New Mexico Medicaid Pharmacy Network Listing Blue Cross Community Centennial SM

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1 New Mexico Medicaid Pharmacy Network Listing Blue Cross Community Centennial SM This print directory is a list of pharmacies in our network. The list is current as of the date it was published. To see the most current list of pharmacies in our network, go to our website, bcbsnm.com/community-centennial. You can check our online Provider Finder to search for pharmacies. Under More Searches, click on a Find a Pharmacy. The Provider Finder is updated daily. It is updated more often than the printed directory. Pharmacy Name Address 1 Address 2 City ST ZIP STD County Phone AVELLA OF DEER VALLEY N 20TH DR STE 12 PHOENIX AZ Maricopa 877/ AVELLA OF PHOENIX III 1101 N CENTRAL AVE STE 102 PHOENIX AZ Maricopa 855/ AVELLA OF SCOTTSDALE 9777 N 91ST ST C-102 SCOTTSDALE AZ Maricopa 480/ AVELLA OF TUCSON 4512 E CAMP LOWELL DR TUCSON AZ Pima 520/ DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CAOFF HWY 191 HOSPITAL ROAD CHINLE AZ Apache 928/ FOOD CITY UNITED DRUG # S HWY 92 SIERRA VISTA AZ Cochise 520/ FOOD CITY UNITED DRUG # SAN ANTONIO AVE DOUGLAS AZ Cochise 520/ FRYS FOOD AND DRUG 4351 E HIGHWAY 90 SIERRA VISTA AZ Cochise 520/ GENOA, A QOL HEALTHCARE COMPANY, LLC 1701 N DOUGLAS AVE DOUGLAS AZ Cochise 520/ GENOA, A QOL HEALTHCARE COMPANY, LLC 4755 CAMPUS DR SIERRA VISTA AZ Cochise 520/ SAFEWAY PHARMACY # NACO HWY BISBEE AZ Cochise 520/ SAFEWAY PHARMACY # N BISBEE AVE WILLCOX AZ Cochise 520/ SAFEWAY PHARMACY # W 4TH ST BENSON AZ Cochise 520/ SAGE MEMORIAL HOSPITAL HWY 264 AND 191 GANADO AZ Apache 928/ SANDERS CLINIC RIO VISTA ESTATES, LOT 24 5 TENTHS MILES E OF POST OFFICE SANDERS AZ Apache 928/ SIERRA PHARMACY & COMPOUNDING LAB 2085 E FRY BLVD SIERRA VISTA AZ Cochise 520/ THE MEDICINE SHOPPE PHARMACY 795 W 4TH ST BENSON AZ Cochise 520/ THE MEDICINE SHOPPE PHARMACY 902 W REX ALLEN DR WILLCOX AZ Cochise 520/ TSAILE HEALTH CENTER PHARMACY INTERSECTION RT 64 AND 12 TSAILE AZ Apache 928/ US PUBLIC HEALTH SERV INDIAN HOSPITAL US HWY 160 RED MESA TEEC NOS POS AZ Apache 928/ VASCO RX 4045 E BELL RD STE 163 PHOENIX AZ Maricopa 602/ WALGREENS # E FRY BLVD SIERRA VISTA AZ Cochise 520/ WALMART PHARMACY N HWY 90 SIERRA VISTA AZ Cochise 520/ WALMART PHARMACY WEST 5TH ST DOUGLAS AZ Cochise 520/ WALMART PHARMACY SOUTH PRICKLY PEAR AVE BENSON AZ Cochise 520/ WALTON DRUG OF MORENCI 408 BURRO ALLEY MORENCI AZ Greenlee 928/ WESTERN DRUG 106 E MAIN SPRINGERVILLE AZ Apache 928/ ANIMAS FOOT AND ANKLE 575 RIVERGATE UNIT 105 DURANGO CO La Plata 970/ AVELLA OF DENVER 1245 E COLFAX AVE SUITE 102 DENVER CO Denver 303/ BAYFIELD PHARMACY 871 COUNTY ROAD 501 BAYFIELD CO La Plata 970/ CENTURA HEALTH MERCY REGIONAL M1010 THREE SPRINGS BLVD DURANGO CO La Plata 970/ CITY MARKET PHARMACY 3130 MAIN AVENUE DURANGO CO La Plata 970/ CITY MARKET PHARMACY 508 E MAIN STREET CORTEZ CO Montezuma 970/ CITY MARKET PHARMACY NO 6 TOWN PLAZA SHOPPING CTR DURANGO CO La Plata 970/ CITY MARKET PHARMACY # COUNTRY CENTER DR PAGOSA SPRINGS CO Archuleta 970/ FRESH RX, LLC 565 GODDARD AVENUE IGNACIO CO La Plata 970/ HOMETOWN PHARMACY AND MEDICAL 824 E MAIN ST TRINIDAD CO Las Animas 719/ LA JARA PHARMACEUTICAL CENTER 412 MAIN ST LA JARA CO Conejos 719/ OMNICARE OF PUEBLO 4602 ELIZABETH STREET SUITE 190 PUEBLO CO Pueblo 719/ RIVERGATE PHARMACY 575 RIVERGATE LANE STE 111 DURANGO CO La Plata 970/ SAFEWAY PHARMACY # W MAIN ST TRINIDAD CO Las Animas 719/ SAFEWAY PHARMACY # EAST MAIN STREET CORTEZ CO Montezuma 970/ SAVON PHARMACY 311 W COLLEGE DR DURANGO CO La Plata 970/ SOUTHERN UTE HEALTH CENTER 123 WEEMINUCHE IGNACIO CO La Plata 970/ UTE MOUNTAIN UTE HEALTH CENTER 232 RUSTLING WILLOW TOWAOC CO Montezuma 970/ WALGREENS # E MAIN ST CORTEZ CO Montezuma 970/ WALGREENS # MAIN AVE DURANGO CO La Plata 970/ WALGREENS # E 16TH AVE AURORA CO Adams 720/ WALMART PHARMACY TOUPAL DRIVE TRINIDAD CO Las Animas 719/ WALMART PHARMACY EAST MAIN ST CORTEZ CO Montezuma 970/ WALMART PHARMACY SOUTH CAMINO DEL RIO DURANGO CO La Plata 970/ WALMART PHARMACY ASPEN VILLAGE DR PAGOSA SPRINGS CO Archuleta 970/ ABQ BESTCARE PHARMACY 2929 COORS BLVD NW STE 110 ALBUQUERQUE NM Bernalillo 505/ Prime Therapeutics LLC Page 1 of 9 10/30/2017

