 7 days a week. 50
I/T/U Pharmacies CLALLAM COUNTY NEAH BAY SOPHIA TRETTEVICK INDIAN HLTH HIGHWAY 2 CLINIC RD NEAH BAY, WA 98357 (360) 645-243 FERRY COUNTY INCHELIUM INCHELIUM COMMUNITY CLINIC INCHELIUM-KETTLE FALLS HWY INCHELIUM, WA 9938 (509) 722-333 GRAYS HARBOR COUNTY TAHOLAH ROGER SAUX HEALTH CENTER 407 CONNUX ST TAHOLAH, WA 98587 (360) 276-4405 KING COUNTY SEATTLE SEATTLE INDIAN HEALTH BOARD 6 2TH AVE S SEATTLE, WA 984 (206) 324-9360 MASON COUNTY SHELTON KAMILCHE PHARMACY 90 SE KLAH CHE MIN DR SHELTON, WA 98584 (360) 432-3990 OKANOGAN COUNTY NESPELEM COLVILLE INDIAN HEALTH CTR AGENCY CAMPUS HWY 55 NESPELEM, WA 9955 (509) 634-294 OMAK OMAK HEALTH STATION PHARMACY 67 BENTON ST OMAK, WA 9884 (509) 422-7454 PIERCE COUNTY TACOMA PUYALLUP TRIBAL HEALTH 2209 E 32ND ST BLDG 5 TACOMA, WA 98404 (253) 593-0232 SNOHOMISH COUNTY TULALIP TULALIP PHARMACY 8825 34TH AVE NE STE A TULALIP, WA 9827 (360) 65-469 STEVENS COUNTY WELLPINIT DAVID C WYNECOOP MEM CLNC 6203 AGENCY LOOP RD WELLPINIT, WA 99040 (509) 258-457 THURSTON COUNTY OLYMPIA NISQUALLY TRIBAL PHARMACY 486 SHE NAH NUM DR SE OLYMPIA, WA 9853 (360) 459-532 WHATCOM COUNTY BELLINGHAM LUMMI TRIBAL HEALTH CENTER 2592 KWINA RD BELLINGHAM, WA 98226 (360) 384-0464 5
YAKIMA COUNTY TOPPENISH YAKAMA INDIAN HLTH CTR PHCY 40 BUSTER RD TOPPENISH, WA 98948 (509) 865-703 52
2TH STREET CHC... 23 ST AVENUE.. 29,48 A AND H PHARMACEUTICAL SVCS... 97 A AND H PHARMACEUTICAL SVCS... 46 ABERDEEN HEALTH MART 9 ACCESS... 99 ACCREDO HEALTH GROUP... 43 ADVENTIST HEALTH COMMUNITY *... 35 AFH PHARAMCY *. 0 AHP. 0 AKERS UNITED DRUG*... 33 ALBERTSON'S *...82-86,92,94,96,99,00,09-,4-7,23,25-29,32,34,35,38, 39 ALLENMORE OUTPATIENT... 7 ALPINE INTEGRATED MEDICINE *... 00 APOTHECARY SHOPPE *... 09 ARLINGTON CHC... 2 ARLINGTON... 2 ASSURED PHARMACY*... 98 BALLARD PLAZA... 0 BARTELL DRUGS *.93-02,07,08,4,7, 9,22,23,25-28 BATES PHARMACEUTICAL SVCS *... 29,48 BATES... 29 BEALL'S... 6 BELLEGROVE... 93,46 BETHEL... 25 BI-MART... 82,86,88,89,,28, 35,38,39 BOB JOHNSONS.. 02,46 BREWSTER HEALTH MART DRUG *... 3 BRIDGEPORT PHARMACY SERVICES... 47 BROADWAY CHC... 23 BUCK PAVILION... 02 CABRINI MEDICAL TOWER PHCY *... 02 CASTLE ROCK... 88,45 CATHLAMET... 35 CAVALLINI'S... CEDAR VILLAGE... 2 CENTRAL WA FAMILY MEDICINE *... 