Bexar Counties: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, and Wilson. Aetna Better Health CVS Caremark STAR, CHIP Amerigroup Express Scripts STAR, CHIP, STAR+PLUS Community First Navitus STAR, CHIP, STAR KIDS Molina Healthcare CVS Caremark STAR+PLUS Superior Health Plan Envolve Pharmacy Solutions STAR, CHIP, STAR+PLUS, STAR KIDS Dallas Counties: Collin, Dallas, Ellis, Hurt, Kaufman, Navarro, and Rockwall. Amerigroup Express Scripts STAR, CHIP, STAR KIDS Children s Medical Center Navitus STAR KIDS Molina Healthcare CVS Caremark STAR, CHIP, STAR+PLUS Parkland Navitus STAR, CHIP Superior Health Plan Envolve Pharmacy Solutions STAR+PLUS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 1 OF 8
El Paso Counties: El Paso and Hudspeth. Amerigroup Express Scripts STAR+PLUS, STAR KIDS El Paso Health Navitus STAR, CHIP Molina Healthcare CVS Caremark STAR, STAR+PLUS Superior Health Plan Envolve Pharmacy Solutions STAR, CHIP, STAR KIDS Harris Counties: Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller, and Wharton. Amerigroup Express Scripts STAR, CHIP, STAR+PLUS, STAR KIDS Community Health Choice Navitus STAR, CHIP Molina Healthcare CVS Caremark STAR, CHIP, STAR+PLUS Texas Children's Navitus STAR, CHIP, STAR KIDS United Healthcare Prescription Solutions STAR, CHIP, STAR+PLUS, STAR KIDS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 2 OF 8
Hidalgo Counties: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Star, Webb, Willacy, and Zapata. Cigna-HealthSpring OptumRx STAR+PLUS Driscoll Health Plan Navitus STAR, STAR KIDS Molina Healthcare CVS Caremark STAR, STAR+PLUS Superior Health Plan Envolve Pharmacy Solutions STAR, STAR+PLUS, STAR KIDS UnitedHealthcare Prescription Solutions STAR, STAR KIDS Jefferson Counties: Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker. Amerigroup Express Scripts STAR, CHIP, STAR+PLUS Community Health Choice Navitus STAR, CHIP Molina Healthcare CVS Caremark STAR, CHIP, STAR+PLUS Texas Children's Navitus STAR, CHIP, STAR KIDS United Healthcare Prescription Solutions STAR, CHIP, STAR+PLUS, STAR KIDS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 3 OF 8
Lubbock Counties: Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, and Terry. Amerigroup Express Scripts STAR, STAR+PLUS, STAR KIDS FirstCare Navitus STAR, CHIP Superior Health Plan Envolve Pharmacy Solutions STAR, CHIP, STAR+PLUS, STAR KIDS Nueces Counties: Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio, and Victoria. Driscoll Health Plan Navitus STAR, CHIP, STAR KIDS Superior Health Plan Envolve Pharmacy Solutions STAR, CHIP, STAR+PLUS, STAR KIDS United Healthcare Prescription Solutions STAR, CHIP, STAR+PLUS Tarrant Counties: Denton, Hood, Johnson, Parker, Tarrant, and Wise. Aetna Better Health CVS Caremark STAR, CHIP, STAR KIDS Amerigroup Express Scripts STAR, CHIP, STAR+PLUS Cigna-HealthSpring OptumRx STAR+PLUS Cook Children's Navitus STAR, CHIP, STAR KIDS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 4 OF 8
Travis Counties: Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis, and Williamson. Amerigroup Express Scripts STAR+PLUS Blue Cross Blue Shield Prime Therapeutics STAR, CHIP, STAR KIDS Dell Children's Health Plan Navitus STAR, CHIP Superior Health Plan Envolve Pharmacy Solutions STAR, CHIP, STAR KIDS United Healthcare Prescription Solutions STAR+PLUS Medicaid Rural Service Area Central Counties: Bell, Blanco, Bosque, Brazos, Burleson, Colorado, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, and Washington. Amerigroup Express Scripts STAR Blue Cross Blue Shield Prime Therapeutics STAR KIDS Scott & White (RightCare) Navitus STAR Superior HealthPlan Envolve Pharmacy Solutions STAR, STAR+PLUS United Healthcare Prescription Solutions STAR+PLUS, STAR KIDS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 5 OF 8