2 ABQ BESTCARE PHARMACY 2 LLC 5400 GIBSON BLVD SE (GIBSON MEDICAL CENTER PHARMACY) ALBUQUERQUE NM Bernalillo 505/ ACL PHARMACY 1 40 EXIT 203 ACOMITA SAN FIDEL NM Cibola 505/ ADDISON DRUG 127 E SUMNER AVE FORT SUMNER NM DeBaca 575/ ADVANCED MEDICATION MANAGEMENT SYSTEMS 2402 W PIERCE STE 2B CARLSBAD NM Eddy 575/ ALAMO NAVAJO HEALTH CENTER HWY 169 MM29 MAGDALENA NM Socorro 575/ ALAMOGORDO FAMILY HEALTH CENTER TH ST ALAMOGORDO NM Otero 575/ ALBERTSONS MARKET PHARMACY 900 W 2ND ST ROSWELL NM Chaves 575/ ALBERTSONS MARKET PHARMACY 721 MECHEM DR RUIDOSO NM Lincoln 575/ ALBERTSONS MARKET PHARMACY # RIDGECREST DR RIO RANCHO NM Sandoval 505/ ALBERTSONS MARKET PHARMACY # MONTGOMERY NE ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # JUAN TABO BLVD NE ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # A EUBANK BLVD ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # COORS BLVD NW ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # RIO BRAVO BLVD S W ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # MAIN ST SE LOS LUNAS NM Valencia 505/ ALBERTSONS MARKET PHARMACY # A PASEO DEL PUEBLO SUR TAOS NM Taos 575/ ALBERTSONS MARKET PHARMACY # CENTRAL AVE SW ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # ENCHANTED HILLS BLVD NE RIO RANCHO NM Sandoval 505/ ALBERTSONS MARKET PHARMACY # VENTURA ST NE ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # N GUADALUPE ST SANTA FE NM Santa Fe 505/ ALBERTSONS MARKET PHARMACY # LOMAS BLVD NE ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # COORS BLVD NW ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # WYOMING BLVD NE ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # ACADEMY RD N E ALBUQUERQUE NM Bernalillo 505/ ALBERTSONS MARKET PHARMACY # ZAFARANO DR SANTA FE NM Santa Fe 505/ ALBERTSONS MARKET PHARMACY # S ST FRANCIS DR SANTA FE NM Santa Fe 505/ ALBERTSONS MARKET PHARMACY # N GRIMES HOBBS NM Lea 575/ ALBERTSONS MARKET PHARMACY # TH ST ALAMOGORDO NM Otero 575/ ALBERTSONS MARKET PHARMACY # N CANAL ST CARLSBAD NM Eddy 575/ ALBERTSONS MARKET PHARMACY # S MAIN ST ROSWELL NM Chaves 575/ ALBUQUERQUE CITY DRUG 205 SILVER AVE SW STE D ALBUQUERQUE NM Bernalillo 505/ ALBUQUERQUE INDIAN HEALTH PHARMACY 801 VASSAR DRIVE NE ALBUQUERQUE NM Bernalillo 505/ ALBUQUERQUE PHARMACY 500 LOUISIANA BLVD NE ALBUQUERQUE NM Bernalillo 505/ ALBUQUERQUE PHARMACY 500 LOUISANA BLVD NE STE A ALBUQUERQUE NM Bernalillo 505/ ARTESIA FAMILY HEALTH CENTER 1105 MEMORIAL DR ARTESIA NM Eddy 575/ ASPCARES 4371 E LOHMAN AVE LAS CRUCES NM Dona Ana 575/ ASPCARES 7600 JEFFERSON ST NE STE 6 ALBUQUERQUE NM Bernalillo 505/ BEST BUY DRUGS 1445 WYOMING BLVD. NE ALBUQUERQUE NM Bernalillo 505/ BESTCARE PHARMACY 4 LLC 2349 STATE ROAD 522 QUESTA NM Taos 505/ BESTCARE PHARMACY ANGEL FIRE LLC UNIT B4, THE INN, HIGHWAY 434 ANGEL FIRE NM Colfax 575/ BESTCARE PHARMACY CHAMA LLC 2215 STATE ROAD 17 #B CHAMA NM Rio Arriba 575/ BESTCARE PHARMACY LORDSBURG LLC 204 E 4TH ST LORDSBURG NM Hidalgo 575/ BESTCARE PHARMACY SPRINGER LLC 307 MAXWELL AVE #B SPRINGER NM Colfax 505/ BESTCARE PHARMACY-MORA LLC #3 A033 MORA NM Mora 575/ BOBS BUDGET PHARMACY INC 511 S 2ND ST TUCUMCARI NM Quay 575/ BROWN DRUG STORE 322 W WASHINGTON AVE ARTESIA NM Eddy 575/ BUCKLAND PHARMACY 600 DALIES AVE BELEN NM Valencia 505/ CANCER CENTER PHARMACY 1201 CAMINO DE SALUD NE ALBUQUERQUE NM Bernalillo 505/ CANONCITO BAND OF NAVAJOS HEALTH CLINIC 129 MEDICINE HORSE RD CANONCITO NM Bernalillo 505/ CAREMART PHARMACY 201 SAN PEDRO DR SE UNIT C ALBUQUERQUE NM Bernalillo 505/ CARLSBAD FAMILY HEALTH CENTER 2013 SAN JOSE BLVD CARLSBAD NM Eddy 575/ CATRON COUNTY CLINIC ONE FOSTER LN RESERVE NM Catron 575/ CHAPARRAL FAMILY HEALTH CENTER 204 ANGELINA BLVD. CHAPARRAL NM Otero 575/ CHRISTUS ST. VINCENT OUTPATIENT PHARMACY 465 SAINT MICHAELS DR STE 112 SANTA FE NM Santa Fe 505/ CITY DRUG 7 MAIN ST CLAYTON NM Union 575/ CJS PILL BOX 109 W 4TH ST PORTALES NM Roosevelt 575/ COCHITI IHS PHARMACY 255 COCHITI ST COCHITI NM Sandoval 505/ COMMUNITY, A WALGREENS PHARMACY # SAN MATEO BLVD NE STE 501 ALBUQUERQUE NM Bernalillo 505/ CORAM CVS/SPECIALTY INFUSION SERVICES 7400 WASHINGTON ST NE ALBUQUERQUE NM Bernalillo 505/ CORRALES PHARMACY 4940 CORRALES RD SUITE 200 CORRALES NM Sandoval 505/ COSTCO PHARMACY 1420 RENAISSANCE BLVD ALBUQUERQUE NM Bernalillo 505/ COSTCO PHARMACY 500 EUBANK BLVD SE ALBUQUERQUE NM Bernalillo 505/ COSTCO PHARMACY 9955 COORS BYPASS NW ALBUQUERQUE NM Bernalillo 505/ COUNSELOR NAVAJO CLINIC 9837 US HIGHWAY 550 COUNSELOR NM Sandoval 575/ CROWNPOINT HEALTH CARE PHARMACY HWY JCT 57 RT 9 CROWNPOINT NM McKinley 505/ Prime Therapeutics LLC Page 2 of 9 10/30/2017