39 CENTRAL WASHINGTON HOSP PHCY *... 84 CHAS*... 28,29,32 CHAS DENNY MURPHY... 29 CHAS... 29 CHAS-NHOS *... 29 CHAS-WASEM *... 82 CHENEY OWL HEALTH MART PHCY *... 28 CHESTERFIELD... 02 CHINOOK PHARMACY... 84 CHS PHARMACY... 45 CHUCK'S DRUGS * 4 CHUNG... 7 CITY CENTER DRUG *... 9 CLARKSTON HEIGHTS... 82 CLE ELUM DRUG * COLTON... 2 COLUMBIA BASIN HEMATOLOGY *... 82 COLUMBIA... 02 COLUMBIA VALLEY COMM H PHCY *... 84 COLVILLE INDIAN HEALTH CTR... 5 COMM HEALTH CARE HILLTOP PHCY *... 7 COMMUNITY HEALTHCARE... 7 CCONNELL FAMILY CLINIC... 90 CONSONUS PHARMACY SERVICES... 46 CONSULTING AND PHARMACY SVCS. 49 COPE'S... 6 CORAM SPECIALTY INFUSION SVCS... 43 COST LESS PRESCRIPTIONS *. 7 53
COST PHARMACY- FIRCREST *... 7 COSTCO * 82,85,86,90,95,96,98,0 3,08,,4,6,8, 20,23,26,28,29, 33,35,36,38 COSTLESS SENIOR SERVICES *... 4,47 COUNTRY DOCTOR COMMUNITY CLN * 03 COVINGTON MULTICARE CLINIC *... 95 CROWN DRUG *... 9 CUSTOM PRESCRIPTION SHOPPE *... 36,49 DARRINGTON... 22 DAVENPORT GOOD NEIGHBOR PHCY * 2 DAVID C WYNECOOP MEM CLNC... 5 DEACONESS OUTPATIENT... 29 DENSOW'S... 83 DES MOINES DRUG... 03 DOANE'S VALLEY... 84 DONG NAI PHARMACY*... 03 DONS 92 DOWNTOWN PUBLIC HLTH CNTR PHCY. 03 DUPONT... 4 DUVALL FAMILY DRUGS *... 95 E WENATCHEE FOOD PAVILION PHCY *... 89 EAST VALLEY... 20 EASTERN STATE HOSPITAL... 48 EDMONDS... 22 EDMONDS PHCY STEVENS HLTH CTR... 47 EDMONDS WELLNESS CLINIC *... 22 ELFERS-LYON... 83 ELK DRUG... 88,45 ELLENSBURG DOWNTOWN HM PHCY *... ELLENSBURG... ELMA HEALTH MART... 9 EVERETT FOOT CLINIC *... 23 EVERGREEN INTEGRATIVE MEDICINE *... 93 EVERGREEN NATUROPATHIC *.. 29 EVERGREEN PHARMACEUTICAL... 46,48 EVERGREEN... 98 EVERGREEN PROF CTR... 98 FAIRFIELD OWL... 28 FAIRHAVEN... 36 FAIRWAY DRUG *.. 37 FAMILY HEALTH CENTERS *... 3 FAMILY MED CTR... 35 FAMILY... 20,22 FAMILY WELLNESS CENTER PC *... 86 FEDERAL WAY... 96 FIESTA... 90 FIFTH AND BROWNE... 29 FIRCREST PHARMACY, *... 4 FIRCREST SCHOOL PHARMACY... 46 FRANCISCAN HOSPICE LTC PHCY *... 20,47 FRANCISCAN... 6 FRANCISCAN PHARMACY AUBURN*... 93 FRANCISCAN PHARMACY FIRST AVE *... 96 FRANCISCAN PHARMACY ST CLARE, *... 5 FRANCISCAN PHARMACY ST JOSEPH *... 8 FRANCISCAN PHARMACY TACOMA*... 8 FRANCISCAN PHCY BONNEY LAKE *... 4 FRANCISCAN PHCY ST ANTHONY *... 4 FRED MEYER... 82,83,85,86,89,90,93, 96-00,03,09,0, 2, 4,6-8,20, 22, 23, 25-27, 30, 32, 33, 36,39 FRIDAY HARBOR DRUG *... 20 GARFIELD PHARMACY... 37 54