Medicaid Rural Service Area Northeast Counties: Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague, Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, and Wood. Amerigroup Express Scripts STAR Cigna-HealthSpring OptumRx STAR+PLUS Superior Health Plan Envolve Pharmacy Solutions STAR Texas Children's Navitus STAR KIDS United Healthcare Prescription Solutions STAR+PLUS, STAR KIDS Medicaid Rural Service Area West Counties: Andrews, Archer, Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brown, Callahan, Castro, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Concho, Cottle, Crane, Crockett, Culberson, Dallam, Dawson, Dickens, Dimmit, Donley, Eastland, Ector, Edwards, Fisher, Foard, Frio, Gaines, Glasscock, Gray, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Howard, Irion, Jack, Jeff Davis, Jones, Kent, Kerr, Kimble, King, Kinney, Knox, LaSalle, Lipscomb, Loving, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Palo Pinto, Parmer, Pecos, Presidio, Reagan, Real, Reeves, Robertson, Runnels, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Taylor, Terrell, Throckmorton, Tom Green, Upton, Uvalde, Val Verde, Ward, Wheeler, Wichita, Wilbarger, Winkler, Yoakum, Young, and Zavala. Amerigroup Express Scripts STAR, STAR+PLUS, STAR KIDS FirstCare Navitus STAR Superior Health Plan Envolve Pharmacy Solutions STAR, STAR+PLUS, STAR KIDS Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 6 OF 8
CHIP Rural Service Area Counties: Anderson, Angelina, Andrews, Archer, Armstrong, Bailey, Baylor, Bell, Blanco, Borden, Bosque, Bowie, Brazos, Brewster, Briscoe, Brown, Burleson, Callahan, Cameron, Camp, Cass, Castro, Cherokee, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Colorado, Comanche, Concho, Coryell, Cooke, Cottle, Crane, Crockett, Culberson, Dallam, Dawson, Delta, DeWitt, Dickens, Dimmit, Donley, Duval, Eastland, Ector, Edwards, Erath, Falls, Fannin, Fisher, Foard, Franklin, Freestone, Frio, Gaines, Gillespie, Glasscock, Gonzales, Gray, Grayson, Grimes, Gregg, Hall, Hamilton, Hansford, Hardeman, Harrison, Hartley, Haskell, Hemphill, Henderson, Hidalgo, Hill, Hopkins, Howard, Houston, Irion, Jack, Jackson, Jeff Davis, Jim Hogg, Jones, Kent, Kerr, Kimble, King, Kinney, Knox, Lamar, Lampasas, LaSalle, Lavaca, Leon, Limestone, Lipscomb, Llano, Loving, Madison, Marion, Martin, Mason, Maverick, McCulloch, McLennan, McMullen, Menard, Midland, Milam, Mills, Mitchell, Montague, Moore, Morris, Motley, Nacogdoches, Nolan, Ochiltree, Oldham, Palo Pinto, Panola, Parmer, Pecos, Presidio, Rains, Reagan, Real, Red River, Reeves, Robertson, Runnels, Rusk, Sabine, San Augustine, San Saba, Schleicher, Scurry, Shackelford, Shelby, Sherman, Smith, Somervell, Star, Stephens, Sterling, Stonewall, Sutton, Taylor, Terrell, Throckmorton, Titus, Tom Green, Trinity, Upton, Upshur, Uvalde, Van Zandt, Val Verde, Ward, Washington, Webb, Wheeler, Wichita, Wilbarger, Willacy, Winkler, Wood, Yoakum, Young, Zapata, and Zavala. Molina Healthcare CVS Caremark CHIP Superior Health Plan Envolve Pharmacy Solutions CHIP Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 7 OF 8
Statewide Counties: All Superior Health Plan Envolve Pharmacy Solutions STAR Health STAR+PLUS Medicare-Medicaid Plans Counties: Bexar, Dallas, El Paso, Harris, Hidalgo, and Tarrant. MMP PBM Counties Amerigroup Express Scripts Bexar, El Paso, Harris, Tarrant Cigna-HealthSpring OptumRx Hidalgo, Tarrant Molina Healthcare CVS Caremark Bexar, Dallas, El Paso, Harris, Hidalgo Superior Health Plan Envolve Pharmacy Solutions Bexar, Dallas, Hidalgo United Healthcare Prescription Solutions Harris Rev. 04/2018 mco-mcosda TxVendorDrug.com PAGE 8 OF 8