3 CUBA HEALTH CENTER 6349 US HWY 550 CUBA NM Sandoval 575/ CUBA HEALTH CENTER PHARMACY 6349 US HIGHWAY 550 CUBA NM Sandoval 575/ CUBA SCHOOL BASED HEALTH CENTER #50 COUNTY ROAD 13 CUBA NM Sandoval 575/ DAVIS-FLECK UNITED PHARMACY 500 N BROADWAY ST TRUTH OR CONSEQUENCE NM Sierra 575/ DEL NORTE PHARMACY AND HOME MEDICAL OF SANT1691 GALISTEO SANTA FE NM Santa Fe 505/ DEL NORTE PHARMACY OF LA VEGAS 615 GRAND AVE LAS VEGAS NM San Miguel 505/ DEL-REY PHARMACY 3291 DEL REY BLVD SUITE 3 LAS CRUCES NM Dona Ana 575/ DEMING HEALTH CENTER 300 S. DIAMOND AVENUE DEMING NM Luna 575/ DULCE IHS PHARMACY STONE LAKE RD DULCE NM Rio Arriba 505/ DURAN CENTRAL PHARMACY 1815 CENTRAL AVE NW ALBUQUERQUE NM Bernalillo 505/ DZILTH NA O DITH HLE HEALTH CENTER 6 RD 7586 BLOOMFIELD NM San Juan 505/ ESPERANZA FAMILY HEALTH CENTER 903 C N 5TH ST ESTANCIA NM Torrance 505/ EZ PHARMACY 550 E LISA DR STE C CHAPARRAL NM Dona Ana 575/ FAIRVIEW PHARMACY 734 N RIVERSIDE DR STE A ESPANOLA NM Santa Fe 505/ FARMERS UPTOWN PHARMACY 2800 N MAIN ST ROSWELL NM Chaves 575/ FARMINGTON COMMUNITY HEALTH CENTER 1001 W BROADWAY FARMINGTON NM San Juan 505/ FIRST NATIONS COMMUNITY HEALTHSOURCE PHARM 5608 ZUNI RD SE ALBUQUERQUE NM Bernalillo 505/ FORT BAYARD MEDICAL CENTER PHARMACY 41 FORT BAYARD RD SANTA CLARA NM Grant 575/ FOUR WINDS BEHAVIORAL HEALTH INC 4100 BARBARA LOOP SE RIO RANCHO NM Sandoval 505/ GALLUP INDIAN MED CENTER PHARMACY 516 EAST NIZHONI BLVD GALLUP NM McKinley 505/ GALLUP TEEN HEALTH CENTER /2 RICO ST GALLUP NM McKinley 505/ GENOA, A QOL HEALTHCARE COMPANY, LLC 7850 JEFFERSON ST NE STE 301 ALBUQUERQUE NM Bernalillo 253/ GENOA, A QOL HEALTHCARE COMPANY, LLC 1007 NORTH POPE STREET, STE P SILVER CITY NM Grant 575/ GENOA, A QOL HEALTHCARE COMPANY, LLC 530 EAST DEMOSS STREET, STE P LORDSBURG NM Hidalgo 575/ GENOA, A QOL HEALTHCARE COMPANY, LLC 105 PASEO DEL CANON W STE P1 TAOS NM Taos 575/ HEALTHCARE PHARMACY 3865 E LOHMAN AVE STE 2 LAS CRUCES NM Dona Ana 575/ HIGHLAND PHARMACY 717 ENCINO PL NE STE 1 ALBUQUERQUE NM Bernalillo 505/ HIT SPECIALISTS GOLF COURSE NW ALBUQUERQUE NM Bernalillo 505/ HOBBS FAMILY HEALTH CENTER 200 W LEA HOBBS NM Lea 575/ ISLETA HEALTH CENTER PHARMACY 1 SAGEBRUSH ST ISLETA NM Bernalillo 505/ JEMEZ HEALTH CENTER PHARMACY 110 SHEEPSPRINGS RD JEMEZ PUEBLO NM Sandoval 575/ JEMEZ VALLEY MEDICAL CLINIC 8372 STATE HIGHWAY 4 CANON NM Sandoval 575/ JOES PHARMACY 3646 HWY 47 PERALTA NM Valencia 505/ KARE DRUG AZTEC 100 LLANO ST AZTEC NM San Juan 505/ KARE PHARMACY-BLOOMFIELD 100 N CHURCH ST STE A BLOOMFIELD NM San Juan 505/ KELLY'S PHARMACY 312 N CALIFORNIA ST SOCORRO NM Socorro 575/ KMART PHARMACY S MAIN ST ROSWELL NM Chaves 575/ LA TIENDA PHARMACY 1301 S CANAL CARLSBAD NM Eddy 575/ LOVING HEALTH CLINIC 602 S 4TH ST LOVING NM Eddy 575/ LOWELLS PHARMACY 612 N 13TH ST STE A ARTESIA NM Eddy 575/ LOWES MARKETPLACE PHARMACY 675 E 10TH ST ALAMOGORDO NM Otero 575/ MAGDALENA CLINIC TH ST MAGDALENA NM Socorro 575/ MAY HEALTH MART PHARMACY II 600 CENTRAL MORIARTY NM Torrance 505/ MENAUL COMPOUNDING PHARMACY MENAUL BLVD NE ALBUQUERQUE NM Bernalillo 505/ MESA PHARMACY 1279 S 2ND ST RATON NM Colfax 575/ MESA PHARMACY 308 COLBERT AVE SPRINGER NM Colfax 575/ MESCALERO INDIAN HOSPITAL PHARMACY 318 ABALONIE LOOP MESCALERO NM Otero 575/ MICHAEL'S PRESCRIPTION CORNER 123 W AVENUE A LOVINGTON NM Lea 575/ MICHAEL'S PRESCRIPTION CORNER EUNICE 1024 MAIN STREET EUNICE NM Lea 575/ MICHAEL'S PRESCRIPTION CORNER NORTE VISTA 2410 N FOWLER ST STE A HOBBS NM Lea 575/ MOUNTAINAIR FAMILY HEALTH CENTER 105 EAST PINON MOUNTAINAIR NM Torrance 505/ MOUNTAINAIR MEDS AND MORE LLC 111 W BROADWAY MOUNTAINAIR NM Torrance 505/ NAMBE DRUGS 501 OLD SANTA FE TRL SANTA FE NM Santa Fe 505/ NAMBE DRUGS LOS ALAMOS 111 CENTRAL PARK SQ LOS ALAMOS NM Los Alamos 505/ NEW MEXICO BEHAVIORAL HEALTH INSTITUE AT LAS V3695 HOT SPRINGS BLVD LAS VEGAS NM San Miguel 505/ NEW MEXICO ONCOLOGY HEMATOLOGY CONSULTAN 4901 LANG AVE NE ALBUQUERQUE NM Bernalillo 505/ NEW MEXICO VETERANS CENTER PHARMACY 992 S BROADWAY ST TRUTH OR CONSEQ NM Sierra 575/ NEWSCRIPTS PHARMACY TH ST NW STE G LOS RANCHOS NM Bernalillo 505/ NORTH VALLEY CENTER FOR FAMILY AND COMMUNIT 301 UNSER BLVD NW STE 106 ALBUQUERQUE NM Bernalillo 505/ NORTH VALLEY CENTER FOR FAMILY AND COMMUNIT 3401 N 4TH ST NW STE 106 ALBUQUERQUE NM Bernalillo 505/ NORTHERN NAVAJO MEDICAL CENTER PHARMACY HWY 491 NORTH SHIPROCK NM San Juan 505/ NOWELL PHARMACY LLC 122 W ADAMS LOVINGTON NM Lea 575/ OJO ENCINO NAVAJO CLINIC #2 OJO ENCINO CHAPTER HOUSE ROAD OJO ENCINO NM Sandoval 505/ OMNICARE OF ALBUQUERQUE 9019 WASHINGTON ST NE SUITE B1 ALBUQUERQUE NM Bernalillo 505/ OPTION CARE 4374 ALEXANDER BLVD NE STE A C ALBUQUERQUE NM Bernalillo 505/ Prime Therapeutics LLC Page 3 of 9 10/30/2017