GENOA HEALTHCARE... 45-49 GIBBONS PHARMACY*... 38,49 GODFREYS... 88 GOOD... 5 GOOD SAMARITAN BEHAVIORAL HLTH *... 6 GROSS DRUG *... 89 HAGGEN FOOD &... 3,2,22,26,28, 36 HAGGEN FOOD AND DRUG *... 20 HAGGEN PHARMACY*... 36 HALLS DRUG CENTER*... HALLS LONG TERM CARE PHCY... 47 HARBOR DRUG *... 9 HARBORVIEW MEDICAL CENTER *... 03 HART AND DILATUSH... 30 HAWKS PRAIRIE HEALTH MART PHCY *... 33 HEALTHPOINT AUBURN PHARMACY*... 93 HEALTHPOINT BOTHELL PHARMACY*... 94 HEALTHPOINT CENTRAL FILL PHCY *... 00 HEALTHPOINT FEDERAL WAY PHCY*... 96 HEALTHPOINT KENT... 97 HEDDEN'S... 34 HIGHLAND... 96,23 HILLTOP... 2,26 HI-SCHOOL PHARMACY... 86,89,,45 HOAGLAND PHARMACY LTC... 36 HOAGLAND PHARMACY SOUTH *... 2 HOAGLAND'S PHARMACY*... 36 HOLLY PARK... 03 HORIZON PHARMACY*... 38 HOWARD'S DRUG *38 INCHELIUM COMMUNITY CLINIC... 5 INFUSION SOLUTIONS... 43 INTEGRATIVE FOOT AND ANKLE CTR *... 98 INTERFAITH... 36 INTERNATIONAL COMM HLTH SVCS *... 03 INTERNATIONAL... 5 INTERNATIONAL PHARMACY LTC... 47 ISLAND DRUG * 92,45 JIM'S... 85,95 JODI BERGS INTGRTVE FMLY HLTH*... 23 JOLLY'S PHARMACY... 00,46 KAMILCHE PHARMACY... 5 KATTERMAN'S SAND POINT PHCY *... 03 KELLEY ROSS LTC PHARMACY... 03,46 KETTLE FALLS HEALTH MART PHCY *... 33 KING PLAZA... 03 KIRK'S CHS PHARMACY... 49 KIRK'S... 6 KITSAP... 0 KMART... 92,2,8,30,39 KUSLER'S PHARMACY*... 27 L J'S FURNESS DRUG*... 88 LA CONNER DRUG *... 2,47 LAFFERRY'S... 03 LAKE CHELAN... 84 LAKE SPOKANE... 33 LAKELAND VILLAGE... 48 LAKEMONT... 93 LAKEWOOD... 5 LAURA J HIEB ND * 00 LEGACY SALMON CREEK APOTHECARY*... 86 LIDGERWOOD OWL HM... 30 55
LINCOLN COUNTY HLTH MRT PHCY *. 2 LINCOLN PHARMACY*... 8,47 LINDEMAN PAVILION... 03 LINDS COUPVILLE... 92 LIND'S FREELAND... 92 LOGAR... 82 LONG BEACH... 3 LOPEZ ISLAND PHARMACY... 20 LOURDES WEST PASCO... 90 LOWRY'S PRESCRIPTIONS *... 03,46 LUKE'S... 03 LUMMI TRIBAL HEALTH CENTER.. 5 LYNNWOOD CHC... 25 MAI LINH PHARMACY*... 8 MALLEYS COMPOUNDING... 83 MAPLE LEAF... 04 MARKS CAMANO... 92 MARTIN'S SOUTHGATE DRUG *... 35 MARY BRIDGE RETAIL CLINIC PHCY *... 8 MCQUINN NATUROPATHIC *.. 23 MEDIART FAMILY CLINIC *... 