4 ORTIZ MOUNTAIN HEALTH CENTER 06B MAIN ST CERRILLOS NM Santa Fe 505/ PARKHURST PHARMACY 1208 BONITA ST SUITE A GRANTS NM Cibola 505/ PECOS VALLEY MEDICAL CENTER 199 HIGHWAY 50 PECOS NM San Miguel 505/ PHARMACA INTEGRATIVE PHARMACY 530 W CORDOVA RD STE B SANTA FE NM Santa Fe 505/ PHARMACA INTEGRATIVE PHARMACY 8910 HOLLY AVE NE ALBUQUERQUE NM Bernalillo 505/ PHARMACY PLUS - BERNALILLO 407 W HWY 550 BERNALILLO NM Sandoval 505/ PHARMERICA 2720 BROADBENT PKWY NE STE A ALBUQUERQUE NM Bernalillo 505/ PHIL'S PHARMACY 5510 LOMAS NE ALBUQUERQUE NM Bernalillo 505/ PINE HILL HEALTH CENTER BIA RT 125 PINE HILL NM Cibola 505/ PINON FAMILY PHARMACY 2300 B E 30TH SUITE 101 FARMINGTON NM San Juan 505/ PLAINS REGIONAL MEDICAL CENTER PHARMACY 2401 W 21ST ST CLOVIS NM Curry 575/ PLAZA DRUGS 178 BRIDGE ST LAS VEGAS NM San Miguel 505/ PRESBYTERIAN INTEL HEALTH FOR LIFE CENTER 4100 SARA RD SE, MSRR5 RIO RANCHO NM Sandoval 505/ PRESBYTERIAN MEDICAL SERVICES FAMILY HEALTH CE 2300 GRANDE BLVD SE RIO RANCHO NM Sandoval 505/ PRIMM DRUG 700 N UNION ROSWELL NM Chaves 575/ PUEBLO OF SANDIA PHARMACY 203 SANDIA DAY SCHOOL RD BERNALILLO NM Sandoval 505/ QUAY COUNTY FAMILY HEALTH CENTER 1302 E MAIN ST TUCUMCARI NM Quay 575/ QUEMADO HEALTH CENTER 8 OLD TOWN LOOP QUEMADO NM Catron 575/ QUESTA HEALTH CENTER 2573 STATE HWY 522 QUESTA NM Taos 575/ RIO RANCHO FAMILY HEALTH CENTER 184 UNSER BLVD NE RIO RANCHO NM Sandoval 505/ RODEN-SMITH PHARMACY 601 E LLANO ESTACADO BLVD STE A CLOVIS NM Curry 575/ ROUTE 66 PHARMACY 117 CAMINO DE VIDA STE 200 SANTA ROSA NM Guadalupe 575/ RX INNOVATIONS 7215 WASHINGTON ST NE ALBUQUERQUE NM Bernalillo 505/ SACRAMENTO MOUNTAIN MEDICAL CENTER 74 JAMES CANYON HWY CLOUDCROFT NM Otero 575/ SAFEWAY PHARMACY # N MAIN ST AZTEC NM San Juan 505/ SAFEWAY PHARMACY # US HIGHWAY 491 GALLUP NM McKinley 505/ SAFEWAY PHARMACY # E MAIN STREET FARMINGTON NM San Juan 505/ SAMS PHARMACY COORS BYPASS NW ALBUQUERQUE NM Bernalillo 505/ SAMS PHARMACY N. TELSHOR BLVD LAS CRUCES NM Dona Ana 575/ SAMS PHARMACY NORTH RENAISSANCE BLVD NE ALBUQUERQUE NM Bernalillo 505/ SAMS PHARMACY NORTH MAIN STREET ROSWELL NM Chaves 575/ SAMS PHARMACY EAST MAIN FARMINGTON NM San Juan 505/ SAMS PHARMACY RODEO ROAD SANTA FE NM Santa Fe 505/ SAMS PHARMACY EUBANK BLVD NE ALBUQUERQUE NM Bernalillo 505/ SAMS REGENT PHARMACY 7120 WYOMING NE STE 7B ALBUQUERQUE NM Bernalillo 505/ SAN FELIPE HEALTH CLINIC PHARMACY 3 CEDAR ST SAN FELIPE PUEBLO SAN FELIPE NM Sandoval 505/ SAN JUAN ONCOLOGY ASSOCIATES, PC 735 W ANIMAS ST FARMINGTON NM San Juan 505/ SANTA ANA HEALTH CLINIC PHARMACY 02 C DOVE RD BERNALILLO NM Sandoval 505/ SANTA CLARA IHS PHARMACY ROUTE 5 ESPANOLA NM Rio Arriba 505/ SANTA FE COMMUNITY GUIDANCE CENTER 2960 RODEO PARK DR WEST SANTA FE NM Santa Fe 505/ SANTA FE INDIAN HOSPITAL PHARMACY 1700 CERRILLOS RD SANTA FE NM Santa Fe 505/ SANTO DOMINGO PUEBLO HEALTH CENTER 85 WEST HIGHWAY 22 SANTO DOMINGO NM Sandoval 505/ SAVON PHARMACY 2551 E LOHMAN AVE LAS CRUCES NM Dona Ana 575/ SAVON PHARMACY # EL PASEO RD LAS CRUCES NM Dona Ana 575/ SAVON PHARMACY # HWY 180 E SILVER CITY NM Grant 575/ SHARE N CARE PHARMACY AND MEDICAL SUPPLY 701 DALIES AVE BELEN NM Valencia 505/ SIERRA BLANCA PHARMACY 1206 MECHEM DR RUIDOSO NM Lincoln 575/ SMITHS PHARMACY # EAST 20TH ST FARMINGTON NM San Juan 505/ SMITHS PHARMACY # RIO RANCHO DR RIO RANCHO NM Sandoval 505/ SMITHS PHARMACY # MAIN ST LOS LUNAS NM Valencia 505/ SMITHS PHARMACY # TH ST NW ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY #424 #2B HWY 344 EDGEWOOD NM Santa Fe 505/ SMITHS PHARMACY # PASEO PUEBLO SUR TAOS NM Taos 575/ SMITHS PHARMACY # TRAMWAY SE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # SHERWOOD BLVD WHITE ROCK NM Los Alamos 505/ SMITHS PHARMACY # TRAMWAY NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # LOMAS NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # GOLF COURSE RD ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # ACADEMY RD NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # WYOMING NE SUITE A ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # CERRILLOS ROAD SANTA FE NM Santa Fe 505/ SMITHS PHARMACY # MCMAHON BLVD NW ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # TRINITY DR STE 100 LOS ALAMOS NM Los Alamos 505/ SMITHS PHARMACY # LOUISIANA NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # PACHECO SANTA FE NM Santa Fe 505/ Prime Therapeutics LLC Page 4 of 9 10/30/2017

5 SMITHS PHARMACY # EUBANK NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # CONSTITUTION NE ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # COORS RD NW ALBUQUERQUE NM Bernalillo 505/ SMITHS PHARMACY # ARENAL SW ALBUQUERQUE NM Bernalillo 505/ SOCORRO COMMUNITY HEALTH CNTR 1300 ENTERPRISE SOCORRO NM Socorro 575/ SOUTHWEST CARE CENTER 649 HARKLE RD STE C SANTA FE NM Santa Fe 505/ SOUTHWEST CARE CENTER PHARMACY 4710 JEFFERSON STREET SUITE A ALBUQUERQUE NM Bernalillo 505/ SOUTHWESTERN MEDICAL PHARMACY 2402 W PIERCE ST 1A CARLSBAD NM Eddy 575/ TAOS PICURIS HEALTH CENTER PHARMACY 1090 GOAT SPRINGS RD TAOS NM Taos 575/ TEEN HEALTH CENTER - CAPITAL HIGH SCHOOL 4851 PASEO DEL SOL SANTA FE NM Santa Fe 505/ TEEN HEALTH CENTER -SANTA FE HIGH SCHOOL 2100 YUCCA ST SANTA FE NM Santa Fe 505/ THE MEDICINE CHEST 1123 CANDELARIA RD NW ALBUQUERQUE NM Bernalillo 505/ THE MEDICINE SHOPPE PHARMACY 1275 A S SECOND ST RATON NM Colfax 575/ THE PILL BOX PHARMACY 1010 BRIDGE BLVD SW STE B2 ALBUQUERQUE NM Bernalillo 505/ TOHATCHI HEALTH CENTER PHARMACY 07 CHOOSGAI TOHATCHI NM McKinley 505/ TORREON NAVAJO CLINIC 2500 STATE HWY 197 TORREON NM Sandoval 505/ TRUST PHARMACY 1000 ROOSEVELT GRANTS NM Cibola 505/ TULAROSA MEDICAL CENTER 111 CENTRAL AVE TULAROSA NM Otero 575/ UNITED DRUG 221 W HALL ST HATCH NM Dona Ana 575/ UNIVERSITY HOSPITAL OUTPATIENT PHARMACY 1209 UNIVERSITY BOULVARD NE ALBUQUERQUE NM Bernalillo 505/ UNM HOSPITALS OUTPATIENT AND DISCHARGE PHARM2211 LOMAS BLVD NE # 4ACC ALBUQUERQUE NM Bernalillo 505/ UNM STUDENT HEALTH CENTER PHARMACY I UNIV OF NEW MEXICO MSC BLDG 73 RM 206 ALBUQUERQUE NM Bernalillo 505/ UNM TRUMAN HEALTH SERVICES PHARMACY 801 ENCINO PL NE STE B4 ALBUQUERQUE NM Bernalillo 505/ UNMH PHARMACY AT SOUTH EAST HEIGHTS CLINIC 8200 CENTRAL AVE SE SUITE 106 ALBUQUERQUE NM Bernalillo 505/ VALLEY COMMUNITY HEALTH CENTER 835 SPRUCE ST ESPANOLA NM Rio Arriba 505/ VICTOR'S REGENT PHARMACY 1643 ISLETA BLVD SW ALBUQUERQUE NM Bernalillo 505/ VIDA PHARMACY LLC 8500 JEFFERSON ST NE STE D STE D ALBUQUERQUE NM Bernalillo 505/ VILLAGE PHARMACY INC 1719 S AVE D PORTALES NM Roosevelt 575/ WALGREENS 9700 MENAUL BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS 2105 CENTRAL AVE NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS 2625 SAN PEDRO DR NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS 3401 ISLETA BLVD, SW ALBUQUERQUE NM Bernalillo 505/ WALGREENS 2500 MAIN ST NE LOS LUNAS NM Valencia 505/ WALGREENS 1861 MAIN ST LOS LUNAS NM Valencia 505/ WALGREENS 9601 GIBSON BLVD SW ALBUQUERQUE NM Bernalillo 505/ WALGREENS 5721 AIRPORT RD SANTA FE NM Santa Fe 505/ WALGREENS 122 N GOLD AVE DEMING NM Luna 575/ WALGREENS 3490 NORTHRISE DR LAS CRUCES NM Dona Ana 575/ WALGREENS 1509 E SANTA FE AVE GRANTS NM Cibola 505/ WALGREENS # ROSEDALE RD SILVER CITY NM Grant 575/ WALGREENS # MONTGOMERY BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # E LOHMAN AVE LAS CRUCES NM Dona Ana 575/ WALGREENS # MENAUL BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # CENTRAL AVE NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # EL PASEO ROAD LAS CRUCES NM Dona Ana 575/ WALGREENS # VENTURA NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # NORTHERN BLVD NE RIO RANCHO NM Sandoval 505/ WALGREENS # UNSER BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # W PICACHO AVE LAS CRUCES NM Dona Ana 575/ WALGREENS # PASEO DEL PUEBLO SUR TAOS NM Taos 575/ WALGREENS # CENTRALSE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # W JOE HARVEY BLVD HOBBS NM Lea 575/ WALGREENS # CEDAR ST SE STE 102 ALBUQUERQUE NM Bernalillo 505/ WALGREENS # RIO RANCHO BLVD RIO RANCHO NM Sandoval 505/ WALGREENS # WALTER STREET SUITE 202 ALBUQUERQUE NM Bernalillo 505/ WALGREENS # JUAN TABO NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # JOURNAL CENTER BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # S MAIN ST ROSWELL NM Chaves 575/ WALGREENS # E HWY 550 BERNALILLO NM Sandoval 505/ WALGREENS # N MAIN ST BELEN NM Valencia 505/ WALGREENS # PARADISE BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # MONTGOMERY PLAZA ALBUQUERQUE NM Bernalillo 505/ WALGREENS # NORTH TURNER HOBBS NM Lea 575/ WALGREENS # MILLS AVENUE LAS VEGAS NM San Miguel 505/ WALGREENS # ST FRANCIS DR SANTA FE NM Santa Fe 505/ Prime Therapeutics LLC Page 5 of 9 10/30/2017