93 MEDICAL ARTS ASSOCIATES PS *... 93 MEDICAL CENTER... 96,24,34 MEDICAL LAKE OWL... 29 MEDICAL MALL... 82 MEDICAL ONCOLOGY ASSOCIATES PS *. 30 MEDICINE MAN LIBERTY LAKE *... 28 MEDICINE SHOPPE... 90,2,28,30,32 MEGA... 8,47 MEMORIAL... 39 MERCURY PHARMACY SERVICES... 48 MERIDIAN PHARMACY*... 04 METMEDS PHARMACY*... 33 MICHAEL K WOO ND *... 94 MILL CREEK... 26 MILL PLAIN MEDICAL AND PHCY *... 86 MOLINA HEALTHCARE*... 24 MT RAINIER CLINIC WHOLISTIC *... 4 MULTICARE BONNEY LAKE 4 MULTICARE CLINIC... 8 MULTICARE GIG HARBOR PHARMACY*... 5 MULTICARE GOOD SAMARITAN PHCY *... 6 MULTICARE MEDICAL CENTER PHCY *... 8 MULTICARE WESTGATE... 8 NATURAL HEALTH AND EDU SVCS *... 8 NATURAL HEALTHCARE NORTHWEST *... 04 NATURAL OPTIONS HEALTH CLINIC *... NATUROPATHIC MEDICINE *... 95 NAVOS *... 04 NEIGHBORCARE HEALTH *... 04 NEIL'S... 2 NGUYENS PHARMACY AND GIFTS *... 04 NICHOLSON'S SUMNER... 7 NISQUALLY TRIBAL PHARMACY... 5 NORTH PUBLIC HEALTH CTR PHCY... 04 NORTH STAR LODGE... 39 NORTHWEST HEALTH SYSTEMS *... 30,48 NORTHWEST KIDNEY CENTER PHCY *... 04 NORTHWEST MEDICATION MGMT... 46 NORTHWEST PRESCRIPTION *... 04 NORTHWEST SPECIALTY PHARMACY... 49 56
NW NATUROPATHY AND ACUPUNCTURE *... 04 OCEAN PARK... 3 OCEAN SHORES... 92 O'HANA WELLNESS CENTER *... 94 OKANOGAN DOUGLAS HOSPITAL PHCY *. 3 OKANOGAN VALLEY... 3 OLYMPIC DRUG *... 86 OLYMPIC PHCY AND HEALTH CARE *... 5 OMAK HEALTH STATION PHARMACY... 5 OMAK... 3 ONURI 96 OPTION CARE... 43 OSTROM DRUG AND GIFT *... 97 OTHELLO FAMILY CLINIC... 82 OTTERSENS PHARMACEUTICAL46 OWL TRI-STATE... 82 PACIFIC DRUGS *.. 04 PACIFIC MEDICAL CENTER PHCY... 22 PACIFIC NW SPECIALTY... 86 PACMED CLINIC PHARMACY 98,00,04 PAIN ASSOCIATES OF WASHINGTON *... 00 PARAMOUNT... 08 PARKLAND MARKETPLACE... 8 PARK'S... 04 PARTNER ONCOLOGY*... 6 PAVILION HOMECARE PHARMACY... 48 PAVILION PHARMACY*... 23 PAYLESS DRUG LTC PHARMACY... 30,48 PEACE HEALTH SOUTHWEST PHCY *... 86 PEACEHEALTH ST JOHN MED CTR *... 89 PECKENPAUGH DRUG, *... 93 PENINSULA COMM HTLH SVCS PHCY *... 0 PENINSULA COMMUNITY HEALTH SVS *... 09,0 PHARM A SAVE MONROE *... 27 PHARMACA INTEGRATIVE.. 00,04 PHARMACARE SPECIALTY PHCY *04 PHARMACY CARE *... 25 PHARMACY PLUS *. 94 PHARM-A-SAVE... 25 PHARMERICA... 48 PHSW PHARMACY AT MEDICAL CTR *... 