6 WALGREENS # COORS BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # HARPER AVE NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # CERRILLOS ROAD SANTA FE NM Santa Fe 505/ WALGREENS # COORS BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # SOUTHERN RIO RANCHO NM Sandoval 505/ WALGREENS # N MAIN LAS CRUCES NM Dona Ana 575/ WALGREENS # E MAIN FARMINGTON NM San Juan 505/ WALGREENS # LOMAS BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # SUDDERTH RUIDOSO NM Lincoln 575/ WALGREENS # COORS BYPASS ALBUQUERQUE NM Bernalillo 505/ WALGREENS # COORS BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # E 21ST STREET CLOVIS NM Curry 575/ WALGREENS # N RIVERSIDE DR ESPANOLA NM Rio Arriba 505/ WALGREENS # SOUTHERN BLVD SE RIO RANCHO NM Sandoval 505/ WALGREENS # N MAIN ST ROSWELL NM Chaves 575/ WALGREENS # GOLF COURSE RD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # ENCHANTED HILLS NE RIO RANCHO NM Sandoval 505/ WALGREENS # INDIAN SCHOOL RD ALBUQUERQUE NM Bernalillo 505/ WALGREENS # MONTGOMERY BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # W ZIA ROAD SANTA FE NM Santa Fe 505/ WALGREENS # E LOHMAN AVE LAS CRUCES NM Dona Ana 575/ WALGREENS # TH ST NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # EUBANK BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # UNSER BLVD SW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # TH ST NW LOS RANCHOS DE ALBUQ NM Bernalillo 505/ WALGREENS # WALKER RD EDGEWOOD NM Santa Fe 505/ WALGREENS # W PIERCE CARLSBAD NM Eddy 575/ WALGREENS # E HWY 66 GALLUP NM McKinley 505/ WALGREENS # E 20TH ST FARMINGTON NM San Juan 505/ WALGREENS # WYOMING BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # TH STREET NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # PASEO DEL NORTE NE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # UNSER BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALGREENS # CENTRAL AVE SE ALBUQUERQUE NM Bernalillo 505/ WALGREENS # N WHITE SANDS BLVD ALAMOGORDO NM Otero 575/ WALGREENS PRESCRIPTION CENTER 3450 S TELSHOR BLVD LAS CRUCES NM Dona Ana 224/ WALMART PHARMACY LOVINGTON HWY HOBBS NM Lea 575/ WALMART PHARMACY A NORTH MAIN ROSWELL NM Chaves 575/ WALMART PHARMACY S WALTON BLVD LAS CRUCES NM Dona Ana 575/ WALMART PHARMACY N PRINCE STREET CLOVIS NM Curry 575/ WALMART PHARMACY ACADEMY ROAD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY EAST MAIN FARMINGTON NM San Juan 505/ WALMART PHARMACY CERILLOS RD SANTA FE NM Santa Fe 505/ WALMART PHARMACY SAN MATEO BLVD SE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY EUBANK BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY CARLISLE BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY W HWY 70 RUIDOSO DOWNS NM Lincoln 575/ WALMART PHARMACY S CANAL ST CARLSBAD NM Eddy 575/ WALMART PHARMACY PASEO DEL PUEBLO SUR TAOS NM Taos 575/ WALMART PHARMACY WEST MALONEY AVE GALLUP NM McKinley 505/ WALMART PHARMACY S NEW YORK AVE ALAMOGORDO NM Otero 575/ WALMART PHARMACY HWY 180 EAST SILVER CITY NM Grant 575/ WALMART PHARMACY TH STREET LAS VEGAS NM San Miguel 505/ WALMART PHARMACY COORS BYPASSNW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY I 25 INTERCHANGE BELEN NM Valencia 505/ WALMART PHARMACY CUTLER AVE NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY ROBERTS DRIVE GRANTS NM Cibola 505/ WALMART PHARMACY EAST SPRUCE STREET PORTALES NM Roosevelt 575/ WALMART PHARMACY N RIVERSIDE DRIVE ESPANOLA NM Rio Arriba 505/ WALMART PHARMACY COORS BLDV NW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY GOLF COURSE ROAD NW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY SAGE ROAD SW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY HERRERA DR SANTA FE NM Santa Fe 505/ WALMART PHARMACY NORTH 26TH STREET ARTESIA NM Eddy 575/ WALMART PHARMACY WEST MAIN STREET FARMINGTON NM San Juan 505/ Prime Therapeutics LLC Page 6 of 9 10/30/2017

7 WALMART PHARMACY MONTGOMERY BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY NM HWY 528 SE RIO RANCHO NM Sandoval 505/ WALMART PHARMACY MAIN STREET NW LOS LUNAS NM Valencia 505/ WALMART PHARMACY NM HIGHWAY 528 BERNALILLO NM Sandoval 505/ WALMART PHARMACY UNSER BLVD SOUTHEAST RIO RANCHO NM Sandoval 505/ WALMART PHARMACY STATE ROAD 344 EDGEWOOD NM Santa Fe 505/ WALMART PHARMACY HR ASHBAUGH DR TRUTH OR CONSEQUENCE NM Sierra 575/ WALMART PHARMACY RINCONADA BLVD LAS CRUCES NM Dona Ana 575/ WALMART PHARMACY UNSER BLVD NW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY SOUTH VALLEY DRIVE LAS CRUCES NM Dona Ana 575/ WALMART PHARMACY EAST PINE STREET DEMING NM Luna 575/ WALMART PHARMACY COORS BLVD SW ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY WYOMING BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY NORTH 6TH STREET SOCORRO NM Socorro 575/ WALMART PHARMACY MENAUL BLVD NE ALBUQUERQUE NM Bernalillo 505/ WALMART PHARMACY INDIAN WELLS ROAD ALAMOGORDO NM Otero 575/ WALMART PHARMACY N SONOMA RANCH BLVD LAS CRUCES NM Dona Ana 575/ WELLBORN PHARMACY 315 S 2ND STREET TUCUMCARI NM Quay 575/ WESTERN NEW MEXICO MEDICAL GROUP BEHAVIORA2025 E AZTEC AVE GALLUP NM McKinley 505/ WESTERN NM MED GROUP GALLUP 610 N 5TH ST GALLUP NM McKinley 505/ WESTERN NM MEDICAL GROUP GRANTS 1217 BONITA ST GRANTS NM Cibola 505/ WESTERN NM MEDICAL GROUP THOREAU 15 E. NAVARRE THOREAU NM McKinley 505/ ZIA INDIAN HEALTH CLINIC PHARMACY 155B CAPITAL SQUARE DR ZIA NM Sandoval 505/ ZIA PHARMACY 2820 BROADBENT PKWY NE STE C ALBUQUERQUE NM Bernalillo 505/ ZUNI INDIAN HOSPITAL PHARMACY ROUTE 301 NORTH B ST ZUNI NM McKinley 505/ BOISE CITY FAMILY PHARMACY 318 W MAIN BOISE CITY OK Cimarron 580/ ADVANT-EDGE PHARMACY 1576 LOMALAND DRIVE EL PASO TX El Paso 915/ ADVANT-EDGE PHARMACY HORIZON BLVD STE J HORIZON CITY TX El Paso 915/ ALAMEDA THRIFTY PHARMACY 4900 ALAMEDA AVE EL PASO TX El Paso 915/ ASPCARES 1015 N ZARAGOZA RD EL PASO TX El Paso 915/ AVELLA OF AUSTIN 3016 GUADALUPE ST STE A AUSTIN TX Travis 512/ BANK PHARMACY 4000 MONTANA AVE EL PASO TX El Paso 915/ BI-WIZE PHARMACY 902 MAIN ST FRIONA TX Parmer 806/ BOWERS PRESCRIPTION SHOP 121 E TEXAS BLVD DALHART TX Hartley 806/ CORAM CVS/SPECIALTY INFUSION SERVICES 3817 CONSTITUTION DR STE 300 EL PASO TX El Paso 915/ COSTCO PHARMACY 6101 GATEWAY WEST BLVD EL PASO TX El Paso 915/ DENVER CITY PHARMACY 105 E BROADWAY ST DENVER CITY TX Yoakum 806/ EL PASO INTEGRATED PHYSICIANS GROUP - SURECARE4532 N MESA STREET EL PASO TX El Paso 915/ EL PASO PAIN CENTER PHARMACY 3215 GATEWAY BLVD W SUITE A EL PASO TX El Paso 915/ FAMILY PHARMACY 2931 GEORGE DIETER DR STE C SUITE C EL PASO TX El Paso 915/ FOUNDATION SURGICAL HOSPITAL OF EL PASO - SURE1400 GEORGE DIETER DR STE 190 EL PASO TX El Paso 915/ GENOA, A QOL HEALTHCARE COMPANY, LLC 1601 EAST YANDELL STREET SUITE 119 EL PASO TX El Paso 915/ GENOA, A QOL HEALTHCARE COMPANY, LLC 2400 TRAWOOD DR STE 303A EL PASO TX El Paso 915/ GRACE PHARMACY LA QUINTA PL STE 101 EL PASO TX El Paso 915/ GUARDIAN ANGEL PHARMACY 1537 ZARAGOSA STE 1A EL PASO TX El Paso 915/ HEREFORD HEALTH MART PHARMACY 809 S 25 MILE AVE HEREFORD TX Deaf Smith 806/ HEREFORD HEALTH MART PHARMACY 809 S 25 MILE AVE HEREFORD TX Deaf Smith 806/ K & K PHARMACY 1411 W AMERICAN BLVD MULESHOE TX Bailey 806/ KERMIT PHARMACY 810 MYER LANE KERMIT TX Winkler 432/ KMART PHARMACY SUNLAND PARK EL PASO TX El Paso 915/ LIBERTY DRUGS 403 MUSTANG DRIVE DENVER CITY TX Yoakum 806/ LOWES MARKETPLACE PHARMACY 310 E AUSTIN ST KERMIT TX Winkler 432/ MCCRORY'S PHARMACY 6151 DEW DR STE 100 EL PASO TX El Paso 915/ MED TIME PHARMACY 641 N RESLER STE EL PASO TX El Paso 915/ MESA HILLS PHARMACY 310 S MESA HILLS DR STE C EL PASO TX El Paso 915/ NEIGHBORHOOD PHARMACY 801 N MAIN ST STE-F ANDREWS TX Andrews 432/ OMNICARE OF FORT WORTH TRINITY BLVD STE 200 FORT WORTH TX Tarrant 817/ OSWALT PHARMACY 701 HOBBS HWY SEMINOLE TX Gaines 432/ PHARMACY CENTER EAST 3100 LEE TREVINO DR STE F EL PASO TX El Paso 915/ PHARMERICA RD STREET SUITE D LUBBOCK TX Lubbock 866/ PHARMERICA 4171 N MESA ST SUITE 210A EL PASO TX El Paso 915/ PRESCRIPTION SHOP 813 HOSPITAL DR ANDREWS TX Andrews 432/ PRIMEMED PHARMACY 7812 GATEWAY BLVD E SUITE 100 EL PASO TX El Paso 915/ RECEPT PHARMACY VISTA DEL SOL STE 1A EL PASO TX El Paso 915/ RGU PHARMACY 7420 REMCON CIRCLE BLDG C STE 150 EL PASO TX El Paso 915/ Prime Therapeutics LLC Page 7 of 9 10/30/2017