86 PHYSICAL REHABILITATION * 24 PIONEER MED CENTER... 9 PLANNED PARENTHOOD OF GRT NW PHCY *... 05 PLATEAU COMMUNITY... 95 POMEROY... 90,45 POULSBO COMPOUNDING... 0 PREMIER LTC PHARMACY... 46 PROPAC PHARMACY*... 97,45,46 PROVIDENCE CENTRALIA HOSPITAL... PROVIDENCE HEALTH SERVICES WA *... 33,48 PROVIDENCE INFUSION PHCY SVS... 46 PROVIDENCE MILL CREEK PHCY *... 24 PROVIDENCE MOTHER JOSEPH CTR*... 34,49 PROVIDENCE PHARMACY MONROE*... 27 PROVIDENCE ST MARY... 35 PROVIDENCO SACRED... 30,48 PUGET PHARMACY SERVICES... 49 PUGET SOUND... 8 PURDY COST LESS PRESCRIPTIONS *. 5 PURITY INTEGRATIVE HEALTH CTR *... 26 57
PUYALLUP TRIBAL HEALTH... 5 QFC... 85,86,92,94,95,97-00,05,2,23,24, 27,33,45 QUE ARESTE ND *. 05 RAINIER SCHOOL.. 47 RALPH'S THRIFTWAY... 34 RANKOS STADIUM... 8 RAYS... 20 READY MEDS... 00 RELIANT RX... 48 REPUBLIC DRUG STORE... 90...83-85,87-97,99-0,05,08-8,20-28,30,32-39 RITZVILLE DRUG *... 82 RIVER VILLAGE PHARMACY... 49 RIVERPOINT... 30 RIVERSTONE FAMILY HEALTH PHCY *... 30 ROGER SAUX HEALTH CENTER... 5 ROSAUERS... 30,3,39 ROY'S HEALTH MART... 3 RUMED... 9 RXPRESS PHARMACY*... 4 RXTRA CARE PHCY VIEW RIDGE *... 05 SAAR'S MARKETPLACE... 92 PHARMACY, *83-85,87-0,05,06,08-3,5,7,9-29,3-39 SAGENS... 3 SAM'S CLUB *... 93,0,06 SAVON... 82 SEA MAR CHC PHARMACY... 06,2 SEA MAR COMMUNITY HEALTH CTRS *... 34 SEATTLE CANCER CARE ALLIANCE *.. 06 SEATTLE CHILDRENS HOSPITAL *... 94,06 SEATTLE INDIAN HEALTH BOARD... 5 SEATTLEMEDS... 06 SEEBER'S HEALTH MART *... 3 SELAH SAVE ON FOODS... 38 SEVAN... 24 SHIRAZ SPECIALTY PHARMACY... 48 SHIRAZ SPECIALTY... 24 SHOPKO PHARMACY* 83,9,3,34,35,37-39 SHORELINE NATURAL MEDICINE *... 08 SID'S LTC PHARMACY... 49 SID'S 37 SIMON WELLNESS *... 06 SIXTH AVE MEDICAL... 3 SKAGIT REGIONAL CLINICS PHCY *... 2 SKAGIT VALLEY HOSP... 2 SKAGIT VALLEY HOSPITAL OP PHCY *... 2 SMOKEY POINT... 22 SNOQUALMIE VILLAGE PHARMACY*... 08 SOPHIA TRETTEVICK INDIAN HLTH... 5 SOUND HOLISTIC HEALTH *... 24 SOUTH BEND... 3 SOUTH PARK... 0 SOUTHGATE... 9 SPOKANE FALLS FAMILY CLIN PHCY *... 3 SRC RIVERBEND... 2 ST JOHN PHARMACY*... 38 STATE OF WA VETERANS HOME. 47 SULTAN PHARMACY AND NAT CARE *... 28 SUMAS DRUG *... 37 SUNSET PLAZA... 0 SUPER ONE..,33 SURECARE RX45,46 SWANSON OWL... 9 SWEDISH FIRST HILL... 07 SWEDISH ISSAQUAH RETAIL PHCY *... 97 SWEDISH ORTHOPEDIC INST PHCY *... 07 58