8 SAM'S CLUB PHARMACY GATEWAY BLVD N EL PASO TX El Paso 915/ SAMS PHARMACY 7970 NORTH MESA EL PASO TX El Paso 915/ SAMS PHARMACY PELLICANO DRIVE EL PASO TX El Paso 915/ SAMS PHARMACY GATEWAY BLVD WEST EL PASO TX El Paso 915/ SAVON PHARMACY 5200 MONTANA AVE EL PASO TX El Paso 915/ SAVON PHARMACY 2200 YARBROUGH DR EL PASO TX El Paso 915/ SAVON PHARMACY # MESA ST EL PASO TX El Paso 915/ SAVON PHARMACY # MONTWOOD DR EL PASO TX El Paso 915/ SAVON PHARMACY # N DESERT BLVD EL PASO TX El Paso 915/ SAVON PHARMACY # N MESA ST EL PASO TX El Paso 915/ SAVON PHARMACY # DYER ST EL PASO TX El Paso 915/ SAVON PHARMACY # KENWORTHY EL PASO TX El Paso 915/ THE FAMILY PHARMACY EDGEMERE BLVD STE 210 EL PASO TX El Paso 915/ THE MEDICINE SHOPPE PHARMACY 2002 GRANT STEA EL PASO TX El Paso 915/ THE MEDICINE SHOPPE PHARMACY 1420 FABENS RD STE B FABENS TX El Paso 915/ THE MEDICINE SHOPPE PHARMACY 3310 FORT BLVD EL PASO TX El Paso 915/ THE PHARMACY CENTER 1700 MURCHISON SUITE A EL PASO TX El Paso 915/ TIGUA PHARMACY 8269 N LOOP DR EL PASO TX El Paso 915/ UNITED PHARMACY 104 W 9TH ST MULESHOE TX Bailey 806/ UNITED PHARMACY 1601 TENNESSEE DALHART TX Hartley 806/ UNIVERSITY MEDICAL CENTER EAST PHARMACY 1485 GEORGE DIETER DR STE 107 EL PASO TX El Paso 915/ UNIVERSITY MEDICAL CENTER FABENS PHARMACY 101 POTASIO ST. FABENS TX El Paso 915/ UNIVERSITY MEDICAL CENTER NORTHEAST PHARMACY9839 KENWORTHY ST EL PASO TX El Paso 915/ UNIVERSITY MEDICAL CENTER OF EL PASO PHARMACY4815 ALAMEDA AVE EL PASO TX El Paso 915/ UNIVERSITY MEDICAL CENTER PHARMACY JOE BATTLE BLVD EL PASO TX El Paso 915/ UNIVERSITY MEDICAL CENTER PHARMACY NORTH DESERT BLVD EL PASO TX El Paso 915/ UNIVERSITY MEDICAL CENTER YSLETA PHARMACY 300 S ZARAGOZA ROAD BUILDING B EL PASO TX El Paso 915/ VIP PHARMACY 1891 N LEE TREVINO STE 200 EL PASO TX El Paso 915/ WALGREENS 8045 N LOOP DRIVE EL PASO TX El Paso 915/ WALGREENS # RUSHING RD EL PASO TX El Paso 915/ WALGREENS # GATEWAY BLVD W EL PASO TX El Paso 915/ WALGREENS # NORTH LOOP DR SOCORRO TX El Paso 915/ WALGREENS # GEORGE DIETER DR EL PASO TX El Paso 915/ WALGREENS # HORIZON BLVD HORIZON CITY TX El Paso 915/ WALGREENS # MONTANA AVE EL PASO TX El Paso 915/ WALGREENS # ANTONIO ST ANTHONY TX El Paso 915/ WALGREENS # WEDGEWOOD DR EL PASO TX El Paso 915/ WALGREENS # MONTWOOD DR EL PASO TX El Paso 915/ WALGREENS # MONTANA AVE EL PASO TX El Paso 915/ WALGREENS # OREGON ST EL PASO TX El Paso 915/ WALGREENS # N ZARAGOZA ROAD EL PASO TX El Paso 915/ WALGREENS # ZARAGOSA ROAD EL PASO TX El Paso 915/ WALGREENS # NORTH RESLER DR EL PASO TX El Paso 915/ WALGREENS # MONTWOOD DR EL PASO TX El Paso 915/ WALGREENS # N MESA ST EL PASO TX El Paso 915/ WALGREENS # MONTANA EL PASO TX El Paso 915/ WALGREENS # N MESA ST EL PASO TX El Paso 915/ WALGREENS # N AMERICAS EL PASO TX El Paso 915/ WALGREENS # LEE TREVINO DR EL PASO TX El Paso 915/ WALGREENS # GEORGE DIETER DR EL PASO TX El Paso 915/ WALGREENS # GERONIMO DR EL PASO TX El Paso 915/ WALGREENS # KENWORTHY EL PASO TX El Paso 915/ WALGREENS # DYER ST EL PASO TX El Paso 915/ WALGREENS # N MESA ST EL PASO TX El Paso 915/ WALGREENS # EDGEMERE EL PASO TX El Paso 915/ WALMART PHARMACY WOODROW BEAN EL PASO TX El Paso 915/ WALMART PHARMACY GATEWAY BLVD WEST EL PASO TX El Paso 915/ WALMART PHARMACY HOBBS HIGHWAY SEMINOLE TX Gaines 432/ WALMART PHARMACY ALAMEDA AVE EL PASO TX El Paso 915/ WALMART PHARMACY N MESA EL PASO TX El Paso 915/ WALMART PHARMACY GATEWAY BLVD EL PASO TX El Paso 915/ WALMART PHARMACY NORTH ZARAGOZA RD EL PASO TX El Paso 915/ WALMART PHARMACY HORIZON BLVD HORIZON CITY TX El Paso 915/ WALMART PHARMACY WEST 15TH STREET HEREFORD TX Deaf Smith 806/ WALMART PHARMACY N ZARAGOZA RD EL PASO TX El Paso 915/ Prime Therapeutics LLC Page 8 of 9 10/30/2017

9 WALMART PHARMACY MONTANA AVE EL PASO TX El Paso 915/ WALMART PHARMACY E REDD RD EL PASO TX El Paso 915/ WALMART PHARMACY NORTH RESLER EL PASO TX El Paso 915/ WALMART PHARMACY NORTH LOOP EL PASO TX El Paso 915/ WALMART PHARMACY SAUL KLEINFELD DRIVE EL PASO TX El Paso 915/ WALMART PHARMACY DYER ST EL PASO TX El Paso 915/ WALMART PHARMACY ALAMEDA AVE SOCORRO TX El Paso 915/ WALMART PHARMACY HONDO PASS DR EL PASO TX El Paso 915/ WALMART PHARMACY MARTIN LUTHE KING BLVD EL PASO TX El Paso 915/ WALMART PHARMACY N ZARAGOZA RD EL PASO TX El Paso 915/ WALMART PHARMACY SUNLAND PARK DRIVE EL PASO TX El Paso 915/ BLUE MOUNTAIN PHARMACY 802 SOUTH 200 WEST BLANDING UT San Juan 435/ MAIN STREET DRUG & BOUTIQUE 140 S MAIN ST MONTICELLO UT San Juan 435/ MONTEZUMA CREEK CHC PHARMACY EAST HWY 262 MONTEZUMA CREEK UT San Juan 435/ MONUMENT VALLEY HEALTH CENTER 30 WEST MEDICAL DRIVE MONUMENT VALLEY UT San Juan 435/ SAN JUAN PHARMACY 65 S MAIN ST BLANDING UT San Juan 435/ Such services are funded in part with the State of New Mexico. Blue Cross and Blue Shield of New Mexico complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711). Díí baa akó nínízin: Díí saad bee yáníłti go Diné Bizaad, saad bee áká ánída áwo dę ę, t áá jiik eh, éí ná hólǫ, kojį hódíílnih (TTY: 711). Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Prime Therapeutics LLC Page 9 of 9 10/30/2017