SWEDISH PHARMACY CHERRY HILL *... 07 TACOMA MEDICAL CENTER... 9 TALLMANS... 35 TARGET... 83,87,89,96-98,00,0,07,08, 4-7,9,24-26,3,34,37 TCCH. 90 TEKOA... 38 TERRACE VILLAGE HM... 39 THE COMPOUNDING APOTHECARY *... 23 THE FALLS PHCY UNITED DRUGS *... 08 THE NATURAL PATH TO HEALING *... 08 THE PRESCRIPTION PAD. 0 THE VANCOUVER CLINIC *... 87 THREE MOON CLINIC*... 95 THRIFTY PAYLESS *... 37 TICK KLOCK DRUGS *... 37 TIETON VILLAGE DRUG *... 39 TIM'S 35 TOP FOOD AND DRUG* 93,98,08,09,7,9, 23,27,34 TRADING COMPANY... 32 TREE OF HEALTH INTEGRATIVE *... 09 TRI-AREA PHARMACY*... 92 TULALIP PHARMACY... 5 TWIN HARBOR DRUG*... 92 ULRICH VALLEY HEALTH MART PHCY... 3 UNION CENTER... 07 UNITED CARE PHARMACY... 98,46 UWMC AMBULATORY... 07 VALLEY DRUG *... 37 VALLEY HEALTH MART DRUG *... 33 VALLEY MISSION HOMECARE PHCY *... 32 VALU DRUG *... 45 VANCOUVER CLINIC... 87 VASHON PHARMACY... 08 VILLAGE PHARMACY*... 84 VISTA ONCOLOGY *... 34 VITAL THERAPEUTICS*... 07...83-85,87-99,0,07-2,4,5,7,9-27,29,3-37,39 WAL-MART *..82-85,88-96,0,0,2,5, 7,9,2,22,24, 26, 28,32-35,37-39 WASEM'S DRUG *... 82,45 WASHINGTON CTR FOR PAIN MGMT *... 94 WASHINGTON HEMATOLOGY ONCOLOGY *... 40 WELL LIFE LATAH... 32 WELL LIFE LIBERTY LAKE *... 29 WENATCHEE CLINIC... 84 WESTERN STATE HOSP PHARMACY. 47 WFHC PHARMACY.. 9 WHITE CENTER... 07 WIND RIVER... 2 WINSLOW DRUG *. 09 WOODINVILLE MED CTR PHCY *... 09 WRAY'S CHALET THRIFTWAY *... 40 WRAY'S THRIFTWAY *... 40 WSU HEALTH AND WELLNESS SVC *.. 38 YAKAMA INDIAN HLTH CTR PHCY... 52 YAKIMA NEIGHBORHOOD HEALTH *... 38 YAKIMA NEIGHBORHOOD... 40 YAKIMA VALLEY FARM WKRS CLINIC *... 40 YAKIMA VALLEY SCHOOL... 49 YAKIMA VALLY FARM WORKERS *... 38 YAKIMA VLY FARM WRKRS CLINIC *... 38 YAKIMA VLY MEMORIAL HOSP PHCY... 49 YAUGER PARK... 34 YOKES *... 83,84,90,28,29, 32,33 59
Community Health Plan of Washington is a Coordinated Care Plan with a Medicare Advantage contract. Enrollment in Community Health Plan of Washington depends on contract renewal. 60
Offered by Prospective Members: -800-944-247 Current Members: -800-942-0247 (TTY Relay: Dial 7--) 8:00 a.m. to 8:00 p.m., 7 days a week 720 Olive Way, Suite 300 Seattle, WA 980-830 www.healthfirst.chpw.org